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Prevalence, Health, and Nutrition Status

Patrick H. Casey, MD; Kitty Szeto, MS, RD; Shelly Lensing, MS; Margaret Bogle, PhD, RD; Judy Weber, PhD, RD

Arch Pediatr Adolesc Med. 2001;155:508-514.

Objective  To examine characteristics of US children living in food-insufficient households and to compare food and nutrient intakes, physical inactivity, and overweight and underweight status of children in food-insufficient households with those in food-sufficient households.

Design  Cross-sectional, nationally representative sample of children and households from the Continuing Survey of Food Intakes by Individuals, from 1994 to 1996.

Participants  A group of 3790 households, including 5669 children (ages 0-17 years).

Main Outcome Measure(s)  Estimates of food insufficiency for children were based on the reported adequacy of their households, described as "often don't have enough to eat" or "sometimes don't have enough to eat." Nutrient consumption was based on two 24-hour dietary recalls from in-person interviews.

Results  Three percent of all households with children, and 7.5% of low-income families with children experienced food insufficiency. Several demographic and characteristic differences were observed between the food-sufficient and food-insufficient low-income groups. Children of low-income families, either food-sufficient or food-insufficient, had similar macronutrient and micronutrient intake, reported exercise, television watching, and percentage of overweight and underweight. When compared with the higher-income food-sufficient households, children in the low-income food-insufficient households consumed fewer calories (P = .05) and total carbohydrates (P = .004), but had a higher cholesterol intake (P = .02). The low-income food-insufficient group included more overweight children (P = .04), consumed less fruits (P = .04), and spent more time watching television (P = .02).

Conclusions  While not different from low-income families who do not report food insufficiency, low-income families with food insufficiency had children who differed from high-income families in several nutrition and anthropometric measures. Clinicians should be aware of the possible effects of poverty and lack of access to food on child health and nutrition status. The long-term effects of these are not yet known.

From the Arkansas Children's Hospital Research Institute, University of Arkansas for Medical Sciences, Little Rock (Drs Casey and Weber and Mss Szeto and Lensing), and the Delta Nutrition Intervention Research Initiative, Agriculture Research Service, US Department of Agriculture, Little Rock (Dr Bogle).

Corresponding author: Patrick H. Casey, MD, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, 800 Marshall St, Little Rock, AR 72202 (e-mail: caseypatrickh{at}exchange.uams.edu).

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