Table 2.

Selected characteristics of included studies of children

Author, year	Study design	Setting	Sample size	Follow-up	Key findings
Overweight/obesity
Nguyen et al. 2017	Cross-sectional	USA, nationally representative survey	4,719	n/a	There was no significant overall relationship between household food security and BMI percentile (0.00 change in percentile per 1 point change in food security [95% CI –0.98, 0.98])
Orr et al. 2020	Cross-sectional	2-year-old children participating in randomized controlled trial	477	n/a	There were no differences in child weight status as assessed by mean BMI z-scores or proportion of children who were overweight or obese, or prevalence of parent overweight/obesity, between food secure and food insecure households
Baer et al. 2018	Cross-sectional	Urban center in northeastern USA	376	n/a	There were no significant associations between food security level and weight classification
Poulsen et al. 2019	Cross-sectional	Pennsylvania, USA	434	n/a	Youth from food-insecure households had higher mean z-scores for (beta [standard error]) BMI (.30 [.15]), waist circumference (.27 [.12]), and percent body fat (.43 [.16])
Drennen et al. 2019	Cross-sectional	Caregivers of young children at medical centers in 5 US cities	28,184	n/a	Except at 25 to 36 months, neither household nor child food insecurity were associated with obesity, underweight, or stunting
Oberle et al. 2019	Cross-sectional	Pediatric patients with obesity (BMI ≥95th percentile) seen at a weight management clinic	822	n/a	FI households had significantly higher BMI relative to the 95th percentile, compared with those from food secure households (147.9% above 95th percentile ± 34.3% vs. 132.2% ± 23.6%; P = 0.000).
Zhu et al. 2020	Longitudinal	Kindergarteners through 8th graders in the USA	6,368	~8 years	Children with food insecurity had a higher body mass index z-score than the food-secure children in the 3rd, 5th, and 8th grades, respectively
Lee et al. 2018	Longitudinal	US nationally representative sample of children in kindergarten in 2010	8,167	~3 years	First-grade food insecurity was significantly correlated with increased BMI z-score in first through third grades; for example, at first grade, with food insecurity 0.6 (95% CI, 0.5, 0.7) vs. food secure 0.4 (95% CI, 0.4, 0.5).
Lohman et al. 2018	Longitudinal	Midwestern USA	559	~16 years	Higher levels of food insecurity at age 15 years led to a more rapid increase in BMI
Hypertension
South et al. 2019	Cross-sectional	USA, nationally representative survey	7,125	n/a	Household food insecurity and child food insecurity associated with elevated blood pressure in adjusted models (OR 1.26, 95% CI 1.04, 1.54; OR 1.42, 95% CI 1.03, 1.96, respectively)
Lee et al. 2019	Cross-sectional	USA, nationally representative survey	2,662	n/a	Food insecurity associated with elevated blood pressure among children 12 to 17 years of age in adjusted models (OR 1.65, 95% CI 1.38, 1.98)
Diabetes mellitus and pre-diabetes
Lee et al. 2019	Cross-sectional	USA, nationally representative survey	2,662	n/a	Food insecurity associated with increased odds of prediabetes in adjusted models (OR 1.96, 95% CI 1.17, 3.19) in adolescents age 12–19 years
Thomas et al. 2019	Cross-sectional	USA, nationally representative survey	29,341	n/a	Food insecurity was not associated with parental-reported diagnosis of diabetes in children 2–17 (estimated difference in prevalence of diabetes between food-insecure and food-secure households 0.000 (95% CI −0.002, 0.001)
Clemens et al. 2020	Longitudinal	Ontario, Canada	34,042	~9.5 years	Food insecurity associated with a point estimate for increased risk of incident diabetes that was not statistically significant in adjusted models (HR 1.30, 95% CI 0.72, 2.37)
Mendoza et al. 2018	Cross-sectional	Washington and South Carolina, USA	226	n/a	Youth and young adults with type 1 diabetes from food-insecure households at greater risk of poor glycemic control (OR 2.37, 95% CI 1.10, 5.09) and emergency department visits (prevalence ratio 2.95, 95% CI 1.17, 7.45)

BMI, body mass index