Food Insecurity, Feeding Style Linked To Obesity

Food insecurity affects obesity rates among children because mothers living with household food insecurity are more likely to engage in infant feeding styles such as restrictive feeding and pressuring feeding than mothers who are not food insecure, says a new study published in the August 2012 issue of the journal Pediatrics.

According to the World Health Organization (WHO), food security as defined at the World Food Summit of 1996 exists “when all people at all times have access to sufficient, safe, nutritious food to maintain a healthy and active life.” Food insecurity is the opposite, when people do not have access to sufficient, safe, nutritious food to maintain a healthy and active life.

In the United States, the Supplemental Nutrition Assistance Program and the Special Supplemental Food Program for Women, Infants, and Children (WIC) aims to fight food insecurity by providing “supplemental foods, health care referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk.” Despite the program, however, up to 37 percent of participants in the WIC program remain food insecure.

According to previous research, food insecurity is linked with obesity. One reason for the link is that individuals suffering from food insecurity cannot make healthy food choices, instead being forced to eat low-cost, low-nutrition food such as inexpensive fast food and overly processed foods.

In the present study conducted by researchers at the Department of Pediatrics in the Albert Einstein College of Medicine at the Children’s Hospital at Montefiore in Bronx, New York, the researchers investigated the relationship between “household food insecurity and maternal feeding styles, infant feeding practices, and perceptions and attitudes about infant weight in low-income mothers.”

The researchers recruited and interviewed a group of 201 pairs of mothers with infants between the ages of 2 weeks and 6 months. All of the mothers were participating in the WIC program, and 35 percent of the participants reported household food insecurity. Two of the questions asked to assess food insecurity were “We worried whether our food would run out before we got money to buy more” and “We relied on only a few kinds of low-cost foods because we were running out of money to buy food.”

To determined a link between food insecurity and obesity, the factors that the researchers examined included (1) controlling feeding styles (restrictive and pressuring); (2) infant feeding practices, including breastfeeding, juice consumption, and adding cereal to the bottle; and (3) perceptions and attitudes about infant weight.

A restrictive feeding style was determined with the following two assessments: (1) If I did not guide or regulate my child’s eating, he/she would eat much more than he/she should; and (2) I have to be especially careful to make sure my child does not eat too much. A pressuring feeding style was determined with the following three assessments: (1) I have to be especially careful to make sure my child eats enough; (2) If I did not guide or regulate my child’s eating, he/she would eat much less than he/she should; and (3) Even when my child seems done, I try to feed him/her a little bit more.

According to the study, mothers struggling with food insecurity were more likely to exhibit restrictive and pressuring infant feeding styles compared with mothers not struggling with food insecurity. Food insecure mothers were also more concerned about their infant becoming overweight in the future. Being concerned about future overweight and obesity resulted in more restrictive and pressuring infant feeding styles.

As the researchers concluded, an “[i]ncreased concern about future overweight and controlling feeding styles represent potential mechanisms by which food insecurity could be related to obesity.” In other words, mothers struggling with food insecurity are more likely to worry about their children’s weight in the future; to combat these future weight worries, these mothers then engage in damaging feeding styles such as withholding food or forcing their children to eat more food than wanted, both of which are linked to an increased risk of obesity.

As the researchers conclude:

“As policy makers aim to prevent early obesity, it may be important to both decrease the overall rates of food insecurity and reduce controlling feeding styles in families who remain food insecure. As the pediatric community aims to reduce early toxic stress that affects many low-income children, WIC may serve as an opportune place for family interventions focusing on reducing sources of stress.”

What do you think about the link between food insecurity and obesity among children?