Skip to main content

Advertisement

Log in

Federal Food Assistance Programs and Cardiovascular Risk Factors in Low-Income Preschool Children

  • Original Paper
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

Childhood obesity remains a significant public health concern. Children from lower income households have a greater risk of being obese. Low-income families generally have less access to healthy, affordable food choices and turn to federal food assistance programs. Few studies have examined the impact of food assistance programs on childhood obesity rates. This study explored the association between BMI, blood lipid levels, and three food assistance programs (WIC, reduced lunch, and food stamps) in a sample of predominantly low-income, minority preschool children enrolled in a city-wide preschool program. Screenings were performed at on-site health fairs conducted at nine schools in disadvantaged areas. Screenings included vital signs, a finger stick, head-to-toe exam, vision screening, dental screening, and hearing screening. Of the sample of 229 preschool children, 23.1 % were obese, almost three times the national rate in preschoolers. Children whose families received WIC benefits weighed significantly less than those who did not receive benefits. In addition, 20.6 % of the children screened had elevated systolic blood pressures. Of the sample, 33 % had unhealthy triglyceride levels and 46 % had unhealthy HDL levels with those that received WIC benefits having significantly lower levels of LDL cholesterol This study confirms that low-income, minority children in the South continue to be disproportionately affected by overweight and obesity. In addition, the results of this study indicate WIC as a potential public health initiative to combat the childhood obesity epidemic and reduce other cardiovascular risk factors, such as blood lipids and blood pressure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Hoyert, D. L., & Xu, J. (2012). Deaths: Preliminary data for 2011. National Vital Statistics Reports: From the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, 61(6), 1–51.

    Google Scholar 

  2. Brogan, K., Danford, C., Yeh, Y., & Jen, K. L. (2014). Cardiovascular disease risk factors are elevated in urban minority children enrolled in head start. Childhood Obesity (Print), 10(3), 207–213. doi:10.1089/chi.2013.0146.

    Google Scholar 

  3. Nadeau, K. J., Maahs, D. M., Daniels, S. R., & Eckel, R. H. (2011). Childhood obesity and cardiovascular disease: Links and prevention strategies. Nature Reviews. Cardiology, 8, 513–525. doi:10.1038/nrcardio.2011.86.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA, 311, 806–814. doi:10.1001/jama.2014.732.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Centers for Disease Control and Prevention. (2013). Vital signs: Obesity among low-income, preschool-aged children-United States, 2008–2011. MMWR. Morbidity and Mortality Weekly Report, 62, 629–634.

    Google Scholar 

  6. Nader, P. R., O’Brien, M., Houts, R., Bradley, R., Belsky, J., Crosnoe, R., et al. (2006). Identifying risk for obesity in early childhood. Pediatrics, 118, e594–e601.

    Article  PubMed  Google Scholar 

  7. Maximova, K., Chiolero, A., O’Loughliin, J., Tremblay, A., Lambert, M., & Paradis, G. (2011). Ability of different adiposity indicators to identify children with elevated blood pressure. Journal of Hypertension, 29, 2075–2083. doi:10.1097/HJH.0b013e32834be614.

    Article  CAS  PubMed  Google Scholar 

  8. Freedman, D. S., Kahn, H. S., Mei, Z., Grummer-Strawn, L. M., Dietz, W. H., Srinivasan, S. R., & Berenson, G. S. (2007). Relation of body mass index and waist-to-height ratio to cardiovascular disease risk factors in children and adolescents: The Bogalusa heart study. The American Journal of Clinical Nutrition, 86, 33–40.

    CAS  PubMed  Google Scholar 

  9. Freedman, D. S., Dietz, W. H., Srinivasan, S. R., & Berenson, G. S. (1999). The relation of overweight to cardiovascular risk factors among children and adolescents: The Bogalusa heart study. Pediatrics, 103(6 Pt 1), 1175–1182.

    Article  CAS  PubMed  Google Scholar 

  10. Gopinath, B., Baur, L. A., Garnett, S., Pfund, N., Burlutsky, G., & Mitchell, P. (2011). Body mass index and waist circumference are associated with blood pressure in preschool-aged children. Annals of Epidemiology, 21, 351–357. doi:10.1016/j.annepidem.2011.02.002.

    Article  PubMed  Google Scholar 

  11. Williams, C. L., Strobino, B., Bollella, M., & Brotanek, J. (2004). Body size and cardiovascular risk factors in a preschool population. Preventive Cardiology, 7(3), 116–121.

    Article  PubMed  Google Scholar 

  12. Bao, W., Threefoot, S. A., Srinivasan, S. R., & Berenson, G. S. (1995). Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: The Bogalusa heart study. American Journal of Hypertension, 8, 657–665.

    Article  CAS  PubMed  Google Scholar 

  13. Drewnowski, A., Rehm, C., Kao, C., & Goldstein, H. (2009). Poverty and childhood overweight in california assembly districts. Health & Place, 15, 631–635. doi:10.1016/j.healthplace.2008.09.008.

    Article  Google Scholar 

  14. Singh, G. K., Siahpush, M., & Kogan, M. D. (2010). Rising social inequalities in US childhood obesity, 2003–2007. Annals of Epidemiology, 20, 40–52. doi:10.1016/j.annepidem.2009.09.008.

    Article  PubMed  Google Scholar 

  15. Skelton, J. A., Cook, S. R., Auinger, P., Klein, J. D., & Barlow, S. E. (2009). Prevalence and trends of severe obesity among US children and adolescents. Academic Pediatrics, 9(5), 322–329. doi:10.1016/j.acap.2009.04.005.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2012). Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA, 307, 483–490. doi:10.1001/jama.2012.40.

    Article  PubMed  Google Scholar 

  17. Ogden, C. L., Flegal, K. M., Carroll, M. D., & Johnson, C. L. (2002). Prevalence and trends in overweight among US children and adolescents, 1999–2000. JAMA, 288, 1728–1732.

    Article  PubMed  Google Scholar 

  18. Grunbaum, J. A., Kann, L., Kinchen, S. A., Williams, B., Ross, J. G., Lowry, R., & Kolbe, L. (2002). Youth risk behavior surveillance—United States, 2001. Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, D.C.), 51(4), 1–62.

    Google Scholar 

  19. Siega-Riz, A. M., Kranz, S., Blanchette, D., Haines, P. S., Guilkey, D. K., & Popkin, B. M. (2004). The effect of participation in the WIC program on preschoolers’ diets. The Journal of Pediatrics, 144, 229–234. doi:10.1016/j.jpeds.2003.10.052.

    Article  PubMed  Google Scholar 

  20. Kimbro, R. T., & Rigby, E. (2010). Federal food policy and childhood obesity: A solution or part of the problem? Health Affairs (Project Hope), 29, 411–418. doi:10.1377/hlthaff.2009.0731.

    Article  Google Scholar 

  21. Emerson, J. S., Towns, D. R., Jones, J. L., Cain, V. A., & Hull, P. C. (2015). Racial/ethnic and weight status differences in food preparation among WIC participants. Journal of Health Care for the Poor and Underserved, 26, 335–344. doi:10.1353/hpu.2015.0044.

    Article  PubMed  Google Scholar 

  22. Chiasson, M. A., Findley, S. E., Sekhobo, J. P., Scheinmann, R., Edmunds, L. S., Faly, A. S., & McLeod, N. J. (2013). Changing WIC changes what children eat. Obesity, 21, 1423–1429. doi:10.1002/oby.20295.

    Article  CAS  PubMed  Google Scholar 

  23. Dinour, L. M., Bergen, D., & Yeh, M. C. (2007). The food insecurity–obesity paradox: A review of the literature and the role food stamps may play. Journal of the American Dietetic Association, 107, 1952–1961.

    Article  PubMed  Google Scholar 

  24. Hofferth, S. L., & Curtin, S. (2005). Poverty, food programs, and childhood obesity. Journal of Policy Analysis and Management: [The Journal of the Association for Public Policy Analysis and Management], 24, 703–726.

    Article  Google Scholar 

  25. American Diabetes Association. (2004). Screening for type 2 diabetes. Diabetes Care, 27(supp11), S11–S14.

    Google Scholar 

  26. Centers for Disease Control and Prevention. (2011). Children’s BMI tool for schools—assessing your weight: Children’s BMI tool for schools. Retrieved from http://www.cdc.gov/healthyweight/assessing/bmi/childrens_BMI/tool_for_schools.html.

  27. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. (2004). The fourth report on the diagnosis, evaluation and treatment of high blood pressure in children and adolescents. Pediatrics, 114, 555–576.

    Article  Google Scholar 

  28. National Cholesterol Education Program Expert Panel on Blood Cholesterol Levels in Children and Adolescents. (1992). National cholesterol education program (NCEP): Highlights of the report of the expert panel on blood cholesterol levels in children and adolescents. Pediatrics, 89, 495–501.

    Google Scholar 

  29. He, J., & Whelton, P. K. (1999). Elevated systolic blood pressure and risk of cardiovascular and renal disease: Overview of evidence from observational epidemiologic studies and randomized controlled trials. American Heart Journal, 138(3 Pt 2), 211–219.

    Article  CAS  PubMed  Google Scholar 

  30. Rosner, B., Cook, N., Portman, R., Daniels, S., & Falkner, B. (2009). Blood pressure differences by ethnic group among united states children and adolescents. Hypertension, 54, 502–508. doi:10.1161/HYPERTENSIONAHA.109.134049.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Simonetti, G. D., Schwertz, R., Klett, M., Hoffmann, G. F., Schaefer, F., & Wuhl, E. (2011). Determinants of blood pressure in preschool children: The role of parental smoking. Circulation, 123(3), 292–298. doi:10.1161/CIRCULATIONAHA.110.958769.

    Article  PubMed  Google Scholar 

  32. Gordon, T., Castelli, W. P., Hjortland, M. C., Kannel, W. B., & Dawber, T. R. (1977). High density lipoprotein as a protective factor against coronary heart disease. The Framingham study. The American Journal of Medicine, 62, 707–714.

    Article  CAS  PubMed  Google Scholar 

  33. Castelli, W. P., Garrison, R. J., Wilson, P. W., Abbott, R. D., Kalousdian, S., & Kannel, W. B. (1986). Incidence of coronary heart disease and lipoprotein cholesterol levels. The Framingham study. JAMA, 256, 2835–2838.

    Article  CAS  PubMed  Google Scholar 

  34. Wilson, P. W., Abbott, R. D., & Castelli, W. P. (1988). High density lipoprotein cholesterol and mortality. The Framingham heart study. Arteriosclerosis, 8, 737–741.

    Article  CAS  PubMed  Google Scholar 

  35. Austin, M. A., Hokanson, J. E., & Edwards, K. L. (1998). Hypertriglyceridemia as a cardiovascular risk factor. The American Journal of Cardiology, 81(4A), 7B–12B.

    Article  CAS  PubMed  Google Scholar 

  36. Sarwar, N., Danesh, J., Eiriksdottir, G., Sigurdsson, G., Wareham, N., Bingham, S., & Gudnason, V. (2007). Triglycerides and the risk of coronary heart disease: 10,158 incident cases among 262,525 participants in 29 western prospective studies. Circulation, 115, 450–458.

    Article  CAS  PubMed  Google Scholar 

  37. Hulley, S. B., Rosenman, R. H., Bawol, R. D., & Brand, R. J. (1980). Epidemiology as a guide to clinical decisions. The association between triglyceride and coronary heart disease. The New England Journal of Medicine, 302, 1383–1389. doi:10.1056/NEJM198006193022503.

    Article  CAS  PubMed  Google Scholar 

  38. Bitler, M. P., Currie, J., & Scholz, J. K. (n.d.). WIC eligibility and participation. Retrieved from http://www.princeton.edu/~jcurrie/publications/WIC_Eligibility.pdf.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Paige Johnson.

Ethics declarations

Conflict of interest

The authors have no actual or potential conflict of interests that need to be disclosed.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Johnson, P., Montgomery, M. & Ewell, P. Federal Food Assistance Programs and Cardiovascular Risk Factors in Low-Income Preschool Children. J Community Health 41, 626–634 (2016). https://doi.org/10.1007/s10900-015-0138-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-015-0138-6

Keywords

Navigation