Abstract
OBJECTIVE: The last decade saw a higher prevalence of overweight reported among food-insecure families in Canada, but no robust evidence exists on the covariate-adjusted association in children. In this study, we examined the association between hunger and overweight in Canadian students, using a propensity score matching analysis to reduce confounding.
METHODS: This research used data from the 2009/2010 Canadian Health Behaviour in School-aged Children study on a representative national sample of students in Grades 6 through 10. Students self-reported their height and weight and how often they have gone to school or to bed hungry due to a lack of food at home. Multivariate logistic regression modeling was conducted on the total sample (N = 17,694) and on the sample matched on propensity scores (n = 7,788).
RESULTS: The overall prevalence of overweight among students was 20.2% with a significant difference between students who reported hunger (24.0%; 95% CI: 22.1–26.0) and students who did not (19.0%; 95% CI: 17.9–20.2). Analysis on the matched sample revealed a significant association between hunger and overweight in children (adjusted odds ratio: 1.30; 95% CI: 1.12–1.50).
CONCLUSIONS: A substantial number of Canadian students have reported being hungry because of a lack of food at home. These students are at increased risk of overweight, regardless of their social class. Child hunger and household food insecurity exist in Canada and constitute a call for policy action at a national level.
Key words: Overweight, child, adolescent, hunger, propensity score, food
Résumé
OBJECTIF: Au cours des 10 dernières années, la prévalence du surpoids déclarée chez les familles aux prises avec l’insécurité alimentaire au Canada a augmenté, mais il n’existe aucune donnée probante solide sur une association pondérée en fonction des covariables chez les enfants. Dans notre étude, nous avons examiné l’association entre la faim et le surpoids chez les élèves canadiens à l’aide d’une analyse d’appariement sur le score de propension pour réduire la confusion.
MÉTHODE: Nous avons appliqué les données du cycle 2009–2010 de l’Étude canadienne « Health Behaviour School-aged Children » (HBSC) à un échantillon national représentatif d’élèves de la 6e à la 10e année. Les élèves ont rapporté leur taille et leurs poids et si ils sont souvent allés à l’école ou au lit en ayant faim par manque de nourriture à la maison. Nous avons appliqué un modèle de régression logistique multivariée à l’échantillon total (N = 17 694) et à l’échantillon apparié sur le score de propension (n = 7 788).
RÉSULTATS: La prévalence globale du surpoids chez les élèves était de 20,2 %, avec un écart significatif entre les élèves ayant connu la faim (24,0 %; IC de 95 %: 22,1–26,0) et les autres élèves (19,0 %; IC de 95 %: 17,9–20,2). L’analyse de l’échantillon apparié a révélé une association significative entre la faim et le surpoids chez les enfants (rapport de cotes ajusté: 1,30; IC de 95 %: 1,12–1,50).
CONCLUSIONS: Un nombre considérable d’élèves canadiens a déclaré avoir connu la faim en raison du manque de nourriture à la maison. Ces élèves présentent un risque accru de surpoids, peu importe leur classe sociale. La faim des enfants et l’insécurité alimentaire des ménages existent au Canada et constituent un appel à l’action des pouvoirs publics à l’échelle nationale.
Mots clés: surpoids, enfant, adolescent, faim, score de propension, nourriture
Footnotes
Acknowledgements: The study was supported by funding provided by the Canadian Institutes of Health Research and the Social Sciences and Humanities Research Council. The Health Behaviour in School-aged Children (HBSC) study is a WHO/Euro collaborative study and funded by public sources in each member country. The HBSC International Coordinating Centre is located at St Andrew’s University, and the databank is managed at the University of Bergen. The Canadian HBSC study (Principal Investigators: John Freeman, William Pickett; National Coordinator: Matthew King) was funded by the Public Health Agency of Canada, with additional support from Health Canada
Conflict of Interest: None to declare
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