Overweight and obesity across nearly all age levels are of increasing
concern in the United States because of the emergence of obesity at
earlier childhood ages and the negative implications for later adult
body composition and health. Recent research has suggested that food
insecurity may actually play a role in the onset of obesity among some low-income
groups. Although the evidence is not yet conclusive, the results of
several lines of current research are consistent with causal associations
between food insecurity and obesity. One line of inquiry is to examine food
insecurity in relation to child feeding and rearing practices that may facilitate
child overweight.
This study assessed the impact of maternal food insecurity, both past
and current, on child feeding practices that encourage weight gain
among children in low-income families enrolled in the Special Supplemental
Nutrition Program for Women, Infants, and Children (WIC). Knowledge gained about factors influencing child feeding practices is relevant to WIC nutrition educators, who are responsible for educating mothers about effective child feeding strategies.
Three research questions guided the study:
- Are mothers who are currently experiencing food insecurity or who have experienced food insecurity in the past more likely than other mothers to
(a) be indulgent with respect to feeding their child, (b) practice controlling/
restrictive feeding practices, (c) use food as a reward, or (d) offer
their children larger portion sizes?
- Are mothers who are overweight or obese more likely to engage in these
child feeding practices?
- Are mothers who engage in these child feeding practices more likely to
have overweight children or children at risk for overweight?
The pilot study examined the possible influence of past and current food
insecurity on child feeding practices and prevalence of childhood overweight.
Rates of child overweight in this pilot study population exceeded
the national norms for low-income Hispanic children ages 2-5 by more
than 100 percent (40 percent versus 17 percent). However, this convenience
sample of WIC-eligible urban and rural mothers of children ages 2-5 is
not representative of either California or urban and rural low-income
Latino populations.
Among Latino immigrants, such as many in this group of young
Mexican-American mothers, acculturation to U.S. culture is associated
with poorer dietary habits, less physical activity, and higher rates of
obesity than pre-acculturation. With higher levels of acculturation and
subsequent generations in the United States, Latinos tend to increase
consumption of fast food, convenience foods, salty snacks, simple sugars,
chocolate candy, and total, added, and saturated fats. Because the habits of
children are largely developed and maintained in the home, parent feeding
practices were of particular concern for these immigrant families.
In these families, few parenting differences were found between past and
current food-insecure mothers. The study’s sample size was small, and the
study was limited by the multiple tests that were done on the data that
could have created some false positive findings. However, trends emerged
among mothers who reported experiences with past food insecurity that
suggest possible differences in factors associated with obesity. The study
observed a tendency for past food-insecure mothers to be less likely to be
obese than mothers who had not experienced food insecurity in their childhood.
Past food-insecure mothers were less likely to believe that their children
should eat all of the food on their plates. They also were more likely to
serve their children larger portions of some foods, notably orange juice and
corn. In addition, they were less likely to worry that their children ate too
much food.
Mothers who reported experiencing food insecurity were not more
likely to be obese than food-secure mothers, which is a contrast to other
studies showing a significant association between food insecurity and
obesity in Latino mothers. A mother who reported currently experiencing
food insecurity was less likely to use restrictive child feeding practices and
more likely to use food as a reward for her child. Specifically, she was
somewhat less likely to keep track of the sweets her child eats and to tell
her child that she/he cannot go out to play or watch television until she/he
eats. However, these mothers were somewhat more likely to offer their children
their favorite foods as a reward for good behavior. At the same time,
these mothers were more likely to worry that their children were eating too
much food. Accordingly, these mothers had a tendency to be more likely to
serve their children smaller portions of higher fat, energy-dense foods,
specifically French fries and chicken nuggets. More of these mothers
reported that a physician or health professional had told them that their
children were overweight (27 percent versus 6 percent for food-secure
mothers).
Other research has corroborated that current food insecurity may affect the
variety of foods available and consumed by families. Thus, it may be
natural for mothers to overfeed their children when food is available while
limiting food in times of food insecurity. From this small study, current food
insecurity, as compared with past food insecurity, appears to be more associated
with certain child feeding practices that are theoretically associated
with childhood overweight.
One of the most dramatic findings is the low level of concern for pediatric
overweight expressed by the mothers of overweight children. Studies have shown that Latino mothers associate thinness with poor health and being prone to disease. Other studies of food insecurity among Latino immigrants have confirmed the mismatch between childhood overweight and maternal concern. WIC nutrition educators and participants have previously reported that mothers typically disagree with educators’ assessments of overweight. In a setting where such a high percentage of children are overweight, mothers may assume that higher weight levels are “normal” weight. Further, mothers may be reluctant to label or believe that their children are overweight. Finally, mothers and parents reportedly give explanations or excuses for their children’s weight status, citing that they
will “grow out of it” or that overweight is determined by genetics.