Examining the Role of Habitual Physical Activity in the Food Insecurity‐Obesity Paradox
Authors: Covello Alicia R. , Nikolaus Cassandra J. , Curran Morgan R. , Edwards Caitlyn G. , Baumgartner Nicholas W. , Liu Ruyu H. , Loehmer Emily H. , McCaffrey Jennifer H. , An Ruopeng H. , Khan Naiman A. 
Published: June 2021

Food insecurity is among the most severe and persistent nutrition‐related public health concerns in the U.S. Defined as the state of being without reliable access to affordable nutritious food, it is estimated that approximately 50 million Americans live in food‐insecure households. Previous work indicates that, relative to their food secure counterparts, low‐resource food insecure females are at greater risk for obesity. However, the contributing factors to this relationship remains unclear. Although an abundance of literature has focused on understanding the dietary factors related to food insecurity, there is a paucity of data pertaining to the potential role of physical activity. Specifically, the role of habitual physical activity in moderating the influence of food security status warrants further study. This is concerning because both diet and physical activity are vital contributors to weight regulation. Obesity is impacted by health behaviors, and is an important component in weight regulation. The literature often focuses on diet when investigating food security, often failing to incorporate physical activity. Therefore, this study aimed to investigate patterns of habitual physical activity in relation to weight status among food secure and food insecure low‐resource women. Adult women (N=113, Mean age = 35y) were recruited from rural counties in East‐Central and Southern Illinois. Food security was measured using the USDA's Six‐Item Short Form of the Food Security Survey Module. Anthropometric measurements of height and weight were used to determine Body Mass Index (BMI) (kg/m2). Diet intake was assessed using a 24‐hr dietary recall using an automated multiple pass phone interview. Physical activity was assessed using the Global Physical Activity Questionnaire, as measured by total metabolic equivalents (METS). According to initial bivariate correlations, age, energy density, household size, and METS were not significantly related to level of food insecurity (all Ps>0.05). However, receiving Supplemental Nutrition Assistance Program (SNAP) benefits (r=−0.23, P=0.02 [0=do not receive assistance, 1=receive assistance]) and BMI (r=0.23, P=0.02) were significantly associated with food insecurity. Subsequently, hierarchical linear regression analyses revealed that food insecurity was inversely related to receiving supplemental nutrition SNAP assistance benefits (β=−0.21, P=0.02) and positively related to BMI (β=0.21, P=0.02). While SNAP and BMI were both independently associated with food insecurity, the addition of total METS did not significantly improve the model. These findings are consistent with previous work suggesting that obesity is associated with food insecurity. However, the mechanism underlying this relationship may be independent of habitual physical activity and energy density. Future research is needed to investigate other aspects of diet quality, physical activity, and environmental and psychological factors to further elucidate the links between food insecurity and obesity.Support or Funding InformationFunded by the USDA North Central Nutrition Education Center for Excellence (NC‐NECE).