Food Insecurity, Parental, and infant Weight Status in the First 1000 Days

Childhood obesity is prevalent, and children in low-income households are disproportionately impacted. The first 1,000 days is well established as a critical period of growth and development. Little is known about the link between food insecurity and childhood obesity risk factors during the first 1,000 days. The study objective is to quantify the cross-sectional relationships of food insecurity with maternal and infant weight parameters during the first 1,000 days that are known to increase risk of childhood obesity. We studied 394 families with a pregnant woman and/or infant under 2 years enrolled in a multi-site Special Supplemental Nutrition Program for Women, Infants, and Children program (WIC) in New York City. After obtaining written, informed consent, staff administered 2-item hunger vital sign screening questionnaire and measured maternal/infant weight, height or recumbent length. We defined maternal excess gestational weight gain based on IOM criteria. For postpartum parental weight outcomes, we examined continuous body mass index (BMI) (kg/m^2) and categorical BMI as healthy BMI (8 to \u3c25), overweight BMI (25 to \u3c30), and obese BMI (30 or greater) (CDC guidelines). For infant weight outcomes, we examined age-adjusted, sex-specific weight -for- length z-scores using WHO growth charts, and defined high infant weight-for-length as z-score that is greater than 2. Food insecurity was defined a response other than never to either screening question. Median parental age was 29 years; 99% were female; 94% were Hispanic/Latino; and 39% had annual household income \u3c$15,000. 249 families had food insecurity. Among the 122 pregnant women, 26% had excess gestational weight gain. Among the 272 postpartum parents, mean BMI was 29.3±6, 28% had overweight, and 45% had obesity. 18% of infants had high infant weight-for-length. Although a higher proportion of women with food insecurity in pregnancy had excess gestational weight gain compared to food secure counterparts, findings were not statistically significant (29% v 22%, p\u3e0.05). Among postpartum parents, 69% with food insecurity had overweight or obesity compared to 79% without food insecurity (p\u3e0.05). For infants, those in households with food insecurity had median weight-for-length +0.84 z-score units while those in food secure households had median weight-for-length +1.02 z-score units (p-value =0.06). In this sample of 394 low-income families, over half of the population had food insecurity despite WIC enrollment. Excess parental weight and high infant weight-for-length were prevalent. Interventions to reduce food insecurity and promote healthy pregnancy and infant weight status should include WIC-enrolled familie