166 - Changes in Food Security: Associations with Parent Feeding Behaviors and Toddler Weight Status

Publication Number: 166.4443

Colin J. Orr, The University of North Carolina at Chapel Hill, Nashville, TN, United States; Eliana M. Perrin, Johns Hopkins University Schools of Medicine, Nursing, and Public Health, Baltimore, MD, United States; William Heerman, Vanderbilt University Medical Center, Nashville, TN, United States; Russell Rothman, Vanderbilt University Medical Center, Nashville, TN, United States; Shonna Yin, NYU Grossman School of Medicine, New York, NY, United States; Alan Delamater, University of Miami, Miami, FL, United States; Lee Sanders, Stanford University School of Medicine, Palo Alto, CA, United States; Feng-Chang Lin, UNC Chapel Hill, Chapel Hill, NC, United States; Yumei Yang, University of North Carolina at Chapel Hill Gillings School of Public Health, Chapel Hill, NC, United States; Charles Wood, Duke University School of Medicine, Durham, NC, United States; Kori Flower, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States

Background: Food insecurity (FI) has been shown to be associated with parental feeding behaviors (PFB) and child weight status in cross-sectional work.

Objective: Examine the association between longitudinal changes in FI with PFB and child weight status

Design/Methods: Secondary data analysis of data from Greenlight, a cluster randomized trial to prevent childhood obesity at 24 months. Exposure of interest was change in household food security status measured at 2 months (baseline) and 24 months. Four food security categories were created: persistently food secure (no FI), change from food insecure to food secure (resolved FI), change from food secure to food insecure (new FI), and persistently food insecure (persistent FI). Primary outcome of interest was parental feeding behaviors as measured by the Child Feeding Questionnaire (CFQ) at 24 months. The CFQ is comprised of 7 domains consisting of parental perceptions of child weight and parental feeding behaviors. Responses for each domain in the CFQ range from 1 to 5, with 1 representing never for each domain. Secondary outcome was child weight status at 24 months as measured by BMI percentile. Linear models were used to estimate the mean and 95% confidence intervals adjusted for confounders, including site to account for intervention effects of trial

Results: A total of 496 parent-child dyads were included. Caregivers identifying as non-Hispanic Black or Hispanic were 29% and 51% of the sample, respectively. Forty-five percent had no FI, 11% had new FI, 19% had resolved FI, and 26% reported persistent FI. We found significant differences in the CFQ “monitoring” domain, with the highest mean score 4.35 (3.85, 4.85) for the no FI group, and lower for all groups that experienced any FI: mean 3.79 (95% CI=3.20, 4.38) for the new FI group, mean 4.02 (95% CI=3.49, 4.55) for the resolved FI group, and mean 4.19 (95% CI=3.65, 4.74) for the persistent FI group (p=0.003). No other significant differences in the CFQ domains were observed. The persistent FI group had higher point estimates of BMI percentile compared to the other food security groups; however, the differences were not statistically significant

Conclusion(s): Changes in food security status from 2 to 24 months were associated with differences in parental feeding behaviors, but not with differences in child weight status at age 24 months. Food security during the first 24 months of life was associated with more parental “monitoring” behaviors, which have previously been shown to be associated with healthier infant diet intake. Interventions addressing food insecurity may improve parental feeding behaviors

Table 1. Sample Demographics (N=496)
PAS abstract tables_2024 (1).pdfStudy demographics

Table 2. Adjusted mean Child Feeding Questionnaire (CFQ)a domain at 24 months by change in food security status between 2 and 24 months
Table 2.pdfAdjusted CFQ means by food security status