Food Insecurity and Age of Menarche Using a Biocultural Approach and Life History Theory to Assess Risks of Food Insecurity among Girls in Tampa Bay, FL

摘要

Using life-history theory within a biocultural perspective, this research explores whether household food insecurity correlates with early or delayed menarche among adolescent females in Tampa Bay, Florida. Early onset of puberty and menstruation is connected with numerous health consequences including growth stunting, obesity, type-2 diabetes, adult-onset asthma, reproductive cancers, increased risk for depression, behavioral problems, and early sexual activity which increases the risk for STIs and ovarian cancer. Early menarche also seems to disproportionally impact disadvantaged and minority groups. While there are many known factors that influence age at menarche (e.g.: genetics, diet), little is understood regarding the effect of food insecurity on menstrual timing. When considering food insecurity as an environmental adversity, long-term exposure may result in biological trade-offs within growth and development.;Using a mixed-methods approach, 40 girls and 36 parents or guardians from Pinellas, Hillsborough, and Manatee counties participated in household dyadic interviews that included the assessment of household food security, girls' dietary analysis, and anthropometry. Using quantitative analyses, the associations of diet, food security, and body size/composition to menarche were evaluated. A Cox hazards model and regression further analyzed the association of food insecurity and the timing of menarche. The research concludes that adolescents and their families are vulnerable to food insecurity for both biological and social reasons. Qualitative results examine the prevalence, experiences, and perpetrators of food insecurity, as well as strategies used by families to mitigate food insecurity. Food insecurity in this study refers to the inconsistent or limited access to adequate amounts of safe and nutritious foods to sustain health and wellbeing. Food insecurity does not necessarily result in hunger. Once can have access to enough calories and not feel hungry but may still be food insecure if their access does not include enough high-quality, nutritious foods. Quantitative analyses showed that iliac height, waist-hip ratio, snack consumption, and household food insecurity is associated with age at menarche among this sample. Spearman's Rho confirms that height, leg length (p = 0.032, rs = 0.407), and snack consumption (p = 0.042, rs = 0.464) significantly positively correlate with age at menarche. Waist-hip ratio significantly negatively correlates with age at menarche (p = 0.032, rs = -0.518). Cox Hazard Regression analysis interprets that for every one unit increase in household food security survey score, the risk of experiencing menarche increases by 25% (p = 0.023, OR = 1.25). However, when adding leg length, waist-hip ratio, and snack consumption to the Cox Hazard Regression equation, no variables significantly predict menarche. These findings provide a better understanding of the biocultural influences within the timing of menarche. The research provides new insights and further stresses the importance of improving food assistance programs for adolescents and families with older children.