Differential Associations of Food Insecurity Risk on Dietary Intake‐Frequency Among Parents and their Adolescent Children
Authors: Calloway Eric , Smith Teresa , Pinard Courtney , Oh April , Nebeling Linda , Hennessy Erin , Yaroch Amy 
Published: November 2023

ObjectiveTo assess the relationships between risk of household food insecurity (HFI) and intake‐frequency of five food and beverage groups for parents and their adolescent children.MethodsIn the National Cancer Institute's (NCI) 2014 Family Life, Activity, Sun, Health, and Eating (FLASHE) cross‐sectional study, parents and their adolescent children (ages 12–17 years) separately completed web‐based surveys on lifestyle factors related to cancer risk (e.g., diet and physical activity), and demographics. The survey included a validated 2‐item measure for risk of HFI and a 27‐item dietary screener. Outcome variables were daily intake‐frequency scores for 5 food groups (i.e., fruits and vegetables (FV), water, sugary snacks, fast/convenience food (F/C), and sugar sweetened beverages (SSB)). These were created by assigning individual items to food groups, and then summing those items for each group. The main independent variable was risk of HFI, defined as affirmative response to either food security survey item. Multiple linear regression models assessed each of the five food groups as predicted by risk of HFI, controlling for sex, age, race, income, assistance use, free and reduced lunch enrollment (adolescents), and education (parents). Survey weights were applied and outcome variables were log transformed (exponentiated linear regression coefficients (exp (β)) are reported). The Bonferroni‐Holm adjustment was used to control the family‐wise error rate at alpha <0.05.ResultsWeighted means (SE) for daily intake frequencies for parents (n=1588) were: FV=3.10 (0.06), water=2.19 (0.03), sugary snacks=1.04 (0.03), F/C=1.71 (0.04), and SSB=0.98 (0.04); and for adolescents (n=1487) values were: FV=2.80 (0.06), water=1.95 (0.03), sugary snacks=1.42 (0.03), F/C=2.14 (0.03), and SSB=1.29 (0.03). In adjusted models, parents at risk for HFI consumed FV (exp (β)=0.92 (95% CI=0.87–0.98, p=0.010)) and water (exp (β)=0.90 (95% CI=0.85–0.97, p=0.002)) less frequently, while consuming SSB (exp (β)=1.10 (95% CI=1.02–1.18, p<0.001)) and F/C (exp (β)=1.11 (95% CI=1.05–1.19, p<0.001)) more frequently, than parents in food secure households. Adolescents at risk for HFI consumed SSB (exp (β)=1.09 (95% CI=1.03–1.16, p=0.005)) and F/C (exp (β)=1.07 (95% CI=1.03–1.13, p=0.003)) more frequently than those in food secure households. Findings for other food groups were not statistically significant.ConclusionsHFI risk may be related to less healthful diets. However, effects of HFI risk on diet frequency were small and the food groups differed for parents and adolescents. These differences may have been due to adolescents’ increased access to water and FV at school, partially protecting them from the decreased intake‐frequency of water and FV seen for parents. More research is needed to investigate differential effects of food insecurity on parents’ and adolescents’ dietary healthfulness, and how this might impact long term dietary habits and health.Support or Funding InformationNational Cancer Institute (NCI)