title: Very low food security predicts obesity predominantly in California Hispanic men and women.
abstract: OBJECTIVE
  A high prevalence of food insecurity has persisted in the USA for the past two decades. Previous studies suggest that the association between food insecurity and obesity may vary by gender and race/ethnicity. We examined whether food insecurity was associated with BMI and obesity within gender and racial/ethnic groups in a large, diverse sample of low-income adults.
  
  
  METHODS
  A cross-sectional analysis of a large population-based health survey. We compared the distribution of BMI and obesity by food security levels within gender and racial/ethnic categories.
  
  
  METHODS
  Data were derived from the 2003-2009 waves of the California Health Interview Survey.
  
  
  METHODS
  The study sample included 35 747 non-elderly adults with households ≤200 % of the federal poverty level.
  
  
  RESULTS
  Among Hispanic men, very low food security was associated with a 1.0 kg/m2 higher BMI (95 % CI 0.3, 1.7 kg/m2) and a 36 % higher prevalence of obesity (95 % CI 17, 58 %) after multivariate adjustment. Among Hispanic women, very low food security was associated with a 1.1 kg/m2 higher BMI (95 % CI 0.4, 1.9 kg/m2) and a 22 % higher prevalence of obesity (95 % CI 8, 38 %). Positive associations were also observed for Asian women and multi-racial men. No significant associations were observed for non-Hispanic whites, African Americans, Asian men or multi-racial women.
  
  
  CONCLUSIONS
  Our results suggest that the association of food insecurity and obesity is limited to individuals of certain low-income, minority racial/ethnic groups. Whether targeted interventions to address food insecurity in these individuals may also decrease obesity risk deserves further investigation.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA, USA. cleung@hsph.harvard.edu
authors.forename: Cindy W
authors.initials: CW
authors.lastname: Leung
authors.forename: David R
authors.initials: DR
authors.lastname: Williams
authors.forename: Eduardo
authors.initials: E
authors.lastname: Villamor
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D044466:Asian People; D015992:Body Mass Index; D002140:California / Q000208:ethnology; D003430:Cross-Sectional Studies; D004032:Diet / Q000191:economics / Q000208:ethnology* / Q000592:standards; D005260:Female; D005523:Food Supply / Q000191:economics; D006306:Health Surveys; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D009765:Obesity / Q000191:economics / Q000208:ethnology* / Q000209:etiology; D011203:Poverty; D044469:Racial Groups; D012737:Sex Factors; D044465:White People; D055815:Young Adult