Adolescent Overweight and Obesity: Links to Food Insecurity and Individual, Maternal, and Family Stressors

doi:10.1016/j.jadohealth.2009.01.003

Journal of Adolescent Health

Volume 45, Issue 3, September 2009, Pages 230-237

https://doi.org/10.1016/j.jadohealth.2009.01.003 Get rights and content

Abstract

Purpose

A high proportion of adolescents living in low-income households in the United States are overweight or obese, food insecure, or exposed to high levels of individual, maternal, and family stressors. The aim of this paper was to identify the associations of food insecurity and the aforementioned stressors with an adolescent's propensity to be overweight or obese. We hypothesized that individual, maternal, and family stressors may exacerbate the relationship between food insecurity and adolescent overweight/obesity.

Methods

The sample included 1011 adolescents aged 10 to 15 years and their mothers in families with incomes below 200% of the poverty line from Wave 1 of the Welfare, Children, and Families: A Three-City Study (Three-City Study).

Results

A series of logistic regressions predicted the probability of an adolescent being overweight or obese. Overall, higher levels of individual stressors increased the probability of being overweight or obese for adolescents, whereas there was no direct association between food insecurity, maternal, or family stressors and overweight or obesity. The interaction of food insecurity and maternal stressors was significantly linked to the probability of being overweight or obese; more specifically, an increase in maternal stressors amplified a food insecure adolescent's probability of being overweight or obese.

Conclusions

Policies addressing adolescent obesity should consider the benefits to reducing the individual stressors facing low-income adolescents and, for food insecure adolescents, the benefits to reducing their mothers' stressors.

Section snippets

Participants

Welfare, Children, and Families: A Three-City Study is a 6-year longitudinal, multimethod investigation. The Three-City Study includes, among other components, a household-based stratified random sample survey with over 2400 children and their mothers in low-income neighborhoods in Boston, Chicago, and San Antonio. A detailed explanation of the sampling design and its scientific rationale can be found in Winston et al [25]. Data from the first wave of interviews conducted in 1999 were used in

Results

Descriptive statistics (Table 1) indicate that about half of the analytic sample was overweight or obese and 8% of the adolescents were food insecure. The average numbers of individual, maternal, and family stressors were 1.44, 2.10, and 6.28, respectively.

Results of the regression models are generally robust across both CDC and IOTF cut points and, therefore, are discussed in general (Table 2). Overall, food insecurity, maternal, and family stressors were not related to the weight status of

The impact of food insecurity and maternal stressors

This study contributes to the often discussed relationship between food insecurity and childhood overweight. Consistent with some previous work (e.g., [7], [8]) there was no direct association between food insecurity and adolescent overweight. To our knowledge, this is only the second study to examine the interaction of food insecurity and stress on the probability of obesity among adolescents. Significant strengths of this study include the ability to consider a wide variety of stressors

Acknowledgments

This research is supported by the USDA, Cooperative State Research, Education, and Extension Service (CSREES) grant number 2007-35215-17871. The authors wish to thank Duhita Mahatmya for her excellent assistance with the preparation of this manuscript.

References (44)

M. Nord et al.
Recent advances provide improved tools for measuring children's food insecurity
J Nutr
(2007)
L. Dubois et al.
Family food insufficiency is related to overweight among preschoolers
Soc Sci Med
(2006)
C. Gundersen et al.
Lack of association between adolescent-specific food insecurity and overweight in a sample of 10–15 year old low-income youth
J Nutr
(2008)
K. Raikkonen et al.
Psychosocial stress and the insulin resistance syndrome
Metabolism
(1996)
D.M. Finkelstein et al.
Socioeconomic differences in adolescent stress: the role of psychological resources
J Adolesc Health
(2007)
T.A. Nicklas et al.
Eating patterns and obesity in adolescents
Am J Prev Med
(2003)
E.W. Jensen et al.
The family routines inventory: Development and validation
Soc Sci Med
(1983)
A. Drewnowski et al.
Poverty and obesity: the role of energy density and energy costs
Am J Clin Nutr
(2004)
J.C. Eisenmann
Insight into the causes of the recent secular trend in pediatric obesity: common sense does not always prevail for complex, multi-factorial phenotypes
Prev Med
(2006)
P. Anderson et al.
Adolescent obesity: trends and potential causes
Future Child
(2006)

S. Kumanyika et al.

Targeting interventions for ethnic minority and low-income populations

Future Child

(2006)

J. Schwimmer et al.

Health-related quality of life of severely obese adolescents and adolescents

JAMA

(2003)

P. Casey et al.

The association of adolescent and household food insecurity with adolescent overweight status

Pediatrics

(2006)

Bhargava A, Jolliffe D, Howard L. Socioeconomic, behavioral and environmental factors predicted body weights and...

D. Rose et al.

Household food insecurity and overweight status in young school adolescents: results from the early adolescent longitudinal study

Pediatrics

(2006)

P. Bjorntorp

Do stress reactions cause abdominal obesity and comorbidities?

Obes Rev

(2001)

S. Jenkins et al.

Eating behaviors among school-aged adolescents associated with perceptions of stress

Issues Compr Pediatr Nurs

(2005)

L.M. Gutman et al.

Financial strain, neighborhood stress, parenting behaviors, and adolescent adjustment in urban African American families

J Res Adolesc

(2005)

T. Melbin et al.

Rapidly developing overweight in school children as an indicator of psychosocial stress

Acta Paediatr Scand

(1989)

F.S. Koch et al.

Psychological stress and obesity

Pediatrics

(2008)

E. Foster

How economists think about family resources and adolescent development

Child Dev

(2003)

M. Robila et al.

Economic pressure and children's psychological functioning

J Child Fam Stud

(2006)

Cited by (102)

Maternal depressiveness and infant growth outcomes: Findings from the MAASTHI cohort study in India
2023, Journal of Psychosomatic Research
The study aims to examine the association between depressiveness in mothers on infant obesity and stunting at one year of age.
We enrolled 4829 pregnant women, followed them up at public health facilities in Bengaluru for one year after birth. We collected information on women's sociodemographic characteristics, obstetric history, depressive symptoms during pregnancy and delivery within 48 h. We took infant anthropometric measurements at birth and one year. We used chi-square tests, and calculated an unadjusted odds ratio using univariate logistic regression. We used multivariate logistic regression to examine the association between maternal depressiveness, childhood adiposity, and stunting.
We found that the prevalence of depressiveness was 31.8% in mothers who delivered in public health facilities in Bengaluru. Infants born to mothers with depressiveness at birth had 3.9 times higher odds of having larger waist circumference than infants born to mothers with no depressiveness (AOR: 3.96, 95% Confidence Interval: 1.24,12.58) and 1.9 times higher odds of having a larger sum of skinfold thickness (AOR: 1.99, 95% CI: 1.18,3.38). Additionally, we found that infants born to mothers with depressiveness at birth had 1.7 times higher odds of stunting than infants born to mothers with no depressiveness (AOR: 1.72; 95%CI: 1.22,2.43) after adjusting for confounders.
Our study highlights a high prevalence of depressiveness among mothers seeking antenatal care at a public hospital is associated with an increased risk of infant adiposity and stunting at one year. Further research is needed to understand the underlying mechanisms and identify effective interventions.
Reprint of: Position of the Academy of Nutrition and Dietetics: Food Insecurity in the United States
2022, Journal of the Academy of Nutrition and Dietetics
Citation Excerpt :
Chronic health conditions and behaviors, including anemia and asthma; childhood aggression; anxiety and depression; hyperactivity40,41; dental caries42; fracture risk (among males)43; and reduced physical activity,44 have all been associated with food insecurity. The literature remains inconsistent related to food insecurity and increased risk for childhood/adolescent overweight and obesity.45-49 Nguyen and colleagues48 reported that, in a nationally representative sample of children 9 to 17 years of age, body mass index was not significantly different among household food-security groups.
It is the position of the Academy of Nutrition and Dietetics that systematic and sustained action is needed to achieve food and nutrition security in the United States. To achieve food security, effective interventions are needed, along with adequate funding for, and increased utilization of, food and nutrition assistance programs; inclusion of nutrition education in such programs; strategies to support individual and household economic stability; and research to measure impact on food insecurity- and health-related outcomes. Millions of individuals living in the United States experience food insecurity. Negative nutritional and non-nutritional outcomes are associated with food insecurity across the lifespan, including substandard academic achievement, inadequate intake of key nutrients, increased risk for chronic disease, and poor psychological and cognitive functioning. Registered dietitian nutritionists and nutrition and dietetics technicians, registered, play key roles in addressing food insecurity and are uniquely positioned to make valuable contributions through competent and collaborative practice, provision of comprehensive food and nutrition education and training, innovative research related to all aspects of food insecurity, and advocacy efforts at the local, state, regional, and national levels.
Using syndemic theory to understand food insecurity and diet-related chronic diseases
2022, Social Science and Medicine
Citation Excerpt :
Gundersen et al. (2008) found that despite not being associated with one another, child specific FI and obesity often coexist, especially among low-income populations, with 25 percent of food insecure children also being overweight. Lohman et al. (2009) found that the interaction between FI and maternal stressors was linked to childhood obesity, as an increase in maternal stressors increased an adolescent's risk for obesity. Finally, a study among homeless youth in Minnesota (n = 202) found that 55 percent of participants did not have enough food in the house and 25 percent went to bed hungry (Smith and Richards, 2008).
Syndemic Theory (ST) provides a framework to examine mutually enhancing diseases/health issues under conditions of social inequality and inequity. ST has been used in multiple disciplines to address interacting infectious diseases, noncommunicable diseases, and mental health conditions. The theory has been critiqued for its inability to measure disease interactions and their individual and combined health outcomes. This article reviews literature that strongly suggests a syndemic between food insecurity (FI) and diet-related chronic diseases (DRCDs), and proposes a model to measure the extent of such interaction. The article seeks to: (1) examine the potential syndemic between FI and DRCDs; (2) illustrate how the incorporation of Life History Theory (LHT), into a syndemic framework can help to highlight critical lifeperiods when FI-DRCD interactions result in adverse health outcomes; (3) discuss the use of mixed methods to identify and measure syndemics to enhance the precision and predictive power of ST; and (4) propose an analytical model for the examination of the FI-DRCD syndemic through the life course. The proposed model is more relevant now given the significant increase in FI globally as a result of the ongoing COVID-19 pandemic. The differential impact that the pandemic appears to have among various age groups and by other demographic factors (e.g., race, gender, income) offers an opportunity to examine the potential FI-DRCD syndemic under the lens of LHT.
When Pandemics Collide: The Impact of COVID-19 on Childhood Obesity
2021, Journal of Pediatric Nursing
Transition to a market economy and chronic psychosocial stress in northern Laos: An exploratory study of urinary free cortisol in rural residents
2024, American Journal of Human Biology
Machine learning techniques for the identification of risk factors associated with food insecurity among adults in Arab countries during the COVID-19 pandemic
2023, BMC Public Health

View all citing articles on Scopus

View full text

Original articleAdolescent Overweight and Obesity: Links to Food Insecurity and Individual, Maternal, and Family Stressors

Abstract

Purpose

Methods

Results

Conclusions

Section snippets

Participants

Results

The impact of food insecurity and maternal stressors

Acknowledgments

J Nutr

Soc Sci Med

J Nutr

Metabolism

J Adolesc Health

Am J Prev Med

Soc Sci Med

Am J Clin Nutr

Prev Med

Adolescent obesity: trends and potential causes

Future Child

Targeting interventions for ethnic minority and low-income populations

Future Child

Health-related quality of life of severely obese adolescents and adolescents

JAMA

The association of adolescent and household food insecurity with adolescent overweight status

Pediatrics

Household food insecurity and overweight status in young school adolescents: results from the early adolescent longitudinal study

Pediatrics

Do stress reactions cause abdominal obesity and comorbidities?

Obes Rev

Eating behaviors among school-aged adolescents associated with perceptions of stress

Issues Compr Pediatr Nurs

Financial strain, neighborhood stress, parenting behaviors, and adolescent adjustment in urban African American families

J Res Adolesc

Rapidly developing overweight in school children as an indicator of psychosocial stress

Acta Paediatr Scand

Psychological stress and obesity

Pediatrics

How economists think about family resources and adolescent development

Child Dev

Economic pressure and children's psychological functioning

J Child Fam Stud

Original article
Adolescent Overweight and Obesity: Links to Food Insecurity and Individual, Maternal, and Family Stressors