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Lamont A, Speed D. Food insecurity and body dissatisfaction in a sample of Canadian adults. J Health Psychol 2024:13591053241242342. [PMID: 38566401 DOI: 10.1177/13591053241242342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Food insecurity may predict poorer body image, which is associated with increased risk of mental health problems. However, minimal attention has been given to the food insecurity-body image link and to factors that may influence this link, such as assigned sex; importantly, females are more likely to experience both food insecurity and body dissatisfaction. The present study used data from the 2017 to 2018 Canadian Community Health Survey (N = 32,017) to investigate the effects of food insecurity and sex on body satisfaction via generalized ordered logistic regression. Results indicated: (1) Food insecurity predicted lower odds of body satisfaction, (2) Males were more likely than females to be satisfied with their bodies, and (3) Food insecurity no longer predicted body satisfaction following the inclusion of sex. Findings suggest the association between food insecurity and body satisfaction may largely be driven by the link between food insecurity and sex. Further investigation is warranted.
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Affiliation(s)
| | - David Speed
- University of New Brunswick - Saint John, Canada
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Ganson KT, Pang N, Testa A, Jackson DB, Nagata JM. Food insecurity is associated with muscle dysmorphia symptomatology among a sample of Canadian adolescents and young adults. Body Image 2023; 47:101628. [PMID: 37738777 DOI: 10.1016/j.bodyim.2023.101628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 09/24/2023]
Abstract
Prior research has documented the association between food insecurity and eating disorders, disordered eating behaviors, and body dissatisfaction. No known research has investigated whether food insecurity is associated with muscle dysmorphia symptomatology, which was the aim of this study. Data from 912 adolescents and young adults in Canada were analyzed. Linear regression analyses were used to determine the association between experiencing past year food insecurity and current muscle dysmorphia symptomatology. Among the sample, 15.7% reported experiencing any food insecurity. In regression analyses, food insecurity was significantly associated with greater overall muscle dysmorphia symptomatology and symptoms of Functional Impairment and Appearance Intolerance. Nearly one in five (18.5%) participants who reported food insecurity were at clinical risk for muscle-dysmorphia. Findings add to the growing literature on the adverse correlates of food insecurity and underscore the need for more research and intervention efforts to address the relationship between food insecurity and muscle dysmorphia symptomatology.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
| | - Nelson Pang
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
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Kells MR, Davis HA, Todorov S, Wildes JE. Health literacy and eating disorder pathology in women with food insecurity: A preliminary cross-sectional study. Eat Behav 2023; 49:101727. [PMID: 37099830 DOI: 10.1016/j.eatbeh.2023.101727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/28/2023] [Accepted: 04/05/2023] [Indexed: 04/28/2023]
Abstract
Food insecurity (FI), or limited consistent access to food, is associated with eating disorder (ED) pathology; however, the underlying mechanisms of this relationship remain unclear. Health literacy, or the ability to comprehend and apply health-related information to decision making, is linked to FI and has implications for outcomes across a broad range of diagnoses. The purpose of this study was to examine associations between health literacy and ED symptoms in a sample of 99 women with FI. Linear regression tested cross-sectional associations between scores on The Newest Vital Sign (NVS), a measure of health literacy, and scores on the Eating Pathology Symptom Inventory (EPSI) and behaviors reported in the Eating Disorder Diagnostic Interview (EDDI). Logistic regression examined the likelihood of ED diagnosis in relation to NVS score. The sample mean (SD) age was 40.3 (14.3) years, and participants self-identified as 54.5 % White, 30.3 % Black, and 13.8 % other. Respondents self-reported 13.1 % marginal, 28.3 % low, and 58.6 % very low food security. Mean NVS score was 4.45, and significantly higher for White compared to Black individuals (F = 3.96, p = .02, η2 = 0.76), but not between other groups. No difference in NVS score by FI status was observed. EPSI Body Dissatisfaction was positively associated with NVS score. No associations were found between remaining EPSI subscales, eating behaviors, or ED diagnosis. White women, but not other groups, were found to have significant negative relationship between NVS and EPSI restricting. Future longitudinal research including components of health literacy related to eating in individuals with FI is warranted.
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Affiliation(s)
- Meredith R Kells
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA; School of Nursing, University of Rochester, Rochester, NY, USA.
| | - Heather A Davis
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA; Virginia Polytechnic Institute and State University, Department of Psychology, Blacksburg, VA, USA
| | - Sophia Todorov
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Jennifer E Wildes
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
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Kuehne C, Hemmings A, Phillips M, İnce B, Chounkaria M, Ferraro C, Pimblett C, Sharpe H, Schmidt U. A UK-wide survey of healthcare professionals' awareness, knowledge and skills of the impact of food insecurity on eating disorder treatment. Eat Behav 2023; 49:101740. [PMID: 37187140 PMCID: PMC10775155 DOI: 10.1016/j.eatbeh.2023.101740] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVE Food insecurity (FI) is associated with significant adverse effects on health and well-being and increasingly recognised as a global problem. The current study explored the impact of FI on eating disorder (ED) clinical practice in the UK, aiming to assess healthcare professionals' (HCPs) knowledge, skills and views on the topic of FI in their patients. DESIGN This study was an exploratory, mixed-methods, descriptive analysis of online survey data collected from ED HCPs in the UK between September and October 2022. MEASURES A 15-item survey with rating and open-ended questions was circulated to ED professional organisations in the UK. Descriptive statistics were used to summarise quantitative data, including perceived prevalence of FI in ED clinical practice and confidence in knowledge on the topic. Descriptive content analyses provided insight into perspectives on FI screening and aspects to be included in guidance and resources. RESULTS 93 ED HCPs completed the survey (40.9 % psychologists). Findings demonstrated healthcare providers' limited knowledge on FI and its relation to EDs, while they increasingly perceive it in their patients, as well as a general lack of available resources on how to address FI in ED treatment. HCPs stressed the need for practical guidance and formal training for dealing with FI in their patients, as well as implementing routine screening. CONCLUSION These findings provide both important directions for future research and clinical applications related to screening, assessment, treatment and support of food-insecure patients with EDs.
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Affiliation(s)
- Carina Kuehne
- Section of Eating Disorders, Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Amelia Hemmings
- Section of Eating Disorders, Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Matthew Phillips
- Section of Eating Disorders, Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Başak İnce
- Section of Eating Disorders, Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | | | | | | | - Helen Sharpe
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Ulrike Schmidt
- Section of Eating Disorders, Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; South London and Maudsley NHS Foundation Trust, London, UK.
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McGowan A, Barry MR, Sonneville KR, Leung CW. Greater social adversity is associated with more disordered eating attitudes and behaviors among children from Southeast Michigan. Int J Eat Disord 2022; 55:1670-1677. [PMID: 35833678 PMCID: PMC10084038 DOI: 10.1002/eat.23775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The objective of this study is to examine the association between indicators of social adversity, including socioeconomic status and race/ethnicity, and children's disordered eating behaviors and attitudes. METHODS Children ages 8-10 years old (n = 183) were recruited from Michigan. Data were collected through in-home surveys. The Children's Eating Attitudes Test (ChEAT-24) measured disordered eating attitudes and behaviors in the sample. Cumulative social adversity was considered the sum of four binary variables: caregiver race/ethnicity, caregiver education, household income, and child-reported food security status. Linear mixed models examined the association between social adversity indicators and ChEAT-24 scores. RESULTS Children of primary caregivers of color had significantly higher ChEAT-24 scores than children of white caregivers (p = .03). Children who reported food insecurity had significantly higher ChEAT-24 scores compared to children who reported food security (p = .01). Compared to children with the lowest social adversity score, children with the highest score had a 4.8-unit higher ChEAT-24 score (95% CI .3-9.4), after adjusting for covariates. A significant trend was observed for greater social adversity and higher ChEAT-24 score (p-trend = .02). CONCLUSION A linear association was observed between greater social adversity and more disordered eating behaviors and attitudes among children in this sample. These findings emphasize the need for eating disorder research in children from racial/ethnic minorities and socioeconomically disadvantaged populations to support future prevention efforts. PUBLIC SIGNIFICANCE Greater exposure to social adversity was associated with more disordered eating behaviors among preadolescent children. Given that eating disorders are understudied in lower-income and minority racial/ethnic populations, this study highlights the need for additional research to better support prevention and treatment efforts among children from socioeconomically diverse backgrounds.
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Affiliation(s)
- Andrea McGowan
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Mikayla R Barry
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Cindy W Leung
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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Barry MR, Sonneville KR, McGowan AR, Needham BL, Kobayashi LC, Leung CW. Caregiver-reported household food insecurity and child-reported food insecurity in relation to eating disorder risk factors and symptoms among preadolescent children. Int J Eat Disord 2022; 55:1331-1341. [PMID: 35869930 PMCID: PMC9551508 DOI: 10.1002/eat.23784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/01/2022] [Accepted: 07/08/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To examine the relation of caregiver-reported household food insecurity (FI) and child-reported FI with eating disorder (ED) risk factors and symptoms, including effect modification by gender, in preadolescent children. METHOD Data were from the Family Food Study, a cross-sectional study of households with incomes ≤200% of the federal poverty line in southeastern Michigan. Children aged 8-10 years (n = 194) and their female primary caregivers reported separately on FI status. Children reported ED risk factors/symptoms via the 24-item Children's Eating Attitudes Test (ChEAT-24), with higher scores indicating more ED risk factors/symptoms. Linear mixed models were used to examine associations between FI measures with the ChEAT-24 total score, plus subscale scores for dieting, food preoccupation, weight preoccupation, vomiting, and social pressure to eat/gain weight. Models were adjusted for child age, child gender, caregiver race/ethnicity, caregiver education, and household income. RESULTS Among all children, child-reported FI, but not caregiver-reported household FI, was associated with more ED risk factors/symptoms. Child-reported FI (vs. no FI) was associated with higher average ChEAT-24 total score (β = 2.41, 95% CI: 0.57, 4.25). Child-reported FI was also associated with more food preoccupation, more weight preoccupation, and more social pressure to eat. Caregiver-reported household FI was marginally associated with less dieting in girls, and child-reported FI was associated with more dieting in boys. DISCUSSION Child-reported FI may be more salient than caregiver-reported household FI as a risk factor for ED-related outcomes in preadolescent children. Gender may modify the association between FI and dieting behavior. PUBLIC SIGNIFICANCE STATEMENT More child-reported food insecurity, but not parent-reported household food insecurity, was associated with more eating disorder risk factors and symptoms among preadolescent boys and girls. These findings emphasize the need for future studies that investigate the role of food insecurity in the development of eating disorders, especially studies that measure child-reported experience of food insecurity.
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Affiliation(s)
- Mikayla R. Barry
- Department of Nutritional SciencesUniversity of Michigan School of Public HealthAnn ArborMichiganUSA,Department of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
| | - Kendrin R. Sonneville
- Department of Nutritional SciencesUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
| | - Andrea R. McGowan
- Department of Nutritional SciencesUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
| | - Belinda L. Needham
- Department of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
| | - Lindsay C. Kobayashi
- Department of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
| | - Cindy W. Leung
- Department of Nutritional SciencesUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
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Hooper L, Mason SM, Telke S, Larson N, Neumark-Sztainer D. Experiencing Household Food Insecurity During Adolescence Predicts Disordered Eating and Elevated Body Mass Index 8 Years Later. J Adolesc Health 2022; 70:788-795. [PMID: 35078732 PMCID: PMC9038678 DOI: 10.1016/j.jadohealth.2021.11.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 10/24/2021] [Accepted: 11/23/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE Growing evidence indicates that experiencing household food insecurity during adolescence is associated with disordered eating and elevated body mass index (BMI). However, little is known about the temporal nature of these relationships. The current longitudinal study examined how adolescent experiences of household food insecurity are related to disordered eating and weight status 8 years later. METHODS A population-based sample of ethnically/racially and socioeconomically diverse participants (n = 1,340) were surveyed as adolescents (mean age = 14.5 years) and as young adults (mean age = 22.0 years). Parents/caregivers completed the six-item U.S. Household Food Security Survey Module at baseline. RESULTS Household food insecurity was common at baseline (37.8% of sample). In analyses adjusted for ethnicity/race and parental education, adolescent food insecurity longitudinally predicted a higher new onset of binge eating (food insecure: 21.3% vs. food secure: 16.2%, p = .038) and BMI ≥30 kg/m2 (food insecure: 15.9% vs. food secure: 11.0%, p = .024), but not unhealthy weight control behaviors in young adulthood. The majority of adolescents with unhealthy weight control behaviors and elevated BMI still had these problems in young adulthood, but persistence was not associated with adolescent household food insecurity for any outcome. DISCUSSION Results of this longitudinal study suggest that household food insecurity during adolescence is a risk factor for disordered eating and elevated BMI in young adulthood, highlighting a need to comprehensively address these intersecting problems.
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Affiliation(s)
- Laura Hooper
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.
| | - Susan M Mason
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Susan Telke
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Nicole Larson
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
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Kim BH, Ranzenhofer L, Stadterman J, Karvay YG, Burke NL. Food Insecurity and Eating Pathology in Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9155. [PMID: 34501745 PMCID: PMC8431477 DOI: 10.3390/ijerph18179155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/16/2021] [Accepted: 08/27/2021] [Indexed: 11/16/2022]
Abstract
Adolescence is a critical period for the emergence of eating disorders, and food insecurity may be related to eating pathology and weight, as evidenced in adults. However, little is known about food insecurity and eating pathology during this developmental period, and associations between food insecurity and body mass index (BMI) are mixed. Therefore, we examined associations between food insecurity and BMI percentile, self-reported eating-related pathology and binge eating, and subgroup differences by race/ethnicity. In a subset, we examined the relationship between food insecurity and real-world hunger, food craving, and loss-of-control eating using ecological momentary assessment (EMA). Fifty-eight adolescents at two sites (clinical sample, n = 38, BMI percentile ≥ 70th; community sample, n = 20, all BMI strata) completed self-report questionnaires. Adolescents were 15.2 ± 2.1 years old, 62% female, 50% Black, 34.5% Hispanic, with BMI percentile = 80.5 ± 25.8 (range 4-99). In the full sample, food insecurity was associated with greater BMI (p < 0.01), higher shape/weight overvaluation (p = 0.04), and greater number of binge eating episodes among those reporting at least one binge episode (p < 0.01), with significant relationships for BMI percentile, shape/weight overvaluation, body dissatisfaction, and binge episode frequency among Hispanic adolescents only (each p < 0.01). As in adults, food insecurity may be a risk factor for eating pathology, particularly for Hispanic teens.
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Affiliation(s)
- Brittany H. Kim
- New York State Psychiatric Institute, New York, NY 10032, USA;
| | - Lisa Ranzenhofer
- New York State Psychiatric Institute, New York, NY 10032, USA;
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Jill Stadterman
- Department of Psychology, Fordham University, Bronx, NY 10458, USA; (J.S.); (Y.G.K.); (N.L.B.)
| | - Yvette G. Karvay
- Department of Psychology, Fordham University, Bronx, NY 10458, USA; (J.S.); (Y.G.K.); (N.L.B.)
| | - Natasha L. Burke
- Department of Psychology, Fordham University, Bronx, NY 10458, USA; (J.S.); (Y.G.K.); (N.L.B.)
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Barry MR, Sonneville KR, Leung CW. Students with Food Insecurity Are More Likely to Screen Positive for an Eating Disorder at a Large, Public University in the Midwest. J Acad Nutr Diet 2021; 121:1115-1124. [PMID: 33773946 DOI: 10.1016/j.jand.2021.01.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 01/12/2021] [Accepted: 01/31/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND College students experience a disproportionately high prevalence of both food insecurity and eating disorders. Food insecurity is associated with stress, irregular eating patterns, weight change, depression, and body dissatisfaction, making it a possible risk factor for the onset of eating disorders. However, the association between food insecurity and eating disorders among college students is not well understood. OBJECTIVE This study explored the relation between food insecurity and screening positive for an eating disorder among students attending a large, public Midwestern university. DESIGN Cross-sectional data were collected using an online survey administered from March through June 2018. PARTICIPANTS/SETTING Participants were recruited from a random sample of 2,000 students, with oversampling from the following groups: racial/ethnic minorities, first-generation students, and students from lower-income households. Of those sampled, 851 students (43%) responded. The final analytic sample comprised 804 students after excluding those with missing data. MAIN OUTCOME MEASURE The validated 5-item Sick, Control, One stone, Fat, Food (SCOFF) questionnaire was used to screen for the presence of an eating disorder. STATISTICAL ANALYSES PERFORMED Poisson regression was used to model prevalence ratios for positive SCOFF screens (≥2 affirmative responses) by levels of food security (ie, high, marginal, low, or very low). Models were adjusted for sex, age, race/ethnicity, degree type, financial aid, and first-generation student status. RESULTS Compared to students with high food security, a higher prevalence of positive SCOFF screens was found among students with marginal food security (prevalence ratio [PR], 1.83, 95% CI 1.26 to 2.65; P = 0.001), low food security (PR 1.72, 95% CI 1.16 to 2.54; P = 0.007), and very low food security (PR 2.83, 95% CI 2.01 to 3.97; P < .0001). CONCLUSIONS Students with food insecurity at any level were more likely to screen positive for an eating disorder via the SCOFF questionnaire. Prospective studies are needed to determine whether food insecurity is a risk factor for the onset of eating disorders among college students.
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Affiliation(s)
- Mikayla R Barry
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor MI; Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor MI.
| | - Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor MI
| | - Cindy W Leung
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor MI
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Household food insecurity: associations with disordered eating behaviours and overweight in a population-based sample of adolescents. Public Health Nutr 2020; 23:3126-3135. [PMID: 32466815 DOI: 10.1017/s1368980020000464] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine how household food insecurity is related to adolescent weight status and disordered eating. DESIGN Cross-sectional, population-based study. Adolescents self-reported unhealthy weight control behaviours, binge eating and meal frequency; weight status was measured. Household food insecurity was assessed by asking parents to respond to the validated six-item US Household Food Security Survey Module. SETTING Adolescents surveyed within Minneapolis/St. Paul public middle and high schools completed surveys at school, and their parents/guardians were surveyed by mail during the 2009-2010 academic year. PARTICIPANTS Ethnically/racially diverse, primarily low-income adolescents (mean age: 14·4 years, range: 10-22 years) and their parents/guardians (n 2285 dyads). RESULTS More than one-third (38·9 %) of the adolescents experienced past-year household food insecurity, 43·2 % reported disordered eating and 39·6 % were overweight. Generalised regression models showed that food insecure (FI) compared with food secure (FS) adolescents had higher prevalence of overweight (FI: 42·3 % v. FS: 37·9 %, P = 0·039), lower breakfast consumption (FI: 4·1 times/week v. FS: 4·4 times/week, P = 0·005) and greater use of unhealthy weight control behaviours (FI: 49·0 % v. FS: 39·5 %, P < 0·001) in unadjusted models. Models adjusted for parental education, ethnicity/race, sex and age found that food insecurity was associated with higher prevalence of unhealthy weight control behaviours (FI: 44·5 % v. FS: 37·8 %, P = 0·007), but not with weight status or other eating behaviours. CONCLUSIONS These results suggest that food insecurity may be an independent risk factor for unhealthy weight control behaviours, indicating a need to approach these intersecting issues in a comprehensive manner.
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Abstract
PURPOSE OF REVIEW This review summarizes emerging evidence for the relationship between food insecurity and eating disorder (ED) pathology, outlines priorities for future research in this area, and comments on considerations for clinical and public health practice. RECENT FINDINGS Among adults, food insecurity is cross-sectionally associated with higher levels of overall ED pathology, binge eating, compensatory behaviors, binge-eating disorder, and bulimia nervosa. Evidence for similar relationships among adolescents has been less robust; however, compared to studies of adults, there have been substantially fewer studies conducted in adolescents to date. Emerging evidence consistently indicates that food insecurity is cross-sectionally associated with bulimic-spectrum ED pathology among adults. Findings emphasize the need for ED research to include marginalized populations who have historically been overlooked in the ED field. Much more research is needed to better understand the relationship between food insecurity and ED pathology and to determine effective ways to intervene.
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Affiliation(s)
- Vivienne M Hazzard
- Sanford Center for Biobehavioral Research, 120 Eighth Street South, Fargo, ND, 58103, USA.
| | - Katie A Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Laura Hooper
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
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