Indirect Effects of Food Insecurity on Body Mass Index Through Feeding Style and Dietary Quality Among Low-Income Hispanic Preschoolers

Objective: To investigate whether food insecurity affects child body mass index (BMI) through parental feeding demandingness and/or responsiveness and dietary quality 18 months later among low-income Hispanic preschoolers.

Design: Secondary analysis of data at baseline and 18 months afterward.

Setting: Houston, TX.

Participants: Hispanic parent-preschooler dyads (n = 137).

Variables: Food insecurity (6-item Household Food Security Survey), child BMI (BMI z-score), child dietary quality (Healthy Eating Index), and parental feeding demandingness and responsiveness (Caregiver's Feeding Style Questionnaire).

Analysis: Ordinary least-squares regression models and 95% bootstrapped confidence intervals (CIs) to estimate effects.

Results: Controlling for baseline child BMI, maternal acculturation, and maternal BMI, total indirect effects of food insecurity on child BMI through feeding demandingness, responsiveness, and subsequent child dietary quality were estimated to be 0.001 (95% bias-controlled bootstrap CI, -0.01 to 0.01). Confidence intervals for all indirect pathways straddled 0. As food insecurity worsened, child dietary quality 18 months after baseline improved (c = 1.06; 95% CI, 0.41-1.71).

Conclusions and implications: Food insecurity had no influence on child BMI through feeding demandingness/responsiveness and/or child dietary quality. Additional research is needed to examine why food insecurity had a protective effect on dietary quality 18 months later. This finding suggests the adoption of coping mechanisms.