Food Insecurity and Weight Faltering: US Multisite Analysis of Young Children’s Weight Trajectory

Abstract

BackgroundFood insecurity is associated with poor health and development among young children, with inconsistent findings related to longitudinal growth. ObjectiveTo investigate associations between household and child food insecurity and young children’s weight trajectory during ages 0-2 years. DesignLongitudinal survey data were analyzed for years 2009-2018. Participants/SettingRacially diverse mothers of 814 children ≤24 months interviewed twice (interval >6 months, mean 11 months) in emergency departments of 4 US cities. Children were included if born at term, with birthweight within 2500g-4500g, weight-for-age z-score (WAZ) within ±2 SD at first interview. Main outcome measuresWAZ difference between 2 visits was defined as ‘expected weight gain’ (within ±1.34 SD), ‘slow weight gain’ (<-1.34 SD), or ‘rapid weight gain’ (>+1.34 SD). Statistical analyses performedMultinomial logistic regression was conducted to examine adjusted associations between household or child food insecurity and WAZ differences. ResultsOf 814 children, 83.5% had expected, 7% slow, and 9.5% rapid weight gain, with mean of 11 months (SD ±4) between visits. Child food insecurity, but not household food insecurity, was associated with slow weight gain (aRRR 2.44 [95% CI 1.16-5.13]; aRRR 1.30; [95% CI 0.69-2.51], respectively). Neither exposure was associated with rapid weight gain. ConclusionsThe association between child food insecurity and slow weight gain during the first two years of life raises clinical concern. Tracking child food insecurity in addition to household food insecurity can be an effective strategy to prevent weight faltering and to support optimal child growth.