Q&A: Association of food insecurity on body mass index change in a pediatric weight management intervention

Alicia Persaud, MPH, a graduate research assistant in the Division of Pediatrics at Massachusetts General Hospital is the lead author; and Lauren Fiechtner, MD, director of the Center for Pediatric Nutrition at Mass General for Children, Assistant Professor of Medicine at Harvard Medical School and Senior Health and Research Advisor at the Greater Boston Food Bank, is the senior author of a recent study published in Pediatric Obesity, The Association of Food Insecurity on Body Mass Index Change in a Pediatric Weight Management Intervention.

What was the question you set out to answer with this study?

Childhood obesity is a critical public health concern. One potential determinant of obesity that is less understood is food insecurity, defined as a lack of consistent access to enough food for everyone in the household to live an active, healthy life.

We wanted to understand the association of food security status on changes in body mass index (BMI) in a Healthy Weight Clinic (HWC), a clinically-based multicomponent Pediatric Weight Management Intervention consistent with national clinical practice recommendations.

What methods or approach did you use?

This analysis included 201 participants from two HWC programs. We compared BMI change per year between the food insecure group and food secure group, accounting for child baseline BMI, age and sex, and Supplemental Nutrition Assistance Program (SNAP) enrollment.

What was unique about our approach was adjusting for SNAP enrollment.

What did you find?

Children in households with food insecurity had a 0.50 (0.26–0.74) kg/m2 BMI increase per year compared to households that were food secure. This means that children in houses experiencing food insecurity had an increase in BMI, suggesting that food insecurity may reduce the effectiveness of the HWC.

What are the Implications?

Our findings highlight the implications food insecurity could have on the success of HWCs, and other pediatric obesity treatments in helping children to achieve a healthy weight.

What are the next steps?

Based on these findings, we suggest that providers identify and address food insecurity in their patient populations. Additionally, collaboration among community-based hunger-relief organizations to reduce food insecurity could support improved effectiveness of pediatric obesity treatment.