Abstract Body: Background: Obesity is influenced by socioeconomic factors such as food insecurity (FI) over the life course. Little is known about longitudinal experiences of FI in childhood and adolescence and how these experiences relate to overweight and obesity status in adulthood.
Objective: Our study aimed to investigate FI trajectories throughout youth and their associations with weight status in young adulthood. We hypothesized that trajectories indicating FI in childhood and adolescence would be associated with increased odds of being overweight and obese in young adulthood and that these associations would differ by extreme poverty status in adulthood.
Methods: We used data from the Future of Families and Child Wellbeing Study, a longitudinal sample of children born in large U.S. cities between 1998-2002. We used group-based trajectory modeling to identify distinct FI trajectories from ages 3 to 15, based on survey questions approximating Hunger Vital Sign at ages 3, 5, 9, and 15. Overweight and obese status were defined using self-reported weight and height at age 22. Associations between FI trajectory and weight status were assessed using multivariate logistic regression, adjusting for relevant covariates. We stratified adjusted analyses by extreme poverty or not at age 22.
Results: Of the total sample (n = 4,296), 12.2% identified as non-Hispanic White, 48.1% as female. Three distinct FI trajectories in youth were identified: 51.3% were food secure, 13.2% were food insecure, and 35.5% transitioned from food insecure-to-secure (Figure). Mean body mass index at age 22 was 27.6 (standard deviation 8.0). In adjusted analyses, young adults in the food insecure-to-secure group had higher odds of being overweight (OR 1.23, 95% CI [1.01-1.51]) compared to those in the food secure group. When stratified by poverty status, among young adults not in extreme poverty, those who were food insecure-to-secure had higher odds of being overweight (OR 1.34 95% CI [1.03-1.75]) and obese [OR 1.50, 95% CI [1.14-1.98]) compared to those who were food secure. These associations were not significant for those in extreme poverty.
Conclusions: Young adults who transitioned from being food insecure to secure, particularly those not in extreme poverty, are vulnerable to having high weight status, highlighting the importance of supporting early childhood food security.