Food insecurity and at-home vegetable and sugar-sweetened beverage availability: TX Sprouts randomized controlled trial

Food insecurity and the at-home availability of vegetables and sugar-sweetened beverages both influence dietary intake. However, most research on food insecurity and the at-home availability of vegetables and sugar-sweetened beverages is cross-sectional, which is problematic as both change frequently. Therefore, this study assessed how changes in food insecurity were associated with changes in the at-home availability of vegetables and sugar-sweetened beverages among those in the intervention and control groups of TX Sprouts. Parents who participated in TX Sprouts, a gardening, cooking, and nutrition cluster-randomized trial conducted with primarily Hispanic, low-income 3rd-5th-grade students, completed surveys at baseline and at the nine-month follow-up regarding household food insecurity and the at-home availability of vegetables and sugar-sweetened beverages (n = 839). Changes in food insecurity were measured as a continuous variable and categorized according to guidelines at baseline and follow-up. Given that the TX Sprouts intervention improved the at-home availability of vegetables, and there was a significant interaction between changes in food insecurity and the intervention on the at-home availability of vegetables, the intervention and control groups were analyzed separately. Multivariable linear regression estimated how changes in food insecurity, as a continuous measure, were associated with changes in vegetable and sugar-sweetened beverage availability among those in the intervention and control groups. Analysis of covariance was used to analyze how changes in food insecurity, as a categorical measure, were associated with changes in vegetable and sugar-sweetened beverage availability among those in the intervention and control groups. In the control group, a one-point increase in food insecurity, indicative of becoming more food insecure, was associated with a decrease in the availability of vegetables (ß=-0.27, P<.001). In the intervention group, a one-point increase in food insecurity was associated with an increase in the availability of sugar-sweetened beverages (ß =0.05, P=.03). Further, in the control group, those with periodic food insecurity had a larger decrease in the availability of sugar-sweetened beverages compared to those with persistent food security (P=.02). In addition, in the intervention group, households with persistent food security experienced an increase in at-home vegetable availability, while households with periodic (P=.02) and persistent food insecurity (P<.001) experienced a significant decrease in at-home vegetable availability. Future interventions should improve the availability of healthy items for food-insecure households.Clinical Trial Registration Number: NCT02668744. Clinical Trial Registry: https://clinicaltrials.gov/study/NCT02668744. First Registration Date: 01/29/2016.