Marginal Food Insecurity is Associated with Increased Sodium and Decreased Fruit Consumption in Mothers and Toddlers from Low‐income Households
Authors: Spiker Marie , Hurley Kristen , Wang Yan , Arbaiza Raquel , Black Maureen 
Published: November 2023

OBJECTIVEFew studies have examined the relationship between food insecurity and dietary intake. The objective was to evaluate associations between food insecurity and dietary intake among mother‐toddler pairs.METHODSThe sample consisted of 276 mother‐toddler pairs enrolled in a randomized controlled trial of overweight prevention, and representing a subset of 304 pairs for whom food security and dietary data were available at the study's baseline. Linear regressions were used to examine associations between food security status and ten different measures of dietary intake for both mothers and toddlers, adjusting for demographic variables. Two binary independent variables were tested: marginal food security, reflecting ≥ 1 affirmative responses on the validated USDA six‐item food security scale; and low food security, reflecting ≥ 2 affirmative responses. The scale had high internal consistency (Cronbach's alpha=0.89) and represented one underlying latent variable, based on a principal components analysis. Dietary intake variables, collected through in‐person 24‐hour recall, included: Healthy Eating Index score, total vegetables (cups), total fruits (cups), solid fats (oz), added sugars (tsp), total calories, fiber (g), sodium (mg), calories from regular juice, and calories from regular carbonated beverages. Regressions were adjusted for demographic variables: race (1=African American, 0=White, Hispanic, or other), education (1=high school graduate or higher, 0=some high school), poverty (1=living at or below poverty line, 0=living above poverty line), and employment status (1=employed, 0=not employed).RESULTS45% of the sample population were classified as having marginal food security and 28% as having low food security. 68% of mothers were African American, 70% of households were living at or below the poverty line, 64% of mothers were unemployed, and 81% of mothers were high school graduates. In comparison to food security, marginal food security was significantly associated with maternal consumption of 435.2 additional mg of sodium (β=435.2, SE=219, p=0.048) and 0.56 fewer cups of total fruit (β=−0.56, SE=0.22, p=0.013) and with toddler consumption of 273.2 additional mg of sodium (β=273.2, SE=106, p=0.011), and was marginally associated with toddler consumption of 0.26 fewer cups of total fruit (β=−0.26, SE=0.14, p=0.07). In comparison to food security, low food security was not associated with significantly different dietary intakes for either mothers or toddlers.CONCLUSIONSMothers and toddlers in marginally food secure households consumed more sodium and fewer cups of total fruit than those in food secure households. Sodium intake has been associated with hypertension and related chronic diseases. This research may inform future efforts to understand the mechanisms by which food insecurity may be linked to health outcomes.Support or Funding InformationNICHD: R01 HD056099.USDA: CSREES 2005 – 04808.