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Application of Noninferiority Tests to Examine the Food Insecurity–Obesity Relationship in Children

ABSTRACT This study applies noninferiority testing to assess the relationship between child weight and food security status in a sample of 808 children between 3 and 5 years old who were attending an urban, state-funded preschool program. Most families were African American (72.3%). Analyses were conducted using noninferiority testing to evaluate the overweight–food security association. Odds of being overweight in the food insecure (FI) group were 0.643 (95% confidence interval [CI], 0.525 to 0.788) and odds from the food secure (FS) group were 0.570 (odds ratio [OR] = 1.127, 95% CI, 0.464 to 0.697, p = 0.004). These findings held across subgroups of gender, race, and family conflict. Children whose parents indicated education beyond high school showed a reversal with FI odds of overweight less than FS odds (OR = 0.663). As illustrated in this study, noninferiority testing provides an alternative analytic approach to examining the association between FI and weight in children.