Food insecurity and metabolic diseases both disproportionately affect Hispanic children. Cross-sectional studies have linked food insecurity with adverse cardiometabolic markers, including elevated plasma triglycerides and glucose concentrations. However, the association between changes in food insecurity and changes in cardiometabolic markers in children remains to be explored. Furthermore, few studies have assessed the impact of school-based nutrition interventions on household food insecurity. The objectives of this study are to assess the effect of the TX Sprouts intervention on household food insecurity and to examine the association between changes in household food insecurity and changes in cardiometabolic markers over 1 academic year. This secondary analysis used data from TX Sprouts, a cluster-randomized school-based gardening, cooking, and nutrition trial. The study enrolled 3rd-5th-grade students from 16 schools that served primarily (>50%) Hispanic families with low income in Austin, TX. Participants (n = 619) provided household food insecurity data and fasting lipid panels at both baseline and postintervention, ∼9 mo following. There was no intervention effect on household food insecurity. Independent of the intervention, a 1-point increase in food insecurity, indicative of becoming more food insecure, was associated with a 2.61 mg/dL increase in triglycerides (P = 0.001; 95% CI: 1.04, 4.19) at follow-up. Children who were food insecure at baseline and became food secure at follow-up had a mean 5.05 mg/dL decrease in triglycerides compared with a 7.50 mg/dL increase in triglycerides in children who remained food insecure throughout (95% CI: -23.40, -1.71, P = 0.023). There were no other associations between changes in food insecurity and cardiometabolic markers. Although the intervention did not improve food insecurity, reductions in food insecurity over 9 mo were associated with improved cardiometabolic markers in high-risk children, emphasizing the need for interventions targeting food insecurity. The study is registered at clinicaltrials.gov under NCT02668744 (https://classic. gov/ct2/show/NCT02668744).

Background: While food insecurity (FI) assesses household access to sufficient food, increasing attention is being paid to nutrition security (NS), the ability to obtain health-promoting foods. Aim: This cross-sectional analysis examined differences in sociodemographics, diet quality, and health status between food insecure families with low versus high NS and assessed if FI and NS severity was associated with food assistance program use. Methods: Data were obtained from the 2023 Massachusetts Statewide Food Access Survey of >3000 adults. FI was assessed using the United States Department of Agriculture 18-item Household Food Security Module, NS via a validated four-item scale, and diet quality via the Prime Diet Quality Score (PDQS). FI and NS were analyzed as binary and continuous variables. Inferential statistics assessed group differences. Logistic regression assessed associations between the severity of FI and NS and food assistance program use. Summary: Households with FI, ≥1 child (≤18 years), and annual income ≤$50,000 (n = 335) were included. Forty-three percent reported low NS. Low (vs. high) household NS was associated with a higher prevalence of child-level FI (79% vs. 43%, P < 0.001), SNAP use (83% vs. 70%, P = 0.009), food pantry use (69% vs. 44%, P < 0.001), adult overweight/obesity (39% vs. 17%, P < 0.001), and lower adult PDQS (43 ± 5.1 vs. 44 ± 4.3, P = 0.023), indicating lower diet quality. More severe household FI and lower NS were associated with higher odds of SNAP and food pantry use ( P < 0.001). These findings support expanding food assistance programs to increase nutritious food access for families with children before food and nutrition insecurity become severe.

Food insecurity and the at-home availability of vegetables and sugar-sweetened beverages both influence dietary intake. However, most research on food insecurity and the at-home availability of vegetables and sugar-sweetened beverages is cross-sectional, which is problematic as both change frequently. Therefore, this study assessed how changes in food insecurity were associated with changes in the at-home availability of vegetables and sugar-sweetened beverages among those in the intervention and control groups of TX Sprouts. Parents who participated in TX Sprouts, a gardening, cooking, and nutrition cluster-randomized trial conducted with primarily Hispanic, low-income 3rd-5th-grade students, completed surveys at baseline and at the nine-month follow-up regarding household food insecurity and the at-home availability of vegetables and sugar-sweetened beverages (n = 839). Changes in food insecurity were measured as a continuous variable and categorized according to guidelines at baseline and follow-up. Given that the TX Sprouts intervention improved the at-home availability of vegetables, and there was a significant interaction between changes in food insecurity and the intervention on the at-home availability of vegetables, the intervention and control groups were analyzed separately. Multivariable linear regression estimated how changes in food insecurity, as a continuous measure, were associated with changes in vegetable and sugar-sweetened beverage availability among those in the intervention and control groups. Analysis of covariance was used to analyze how changes in food insecurity, as a categorical measure, were associated with changes in vegetable and sugar-sweetened beverage availability among those in the intervention and control groups. In the control group, a one-point increase in food insecurity, indicative of becoming more food insecure, was associated with a decrease in the availability of vegetables (ß=-0.27, P<.001). In the intervention group, a one-point increase in food insecurity was associated with an increase in the availability of sugar-sweetened beverages (ß =0.05, P=.03). Further, in the control group, those with periodic food insecurity had a larger decrease in the availability of sugar-sweetened beverages compared to those with persistent food security (P=.02). In addition, in the intervention group, households with persistent food security experienced an increase in at-home vegetable availability, while households with periodic (P=.02) and persistent food insecurity (P<.001) experienced a significant decrease in at-home vegetable availability. Future interventions should improve the availability of healthy items for food-insecure households.Clinical Trial Registration Number: NCT02668744. Clinical Trial Registry: https://clinicaltrials.gov/study/NCT02668744. First Registration Date: 01/29/2016.

Objective: Assess how changes in food insecurity in the first 2 years of life are associated with overweight and obesity among children 6–11 years old born to mothers with gestational diabetes mellitus (GDM). Methods: This secondary analysis utilised data from the Study of Women, Infant Feeding and Type 2 Diabetes Mellitus after GDM pregnancy, a prospective cohort of 1033 mother–child dyads. Food insecurity was assessed 6–9 weeks, 1 year and 2 years postpartum. Children were categorized as having persistent food security (food secure all visits), persistent food insecurity (food insecure all visits), or transient food insecurity (experienced both food security and insecurity). Overweight, obesity and severe obesity were classified using height and weight at 6–11 years old. Linear and logistic regressions estimated the relationship between food insecurity groups and BMI percentile, overweight, obesity and severe obesity. Results: Among 748 youth, 72% had persistent food security, 18% had transient food insecurity and 10% had persistent food insecurity. Compared to those with persistent food security, those with persistent food insecurity had higher odds of overweight (aOR = 2.81, [1.36, 5.80]), obesity (aOR = 2.17, [1.05, 4.47]) and severe obesity (aOR = 2.62, [1.02, 6.74]) ( p < 0.05). Conclusions: Screening and addressing food insecurity during early childhood may help identify children at risk for overweight, obesity and severe obesity among children exposed to GDM. Trial Registration: ClinicalTrials.gov identifier: NCT019967030

Background/Objectives: Food insecurity has been associated with adverse eating patterns, which increase the risk for overweight and obesity. However, most studies measure food insecurity and eating behaviors cross-sectionally, not assessing whether experiencing food insecurity over time influences eating behaviors. Therefore, this study assessed the relationship between cumulative food insecurity and food approach and food avoidance eating behaviors and evaluated the effect of breastfeeding intensity and duration on this relationship. Methods: The Study of Women, Infant Feeding and Type 2 Diabetes after Gestational Diabetes Pregnancy (SWIFT) is a prospective longitudinal cohort of 1033 mothers diagnosed with gestational diabetes and their youth. Breastfeeding intensity and duration were assessed at research visits and through mailed monthly surveys from birth to one year postpartum. The SWIFT study in Youth (SWIFT-Y) was a cohort of 701 SWIFT offspring that consented to participate in a research visit 11–16 years postpartum. Youth’s BMI was measured at 11–16 years old through a research visit or their electronic health record. At each of the four research visits (6–9 weeks, one year, two years, and 11–16 years postpartum), participants were categorized as being food secure (0) or food insecure (1). Scores across the four visits were summed (range 0–4), reflecting the number of assessments one was classified as food insecure. The Child Eating Behavior Questionnaire was used to measure the prevalence of eight eating behaviors in the youth, with higher scores indicating that the behaviors were more apparent. According to the measure, the behaviors were categorized into two groups: food approach and food avoidance. Food approach consists of youth’s food responsiveness, emotional overeating, enjoyment of food, and desire to drink, and has been positively associated with a child’s BMI. Food avoidance includes the youth’s satiety responsiveness, slowness in eating, emotional undereating, and food fussiness, and is negatively associated with BMI. Linear regressions assessed whether cumulative food insecurity was associated with eating patterns, and exploratory analysis analyzed whether this relationship differed by breastfeeding duration (<six months, ≥six months) and intensity (exclusive, not exclusive), controlling for the child’s BMI and sociodemographic characteristics. Results: In this complete-case secondary analysis (n = 321), each additional experience of food insecurity was associated with a higher food approach score (B = 0.30, 95% CI [0.04, 0.57], p = 0.03), but not food avoidance (B = −0.03, 95% CI [−0.21, 0.15], p = 0.74). These results varied by breastfeeding duration (B = −0.74, p = 0.001), as the relationship remained significant among those who were breastfed for <six months (B = 0.73, p < 0.001) but was attenuated among those who were breastfed for ≥six months (B = −0.26, p = 0.18). Conclusions: Experiencing food insecurity more during childhood is associated with adverse eating patterns at 11–16 years old. However, breastfeeding for ≥six months influenced this relationship, suggesting that early-life feeding may impact the effect of food insecurity on one’s eating behaviors later in life.