Childhood food insecurity and incident asthma: A population-based cohort study of children in Ontario, Canada.
<h4>Background</h4>Childhood food insecurity has been associated with prevalent asthma in cross-sectional studies. Little is known about the relationship between food insecurity and incident asthma.<h4>Methods</h4>We used administrative databases linked with the Canadian Comm...
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Public Library of Science (PLoS)
2021-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0252301&type=printable |
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| author | Kristin K Clemens Britney Le Alexandra M Ouédraogo Constance Mackenzie Marlee Vinegar Salimah Z Shariff |
| author_facet | Kristin K Clemens Britney Le Alexandra M Ouédraogo Constance Mackenzie Marlee Vinegar Salimah Z Shariff |
| author_sort | Kristin K Clemens |
| collection | DOAJ |
| description | <h4>Background</h4>Childhood food insecurity has been associated with prevalent asthma in cross-sectional studies. Little is known about the relationship between food insecurity and incident asthma.<h4>Methods</h4>We used administrative databases linked with the Canadian Community Health Survey, to conduct a retrospective cohort study of children <18 years in Ontario, Canada. Children without a previous diagnosis of asthma who had a household response to the Household Food Security Survey Module (HFSSM) were followed until March 31, 2018 for new asthma diagnoses using a validated administrative coding algorithm. We used multivariable Cox proportional hazard models to examine the association between food insecurity and incident asthma, and adjusted models sequentially for clinical and clinical/socioeconomic risk factors. As additional analyses, we examined associations by HFSSM respondent type, severity of food insecurity, and age of asthma diagnosis. Moreover, we assessed for interaction between food security and child's sex, household smoking status, and maternal asthma on the risk of incident asthma.<h4>Results</h4>Among the 27,746 included children, 5.1% lived in food insecure households. Over a median of 8.34 years, the incidence of asthma was 7.33/1000 person-years (PY) among food insecure children and 5.91/1000 PY among food secure children (unadjusted hazard ratio [HR] 1.24, 95% CI 1.00 to 1.54, p = 0.051). In adjusted analyses associations were similar (HR 1.16, 95% CI 0.91 to 1.47, p = 0.24 adjusted for clinical risk factors, HR 1.24, 95% CI 0.97 to 1.60, p = 0.09 adjusted for clinical/socioeconomic factors). Associations did not qualitatively change by HFSSM respondent type, severity of food insecurity, and age of asthma diagnosis. There was no evidence of interaction in our models.<h4>Conclusions</h4>Food insecure children have numerous medical and social challenges. However, in this large population-based study, we did not observe that childhood food insecurity was associated with an increased risk of incident asthma when adjusted for important clinical and socioeconomic confounders. |
| format | Article |
| id | doaj-art-eece1270aa4b466f9ea9af1780c029f2 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj-art-eece1270aa4b466f9ea9af1780c029f22025-08-20T02:54:33ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01166e025230110.1371/journal.pone.0252301Childhood food insecurity and incident asthma: A population-based cohort study of children in Ontario, Canada.Kristin K ClemensBritney LeAlexandra M OuédraogoConstance MackenzieMarlee VinegarSalimah Z Shariff<h4>Background</h4>Childhood food insecurity has been associated with prevalent asthma in cross-sectional studies. Little is known about the relationship between food insecurity and incident asthma.<h4>Methods</h4>We used administrative databases linked with the Canadian Community Health Survey, to conduct a retrospective cohort study of children <18 years in Ontario, Canada. Children without a previous diagnosis of asthma who had a household response to the Household Food Security Survey Module (HFSSM) were followed until March 31, 2018 for new asthma diagnoses using a validated administrative coding algorithm. We used multivariable Cox proportional hazard models to examine the association between food insecurity and incident asthma, and adjusted models sequentially for clinical and clinical/socioeconomic risk factors. As additional analyses, we examined associations by HFSSM respondent type, severity of food insecurity, and age of asthma diagnosis. Moreover, we assessed for interaction between food security and child's sex, household smoking status, and maternal asthma on the risk of incident asthma.<h4>Results</h4>Among the 27,746 included children, 5.1% lived in food insecure households. Over a median of 8.34 years, the incidence of asthma was 7.33/1000 person-years (PY) among food insecure children and 5.91/1000 PY among food secure children (unadjusted hazard ratio [HR] 1.24, 95% CI 1.00 to 1.54, p = 0.051). In adjusted analyses associations were similar (HR 1.16, 95% CI 0.91 to 1.47, p = 0.24 adjusted for clinical risk factors, HR 1.24, 95% CI 0.97 to 1.60, p = 0.09 adjusted for clinical/socioeconomic factors). Associations did not qualitatively change by HFSSM respondent type, severity of food insecurity, and age of asthma diagnosis. There was no evidence of interaction in our models.<h4>Conclusions</h4>Food insecure children have numerous medical and social challenges. However, in this large population-based study, we did not observe that childhood food insecurity was associated with an increased risk of incident asthma when adjusted for important clinical and socioeconomic confounders.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0252301&type=printable |
| spellingShingle | Kristin K Clemens Britney Le Alexandra M Ouédraogo Constance Mackenzie Marlee Vinegar Salimah Z Shariff Childhood food insecurity and incident asthma: A population-based cohort study of children in Ontario, Canada. PLoS ONE |
| title | Childhood food insecurity and incident asthma: A population-based cohort study of children in Ontario, Canada. |
| title_full | Childhood food insecurity and incident asthma: A population-based cohort study of children in Ontario, Canada. |
| title_fullStr | Childhood food insecurity and incident asthma: A population-based cohort study of children in Ontario, Canada. |
| title_full_unstemmed | Childhood food insecurity and incident asthma: A population-based cohort study of children in Ontario, Canada. |
| title_short | Childhood food insecurity and incident asthma: A population-based cohort study of children in Ontario, Canada. |
| title_sort | childhood food insecurity and incident asthma a population based cohort study of children in ontario canada |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0252301&type=printable |
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