Journal of Clinical Nutrition & Dietetics

Physical Activity Mediates the Association between Food Insecurity and Childhood Obesity

Context: Childhood obesity and food insecurity constitute a global public health concern. Food insecurity could increase the risk of obesity but the mechanisms and pathways underlying the relationship are not clear.

Objective: To explore the role of physical activity in the association between food insecurity and obesity.

Methods: Data from the National Survey of Children’s Health for the years 2016- 2020 were used. Only children aged 10 to 17 years were included in this analysis. Logistic regression and causal mediation analysis within the counterfactual framework were employed to explore the role of physical activity.

Results: The prevalence of obesity was 15.8% in our study sample. Children experiencing food insecurity had 79% higher odds (OR=1.79, 95% CI: 1.72, 1.87) of obesity compared to children living in food-secure households after adjusting for age, sex, race/ethnicity, education, and poverty level. Physical activity was not a confounder nor an effect measure modifier. However, physical activity mediates 11.59% of the association between food insecurity and obesity. Evidence of mediation was more pronounced in Non-Hispanic Whites (proportion mediated=13.55%) and when comparing children less physically active to the most physically active (proportion mediated=24.1%).

Conclusion: Physical activity partially mediates the association between food insecurity and obesity in children.

Author(s): Wendemi Sawadogo* and Tilahun Adera

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