Food Security, Diet and Caries Prevalence in Children Ages 2-<12

Background: Children with low food security (a measure of ability to access healthy food at all times) are more likely to have fair or poor health than children in food secure homes. The association of food security and caries is unknown.

Objective: To evaluate the associations of food security, diet quality and caries prevalence in children ages 2-<12.

Methods: Children ages 2-<6 (n= 801) and 6-<12 years (n=1097) from the 2001-2002 National Health and Nutrition Examination Survey (NHANES) who had dental exam, food security, and diet data were studied. The Revised Child Diet Quality Index (RC-DQI) was used to assess diet quality. Meal, snack and soda frequency were evaluated. Odds ratios (OR) and 95% confidence intervals (CI) were computed and adjusted for the complex sampling design, age, race, dental visit, poverty income ratio, family smoking and diet quality (SAS v. 9.1.3).

Results: In children ages 2-<6, caries prevalence was greater for food insecure than food secure children (38.2% vs. 23.0%, p=0.0037). Young food insecure children had 1.8 times greater odds of experiencing caries (95% CI 1.09, 2.97) than food secure children. Children with the best diet quality had lower odds of caries compared with those with the worst diet quality (OR=0.31, 95% CI 0.18, 0.56) Meal and soda frequency were significant in bivariate analyses but not in logistic regression models.

Food security status and diet quality were not associated with caries experience in permanent teeth in children 6-<12 in bivariate or logistic regression analyses. Eating breakfast was significant only in the bivariate analysis (p=0.0315) in the older children.

Conclusion: Child food security and diet quality are independently associated with caries prevalence in children ages 2-<6, though not with caries prevalence in permanent teeth in children ages 6-<12. Food insecurity can be considered a risk factor for early childhood caries.