Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. Evidence is mixed regarding the relationship between childhood obesity and food insecurity in longitudinal studies, with study heterogeneity limiting broader conclusions.

2. Further studies are required with consideration given to standardization of food security groups and covariates that address demographics, maternal status, and home environments, to provide stronger evidence to support a possible correlation between food insecurity and childhood obesity.

Evidence Rating Level: 2 (Good)

Study Rundown:

Childhood obesity is a serious public health challenge that has worsened significantly over the last decade and during the COVID-19 pandemic. The prevalence of childhood obesity is higher in lower income households. Despite this longstanding correlation, the relationship between food insecurity and weight status have not been well studied. In this systematic review of 13 studies, researchers examined the longitudinal association between food insecurity and obesity in children in the United States aged 1 to 19 years. Due to study heterogeneity, a meta-analysis could not be performed. Of the included studies, 5 studies assessed odds of obesity, 4 studies assessed changes in body mass index (BMI), and 9 studies assessed changes in BMI z-scores in relation to food insecurity. This study suggests a potential relationship between childhood obesity and food insecurity with 1/5 studies showing an increase in odds of obesity, 2/4 showing increased change in BMI, and 5/9 showing increase in BMI z-scores in food insecure cohorts. Broader conclusions were not possible due to significant differences in included studies such as food security categorizations and the covariates used in analysis (e.g., cofounding variables such as age, sex, race, household income, physical activity, maternal BMI). A notable limitation of the study is the inclusion criteria for longitudinal studies, which are scarce in the literature. In general, there is mixed evidence regarding the relationship between food insecurity and childhood obesity. Future studies should include more demographic information and information on maternal and household environments to better study this relationship that has critical public health implications.

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