Award Date

5-1-2021

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Epidemiology and Biostatistics

First Committee Member

Ann Vuong

Second Committee Member

Chad Cross

Third Committee Member

Courtney Coughenour

Fourth Committee Member

Aripta Basu

Number of Pages

75

Abstract

Background: Obesity is a preventable disease that has been associated with many adverse health outcomes. A possible factor that may influence adiposity development is food insecurity. Although several epidemiological studies have been conducted examining the association between food insecurity and adiposity among children and adults, results have been inconsistent. Objective: This cross-sectional study investigates the relationship between food insecurity and adiposity among children and adults using recent data from a representative sample of the US population. Methods: We examined 3,391 adults and 2,837 children from the National Health and Nutrition Examination Survey (NHANES) 2015-2016. Household food insecurity was assessed using the United States Department of Agriculture (USDA) 18 item questionnaire. Weighted linear regression models were used to estimate βs and 95% confidence intervals (CI) between food insecurity with continuous measures of adiposity, including body mass index (BMI), body fat percentage (BF%), lean mass index (LMI), and fat mass index (FMI), among adults. Weighted logistic regression models were used to estimate odds ratios (OR) and 95% CIs for the associations between food insecurity and being overweight or obese for both children and adults as well as the odds of having a waist circumference (WC) that is at risk for developing obesity in adults. For children, ORs and 95% CIs were also estimated for the association between food insecurity and low LMI and elevated FMI. Results: Compared to household food secure adults, food insecure adults had elevated BMI (β=1.20, 95% Cl 0.14, 2.25) and FMI (β=0.62, 95% Cl 0.02, 1.22). They also were 1.30 (95% CI 1.03, 1.66) times more likely to be overweight/obese compared to adults who were household food secure. Household food insecurity was also associated with elevated LMI (β=0.68, 95% Cl 0.21, 1.14) in adults. There were no statistically significant associations found between household food insecurity and any of the adiposity measurements among children. We observed evidence of effect measure modification by sex in the association between household food insecurity with BMI (pint=0.006) and FMI (pint=0.0047), with only women having significant positive associations. There was no evidence that the associations between household food insecurity and adiposity in adults were modified by either educational attainment, race/ethnicity, or income (pint>0.10). Conclusions: Findings from this study indicate that household food insecurity may play a role in increased adiposity, particularly among women. There was no evidence to support food insecurity increases adiposity among children.

Keywords

Adiposity; Adult; Children; Food insecurity

Disciplines

Biostatistics | Epidemiology

File Format

pdf

File Size

873 KB

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

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