Household Food Insecurity and Home Food Availability in Relation to Youth Diet, Body Mass Index, and Adiposity

Background: Food security status is related to food types available in the home, which may shape youth dietary patterns, with implications for obesity. Objective: Investigate whether household food insecurity and home food availability (HFA) are associated with youth fruit and vegetable (F/V) consumption and anthropometric outcomes. Design: Cross-sectional study. Youth and parents completed questionnaires during in-home visits (2013-2014). Research staff obtained anthropometric measures. Participants/setting: Medical record data for 10- to 15-year-old Pennsylvania youths were used to identify 434 parent-youth dyads, with 408 evaluated after excluding missing data. Main outcome measures: Parent-reported household food security was assessed with the six-item US Department of Agriculture Food Security Scale (dichotomized as high vs low). Healthy and obesogenic HFA scales assessed parent report of how frequently particular foods were present in the home. Youth self-reported daily average F/V consumption. Anthropometric outcomes included age- and sex-standardized z scores for body mass index (BMIz), waist circumference (WCz), and percent body fat (PBFz). Statistical analyses: Associations were evaluated with multivariable linear regression adjusted for youth age, sex, and race or ethnicity, and parent age and income. Results: Compared with food secure counterparts, youth from food insecure households had higher mean (beta [standard error]) BMIz (.30 [.15]), WCz (.27 [.12]), and PBFz (.43 [.16]). Food insecure households had lower mean healthy HFA scores (−1.23 [.54]); there was no evidence obesogenic HFA differed between food secure and insecure households. Youth from lower healthy HFA or higher obesogenic HFA households reported fewer mean daily F/V servings (healthy HFA: .08 [.02]; obesogenic HFA: −.06 [.02]). Food security status was not associated with F/V consumption, nor was there evidence HFA modified associations between food insecurity and anthropometric outcomes. Conclusions: Despite an observed association between healthy HFA and youth F/V consumption, this study did not provide evidence that HFA explained associations between food insecurity and youth anthropometric outcomes.