Food Insecurity in Pregnancy & Early Life May Be Linked to Higher Chance of Obesity in Children & Adolescents

Authors: Izzuddin M. Aris, et al

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

Why was this study needed?

Previous studies have linked food insecurity with obesity in adults, but evidence around the impact in children isn’t as clear. Many of these studies have looked at food insecurity and obesity at a single point in time rather than following the children over time. Because of this, it’s difficult to understand whether childhood obesity is directly influenced by food insecurity. Additionally, the few long-term studies that have addressed food insecurity and childhood obesity have primarily focused on late childhood or adolescence. ECHO Cohort researchers aimed to explore how food insecurity during pregnancy and early life—stages that may be particularly important to influencing long-term health outcomes—could be related to obesity in childhood and adolescence.

What were the study results?

Children who lived in low-income, low-food-access (LILA) neighborhoods during early childhood or whose mothers lived there during pregnancy were found to have higher body mass index (BMI) at ages 5 and 15. Living in those conditions was also associated with a 50% greater chance of developing obesity or severe obesity at ages 5, 10, and 15 years—regardless of individual sociodemographic factors. The association was strongest for those living in LILA neighborhoods during early childhood and their mother’s pregnancy. A LILA neighborhood is defined as a low-income neighborhood where a third or more residents live more than one half mile from a grocery store in urban areas or more than 10 miles in rural areas.

What was this study's impact?

These findings suggest that pregnancy and early childhood may be life stages when neighborhood food access can play the biggest role in long-term health outcomes. Living in neighborhoods with access to healthy foods during these stages may be important in preventing the development of obesity later in childhood and adolescence.

Who was involved?

The study included 28,359 participants from 55 ECHO Cohort Study Sites, including racially, ethnically, and geographically diverse mother-child pairs. Approximately 23% of the participants lived in a LILA neighborhood during pregnancy, and around 24% lived in these areas during early childhood.

What happened during the study?

Researchers mapped out where participants lived during pregnancy (from 1994 to 2023) or early childhood (from 1999 to 2023), matching each address to a specific neighborhood based on census data. They then linked these neighborhoods to food access data from the USDA Food Access Research Atlas for the years closest to when the participants lived there. The database offers information on household income, vehicle availability, and food access in neighborhoods.

Child weight and height data were collected from birth to adolescence through in-person research visits, medical records, and parent or caregiver reports. Researchers compared this data with information on where the children lived to determine if there was a link between neighborhood food access and child BMI or obesity.

Note: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What happens next?

Future studies are needed to learn whether improving access to healthy food early in life helps prevent childhood obesity. Improvements could include encouraging new supermarkets in existing food deserts, offering healthy food options at food pantries, or making healthier choices available in small retail and convenience stores.

Where can I learn more?

Access the full journal article, titled “Neighborhood Food Access in Early Life and Trajectories of Child Body Mass Index and Obesity,” in JAMA Pediatrics.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published September 16, 2024

Read the associated article.