The complex household food system: Mitigating factors in early childhood anemia

Date of Completion

January 2009


Health Sciences, Nutrition




Families living in poverty experience high rates of food insecurity leading to irregular household food supply, interrupted eating patterns, and poor diet quality. Food insecurity is linked to inadequate intake of key nutrients, behavioral and psychosocial dysfunction in children and adults, poor health in children, including iron deficiency anemia. The purpose of this research was to better understand the impact that changing food security (FS) and the household food environment have on dietary intake and health outcomes such as childhood anemia. Low-income families with children 2-5 years of age were recruited from family centers in low-income communities throughout Hartford, CT. Three home visits were conducted over a 4-week period (mean 10 days apart) and the US Household Food Security Survey (USHFSS), complete food inventory, and 24-hr food recall were collected at each visit. Hemoglobin was measured and medical charts reviewed for the presence and history of anemia. Sixty-nine families with 84 children met study criteria. Over one-third (38%) of families were food insecure (FI) in the prior year, and 37% of children recently experienced anemia. Children in FI families were more likely to be anemic than children from FS families (Odds Ratio = 6.14, [95% CI = 2.09 – 18.05], p<.01). Children in families with worsening FS (1-2 points) were more likely to be anemic than children in families with no change in FS (Odds Ratio = 32.6, [95% CI = 4.56 – 232.941, p<.01). Anemic children from FI families and children from households with worsening FS consumed less energy and carbohydrate compared to non-anemic children living in FS households. Total food inventory size was not significantly related to household FS nor worsening food security throughout the month. This is the first time FI variability has been linked to anemia and illustrates the relationship between FI and negative health outcomes. This finding has implications for the measurement schedule for the national USHFSS, and also for policies and programs designed to reduce FI. These findings also help develop an understanding of how low-income families maintain and utilize their available food inventory and can help researchers develop targeted food assistance programs that better meet the needs of low-income families. ^