Food Insecurity Is Associated with Increased Risk of Obesity in California Women

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Abstract
Food insecurity, the limited or uncertain availability of nutritionally adequate and safe foods, may be associated with disordered eating and a poor diet, potentially increasing risk for obesity and health problems. Patterns of food insecurity in California women are described and relationships between food insecurity and obesity (body mass index ≥ 30 kg/m2) are evaluated using data from the 1998 and 1999 California Women's Health Survey. A total of 8169 women aged ≥ 18 y were randomly selected and interviewed by telephone. Food insecurity was evaluated by use of four questions adapted from the U.S. Household Food Security Module. Logistic regression was used to examine the relationship between food insecurity and obesity, controlling for income, race/ethnicity, education, country of birth, general health status and walking. Food insecurity without hunger affected 13.9% of the population and food insecurity with hunger, 4.3%. Almost one fifth (18.8%) of the population was obese. Obesity was more prevalent in food insecure (31.0%) than in food secure women (16.2%). Food insecurity without hunger was associated with increased risk of obesity in whites [odds ratio (OR) = 1.36] and others (OR = 1.47). Food insecurity with hunger was associated with increased risk of obesity for Asians, Blacks and Hispanics (OR = 2.81) but not for non-Hispanic Whites (OR = 0.82). Food insecurity is associated with increased likelihood of obesity and risk is greatest in nonwhites.