Anthropometric Characteristics of Children Living in Food Insecure Households in the United States

Objective: This study provides information on food insecurity and child malnutrition in a technologically advanced nation. Design: Population-based study using multistage probability cluster sampling design to collect survey data. Multivariable regression models were used to determine associations between food security status and various malnutrition indices. Setting: We used a national sample from the United States National Health and Nutrition Examination Survey (NHANES) 2011-2014. Participants: The anthropometric and demographic datasets of 4,121 children <7 years old were analyzed for this study. Results: Food insecure infants younger than 6 months had shorter upper arm length (−0.4 cm, p=0.012) and smaller mid-upper arm circumference (−0.5 cm, p=0.004), likewise those aged 6 months-1 year who had shorter upper arm length (−0.4 cm, p=0.008), body length (−1.7 cm, p=0.007) and lower body weight (−0.5 kg, p=0.008). Food insecure children younger than 2 years were more likely to be underweight (OR: 4.34; 95% CI: 1.99-9.46) compared to their food secure counterparts. Contrarywise, food insecure children older than 5 years were more likely to be obese (OR: 3.12; 95% CI: 1.23-7.96). Conclusion: Food insecurity associates with child growth deficits in the United States. Food insecure infants and young children are generally smaller and shorter, whereas older children are heavier than their food secure counterparts, implying a double burden of undernutrition-overnutrition associated with child food insecurity. Child food and nutrition programs to improve food insecurity should focus on infants and children in the transition ages.