Abstract
Food insecurity is associated with high body weight amongst women, but not men, in high-income countries. Previous research using food recalls suggests that the total energy intake of food-insecure women is not elevated, though macronutrient composition may differ from that of food-secure women. There is limited evidence on temporal patterns of food consumption. Here, we used food recalls from women in the 2013-4 cycle of the National Health and Nutrition Examination Survey (NHANES, n = 2798) to characterise temporal patterns of food consumption in relation to food insecurity. Compared to the food-secure, food-insecure women had more variable time gaps between eating; ate a smaller and less variable number of distinct foods at a time; were more variable from day to day in their time of first consumption; were more variable from day to day in the number of times they ate; and consumed relatively more carbohydrate, less protein, and less fibre. However, their overall energy intake was no higher. Food-insecure women had higher BMIs (2.25 kg/m2), and around 15% of the BMI difference between food-insecure and food-secure women was accounted for by their more variable time gaps between eating, their lower diversity of foods, and their lower fibre consumption. Food insecurity is associated with measureable differences in the temporal pattern of food consumption, and some of these differences shed light on how food-insecure women come to have higher body weights.
Highlights
Food insecurity (FI)—defined as limited or uncertain access to adequate food—is robustly associated with overweight and obesity amongst women, but not men, in high-income countries [1, 2]
Using 24 hr food recalls from participants in the large, nationally representative National Health and Nutrition Examination Study (NHANES) survey, we found that total energy intake was no higher in women classified as food-insecure than in women classified as food-secure
An experimental study in humans in which participants were assigned to isocaloric diets that involved either temporally regular or temporally irregular intake found that irregularity reduced energy expenditure via a diminished thermic effect of food [18, 19]. is mechanism could potentially explain why we found evidence for a mediating role of temporal consumption irregularity in the FI-body weight relationship, the NHANES data do not allow us to test this directly as they include no measure of the thermic effect of food
Summary
Food insecurity (FI)—defined as limited or uncertain access to adequate food—is robustly associated with overweight and obesity amongst women, but not men, in high-income countries [1, 2]. Discussions of why this might be the case suggest that experiencing FI promotes greater overall energy intake, by intensifying food motivation [2,3,4]. Neither of the studies cited in this passage [6, 7] report any data on the birds’ food intake, only that the birds had higher masses in the uncertain food condition. Bird studies that do record food intake have found that the weight gain in response to uncertain food can occur concomitantly with an increase in energy intake [8, 9], with no change in total energy intake [10], or even whilst total energy intake goes down [11]
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