Regional variability in the prevalence of food insecurity and diet quality among United States children

Authors: DAVE, JAYNA - Children'S Nutrition Research Center (CNRC); CHEN, TZUAN - University Of Houston; CASTRO, ALEXANDRA - Children'S Nutrition Research Center (CNRC); WHITE, MAMIE - Children'S Nutrition Research Center (CNRC); ONUGHA, ELIZABETH - Baylor College Of Medicine; ZIMMERMAN, SLOANE - Baylor College Of Medicine; Thompson, Deborah - Debbe

Submitted to: Nutrients
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/8/2024
Publication Date: 1/10/2024
Citation: Dave, J.M., Chen, T.A., Castro, A.N., White, M., Onugha, E.A., Zimmerman, S., Thompson, D.J. 2024. Regional variability in the prevalence of food insecurity and diet quality among United States children. Nutrients. 16(2). Article 224. https://doi.org/10.3390/nu16020224.
DOI: https://doi.org/10.3390/nu16020224

Interpretive Summary: Although the determinants of food insecurity in the US are well-researched, gaps in the literature exist, particularly concerning the urban–rural divide. The study investigated urban-rural differences in food security status (FSS), participation in the federal nutrition assistance program (FNAP), and dietary intake among children aged 2–17. Analyzing data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2013 to 2016, the research utilized multiple regression models to assess the associations between FSS, FNAP participation, and diet quality. Among a sample of children, with an average age of 7.5 years and a diverse demographic composition, the study found that urban children face higher household food insecurity than their rural counterparts, despite access to food assistance programs. FNAP participation partially mitigates, but doesn't eliminate, food insecurity's impact on diet. The study found no significant differences in the associations between child/household FSS and FNAP participation or diet quality based on urban/rural residence status. Regardless of age or location, there is a consistent need for improvement in children's diet quality, highlighting the importance of addressing food insecurity comprehensively. The results emphasize the necessity for interventions beyond existing programs, especially in urban areas, to improve children's diets and address food insecurity comprehensively.

Technical Abstract: Understanding the association between food security status (FSS) and diet quality in children is crucial. This study investigated regional variability in FSS, participation in the federal nutrition assistance program (FNAP), and diet quality among US children. National Health and Nutrition Examination Survey (NHANES) data from 2013 to 2016 were analyzed. The association between FSS, FNAP participation, and diet quality (Healthy Eating Index—HEI-2015) was assessed using multiple linear/logistic regression models. The sample included 6403 children (mean age: 7.5 years; 51% male; 33% Hispanic). Within the sample, 13% reported child food insecurity, and 30% reported household food insecurity. Additionally, 90% participated in the FNAP, and 88% were enrolled in school lunch programs. Children in urban areas were significantly more likely to report household food insecurity than those in rural areas (29.15% vs. 19.10%). The overall HEI-2015 score was 48.2. The associations between child/household FSS and FNAP participation as well as between child/household FSS and diet quality did not differ by urban/rural residence status, irrespective of the children's age groups. There is a need for improvement in children's diet quality, regardless of age or urban/rural residence. The findings suggest that improving children's diets requires broader action as well as the prioritizing of children in urban areas experiencing food insecurity in future dietary interventions.