Food insecurity in early life, pregnancy may be linked to higher chance of obesity in children, NIH-funded study finds

Children who faced food insecurity during early childhood—or whose mothers experienced it during pregnancy—had a higher body mass index (BMI) and more than 50% increased chance of developing obesity or severe obesity in childhood and adolescence, according to a new study funded by the NIH Environmental influences on Child Health Outcomes (ECHO) Program.

While previous research has linked food insecurity to obesity in adults, its impact on children is less clear. ECHO Cohort researchers explored how food insecurity during early life and pregnancy may affect the incidence of obesity in childhood and adolescence. 

“Living in neighborhoods with access to healthy foods during these stages may be an important factor in preventing the development of obesity later in childhood and adolescence,” said Izzuddin M. Aris, PhD of the Harvard Pilgrim Health Care Institute. “Our findings support the need for further research on strategies to improve access to healthy food in early life.”

The study looked at data from nearly 30,000 mother-child pairs from 55 ECHO Cohort research sites nationwide. About 23% had mothers who lived in an area with limited access to grocery stores during pregnancy, and around 24% of the children lived in these areas during early childhood. Low-income-low-food-access (LILA) refers to a neighborhood with a third or more residents living more than one-half mile from a grocery store in urban areas or more than 10 miles in rural areas.

Key findings include:

• Living in LILA neighborhoods during pregnancy or early childhood was associated with a higher BMI in the child at ages 5 and 15 and a more than 50% higher chance of developing obesity or severe obesity at ages 5, 10, and 15.
• The associations became stronger as the children aged and were strongest among those who lived in LILA neighborhoods during early childhood and their mother’s pregnancy.

Researchers used participants' residential addresses from either pregnancy (1994 to 2023) or early childhood (1999 to 2023). They then matched these addresses with food access data from the USDA Food Access Research Atlas, which provides information on household income, vehicle availability, and neighborhood food access.

Data on children's weight and height were collected from birth through adolescence through in-person visits, medical records, and parent or caregiver reports. Researchers analyzed this data alongside the neighborhood information to investigate the relationship between food access and child BMI or obesity.

The full study, titled “Neighborhood Food Access in Early Life and Trajectories of Child Body Mass Index and Obesity in ECHO,” was published in JAMA Pediatrics.

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Aris, I.M., “Neighborhood Food Access in Early Life and Trajectories of Child Body Mass Index and Obesity in ECHO.” JAMA Pediatrics. DOI: 10.1001/jamapediatrics.2024.3459.

About ECHO: Launched in 2016, the Environmental influences on Child Health Outcomes (ECHO) Program is a research program in the Office of the Director at the NIH with the mission to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.