Food insecurity, a household condition of limited food availability, affects 16 million US children today. Food- insecure children are at risk for adverse diet-related health conditions; however, the mechanisms underlying these associations have not been clearly identified. Chronic, psychological stress may represent an important pathway between food insecurity and childhood obesity. The effects of chronic stress on children's cognitive development and cardio-metabolic health have been well-documented. However, research of the psychological component of food insecurity is sparse. Understanding the psychosocial and cognitive mechanisms underlying children's experiences of food insecurity is important to inform the development of strategies to reduce children's food insecurity and its sequelae. I am pursuing a K99/R00 Pathway to Independence Award to fill critical training gaps in the areas of stress mechanisms and measurement, children's development of cognitive processes related to overeating, and causal mediation analysis. This award will build upon my advanced training as a nutrition epidemiologist and my prior research on the relations between participation in the federal food programs and diet-related chronic disease. The detailed training plan includes formal coursework at UCSF and UC Berkeley, meetings, seminars, readings, and research apprenticeships. The research component of my project will provide opportunities to integrate knowledge from these new areas. Through the proposed series of studies, I will test the hypothesis that household food insecurity increases children's psychological stress, which shapes their cognitive processes related to eating behaviors and food choice, and predicts subsequent weight gain. First, I will develop a measure to capture children's psychological stress of food insecurity, drawing from qualitative interviews with food-insecure children and existing measures of children's psychological stress. The measure's psychometric properties will be empirically tested in a separate sample of low-income children. Second, in a laboratory setting, I will determine the extent to which children's food insecurity-stress mediates the relationship between household food insecurity and children's cognitive processes related to overeating, using the newly developed measure. Finally, I will design and conduct a two- year longitudinal study to examine associations between household food insecurity and children's weight gain, and the extent to which this is mediated through the proposed pathway. This program of research will focus on children during the transition to adolescence (ages 8-12), a significant period for cognitive development and weight gain with lifelong implications. These findings will highlight a novel and important pathway to explain the adverse effects of food insecurity on children's developmental and diet-related outcomes. The proposed training plan and series of studies will provide me with a set of skills and expertise needed to successfully compete for funding as an independent investigator and to serve as a leader in developing interventions and policies to minimize food insecurity and promote health in low-income children.

Public Health Relevance

Food insecurity has been linked with adverse diet-related health outcomes in children; however, the mechanisms underlying these associations are not well-understood. This project will test the hypothesis that household food insecurity promotes children's psychological stress, which shapes their cognitive processes related to eating behaviors and food choice, predicting subsequent weight gain. The proposed research may hold particular promise for interventions and policies that simultaneously address food insecurity and promote children's health.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Career Transition Award (K99)
Project #
5K99HD084758-02
Application #
9123640
Study Section
Biobehavioral and Behavioral Sciences Subcommittee (CHHD)
Program Officer
Esposito, Layla E
Project Start
2015-08-10
Project End
2017-07-31
Budget Start
2016-08-01
Budget End
2017-07-31
Support Year
2
Fiscal Year
2016
Total Cost
Indirect Cost
Name
University of California San Francisco
Department
Psychiatry
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94118
Tester, June M; Phan, Thao-Ly T; Tucker, Jared M et al. (2018) Characteristics of Children 2 to 5 Years of Age With Severe Obesity. Pediatrics 141:
Leung, Cindy W; Tester, June M (2018) The Association between Food Insecurity and Diet Quality Varies by Race/Ethnicity: An Analysis of National Health and Nutrition Examination Survey 2011-2014 Results. J Acad Nutr Diet :
Leung, Cindy W; Fung, Teresa T; McEvoy, Claire T et al. (2018) Diet Quality Indices and Leukocyte Telomere Length Among Healthy US Adults: Data From the National Health and Nutrition Examination Survey, 1999-2002. Am J Epidemiol 187:2192-2201
Leung, Cindy; Tester, June; Laraia, Barbara (2017) Household Food Insecurity and Ideal Cardiovascular Health Factors in US Adults. JAMA Intern Med 177:730-732
Ryan-Ibarra, Suzanne; Sanchez-Vaznaugh, Emma V; Leung, Cindy et al. (2017) The relationship between food insecurity and overweight/obesity differs by birthplace and length of US residence. Public Health Nutr 20:671-677
Leung, Cindy W; Musicus, Aviva A; Willett, Walter C et al. (2017) Improving the Nutritional Impact of the Supplemental Nutrition Assistance Program:: Perspectives From the Participants. Am J Prev Med 52:S193-S198
Tester, June M; Leung, Cindy W; Leak, Tashara M et al. (2017) Recent Uptrend in Whole-Grain Intake Is Absent for Low-Income Adolescents, National Health and Nutrition Examination Survey, 2005-2012. Prev Chronic Dis 14:E55
Leung, Cindy W; Tester, June M; Rimm, Eric B et al. (2017) SNAP Participation and Diet-Sensitive Cardiometabolic Risk Factors in Adolescents. Am J Prev Med 52:S127-S137
Tester, June M; Laraia, Barbara A; Leung, Cindy W et al. (2016) Dyslipidemia and Food Security in Low-Income US Adolescents: National Health and Nutrition Examination Survey, 2003-2010. Prev Chronic Dis 13:E22
Prather, Aric A; Leung, Cindy W; Adler, Nancy E et al. (2016) Short and sweet: Associations between self-reported sleep duration and sugar-sweetened beverage consumption among adults in the United States. Sleep Health 2:272-276

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