- Click here for explanation of classification scheme.

The relationship was examined between food sufficiency status and "reliance on a few foods" among two- and three-year-old and four- to eight-year-old children in low income families.

Two- and 3-year old and 4-to 8-year old children drawn from the 1994-1996 and 1998 Continuing Survey of Food Intakes by Individuals (CSFII). Children were selected that had 2 days of completed dietary recall data, whose households could be staged into one of three categories of food sufficiency and who lived in households in which income was 185% of the federal poverty level or less.

Not defined.

Recruitment

• A sample was drawn from the 1994-1996 and 1998 Continuing Survey of Food Intakes by Individuals
• Children were selected with two days of completed dietary recall data, whose households could be staged into one of three categories of food sufficiency and who lived in households in which income was 185% or less of the federal poverty level
• Only one eligible child was chosen from each income-qualified household by first selecting the sample from the original CSFII data set and then randomly-selecting one child from each household using SAS 8.2. 

Design

Cross-sectional.

Statistical Analysis

• T-test: Tested for difference in mean Variety Scores between the two- to three-year-old and four- to eight-year-old children, using SUDAAN to account for sampling weights and survey design
• Linear regression: Differences in Variety Scores across the three levels of food sufficiency status were tested for each age group.

Timing of Measurements

The sample was drawn from the 1994-1996 and 1998 CSFII, which is a nationally representative sample of noninstitutionalized people living in US households and provides individual estimates of food and nutrient intakes from two non-consecutive days of 24-hour recall.

A HEI Variety Score was used to measure "reliance on a few foods," which is calculated based on the total number of different foods eaten in a day, in sufficient amounts to contribute at least one-half of a serving or more from the five food groups of the Food Guide Pyramid, based on Pyramid serving sizes. Foods eaten more than once per day or those that differ only by preparation method are counted only once.

• Variety Score range from zero to 10: When three or fewer different foods are consumed in a day, then no points were assigned; when at least eight different foods are consumed, then 10 points are assigned
• Intermediate intakes are scored proportionally. For this study, Variety Scores were calculated for Day One and Day Three separately and then averaged.

Food sufficiency status was based on the household respondent's answer to the close-ended CSFII question, "Which of the following statements best describes the foods eaten in the household?" Consistent with other research, children were placed into one of three categories: food sufficient (enough of the kinds of food wanted), food sufficient with limitations (enough but not always the kinds of food wanted) and food insufficient (sometimes or often not enough to eat).

Dependent Variables

Food sufficiency status.

Independent Variables

•  Low income
• "Reliance on a few foods."

Control Variables

Sociodemographic factors.

• Initial N: 1,242 children ages two to three and 1,506 children ages four to eight
• Attrition (final N): N/A
• Age: Two- to three-year-old and four- to eight-year-old children
• Ethnicity: Children were categorized as non-Hispanic white, non-Hispanic African-American, Hispanic and other
• Other relevant demographics: Low-income families
• Anthropometrics: Not defined
• Location: USA.

Key Findings

• HEI Variety Scores were compared across the three categories of food sufficiency status and there were no significant differences between the two- to three-year-old (P=0.11) or four- to eight-year-old children (P=0.33), although the scores decreased slightly as food sufficiency status worsened for the younger children
• Among two- to three-year-old children, the only significant factor tested within this model was household participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), which suggests that household WIC participation improves the number of different foods they consume
• WIC participation had a strong effect on diet quality measured by the overall HEI and variety measured through the HEI Variety Score.

HEI Variety Scores by Selected Household and Demographic Characteristics, Two- to Three-Year-Old and Four- to Eight-Year-Old Children

		2 to 3 Years Old (N=1,242)	4 to 8 Years Old (N=1,506)
HEI Variety Score (overall variety)		7.99±0.05	7.54±0.08
Food Sufficiency Status	Food sufficient	8.16±0.07	7.58±0.12
	Food sufficient with limitations	7.79±0.13	7.49±0.11
	Food insufficient	7.71±0.27	7.54±0.33
Income Category	0%-130% federal poverty level	7.95±0.07	7.58±0.08
	130%-185% federal poverty level	8.80±0.13	7.47±0.17
	Food assistance programs
	Anyone in household on WIC (Yes)	8.17±0.11	7.78±0.16
	Anyone in household on WIC (No)	7.84±0.08	7.47±0.17
Household Receiving Food Stamps	Yes	7.89±0.12	7.78±0.16
	No	8.06±0.09	7.47±0.10
Child Participates in National School Lunch Program	Yes	--	7.60±0.14
	No	--	7.51±0.10
Region	Northwest	8.03±0.12	7.96±0.15
	Midwest	8.03±0.13	7.58±0.23
	South	7.93±0.10	7.04±0.12
	West	8.02±0.09	7.83±0.11
Urbanization	Urban, central city	8.12±0.11	7.80±0.11
	Urban, outside central city	7.99±0.10	7.51±0.14
	Rural	7.79±0.13	7.22±0.21
	Household head is female	7.97±0.11	7.61±0.14
	Household head is not female	8.00±0.07	7.50±0.09
Race/Ethnicity	Non-Hispanic white	7.84±0.11	7.38±0.16
	Non-Hispanic African-American	7.97±0.13	7.44±0.15
	Hispanic	8.33±0.15	7.98±0.14
	Other	7.66±0.40	7.46±0.38

Association of Selected Household and Demographic Characteristics with HEI Variety Scores in Two- to Three-Year Old and Four- to Eight-Year-Old Children

		2- to 3-Year-Old Children			4- to 8-Year-Old Children
		Beta	T	P-value	Beta	T	P-value
Food Sufficiency Status	Food sufficient	--	--	--	--	--	--
	Food sufficient with limitations	1.34	2.14	0.4	1.81	1.21	0.23
	Food insufficient	1.01	1.27	0.21	1.53	1.28	0.21
Income Category	0%-130% federal poverty level	1.67	0.45	0.65	1.91	0.00	1.00
	130-185% federal poverty level	--	--	--	--	--	--
	Anyone in household on WIC	1.40	2.92	<.01	2.05	1.89	0.06
	Household receiving food stamps	1.47	1.03	0.31	2.09	0.12	0.90
	Child participates in school breakfast program	--	--	--	2.60	0.15	0.88
	Child participates in school lunch program	--	--	--	2.56	0.67	0.51
Region of Country	Northwest	0.97	0.09	0.93	1.72	3.41	<0.001
	Midwest	0.95	1.04	0.30	2.35	2.49	0.02
	South	--	--	--	--	--	--
	West	0.75	0.17	0.87	1.25	3.71	<0.001
Urbanization	Urban, central city	1.50	1.24	0.22	1.71	1.62	0.11
	Urban, outside central city	1.12	1.13	0.27	2.15	0.86	0.39
	Rural	--	--	--	--	--	--
	Household head is female	0.90	0.84	0.41	1.95	0.39	0.70
Race/Ethnicity	Non-Hispanic white	1.53	2.64	0.02	2.08	2.11	0.04
	Non-Hispanic African American	1.88	1.32	0.19	1.61	2.00	0.05
	Hispanic	--	--	--	--	--	--
	Other	2.40	1.27	0.21	02.33	1.32	0.20
	Head of household education status	0.73	1.60	0.12	1.82	1.02	0.31
	Household size	1.63	1.94	0.06	1.50	0.14	0.89

 

 

• Variety Scores did not differ by food sufficiency status for either group
• The older children's Variety Scores did not differ by food sufficiency status, although the younger children's scores decreased slightly, but not significantly, as food insufficiency worsened
• Low-income families rely on a limited number of different foods to feed their young children, regardless of food sufficiency. Therefore, all families would benefit from nutrition education about the importance of dietary variety.
• Food-insecure families have special needs because of the health, developmental and psychosocial problems associated with food insecurity. These families would not only benefit from nutrition education, but would also from access to food assistance resources that support dietary variety.

• The CSFII question did not capture the full range of conditions, behaviors or experiences associated with food insecurity and hunger, which are addressed in the newer US Food Security Survey Instrument
• The HEI Variety Score may not accurately reflect "reliance on a few foods" because it is based on a variety across whether within-food-group variety is compromised during food insecurity or insufficiency
• How the HEI Variety Score is constructed may have influenced the results of the study
• The Variety Score may only detect variations within the number of different foods eaten when that number is between three and eight foods per day, although it was found that most children consumed fewer than eight different foods: The maximum score was found in only 37.1% of the younger children and 27.5% of the older children.