Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger Workshop Summary (2013) / Chapter Skim
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8 Health and Developmental Correlates of Child Food Insecurity from Pregnancy to Adolescence
8 Health and Developmental Correlates of Child Food Insecurity from Pregnancy to Adolescence
Pages 94-120
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From page 94... ...
The first speaker in Session 6 was Barbara Laraia, School of Public Health, University of California, Berkeley, who focused her remarks on food insecurity and child outcomes. The second speaker, Rafael Pérez-Escamilla, Yale School of Public Health, spoke on household food insecurity and the impact on a child's psycho-emotional, social, and academic condition.
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From page 95... ...
Thus, food insecurity has a real role in metabolic disturbances during pregnancy. Laraia illustrated a conceptual framework of household food insecurity on adiposity and health (see Figure 8-1)
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From page 96... ...
The survey asked questions related to socioeconomic status, eating behaviors, dietary intake, physical activity, and other health behaviors. It assessed household food insecurity status at 26–32 weeks gestation using the Household Food Security Survey Module (HFSSM)
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From page 97... ...
The PIN Study found that food insecurity was associated with greater weight gain, greater risk for gaining in excess of the Institute of Medicine (IOM) guidelines, and a much higher risk for developing gestational diabetes (Laraia et al., 2010)
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From page 98... ...
Thus, the baby was more likely to be born with macrosomia or develop chronic diseases later. Laraia reported that the PIN Study also found that food insecurity in the postpartum period was associated with a significant increase in stress beyond the baseline level of stress, which was already clinically significant.
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From page 99... ...
When these children were subjected to the marshmallow paradigm, they waited an average of three minutes. Laraia stated that cross-sectional studies have not shown a consistent relationship between food insecurity and child weight status, but said longitudinal studies will be the key to examining this issue, including the Early Childhood Longitudinal Study (ECLS)
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From page 100... ...
Laraia stated that future studies should consider the role of food security in chronic disease management. Next Steps In ending her presentation, Laraia posed several questions and provided her own views.
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From page 101... ...
The association between household food insecurity and poor maternal mental health and child development outcomes is, in turn, mediated by nutritional and non-nutritional stress-related pathways. Household Food Insecurity and Child Psycho-Emotional, Social, and Cognitive Development Pérez-Escamilla described a review of 26 studies examining household food insecurity and child development outcomes (Pérez-Escamilla and Pinheiro de Toledo Vianna, 2012)
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From page 102... ...
Pérez-Escamilla stated another important question is whether parental personality mediates the relationship between household food insecurity and child development outcomes. Two longitudinal studies support this possible mediation.
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From page 103... ...
He said that an integration of findings from the literature clearly supports the policy research agenda to figure if and how parental mental health and child development remedial programs can be better linked with food assistance programs. A question concerns the importance of linking food assistance programs with parental mental health services or child development remedial programs, and whether a maternal child health care services screen might routinely also screen for household food insecurity, providing referrals for food assistance and child development evaluations.
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From page 104... ...
Jacknowitz reported that the study looked at the outcomes of cognitive and motor development as measured by the Bayley scores, weightfor-age z-scores, and health status. Given the above hypothesis, one would expect that a child who resides in a household that is food insecure in both waves would exhibit worse outcomes, but the study found no negative effects of experiencing persistent food insecurity.
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From page 105... ...
The hypothesis that constant food insecurity is worse than transitioning in and out of that condition may not be correct, which, she said, is a reason why further research is important. Identifying the Pathway Jacknowitz stated that understanding the pathway through which food insecurity affects the outcome of interest provides policy-relevant information -- for example, whether the academic or socioeconomic outcome of a child living in a household experiencing food insecurity is influenced by maternal depression or maternal stress.
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From page 106... ...
There is a measure of child-level food insecurity, but it is unclear whether the targeted child or another child in the household is experiencing that insecurity. Finally, very few children in this age group experience very low food security or even low food security.
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From page 107... ...
IRT methods guide and inform decisions about thresholds and categories. The food security categories that are still used are human constructs, based on understanding and judgment.
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From page 108... ...
Some of these deficits can be made up later on under the right conditions, but this is much more difficult and much more expensive than ensuring adequate nutrition during the prenatal period and early childhood. Cook said adverse growth impacts from food insecurity and hunger persist in the United States, including stunting, wasting, structural system anomalies, endocrine system anomalies, obesity, and oral health issues, the latter of which he identified as an area that warrants more study.
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From page 109... ...
(2004) on maternal depression, which found that maternal depressive symptoms were positively associated with household food insecurity, fair to poor child health, and child hospitalizations.
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(2006) used the food security scale to examine risk of depression and anxiety in early childhood.
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From page 111... ...
Cook stated that most Children's HealthWatch studies make sure of their sentinel sample of more than 40,000 mother-child dyads with the dichotomous variable, household food security status as a predictor. In their studies, they found that food insecurity status was highly predictive of a number of adverse child health outcomes in children and care ivers.
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From page 112... ...
Closing Remarks As wrap-up, Cook posed the question of how living in households where adults, but not children, have very low food security affects those children. He reported that in 2011, based on the official food security data from the CPS, his analysis indicates that there were nearly four million children who were not food insecure but lived in households where adults had very low food security.
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From page 113... ...
First was a metabolic syndrome index, based on health effects, such as whether a person in adulthood is obese, has high blood pressure, has diabetes, has had a heart attack, or has heart disease. The second is an economic self-sufficiency index, based on whether a person graduated from high school, is currently employed, is poor, or participates in TANF or food stamp programs, and his or her earnings and family income.
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From page 114... ...
Thus, Schanzenbach said, the exogeneous shock to resources during early life (receipt of food stamps) improved adult health and, for women, improved economic outcomes.
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From page 115... ...
categorizing boys and girls, 12–19 years, into four groups (food secure, marginal food security, low food security, and very low food security) and found the average BMI was highest for the marginal food security group.
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First, the mother's eating patterns were established when she was food insecure as a child. Second, she developed coping strategies that might increase her risk of chronic disease as an adult.
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From page 117... ...
In closing, Seligman addressed the research gap in terms of the longterm health implications of childhood food insecurity. She suggested longitudinal studies, starting with adolescents or younger, with follow-up into adulthood; a primary focus on understanding the health implications of food insecurity; repeated measures of food insecurity to develop a etter understanding of what it is about food insecurity over time that b confers the greatest risk, and whether there is a way to quantify the "dose" of food insecurity over time; robust measurement of health data, rather than relying on self-reported data; and robust measurement of coping strategies, public program participation, tobacco/drug use, dietary intake, geographic food access, and parental feeding behaviors.
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From page 118... ...
Cook said that a periodic census of the household members, in which all the people in the households are interviewed to collect food security information from each individual in the household instead of just the household respondent, or alternatively all adults and all children as groups could be done easily with the child scale. Although a little more expensive, the main cost is associated with having the household interview.
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From page 119... ...
She said food insecurity may suggest a wide set of policies. However, if the real problem is economic insecurity or another family issue, then food stamps may not be the best response.
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From page 120... ...
120 CAUSES AND CONSEQUENCES OF CHILD FOOD INSECURITY AND HUNGER are both important, as is the frequency of bouts of food insecurity. One of the measurement challenges is to devise a way for cross-sectional surveys to ask questions retrospectively over some period of time, which can be validated in some simple way and fed into the research process.
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