Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
Int J Eat Disord. 2022 Oct;55(10):1331-1341. doi: 10.1002/eat.23784. Epub 2022 Jul 23.
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.
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.
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.
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.
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.
研究照顾者报告的家庭食物不安全（FI）和儿童报告的 FI 与饮食失调（ED）风险因素和症状的关系，包括性别对其的调节作用，研究对象为青春期前儿童。
数据来自家庭食物研究，这是密歇根州东南部收入低于联邦贫困线 200%的家庭的一项横断面研究。年龄在 8-10 岁的儿童（n=194）及其女性主要照顾者分别报告 FI 状况。儿童通过 24 项儿童饮食态度测试（ChEAT-24）报告 ED 风险因素/症状，得分越高表示 ED 风险因素/症状越多。线性混合模型用于研究 FI 指标与 ChEAT-24 总分及节食、食物关注、体重关注、呕吐和社会压力进食/增重亚量表评分之间的关联。模型调整了儿童年龄、儿童性别、照顾者种族/民族、照顾者教育程度和家庭收入。
在所有儿童中，儿童报告的 FI，而不是照顾者报告的家庭 FI，与更多的 ED 风险因素/症状有关。与无 FI 相比，儿童报告的 FI 与更高的 ChEAT-24 总分平均水平相关（β=2.41，95%CI：0.57，4.25）。儿童报告的 FI 也与更多的食物关注、更多的体重关注和更多的社会压力进食有关。照顾者报告的家庭 FI 与女孩的节食行为减少呈边际相关，而儿童报告的 FI 与男孩的节食行为增加有关。
儿童报告的 FI 可能比照顾者报告的家庭 FI 更能成为青春期前儿童 ED 相关结局的风险因素。性别可能会调节 FI 与节食行为之间的关系。
更多的儿童报告的食物不安全，而不是父母报告的家庭食物不安全，与青春期前男孩和女孩更多的饮食失调风险因素和症状有关。这些发现强调了未来研究的必要性，这些研究需要调查食物不安全在饮食失调发展中的作用，特别是需要调查衡量儿童报告的食物不安全体验的研究。
