Knowledge Bank

Rates of childhood overweight and obesity continue to be high, particularly among rural Appalachian children and adolescents. Specific information about current eating behaviors and their relationship to possible economic barriers is necessary to develop interventions and educational programs that will effectively reduce rates of overweight and improve the health of Appalachian children and adolescents. This study aims to elucidate the interrelationships between food security, dietary patterns and overweight among Appalachian adolescents. Students in the ninth grade at participating southeastern Ohio high schools were recruited for this study. Students and their parents or primary caregivers completed surveys and participated in focus groups. All surveys asked for demographic information as well as weight and height, which were used to calculate weight status. Student surveys included the Early Childhood Longitudinal Study Food Frequency Questionnaire and the physical activity questions from the 2003-2004 National Health and Nutrition Examination Study. Parent surveys included the U.S. Household Food Security Survey Module Short Form, used to assess food security status, in addition to questions on income and educational attainment. Separate focus groups for students and parents were conducted to probe participants for their perceptions of healthy weight, healthy diet and barriers to health. Data was collected from eight student-caregiver pairs at three Appalachian Ohio high schools. Overweight and obesity were found to be widespread among both adolescents and adults, although food insecurity was not prevalent in this sample. Overweight in adolescents does not appear to be linked to household food insecurity. Fast food, snack and sugar-sweetened beverage consumption were high among adolescents, while fruit and vegetable consumption was low. In focus groups, lack of time, desire and ability to prepare healthy meals along with the greater availability of unhealthy foods were cited as barriers to consuming a more nutritious diet. Further research is needed to elaborate on these relationships and determine the most promising areas for intervention.