Today’s post comes from Casey Sobool. Casey is a dietetic intern at the University of Alberta.
In discussing weight, it can be easy to blame individual choices and laziness as the culprit of weight gain. Socioeconomic factors are often left out of the conversation. Food security is one of the many factors that may impact a person’s weight. Food security exists “when all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life,” (Food and Agriculture Organization, 1996).
In the Canadian Community Health Survey (CCHS) for 2007-08, 961,000 households were classified as food insecure (Health Canada, 2008). A higher prevalence of food insecurity was found in households with low income, single-mother households, households with children, recent immigrants, and indigenous households not on reserves (Health Canada, 2008).
While it would logically make sense that having unstable access to food would lead to lower intake of calories and a lower BMI, many studies have found the opposite to be true. Food insecurity was positively associated with overweight status in women when excluding the severely food insecure (Townsend, 2001). Mildly food insecure women were found to be 30% more likely to be overweight than their food secure counterparts (Townsend, 2001). One explanation for this higher weight in food insecure population could be that as money fluctuates throughout the month, so does food access resulting in a binge-type eating during periods of bounty and restriction-type eating when waiting for the next payday. It is well known that food restriction leads to overeating as the body compensates for the previous lack of energy and prepares for another period of restriction (Janet, 1994).
Obesity was found to be more prevalent in food insecure children as well. From kindergarten to grade 3 (the only periods studied), food insecurity was associated with obesity (Arthur, 2017). Furthermore, food insecurity without hunger was related to excess weight in childhood (Metallinos-Katsaras, 2012). On the other hand, food insecurity was not associated with increased body size in ages 4-17 based on NHANES 2007-08 data (Kohn, 2012). The connection between food insecurity and weight is mediated by many factors such as education, family size, and occupation and is not a clear cut cause of obesity. Nonetheless, food security needs to be included in discussions of weight as it is a risk factor outside of the individual’s control.
In the long term, we should work towards building food security through the 3 stage system proposed by McCullum with stage 1 focused on more individual choices, stage 2 focused on capacity building and partnerships in the community such as urban gardens, and stage 3 focused on a redesign of the food system through local, provincial, and national policies that support economic development and long term health for everyone (McCullum, 2005).
Health Canada. (2008, January 07). Canadian Community Health Survey, Cycle 2.2, Nutrition (2004): Income-Related Household Food Security in Canada. Retrieved from https://www.canada.ca/en/health-canada/services/food-nutrition/food-nutrition-surveillance/health-nutrition-surveys/canadian-community-health-survey-cchs/canadian-community-health-survey-cycle-2-2-nutrition-2004-income-related-household-food-security-canada-health-canada-2007.html#key31
Janet, P., Sharon B., Z., C Peter, H., & A Lynne, B. (1994). Food Restriction and Binge Eating: A Study of Former Prisoners of War. Journal Of Abnormal Psychology, (2), 409. doi:10.1037/0021-843X.103.2.409
Kohn, M. J., Bell, J. F., Grow, H. M., & Chan, G. (2013). Food insecurity, food assistance and weight status in US youth: New evidence from NHANES 2007-08. Pediatric Obesity,9(2), 155-166. doi:10.1111/j.2047-6310.2012.00143.x
Lee, A. M., Scharf, R. J., & Deboer, M. D. (2018). Association between kindergarten and first-grade food insecurity and weight status in U.S. children. Nutrition,51-52, 1-5. doi:10.1016/j.nut.2017.12.008
McCullum, C., Desjardins, E., Kraak, V. I., Ladipo, P., & Costello, H. (2005). Evidence-based strategies to build community food security. Journal of the American Dietetic Association,105(2), 278-283. doi:10.1016/j.jada.2004.12.015
Metallinos-Katsaras, E., Must, A., & Gorman, K. (2012). A Longitudinal Study of Food Insecurity on Obesity in Preschool Children. Journal of the Academy of Nutrition and Dietetics,112(12), 1949-1958. doi:10.1016/j.jand.2012.08.031
Thirsk, J. Food Security Background. Dietitians of Canada. (2018).
Townsend, M. S., Peerson, J., Love, B., Achterberg, C., & Murphy, S. P. (2001). Food Insecurity Is Positively Related to Overweight in Women. The Journal of Nutrition,131(6), 1738-1745. doi:10.1093/jn/131.6.1738