Food Insecurity, Diet Quality, and Body Weight: Inter-Relationships and the Effect of Smoking and Alcohol Consumption

Using data from the 1999-2002 rounds of the continuous National Health and Nutrition Examination Survey (NHANES), the inter-relationships between food insecurity, diet quality and body mass index (BMI) were examined. The impact of smoking and alcohol consumption behaviors were also examined. The relationship between BMI and food insecurity was found to be sensitive to the specification of control variables, such as age, income, and race and ethnicity. Smoking was directly associated with lower BMI for both men and women; while alcohol consumption was directly associated with lower BMI only for men. Smoking negatively affected food insecurity and diet quality, as measured by the Healthy Eating Index (HEI). For women, these indirect effects were statistically significant and positive, but extremely small in magnitude compared to the direct effect. For both men and women, level of physical activity was found to be a much more important determinant of body weight than smoking, drinking, and food insecurity. For women, race had a more important impact on body weight than smoking or drinking.