Food availability in the homes of overweight children

Abstract

Background: The home is a highly influential food environment for young children, dictating what they can and choose to eat. Previous studies exploring the relationship between home food availability (HFA) and diet have only looked at specific foods and have used poor measures of availability that have not been validated. Furthermore, longitudinal relationships between HFA and both diet and weight remain poorly examined.

Objective: To determine if HFA was related to dietary intake and weight over 2 years in overweight children (aged 4-8 years).

Design: This study involved cross-sectional and longitudinal analyses of data that was collected for the Motivational Interviewing in Treatment (MInT) study. Participants were 4-8 year old children (n=206) that had been classified as overweight (BMI ≥85th percentile). Demographic information, HFA, dietary intake and anthropometric measurements were gathered at baseline, 12 and 24 months. HFA data was measured with a validated home food inventory redesigned for New Zealand family households. To allow for comparison to the dietary measure four scores were generated from this inventory; obesogenic, fruit and vegetable, non-core foods and sweetened beverage. Dietary intake was measured using the Children’s Dietary Questionnaire, completed by parents. From this three scores were generated; fruit and vegetable, non-core foods and sweetened beverage. BMI z-score was determined using CDC cut-offs.

Results: Socio-economic status was the only demographic predictor of household food variety, not maternal education, age of child, size of household, or ethnicity. A greater presence of obesogenic foods in the home was associated with a higher intake of both non-core foods (B=0.03 (0.02, 0.04), p<0.001) and sweetened beverages (B=0.04 (0.02, 0.05), p<0.001) in children. Fruit and vegetable availability was related to higher consumption of fruits and vegetables (B=0.07 (0.03, 0.11), p=0.001) and to lower consumption of non-core foods (B=-0.01 (-0.02, 0.00), p=0.04). While HFA remained relatively stable over two years, a change in availability of obesogenic foods in the home was associated with a change in both non-core food (p=0.025) and sweetened beverage intakes (p=0.023). No relationships were found between change in food availability and change in BMI z-scores.

Conclusion: While food availability in the home does not differ substantially by many demographic factors, nor over time, it is clearly associated with the dietary intake of overweight children. Using the home food inventory could be an effective way to gather information about what foods are available in the homes of overweight children. This information could be used to target specific purchasing behaviours in a bid to create a healthier home food environment that encourages positive dietary changes.