Prevalence and associations between food insecurity and overweight/obesity among native Hawaiian and Pacific Islander adolescents

Objective:This study estimates the prevalence of, and associations between, family food insecurity and overweight/obesity among Native Hawaiian and Pacific Islander (NHPI) adolescents and explores socio-demographic factors which might have a moderation effect on the association. Design:Cross-sectional study using 2014 NHPI-National Health Interview Survey data reported by a parent or guardian. Family-level food security was assessed by the US Department of Agriculture 10-item questionnaire. BMI for age and sex >= 85th and 95th percentiles defined overweight and obesity, respectively, according to US Centers for Disease Control and Prevention criteria. Setting:The USA, including all 50 states and the District of Columbia. Participants:383 NHPI adolescents aged 12-17 in the USA. Results:A third (33 center dot 5 %) of NHPI adolescents aged 12-17 were overweight (19 center dot 1 %) or obese (14 center dot 4 %); 8 center dot 1 % had low food security; and 8 center dot 5 % had very low food security. Mean family food security score was 1 center dot 06, which corresponds to marginal food security. We found no association between family food insecurity and adolescent overweight/obesity or between any other covariates and overweight/obesity, except for family Supplemental Nutrition Assistance Program (SNAP) participation. Odds of being overweight/obese were 77 % lower for adolescents in families participating in SNAP (OR: 0 center dot 23, 95 % CI: 0 center dot 08, 0 center dot 64, P = 0 center dot 007). The association between SNAP participation and lower odds of overweight/obesity was particularly pronounced for adolescent girls in food-insecure families. Conclusions:The association between SNAP participation and lower odds of overweight/obesity suggests potential benefit of research to determine whether interventions to increase SNAP enrollment would improve NHPI adolescents' health outcomes.