Food security and trajectories of childhood overweight: Results from the Growing Up in Scotland Study

BACKGROUND: Inequalities in childhood obesity have widened since 2010 in Scotland, raising concerns for future adult and child health. Increasing food insecurity may contribute to the trend, however evidence for an association with childhood overweight is mixed. We estimate the association between food insecurity and trajectories of overweight among primary school aged children in Scotland. METHODS: Data were from 1824 children in the Growing Up in Scotland Study, a nationally representative cohort born 2004/5. Height and weight were measured at ages 4, 6, 8 and 10 years, and classified as overweight/obese using age and sex standardised cut-offs. Observed trajectories included: never, always, increasing, decreasing, and mixed patterns of overweight (including obesity). Associations between household food insecurity, measured at age 2, and overweight trajectory were estimated using multinomial regression (never overweight as baseline), adjusted for area deprivation, lone parenting, and mother education. RESULTS: Most children were never overweight (54.8%), while 12.6% were overweight throughout. Children with high household food insecurity (6.2%) had nearly twice the risk of experiencing persistent overweight (including obesity) than those with no food insecurity (RRR 1.84, 95% CI 1.02-3.30). Additional analysis showed an even larger association for persistent obesity (RRR 2.53, 95% CI 1.06-6.08). Risk of experiencing increasing, decreasing or mixed patterns of overweight were also elevated. Associations were similar for boys and girls. CONCLUSIONS: Food insecurity is associated with persistent childhood overweight and obesity. The cost-of-living crisis has exacerbated barriers to accessing healthy, nutritious food. Interventions to tackle childhood food security are vital to avoid storing up future health inequalities. KEY MESSAGES: • The cost-of-living crisis is exacerbating food insecurity among UK families. • Food insecurity is associated with persistent overweight and obesity during childhood in Scotland.