While eating too much food can cause obesity, the fear of not having enough food may lead to the same result, according to a study to be presented Saturday, April 28, at the Pediatric Academic Societies (PAS) annual meeting in Boston.

Being worried about not having enough food to feed one's family, a situation called food insecurity, is common in low-income families. These families often are overweight, too.

"Understanding the reasons why poverty puts families at greater risk of obesity is essential to addressing the epidemic," said study lead author Rachel Gross, MD, MS, FAAP, assistant professor in the Department of Pediatrics at Albert Einstein College of Medicine and The Children's Hospital at Montefiore in New York.

Dr. Gross and her colleagues at the New York University School of Medicine and Bellevue Hospital Center, interviewed 201 low-income mothers with infants younger than 6 months about their feeding styles (whether they tried to control how much the child ate), feeding practices (e.g., breastfeeding, adding cereal to bottles) and concerns about their child becoming overweight. Studies have shown that feeding patterns leading to obesity often begin in infancy.

The mothers primarily were Hispanic, and all participated in the Special Supplemental Food Program for Women, Infants and Children (WIC).

Results showed that about one-third of the mothers reported food insecurity.

"We found that food insecurity is related to controlling feeding practices, which have been shown to increase child obesity," Dr. Gross said. "These controlling feeding practices involved both restriction, in which parents limit the infant's intake even if the infant is hungry, and pressuring, in which the parent encourages the infant to eat more even if the infant is full."

It is believed that when mothers control what an infant eats, it may disrupt the child's ability to regulate his or her own hunger and fullness, leading to overeating and inappropriate weight gain, Dr. Gross explained.

Food-insecure mothers also were more concerned about their child becoming overweight than mothers who weren't worried about having enough food for their families.

"This work suggests that in addition to addressing hunger and malnutrition, it is critical that policy efforts be made to work with food-insecure families to prevent the opposite problem — obesity," Dr. Gross said.