Dietary Intakes of Children From Food Insecure Households.

Food security refers to access by all people at all times to enough food for an active, healthy life.1,2 According to the classifications obtained with the USDA food security survey, a food secure household can be further classified as high food security or marginal food security. Individuals or households with limited or uncertain access to adequate food are considered to be food insecure. In turn, food insecurity has two categories: low food security (LFS) or very low food security (VLFS) (see Figure 1).2 Figure 1 Food Security Categories and Description of Conditions in the Household2 In 2010, 14.5 percent of US households were food insecure at least some time during that year, of which 5.4 percent experienced VLFS.3 As described in Figure 1, VLFS occurs when household members are unable to feed themselves adequately due to economic deficiencies or lack of resources. This results in reduced food intake or disrupted eating patterns. Household members with very low food security may experience hunger because they are unable to afford enough food. A consistent relationship between food insecurity and poor health status has been demonstrated across a wide range of literature. Numerous studies have shown that individuals living in food insecure households are more likely to report poor physical and mental health than those living in food secure households.4 Food insecurity has been associated with increased risk of obesity, heart disease, type 2 diabetes mellitus, high blood pressure, and food allergies.4–6 However, these relationships have been found more often among adults, especially mothers, compared to children. While causal relationships between food insecurity and obesity are difficult to establish, there are several associations that may account for this seemingly paradoxical relationship. Studies have found that food insecurity is associated with lower quality diets, inadequate nutrient intake, and reduced consumption of fruits, vegetables, meat, and dairy products with increased consumption of cereals, sweets, and added fats.7–9 Despite this vulnerability, very little research attention has been given to the diet of food insecure individuals, especially children. The relationship between food insecurity and dietary outcomes is complex. While some studies have shown that food insecurity is associated with lower dietary intakes, some point in the opposite direction. There is substantial evidence that living in a food insecure household has undesirable consequences for children, including poor quality diets10,11 and negative health outcomes.12–15 Because of the paucity of the literature on this issue, we undertook this study to understand further the dietary behaviors of children living in food insecure homes. As the definitions of LFS and VLFS suggest, there could be a difference in dietary intake in children from LFS households compared to children from VLFS households. Thus, the objective of this descriptive paper is to compare the dietary behaviors of children from LFS households with children from VLFS households over an entire day and during meals specifically consumed at home.