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Huang YC, Tan CX, Lee CT, Tsai MC. Relationships between Food Insecurity, Self-Efficacy, and Changes in Body Mass Index among the Youth in Taiwan: Analysis from a Longitudinal Cohort Survey. CHILDREN (BASEL, SWITZERLAND) 2024; 11:663. [PMID: 38929242 PMCID: PMC11201673 DOI: 10.3390/children11060663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 05/26/2024] [Accepted: 05/26/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Food insecurity is a heightened concern among economically disadvantaged youth, and it may contribute to the atypical body mass index (BMI) patterns frequently observed in this group. Self-efficacy seems to intervene in the negative impacts of contextual restraints. This study investigated the relationship between food insecurity, self-efficacy, and BMI trajectory among economically disadvantaged Taiwanese youth. METHODS We utilized three-wave longitudinal data from the Taiwan Database of Children and Youth in Poverty. The Food Insecurity Score (FIS) assessed food insecurity with a 4-item scale measuring reduced meal frequency, hunger, skipping meals, and economic constraints. Moreover, the General Self-Efficacy Scale (GSES) assessed self-efficacy, showcasing the ability to handle stress effectively and envision success scenarios, contributing to positive outcomes. By employing latent growth modeling, we were able to delineate the impacts of baseline food insecurity and self-efficacy on initial BMI and its subsequent growth trajectory. RESULTS Elevated baseline FIS significantly predicted higher initial BMI (coefficient = 0.420, p = 0.042). Baseline GSES was negatively associated with initial BMI (coefficient = -0.093, p < 0.001) but positively predicted the BMI growth rate (coefficient = 0.023, p = 0.011). CONCLUSION Enhancing self-efficacy may be an effective multidisciplinary intervention to address psychosocial and socioeconomic factors when tackling weight problems in vulnerable youth groups.
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Affiliation(s)
- Ya-Chi Huang
- School of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Division of General Practice, Department of Medical Education, Changhua Christian Hospital, Changhua 500, Taiwan
| | - Chin Xuan Tan
- Department of Allied Health Sciences, Faculty of Science, Universiti Tunku Abdul Rahman, Kampar 31900, Malaysia
| | - Chih-Ting Lee
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Meng-Che Tsai
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Department of Medical Humanities and Social Medicine, College of Medication, National Cheng Kung University, Tainan 701, Taiwan
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Lee CT, Pramukti I, Ubeda Herrera JJ, Tsai MC. Investigating psychological distress and peer influence in the longitudinal path linking food insecurity to adolescent substance use: a nationwide low-income cohort study. PSYCHOL HEALTH MED 2024; 29:556-573. [PMID: 37772742 DOI: 10.1080/13548506.2023.2263681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/21/2023] [Indexed: 09/30/2023]
Abstract
Food insecurity (FI), defined as the limited or uncertain availability of nutritionally adequate and safe foods, remains a major life concern among many poor subpopulations. Few investigations have been made into the mechanism underlying its impact on adolescent substance use. This study aimed to examine the longitudinal relationship between FI and cigarette and alcohol use among economically disadvantaged adolescents and then explore the role of psychological distress and peer substance use in the aforementioned association. Data of 1,243 adolescents (Mage = 13.3 years; 645 males) were obtained from a nationwide cohort study on Taiwanese adolescents from low-income families. Multiple hierarchical regression analyses based on generalized linear mixed-effects models with binomial distribution found that FI was consistently associated with cigarette smoking (β = 0.458, p < 0.001) but not alcohol drinking (β = 0.142, p = 0.143) when both psychological distress and peer substance use were adjusted. In the moderated mediation analysis based on bootstrap methods, we observed that psychological distress mediated the association between food insecurity and alcohol drinking (β = 0.036, 95% CI = 0.015-0.063) but not cigarette smoking (β = 0.018, 95% CI =-0.001-0.037). Furthermore, the indirect effects varied by peer drinking status (index of moderated mediation = 0.04, 95% CI 0.015-0.072). Clinical and public health attention should be given to evaluating food-insecure adolescents' psychological well-being and peer influence when counseling their substance use issues.
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Affiliation(s)
- Chih-Ting Lee
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Iqbal Pramukti
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Faculty of Nursing, Universitas Padjadjaran, West Java, Indonesia
| | - Josue Jaru Ubeda Herrera
- Institute of International Management, National Cheng Kung University, Tainan, Taiwan
- Department of Business Administration, College of Management, National Cheng Kung University, Tainan, Taiwan
| | - Meng-Che Tsai
- Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan
- Department of Medical Humanities and Social Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Doggui R, Ward S, Johnson C, Bélanger M. Trajectories of beverage consumption during adolescence. Appetite 2022; 175:106092. [PMID: 35609826 DOI: 10.1016/j.appet.2022.106092] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 05/02/2022] [Accepted: 05/18/2022] [Indexed: 11/28/2022]
Abstract
Beverages contribute substantially to daily energy and nutrient intakes. However, little is known about the co-development of beverage consumption throughout adolescence. This study aimed to investigate the presence of naturally occurring sub-groups of girls and boys following distinct trajectories of various types of beverage consumption (i.e. sugary beverages, tea and coffee, water, and milk) throughout adolescence. During the Monitoring Activities for Teenagers to Comprehend their Habits study, data were collected from 744 Canadian youths followed for six years (2013-2019). The participants were asked yearly (start-age 10-11 years old) to report how many times they consumed sugary beverages, tea and coffee, water, and milk in a week. Trajectories of beverage consumption were identified from age 11 to 18 using a person-centred approach, namely group-based multi-trajectory modelling. For girls, three different groups were identified: 'Water consumers' (62.7%), 'High beverage consumers' (20.9%), and 'Water and milk consumers' (16.4%). For boys, four different groups were identified: 'Water consumers' (39.1%), 'Water and milk consumers' (30.5%), 'Sugary drinks, coffee and tea consumers' (20.1%), and 'High beverage consumers' (10.4%). This study illustrates the complexity of beverage consumption patterns in adolescence. Various types of public health messaging and interventions may be required to promote healthier beverage consumption patterns among all adolescents.
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Affiliation(s)
- Radhouene Doggui
- Centre de Formation Médicale Du Nouveau-Brunswick (Université de Sherbrooke), Moncton, Canada; Department of Family and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Canada.
| | - Stéphanie Ward
- École des Sciences des Aliments, de Nutrition et D'Études Familiales, Université de Moncton, Canada
| | - Claire Johnson
- École des Hautes Études Publiques, Université de Moncton, Canada
| | - Mathieu Bélanger
- Centre de Formation Médicale Du Nouveau-Brunswick (Université de Sherbrooke), Moncton, Canada; Department of Family and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Canada; Vitalité Health Network, Moncton, Canada
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Chiang S, Bai S. Internalizing symptoms among Taiwanese adolescents in poverty: Longitudinal influences of neighborhood, family, and school. J Adolesc 2022; 94:390-400. [PMID: 35390190 PMCID: PMC9009220 DOI: 10.1002/jad.12030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/01/2020] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Identifying specific contextual factors that contribute to the development of internalizing symptoms in adolescents in poverty is critical for prevention. This study examined the longitudinal effects of neighborhood disadvantage, family cohesion, and teacher-student relationship on adolescent internalizing symptoms from economically disadvantaged families. METHODS Participants were 1404 Taiwanese adolescents (49% female) in the nationally representative Taiwan database of children and youth in poverty. Youth were enrolled in the seventh, eighth, or ninth grades (Time 1; Mage = 14.85, SD = 0.95) and completed biennial follow-up assessments 2 (Time 2; Mage = 16.47, SD = 0.74) and 4 years after baseline (Time 3; Mage = 18.21, SD = 0.70). Latent growth models examined longitudinal associations between contextual factors and internalizing symptoms over time. RESULTS Adolescents reported declines in neighborhood disadvantage and teacher-student relationship but increases in family cohesion over the 4 years. At baseline, greater neighborhood disadvantage was associated with higher levels of internalizing symptoms, whereas higher family cohesion was associated with lower levels of internalizing symptoms. Over time, an increase in family cohesion was associated with a decrease in internalizing symptoms. CONCLUSION This study provides empirical support that family cohesion plays a critical role in shaping the development of adolescent internalizing symptoms despite poverty. There was an increase in family cohesion from early to late adolescence among Taiwanese adolescents in poverty and such change was correlated with decreases in youth internalizing symptoms. Family cohesion may be a key target of prevention programs aiming to reduce internalizing symptoms for youth in poverty.
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Affiliation(s)
- Shou‐Chun Chiang
- Department of Human Development and Family Studies The Pennsylvania State University University Park Pennsylvania USA
| | - Sunhye Bai
- Department of Human Development and Family Studies The Pennsylvania State University University Park Pennsylvania USA
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Liu I, Huang YJ, Wang LK, Tsai YH, Hsu SL, Chang CJ, Li YH, Hsiao YC, Chen CY, Wann SR. Dual trajectories of loneliness and depression and their baseline correlates over a 14-year follow-up period in older adults: Results from a nationally representative sample in Taiwan. Int J Older People Nurs 2021; 16:e12410. [PMID: 34379889 DOI: 10.1111/opn.12410] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/30/2021] [Accepted: 07/12/2021] [Indexed: 11/28/2022]
Abstract
AIMS To explore the codevelopment between loneliness and depression in older adults, and to identify its potential baseline individual, family and extrafamilial correlates. BACKGROUND The number of older adults around the world has steadily increased over the last decades. Later life is a particularly vulnerable life stage due to multiple unfavourable conditions, and mental health in this stage appears to become an inescapable issue. Previous research has found the cross-sectional association between loneliness and depression, but their codevelopment has been understudied. Therefore, exploring the codevelopment and its correlates has significant implications for prevention and healthcare professionals. DESIGN A longitudinal follow-up study. METHODS The study used nationally representative data over a 14-year follow-up period from the Taiwan Longitudinal Study on Ageing focused on Taiwanese aged 60 years and above (n = 4049). Group-based trajectory modelling, group-based dual-trajectory modelling and multinomial logistic regression were the primary analytical methods. RESULTS We identified three distinct dual trajectories of loneliness and depression: longitudinal low-frequency lonely depressed (29.3%), longitudinal moderate-frequency lonely depressed (59.4%) and longitudinal high-frequency lonely depressed (11.3%). After considering several demographic and background characteristics, difficulty in physical functioning, number of physical symptoms and diseases, sleep quality and number of child deaths were found to be significantly associated. CONCLUSION Across the three identified dual-trajectory groups, they all showed a stable loneliness frequency pattern over time; however, the moderate-frequency group and high-frequency group both had a trajectory of increasing depression. It seems that depression tends to change over time in a worsening direction, especially for those with a certain frequency of loneliness. Furthermore, differences in individual and family correlates were found across the groups. IMPLICATIONS FOR PRACTICE Interventions focusing on the specific factors may help hinder coexisting loneliness and depression, and have implications for developing health promotion strategies and chronic disease care plans.
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Affiliation(s)
- I Liu
- Department of Family Medicine, Kaohsiung Veterans General Hospital, Pingtung Branch, Pingtung, Taiwan
| | - Yu-Jen Huang
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taiwan
| | - Liang-Kai Wang
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taiwan
| | - Yi-Hsuan Tsai
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taiwan
| | - Sheng-Lun Hsu
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taiwan
| | - Chun-Jui Chang
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taiwan
| | - Ying-Hsien Li
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taiwan
| | - Yi-Chen Hsiao
- Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taiwan.,Institute of Health and Welfare Policy, School of Medicine, National Yang-Ming University, Taiwan
| | - Chun-Yuan Chen
- Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taiwan.,Biostatistics Center, Wan Fang Hospital, Taipei Medical University, Taiwan.,Research Institute and Centre for Global Child Health, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Canada
| | - Shue-Ren Wann
- Kaohsiung Veterans General Hospital, Pingtung Branch, Pingtung, Taiwan.,Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
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Trajectory of Food Insecurity and Its Association with Longitudinal Mental Health and Sleep Outcomes in Adolescents from Economically Disadvantaged Families. Nutrients 2021; 13:nu13051696. [PMID: 34067617 PMCID: PMC8157056 DOI: 10.3390/nu13051696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/11/2021] [Accepted: 05/15/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Adolescence is a critical transition period in the course of human development. Although food insecurity (FI) has been shown to be associated with adverse mental health and sleep outcomes in US adolescents, there is a paucity of research examining the relationships between FI, mental health, and sleep outcomes in Taiwanese adolescents. Furthermore, it is unknown how the change of FI over time (i.e., the trajectory of FI) is related to health outcomes. METHODS The data come from the Taiwan Database of Children and Youth in Poverty, which is a national longitudinal project measuring FI in five survey waves (2009-2017). We employed group-based trajectory modeling to classify various FI trends over the five waves using STATA. Furthermore, a generalized estimating equation analysis was conducted with FI trajectories as the independent variable to see how FI trajectory is related to mental health and sleep outcomes. RESULTS In total, 1921 participants aged 12-18 years in the first wave were deemed valid for the analysis. We classified the participants into four FI trajectory groups: persistently low FI (24.8%), persistently moderate FI (64.7%), declining from high to low FI (4.1%), and food-secure groups (6.4%). As compared to food-secure adolescents, the persistently moderate FI group was more likely to have mental problems (β = 0.30, [95% confidence interval 0.21-0.38]), while the other FI groups were only marginally associated with mental health problems. Moreover, adolescents in the persistently low FI group (β = 0.13, [0.02-0.23]) and persistently moderate FI group (β = 0.39, [0.29-0.48]) were found to have more sleep problems than those in the food-secure group. CONCLUSIONS Our study describes the FI profile of adolescents from economically disadvantaged families and the difficulties they might encounter. With this information, healthcare providers can aid adolescents in the early stages of mental health problems and provide guidance when appropriate.
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Doggui R, Ward S, Johnson C, Bélanger M. Trajectories of Eating Behaviour Changes during Adolescence. Nutrients 2021; 13:1313. [PMID: 33923453 PMCID: PMC8073249 DOI: 10.3390/nu13041313] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022] Open
Abstract
Adolescence represents a critical transition phase during which individuals acquire eating behaviours that can track into adulthood. This study aims to characterise trends in eating behaviours throughout adolescence by investigating the presence of sub-groups of individuals presenting distinct trajectories of vegetable and fruit, sugary beverage, breakfast and fast-food consumption. Data from 744 MATCH study Canadian participants followed from 11 to 18 Years old (2013-2019) were included in the analyses. Participants reported how often they ate breakfast and consumed vegetables and fruits, sugary beverages and fast foods. Trajectories of eating behaviours over seven years were identified using group-based multi-trajectory modelling. For girls, three different groups were identified, namely 'stable food intake with a decline in daily breakfast consumption' (39.9%), 'moderate food intake and worsening in overall eating behaviours' (38.0%) and 'stable high food intake' (22.1%). For boys, five different groups were identified, namely 'low food intake with stable daily breakfast consumption' (27.3%), 'breakfast-skippers and increasing fast food intake' (27.1%), 'low food intake with a decline in daily breakfast consumption' (23.9%), 'high food intake with worsening of eating behaviours' (13.3%) and 'average food intake with consistently high breakfast consumption' (8.4%). Eating behaviours evolve through various distinct trajectories and sub-group-specific strategies may be required to promote healthy eating behaviours among adolescents.
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Affiliation(s)
- Radhouene Doggui
- Centre de Formation Médicale du Nouveau-Brunswick (Université de Sherbrooke), Pavillon J.-Raymond-Frenette, Université de Moncton, 18 Antonine-Maillet Ave, Moncton, NB E1A 3E9, Canada;
| | - Stéphanie Ward
- École des Sciences des Aliments, de Nutrition et d’Études Familiales, Université de Moncton, Moncton, NB E1A 3E9, Canada;
| | - Claire Johnson
- École des Hautes Études Publiques, Université de Moncton, Moncton, NB E1A 3E9, Canada;
| | - Mathieu Bélanger
- Centre de Formation Médicale du Nouveau-Brunswick (Université de Sherbrooke), Pavillon J.-Raymond-Frenette, Université de Moncton, 18 Antonine-Maillet Ave, Moncton, NB E1A 3E9, Canada;
- Department of Family and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
- Vitalité Health Network, Moncton, NB E2A 1A9, Canada
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Taverno Ross SE, Militello G, Dowda M, Pate RR. Changes in Diet Quality in Youth Living in South Carolina From Fifth to 11th Grade. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:928-934. [PMID: 32334976 PMCID: PMC7554150 DOI: 10.1016/j.jneb.2020.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 02/26/2020] [Accepted: 03/02/2020] [Indexed: 05/06/2023]
Abstract
OBJECTIVE To examine diet quality levels and changes in a diverse sample of youth from fifth to 11th grade, and interactions by race/ethnicity and socioeconomic status. DESIGN Transitions and Activity Changes in Kids prospective cohort study. SETTING Elementary, middle, and high schools in South Carolina. PARTICIPANTS A sample of 260 fifth-graders (106 boys and 154 girls) with complete data at baseline and at least 1 time point each in middle school and in high school. MAIN OUTCOME MEASURE Dietary intake assessed with the Block Food Screener for Kids (last week). Diet quality was assessed using energy-adjusted intakes of 5 food groups. ANALYSIS Descriptive statistics and growth curve models for the total group and by gender for diet quality from fifth to 11th grade (P < 0.05). RESULTS Both boys and girls had low levels of diet quality, which continued to decline through 11th grade. Significant main effects by race and poverty as well as a race by poverty interaction were observed. CONCLUSIONS AND IMPLICATIONS Programs and policies that support healthy dietary patterns in children transitioning from elementary to middle and high school are needed. Specific efforts that focus on nutrition disparities in children from low-income and minority backgrounds are warranted.
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Affiliation(s)
- Sharon E Taverno Ross
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA.
| | - Geena Militello
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - Marsha Dowda
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - Russell R Pate
- Department of Exercise Science, University of South Carolina, Columbia, SC
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Does active leisure participation promote psychological capital through peer support in economically disadvantaged children? PLoS One 2020; 15:e0234143. [PMID: 32479528 PMCID: PMC7263618 DOI: 10.1371/journal.pone.0234143] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 05/19/2020] [Indexed: 11/19/2022] Open
Abstract
This study’s main purpose was to explore the effects of active leisure participation on poor children’s psychological capital, while also investigating the mediated effect of peer support. The sample consisted of 483 economically disadvantaged children, selected and analysed from the Taiwan Database of Children and Youth in Poverty (fifth wave). The study employed partial least squares-structural equation modelling to analyse the relationship between the variables: active leisure participation (exercise and nature travel), peer support, and psychological capital in economically disadvantaged children. The results showed that active leisure participation improved psychological capital and peer support in economically disadvantaged students; and peer support was an important mediator between the other two variables.
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Wu CH, Lin CY, Hsieh YP, Strong C, Meshki C, Lin YC, Tsai MC. Dietary behaviors mediate the association between food insecurity and obesity among socioeconomically disadvantaged youth. Appetite 2018; 132:275-281. [PMID: 30327150 DOI: 10.1016/j.appet.2018.10.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 09/19/2018] [Accepted: 10/09/2018] [Indexed: 02/05/2023]
Abstract
Across many Asian countries, the prevalence of obesity is increasing and is increasingly recognized as an emerging public health issue. Food insecurity, defined as the limited or uncertain availability of nutritionally adequate and safe foods, is major difficulty faced by many poor subpopulations despite national economic growth. Previous research has yielded inconsistent results about the association between food insecurity and obesity, with positive associations more consistently observed among women than men. This study aims to elucidate relationships between food insecurity, dietary behaviors, and weight status, stratified by gender. Data come from the Taiwan Database of Children and Youth in Poverty. Participants (n = 1326) aged 10-18 years (2009-2013), which included measures of food security and dietary behaviors in three survey waves. Weight status was determined using self-reported body mass index (BMI; kg/m2) with the category "overweight/obesity" defined as a BMI above the 85th percentile within a representative population. Logistic regression analyses indicated a significant association between food insecurity and obesity/overweight with an odds ratio (OR) = 1.45, 95% confidence interval (CI) 1.25-1.70. Food insecurity was associated with a select number of unhealthy dietary behaviors. Skipping breakfast in females (OR = 1.63, 95% CI 1.20-2.22) and consuming snacks and sugared drinks in males (OR = 1.51, 95% CI 1.15-1.98) were associated with obesity/overweight. Food insecurity remained significantly associated with obesity/overweight after adjusting for dietary behaviors. In addition, there was some evidence that dietary behaviors mediated the association between food security and obesity/overweight. In conclusion, economically disadvantaged youth are vulnerable to food insecurity and obesity, and food insecurity may increase the likelihood of obesity due to its association with dietary behaviors. Understanding the mediating factors between food insecurity and obesity may help to amend weight-related health problems in poverty-affected populations.
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Affiliation(s)
- Chang-Han Wu
- School of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Yi-Ping Hsieh
- Department of Social Work, College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, ND, USA
| | - Carol Strong
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Camilla Meshki
- School of Human Health and Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Yi-Ching Lin
- Department of Early Childhood and Family Education, College of Education, National Taipei University of Education, Taipei, Taiwan
| | - Meng-Che Tsai
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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