Associations of Food Insecurity with Dietary Intake in Children of Mexican Descent: Results of a Binational Study Lisa Goldman Rosas, PhD MPH: University.

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Presentation transcript:

Associations of Food Insecurity with Dietary Intake in Children of Mexican Descent: Results of a Binational Study Lisa Goldman Rosas, PhD MPH: University of California San Francisco (UCSF) Kim Harley, PhD MPH: UCSF Lia H.C. Fernald, PhD MBA: UCSF Sylvia Guendelman, PhD LCSW: UCSF Fabiola Mejia, MS: National Institute of Public Health (NIPH) Lynnette Neufeld, PhD: NIPH Brenda Eskenazi, PhD: UCSF JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Rosas L, et al. J Am Diet Assoc. 2009;109 (December).

Associations of Food Insecurity with Dietary Intake in Children of Mexican Descent: Results of a Binational Study Research Question Study overview Is household food insecurity associated with dietary intake among 5-year-old children of Mexican descent? Does this association differ by place of residence (California/Mexico)? JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Rosas L, et al. J Am Diet Assoc. 2009; 109 (December).

Background: Food insecurity Associations of Food Insecurity with Dietary Intake in Children of Mexican Descent: Results of a Binational Study Background: Food insecurity Baseline data Definition: Limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire foods in socially acceptable ways US: Twice as prevalent among Mexican-Americans vs. general population (19% vs. 11%)* Mexico: Little research, 2 studies suggest high**: 40% in urban area 97% in rural area * 2006 current Population Survey of US Households ** Ortiz-Hernandez, 2007 & Melgar-Quinonez, 2005 JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Rosas L, et al. J Am Diet Assoc. 2009;109 (December).

BMI & Psychosocial measures Associations of Food Insecurity with Dietary Intake in Children of Mexican Descent: Results of a Binational Study Binational Study Design BMI & Psychosocial measures CHAMACOS: Mexican mothers & 5-yr-old children Proyecto Mariposa: Mothers & 5-yr-old children Migrant receiving community, Salinas, CA Most commonly from the states of Guanajuato, Jalisco and Michoacán Recruited in clinics Migrant sending communities in Guanajuato, Jalisco, Michoacán Participants in Oportunidades, federal social welfare program Recruited in clinics JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Rosas L, et al. J Am Diet Assoc. 2009;109 (December).

Measures: Food Insecurity Associations of Food Insecurity with Dietary Intake in Children of Mexican Descent: Results of a Binational Study Measures: Food Insecurity Correlation matrix US Dept. of Agriculture Household Food Security Scale (Short form, Spanish) in both sites: The food we bought just didn’t last, and we didn’t have money to get more We couldn’t afford to eat balanced meals Do adults ever cut the size of meals or skip meals because there is not enough food? Were you ever hungry because you couldn’t afford enough food? Households classified as: Secure Low food security Very low food security JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Rosas L, et al. J Am Diet Assoc. 2009;109 (December).

Measures: Weight Status Associations of Food Insecurity with Dietary Intake in Children of Mexican Descent: Results of a Binational Study Measures: Weight Status Correlation matrix Identical anthropometric protocols in each site Calculated Body Mass Index (BMI) (kg/m2) Compared children’s BMI with sex-specific BMI-for-age percentiles (CDC 2000)*: *According to current guidelines, these categories are now: normal weight, overweight and obese <85th % normal weight > 85th % & < 95th % at risk for overweight > 95th % overweight JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Rosas L, et al. J Am Diet Assoc. 2009;109 (December).

Measures: Dietary intake Associations of Food Insecurity with Dietary Intake in Children of Mexican Descent: Results of a Binational Study Measures: Dietary intake Figure Children’s diet: Different food frequency questionnaires (FFQ): CA: Harvard Service FFQ for Hispanic children Mexico: FFQ developed by Instituto Nacional de Salud Publica Same structure and response options, different food items Total energy Nutrients: Fat Saturated fat Carbohydrates Protein Food groups: Vegetables Fruit Bread Cereals, grains Dairy Meat Sweetened beverages Fast food Sweets/snacks Fiber Cholesterol Sodium Vitamin A, E, C, B6, B12 Folate Calcium Magnesium Potassium Iron JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Rosas L, et al. J Am Diet Assoc. 2009;109 (December).

Socio-demographic characteristics Associations of Food Insecurity with Dietary Intake in Children of Mexican Descent: Results of a Binational Study Socio-demographic characteristics Figure Characteristic California (CHAMACOS) Mexico (Proyecto Mariposa) Female 53% Breastmilk only at least 6 months 12% 32% Mother overweight/obese 87% 75% Mother elementary school or less 50% 69% Mother work 46% 28% Mother years in the US 5-10 56% 11-15 16+ 18% Family member currently in US 44% JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Rosas L, et al. J Am Diet Assoc. 2009;109 (December).

Data analysis: Food insecurity & dietary intake Associations of Food Insecurity with Dietary Intake in Children of Mexican Descent: Results of a Binational Study Data analysis: Food insecurity & dietary intake Figure Children with implausible total energy values excluded Diet variables transformed to approximate a normal distribution Test for differences in diet by food security status: Unadjusted & adjusted ANOVA Multiple comparisons Separate models for CA & Mexico because of significant interaction Test for trend in diet by food security status All analyses conducted using STATA 10.0 JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Rosas L, et al. J Am Diet Assoc. 2009;109 (December).

Household Food Insecurity Associations of Food Insecurity with Dietary Intake in Children of Mexican Descent: Results of a Binational Study Household Food Insecurity Figure JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Rosas L, et al. J Am Diet Assoc. 2009;109 (December).

Food security status & macronutrients: California (n=301) Associations of Food Insecurity with Dietary Intake in Children of Mexican Descent: Results of a Binational Study Food security status & macronutrients: California (n=301) Figure Daily nutrient intake (Median) Secure Low food security Very low food security ANOVA Adjusted ANOVA Energy (kcal) 1897.3 2114.2 2042.4 * Fat (g) 61.0 68.2 71.5 Saturated Fat (g) 23.3 26.3 27.6 Carbohydrate (g) 275.8 309.2 291.7 Protein (g) 66.9 73.0 Adjusted for SESa, maternal education, receiving food assistance and mother currently working in farmwork Test for trend significant for all above nutrients * Significant p<0.05 a. SES = socio-economic status JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Rosas L, et al. J Am Diet Assoc. 2009; 109 (December).

Food security status & macronutrients: Mexico (n=301) Associations of Food Insecurity with Dietary Intake in Children of Mexican Descent: Results of a Binational Study Food security status & macronutrients: Mexico (n=301) Figure Daily nutrient intake (Median) Secure Low food security Very low food security ANOVA Adjusted ANOVA Energy (kcal) 1631.7 1521.9 1356.6 * Fat (g) 45.5 41.5 39.3 Saturated Fat (g) 12.2 11.1 9.8 Carbohydrate (g) 277.3 244.2 219.6 Protein (g) 44.4 42.7 39.2 Adjusted for SESa and maternal education Test for trend significant for all above nutrients * Significant p<0.05 a. SES = socio-economic status JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Rosas L, et al. J Am Diet Assoc. 2009;109 (December).

Food Security & food groups: California & Mexico Associations of Food Insecurity with Dietary Intake in Children of Mexican Descent: Results of a Binational Study Food Security & food groups: California & Mexico Conclusions Adj. ANOVA <0.01 0.09 0.05 0.10 ANOVA <0.01 0.04 0.01 0.05 California Mexico JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Rosas L, et al. J Am Diet Assoc. 2009;109 (December).

Conclusion Conclusions Association of Food insecurity with: California Associations of Food Insecurity with Dietary Intake in Children of Mexican Descent: Results of a Binational Study Conclusion Conclusions Association of Food insecurity with: California (CHAMACOS) Mexico (Proyecto Mariposa) Dietary intake  energy, fat*, sweets & snacks*  energy, carbohydrates*, dairy*, meat, fruit *Significant in adjusted analysis JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Rosas L, et al. J Am Diet Assoc. 2009;109 (December).

Thank you to our funders: Associations of Food Insecurity with Dietary Intake in Children of Mexican Descent: Results of a Binational Study Thank you to our funders: Conclusions W.K. Kellogg Health Scholars National Institute of Environmental Health Sciences (PO1 ES009605) Environmental Protection Agency (RD 83171001) UC-Mexus & Health Initiative of the Americas (PIMSA) Center for Latino Policy Research, UC Berkeley UC-Mexus Dissertation Grant Institute for the Study of Social Change, UC Berkeley Tinker Fellowship, Center for Latino Policy Studies, UC Berkeley JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Rosas L, et al. J Am Diet Assoc. 2009;109 (December).