Food insufficiency, Supplemental Nutrition Assistance Program status, and variability in weight and body composition: Longitudinal analysis of the National Health and Aging Trends Study Cohort 2012–2021

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS American Journal of Clinical Nutrition Pub Date : 2025-02-01 DOI:10.1016/j.ajcnut.2024.11.025

Muzi Na , Martin J Sliwinski , Penny M Kris-Etherton

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Abstract

Background

The impact of food insecurity and food assistance programs on long-term body weight and composition is unclear.

Objectives

The aim of the study was to investigate the associations between baseline and duration of food insufficiency (FI), the Supplemental Nutrition Assistance Program (SNAP) status, and variability in weight, BMI, and waist circumference (WC).

Methods

Data from 3897 eligible Medicare beneficiaries aged ≥ 65 y recruited in the National Health and Aging Trends Study (2012–2021) were analyzed. At baseline, SNAP status was assessed. With repeated measurements over follow-up, baseline FI status, years with FI experience (nFI), 3 variability metrics for weight, BMI, and WC [i.e. SD, coefficient of variation (CV), root mean squared error (RMSE)] and 4 patterns (stable, loss, gain and cycling) were defined. Partial proportional-odds generalized ordered logit models and multinomial logistic regression models were fit to investigate the association between FI status, nFI, and SNAP status and quartiles of variability metrics and patterns, respectively.

Results

The median (IQR) follow-up years was 8 (4, 9). Per 1-unit increase in the nFI, older adults had significantly higher variability in BMI (OR: 1.08–1.10), weight (OR: 1.14–1.15), and waist circumference (OR: 1.11–1.27) by SD, CV, and RMSE. SNAP participants did not differ from eligible nonparticipants in any variability metrics. Older adults with FI at baseline were 2.72 times (95% CI: 1.32, 5.58) more likely to gain weight. Relative risk of weight loss (RRR: 1.29; 95% CI: 1.06, 1.56), gain (RRR: 1.34; 95% CI: 1.09, 1.65), or cycling (RRR: 1.27; 95% CI: 1.04, 1.21) increased per 1-unit increase in nFI. SNAP participants did not differ in BMI, weight, or WC patterns from eligible nonparticipants.

Conclusions

Recurring food insecurity is associated with variability in older adults’ weight and body composition. Additional interventions beyond SNAP are needed to prevent food insecurity and instability in body weight and composition.

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食物不足，SNAP状态和体重和身体组成的变异性：2012 - 2021年国家健康和老龄化趋势研究队列的纵向分析

背景：粮食不安全和粮食援助计划对长期体重和成分的影响尚不清楚。目的：探讨基线和食物不足持续时间、补充营养援助计划（SNAP）状态与体重、BMI和腰围（WC）变化之间的关系。方法：分析全国健康与老龄化趋势研究（2012-2021）招募的3897名年龄≥65岁的符合条件的医疗保险受益人的数据。在基线时，评估SNAP状态。通过在随访中重复测量，定义了基线食物不足（FI）状况、FI经验年数（nFI）、体重、BMI和WC的三个变异性指标（即标准差（SD）、变异系数（CV）、均方根误差（RMSE））和四种模式（稳定、损失、增加和循环）。拟合偏比例-odds广义有序logit模型和多项逻辑回归模型，分别研究了FI状态、nFI状态和SNAP状态与变异指标和模式四分位数之间的关系。结果：中位[IQR]随访时间为8年[4,9]。nFI每增加一个单位，老年人的BMI （OR: 1.08 - 1.10）、体重（OR = 1.14-1.15）和腰围（OR = 1.11 - 1.27）的标准差、CV和RMSE均显著增加。SNAP参与者与符合条件的非参与者在任何变异性指标上没有差异。在基线时患有FI的老年人体重增加的可能性是前者的2.72倍（95%CI: 1.32, 5.58）。nFI每增加一个单位，体重减轻（RRR = 1.29, 95%CI: 1.06, 1.56）、体重增加（RRR = 1.34, 95%CI: 1.09, 1.65）或循环（RRR = 1.27, 95%CI: 1.04, 1.21）的相对风险增加。SNAP参与者与符合条件的非参与者在BMI、体重或WC模式上没有差异。结论：反复出现的粮食不安全与老年人体重和身体成分的变化有关。除了SNAP之外，还需要采取其他干预措施，以防止粮食不安全和体重和体质不稳定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Clinical Nutrition 医学-营养学

CiteScore

12.40

自引率

4.20%

发文量

332

审稿时长

38 days

期刊介绍： American Journal of Clinical Nutrition is recognized as the most highly rated peer-reviewed, primary research journal in nutrition and dietetics.It focuses on publishing the latest research on various topics in nutrition, including but not limited to obesity, vitamins and minerals, nutrition and disease, and energy metabolism. Purpose: The purpose of AJCN is to: Publish original research studies relevant to human and clinical nutrition. Consider well-controlled clinical studies describing scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention or health benefits. Encourage public health and epidemiologic studies relevant to human nutrition. Promote innovative investigations of nutritional questions employing epigenetic, genomic, proteomic, and metabolomic approaches. Include solicited editorials, book reviews, solicited or unsolicited review articles, invited controversy position papers, and letters to the Editor related to prior AJCN articles. Peer Review Process: All submitted material with scientific content undergoes peer review by the Editors or their designees before acceptance for publication.