Low-income households, including those of racial and ethnic minority groups, are at higher risk of experiencing food insecurity (FI), or inconsistent access to sufficient quantities of nutritionally adequate food. FI is a significant contributor to health disparities and high obesity rates among adults in the U.S. In this proposal, we seek to understand how FI affects what mothers feed to their infants. Mothers or caretakers, who generally play a key role in managing their household food budgets, buy cheaper foods to maintain satiety and prevent hunger on a limited budget. These cheaper foods are generally high in calories and saturated fats, and low in fiber. Hence, paradoxically, FI and obesity co-exist among caretakers. Although mothers generally govern infant feeding practices, how maternal FI influences feeding choices from early to late infancy is less clear. This is critical because feeding practices determine energy intake and growth rate during infancy, which in turn, predict the risk for obesity. Infants who gain excessive weight during the first year of life are at higher risk of becoming obese children and adults later in life. The overall goal of this longitudinal study is to identify and characterize the relationships between maternal FI, feeding choices and, ultimately, weight gain during infancy. Our central hypothesis is that mothers? FI or anxiety about food availability, and preoccupation in preventing/managing food shortage and hunger, lead to infant feeding practices that cause high energy intake, cyclical feeding patterns, and ultimately excess weight gain among their infants. To test this hypothesis and achieve our overall goal, we propose the following Specific Aims: 1) Determine associations between maternal FI and initiation and intensity of breastfeeding among infants; 2) Determine associations between maternal FI and feeding choices and daily energy intake during infancy; 3) Determine associations between maternal FI and disrupted feeding patterns during infancy, and; 4) Determine associations between maternal FI and rate of weight gain and weight status during infancy. Study participants will be low-income mother-and- infant dyads (n = 240), recruited from the pediatric clinic in the study area. Mothers will be interviewed by trained research staff when their infants are 2, 4, 6, 9 and 12 months old, to collect information on FI and feeding choices, including daily energy intake among infants. Information will also be collected to assess occurrence of any feeding shortages and inconsistent feeding due to limited availability of formula and other foods. In addition, weight and length of the infants will be retrieved from medical records to estimate rate of weight gain during infancy. The results of this study, targeting low-income and minority mothers and infants, will inform the importance of addressing FI in reducing childhood obesity. Further, this R15 proposal will help to strength the research environment at our institution and provide students with meaningful research experiences.
The proposed research is relevant to public health because the discovery of the role of food insecurity in predicting infant feeding practices and weight gain trajectory is expected to help control the obesity epidemic, the most wide-spread nutritional disease in the U.S. As a result, this research is relevant to NIH?s mission to reduce the epidemic of obesity and related health problems such as diabetes, cardiovascular disease and hypertension in the U.S. population.
