Use of four models to assess BMI differences among US adults by gender and household adult food security status

Using a sample of US adults 19 years and older (n=8,342) (NHANES, 1999–2000/2000–2001), this study examined: 1) differences in BMI by household adult food security status (FSS) using four models of reporting FSS [model 1(M1)‐fully food secure (FFS) vs. marginally food secure (MFS) vs. food insecure without hunger (FINH) vs. food insecure with hunger (FIH); model 2 (M2)‐FFS vs. MFS, FINH vs. FIH; model 3 (M3)‐FFS vs. any indication of food insecurity (MFS, FINH, FIH); model 4 (M4)‐food secure (FFS, MFS) vs. food insecure (FINH, FIH); 2) the proportions of weight status class (underweight, normal, overweight, class I obesity, class II obesity) for each model; and 3) the significance of gender in each of the four models for both BMI and weight class. Gender was a significant factor for each of the four models for both BMI and weight class (p<.05). M1 yielded differences in BMI for both males (p=.014) and females (p<.001). M2, M3, and M4 only yielded differences in BMI for females (M2, p<.001; M3, p<.001; M4, p=.008), rather than males (M2, M3, M4, p>.05). Both M1 and M4 yielded differences by weight status class, while M2 and M3 only yielded differences among females (p<.001), rather than for males (p>.05). M1 appears to be the most sensitive to identifying differences among both males and females for both BMI and weight class, supporting the need to further stratify FSS by inclusion of a MFS category when examining BMI and weight status.