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Difficulty buying food, BMI, and eating habits in young children


OBJECTIVES: To determine whether parent report of difficulty buying food was associated with child body mass index (BMI) z-score or with eating habits in young children.

METHODS: This was a cross-sectional study in primary care offices in Toronto, Ontario. Subjects were children aged 1–5 years and their caregivers, recruited through the TARGet Kids! Research Network from July 2008 to August 2011. Regression models were developed to test the association between parent report of difficulty buying food because of cost and the following outcomes: child BMI z-score, parent’s report of child’s intake of fruit and vegetables, fruit juice and sweetened beverages, and fast food. Confounders included child’s age, sex, birth weight, maternal BMI, education, ethnicity, immigration status, and neighbourhood income.

RESULTS: The study sample consisted of 3333 children. Data on difficulty buying food were available for 3099 children, and 431 of these (1 3.9%) were from households reporting difficulty buying food. There was no association with child BMI z-score (p = 0.86). Children from households reporting difficulty buying food (compared with never having difficulty buying food) had increased odds of consuming three or fewer servings of fruits and vegetables per day (odds ratio [OR]: 1.31, 95% confidence interval [CI]: 1.03–1.69), more than one serving of fruit juice/sweetened beverage per day (OR: 1.60, 95% CI: 1.28–2.00), and, among children 1–2 years old, one or more servings of fast food per week (OR: 2.91, 95% CI: 1.67–5.08).

CONCLUSION: Parental report of difficulty buying food is associated with less optimal eating habits in children but not with BMI z-score.


OBJECTIFS: Déterminer si la difficulté indiquée par les parents d’acheter des aliments est associée à l’écart Z de l’indice de masse corporelle (IMC) ou aux habitudes alimentaires des jeunes enfants.

MÉTHODE: Il s’agissait d’une étude transversale menée dans des cabinets de soins primaires de Toronto (Ontario). Elle portait sur des enfants de 1 à 5 ans et leurs proches aidants, recrutés par le réseau de recherche TARGet Kids! entre juillet 2008 et août 2011. Des modèles de régression ont été mis au point pour tester l’association entre la difficulté indiquée par les parents d’acheter des aliments en raison de leur coût et les résultats suivants: l’écart Z de l’IMC des enfants, et la consommation de fruits et légumes, de jus de fruits, de boissons édulcorées et d’aliments de restauration rapide par les enfants selon les parents. Les facteurs confusionnels étaient l’âge, le sexe et le poids de naissance des enfants, l’IMC maternel, l’instruction, l’ethnicité, le statut d’immigration et le revenu selon le quartier.

RÉSULTATS: L’échantillon de l’étude comprenait 3 333 enfants, dont 431 (14,09 %) provenaient de ménages dont les parents disaient avoir de la difficulté à acheter des aliments. Aucune association n’a été observée avec l’écart Z de l’IMC des enfants (p = 0,86). Les enfants des ménages disant avoir de la difficulté à acheter des aliments (comparativement à ceux des ménages n’ayant jamais de difficulté à acheter des aliments) présentaient une probabilité accrue de consommer trois portions de fruits et légumes par jour ou moins (rapport de cotes [RC]: 1,31, intervalle de confiance de 95 % [IC]: 1,03–1,69), de consommer plus d’une portion de jus de fruit ou de boissons édulcorées par jour (RC: 1,60, IC de 95 %: 1,28–2,00) et, chez les enfants de 1 à 2 ans, de consommer une portion ou plus d’aliments de restauration rapide par semaine (RC: 2,91, IC de 95%: 1,67–5,08).

CONCLUSION: La difficulté indiquée par les parents d’acheter des aliments est associée à des habitudes alimentaires sous-optimales chez les enfants, mais pas avec l’écart Z de l’IMC.

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Correspondence to Anne Fuller MD.

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Conflict of Interest: Parkin reports funding from Danone Institute of Canada (2002–2004, 2006–2009), Dairy Farmers of Ontario (2008–2010), and non-financial support from Mead Johnson Nutrition (2011–2017). Maguire and Parkin report funding from Dairy Farmers of Canada (2011–2013). These agencies had no role in the design, collection, analysis or interpretation of the results of this study or in the preparation, review or approval of the manuscript. The other authors have no conflict of interest to declare.

TARGet Kids! Collaboration Co-Leads: Catherine S. Birken, Jonathon L. Maguire; Advisory Committee: Eddy Lau, Andreas Laupacis, Patricia C. Parkin, Michael Salter, Peter Szatmari, Shannon Weir; Science Review and Management Committees: Laura N. Anderson, Cornelia M. Borkhoff, David W.H. Dai, Christine Kowal, Dalah Mason; Site Investigators: Murtala Abdurrahman, Barbara Anderson, Kelly Anderson, Gordon Arbess, Jillian Baker, Tony Barozzino, Sylvie Bergeron, Dimple Bhagat, Nicholas Blanchette, Gary Bloch, Joey Bonifacio, Ashna Bowry, Anne Brown, Jennifer Bugera, Caroline Calpin, Douglas Campbell, Sohail Cheema, Elaine Cheng, Brian Chisamore, Evelyn Constantin, Erin Culbert, Karoon Danayan, Paul Das, Mary Beth Derocher, Anh Do, Michael Dorey, Kathleen Doukas, Anne Egger, Allison Farber, Amy Freedman, Sloane Freeman, Sharon Gazeley, Charlie Guiang, Dan Ha, Shuja Hafiz, Curtis Handford, Laura Hanson, Leah Harrington, Hailey Hatch, Teresa Hughes, Sheila Jacobson, Lukasz Jagiello, Gwen Jansz, Mona Jasuja, Paul Kadar, Tara Kiran, Lauren Kitney, Holly Knowles, Bruce Kwok, Sheila Lakhoo, Margarita Lam-Antoniades, Eddy Lau, Fok-Han Leung, Alan Li, Patricia Li, Jennifer Loo, Joanne Louis, Sarah Mahmoud, Jessica Malach, Roy Male, Vashti Mascoll, Aleks Meret, Rosemary Moodie, JuliaMorinis,Maya Nader, Katherine Nash, Sharon Naymark, James Owen, Jane Parry,Michael Peer, Kifi Pena, Marty Perlmutar, Navindra Persaud, Andrew Pinto, Michelle Porepa, Vikky Qi, Nasreen Ramji, Noor Ramji, Jesleen Rana, Danyaal Raza, Alana Rosenthal, Katherine Rouleau, Janet Saunderson, Rahul Saxena, Vanna Schiralli, Michael Sgro, Hafiz Shuja, Susan Shepherd, Barbara Smiltnieks, Cinntha Srikanthan, Carolyn Taylor, Suzanne Turner, Fatima Uddin, Meta van den Heuvel, Joanne Vaughan, Thea Weisdorf, Sheila Wijayasinghe, Peter Wong, Anne Wormsbecker, Ethel Ying, Elizabeth Young, Michael Zajdman; Research Team: Farnaz Bazeghi, Vincent Bouchard, Marivic Bustos, Charmaine Camacho, Dharma Dalwadi, Christine Koroshegyi, Tarandeep Malhi, Sharon Thadani, Julia Thompson, Laurie Thompson; Project Team: Mary Aglipay, Imaan Bayoumi, Sarah Carsley, Katherine Cost, Karen Eny, Theresa Kim, Laura Kinlin, Jessica Omand, Shelley Vanderhout, Leigh Vanderloo; Applied Health Research Centre: Christopher Allen, Bryan Boodhoo, Olivia Chan, Judith Hall, Peter Juni, Gerald Lebovic, Karen Pope, Kevin Thorpe; Mount Sinai Services Laboratory: Rita Kandel.

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Fuller, A., Maguire, J.L., Carsley, S. et al. Difficulty buying food, BMI, and eating habits in young children. Can J Public Health 108, e497–e502 (2017).

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Key words

  • Child
  • obesity
  • diet
  • poverty
  • food supply

Mots clés

  • enfant
  • obésité
  • régime alimentaire
  • pauvreté
  • approvisionnement en nourriture