ASPO Abstracts
Changes in diet quality, energy intake, and the home food environment during an adolescent behavioral weight loss intervention differ by race and food security status
Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2020
Abstract Body:
Purpose: Racial minorities have greater obesity and cancer risk and often fare worse in obesity treatments. This secondary analysis examined if changes in the home food environment, dietary quality, and energy intake observed during adolescent obesity treatment differed by race and food security status, to explore potential reasons for these disparities.
Methods: Adolescent (N=82; 63% female; 66% non-White; 24% food insecure)/parent dyads were enrolled in a 4-mo behavioral weight loss treatment. Adolescents were taught empirically-supported strategies to adhere to personalized calorie and “go food” goals designed to create energy imbalance and increase diet quality. Parents were encouraged to make home food environment changes. At baseline and post-intervention, parents completed the Home Food Inventory (HFI), and adolescents completed a 3-day food recall; Nutrition Data Systems for Research calculated energy intake and Healthy Eating Index (HEI) scores. Race (White vs. Non-White) and food security (food secure vs. insecure) were reported at baseline. Mixed models analyzed HFI, HEI, and energy intake over the intervention period, by race and food security status.
Results: All adolescents, regardless of race or food security status, decreased energy intake (~300-400 kcal/day; p’s<.05). Diet quality improved for White and food secure (HEI [post-baseline]: 10.9±17.0, p=0.02; 6.9±15.7, p=.04; respectively), but not Non-White or food insecure adolescents (p’s>.05). The home food environment improved for both racial groups and food secure adolescents (HFI decreased; p’s<.01), but not for food insecure adolescents (p=.52). Improved home food environment was associated with improved diet quality and decreased energy intake for White (p’s<.05), but not Non-White (p’s>.05) adolescents. Improved home food environment was also associated with improved diet quality (p=.02), with a trend for decreased energy intake (p=.08), for food secure adolescents.
Conclusion: Improvements to the home food environment seemed challenging for food insecure families, which might contribute to poorer diet quality. While non-White adolescents made changes to the home food environment, this was not associated with diet outcomes. Implications for future interventions will be discussed.
Keywords: obesity treatment health disparities diet quality home food environment energy intake