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从青少年到青年期,严重的食物不安全与饮食行为障碍之间的关联:一项为期 10 年的纵向研究结果。

Associations between severe food insecurity and disordered eating behaviors from adolescence to young adulthood: Findings from a 10-year longitudinal study.

机构信息

Sanford Center for Biobehavioral Research, Fargo, ND, United States of America.

Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America.

出版信息

Prev Med. 2022 Jan;154:106895. doi: 10.1016/j.ypmed.2021.106895. Epub 2021 Nov 17.

Abstract

Emerging evidence suggests a cross-sectional association between food insecurity (FI) and disordered eating among adults, while evidence among adolescents is limited. Longitudinal research is needed to elucidate the temporality of this relationship and clarify whether the association differs by age. Three waves of prospective data came from 1813 participants in the Project EAT (Eating and Activity in Teens and Young Adults) cohort study. Data were collected at five-year intervals, with the baseline survey in 1998-1999 (EAT-I; M = 14.9 years) and follow-up surveys in 2003-2004 (EAT-II; M = 19.5 years) and 2008-2009 (EAT-III; M = 24.9 years). Severe FI was assessed as any past-year hunger with one item from the U.S. Household Food Security Survey Module, and a range of disordered eating behaviors were self-reported. Associations adjusted for sociodemographic characteristics were examined with generalized estimating equations. Effect modification by age was also tested. Cross-sectionally, severe FI was significantly associated with greater prevalence of all disordered eating behaviors examined, with the strongest associations observed for extreme weight-control behaviors (prevalence ratio [PR] = 1.49, 95% confidence interval [CI]: 1.13-1.95) and binge eating (PR = 1.49, 95% CI: 1.04-2.12). Longitudinally, severe FI significantly predicted 1.41 (95% CI: 1.05-1.90) times greater prevalence of binge eating five years later after accounting for prior binge eating. Effect modification by age indicated a stronger cross-sectional association between severe FI and unhealthy weight-control behaviors among younger participants. Results support a cross-sectional link between severe FI and disordered eating and provide longitudinal evidence suggesting severe FI is a risk factor for binge eating.

摘要

新出现的证据表明,成年人的粮食不安全(FI)与饮食失调之间存在横断面关联,而青少年的证据有限。需要进行纵向研究以阐明这种关系的时间性,并澄清这种关联是否因年龄而异。来自 EAT(青少年和年轻人的饮食和活动)队列研究的 1813 名参与者的三波前瞻性数据。数据每五年收集一次,基线调查于 1998-1999 年进行(EAT-I;M=14.9 岁),后续调查于 2003-2004 年(EAT-II;M=19.5 岁)和 2008-2009 年(EAT-III;M=24.9 岁)进行。严重的粮食不安全状况通过美国家庭粮食安全调查模块的一项内容来评估,各种饮食失调行为则通过自我报告来评估。通过广义估计方程来调整社会人口统计学特征后,检验了与这些特征的关联。还测试了年龄的调节作用。横断面研究结果表明,严重的粮食不安全状况与所检查的所有饮食失调行为的发生率显著相关,与极端体重控制行为(比值比 [PR] = 1.49,95%置信区间 [CI]:1.13-1.95)和暴食行为(PR = 1.49,95% CI:1.04-2.12)的关联最强。纵向研究结果表明,在考虑到先前的暴食行为后,严重的粮食不安全状况五年后预测暴食行为的发生率增加了 1.41 倍(95% CI:1.05-1.90)。年龄的调节作用表明,在年轻参与者中,严重的粮食不安全状况与不健康的体重控制行为之间存在更强的横断面关联。结果支持严重的粮食不安全状况与饮食失调之间的横断面联系,并提供了纵向证据表明严重的粮食不安全状况是暴食行为的一个风险因素。

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