Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States of America; Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States of America.
Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States of America.
Eat Behav. 2023 Apr;49:101728. doi: 10.1016/j.eatbeh.2023.101728. Epub 2023 Apr 17.
This study examined cross-sectional and longitudinal associations between household food insecurity (FI) and a range of disordered eating behaviors (DEBs) and explored whether associations differ by Supplemental Nutrition Assistance Program (SNAP)/Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation. Data came from 1120 racially/ethnically diverse parents (M = 35.7 ± 7.8 years at baseline) in the Family Matters longitudinal cohort study. Parents reported on household FI and SNAP/WIC participation at baseline, and on past-year restrictive weight-control behaviors (WCBs; e.g., fasting), compensatory WCBs (e.g., self-induced vomiting), and binge eating at baseline and 18-month follow-up. Sociodemographics-adjusted modified Poisson regressions examined baseline household FI in relation to baseline prevalence and 18-month incidence (i.e., new onset) of each type of DEB. Moderation by SNAP/WIC participation was also tested. Household FI affected 29.6 % of participants and was associated with significantly greater baseline prevalence (prevalence ratios ranging from 1.38 to 2.69) and 18-month incidence (risk ratios ranging from 1.63 to 2.93) of each type of DEB examined. The association between household FI and incident compensatory WCBs differed significantly by SNAP/WIC participation, such that household FI significantly predicted new-onset compensatory WCBs at follow-up only among those participating in SNAP/WIC. Results from this study are the first, to our knowledge, to demonstrate that FI is longitudinally associated with restrictive and compensatory DEBs, thereby highlighting FI as a risk factor not only for binge eating, but for a range of DEBs. These findings emphasize the importance of screening for FI in clinical settings and the need to address structural barriers to food security.
本研究考察了家庭食物不安全（FI）与一系列饮食失调行为（DEBs）之间的横断面和纵向关联，并探讨了这些关联是否因补充营养援助计划（SNAP）/特殊补充营养计划针对妇女、婴儿和儿童（WIC）的参与而有所不同。数据来自家庭事务纵向队列研究中的 1120 名不同种族/族裔的父母（基线时平均年龄为 35.7±7.8 岁）。父母在基线时报告家庭 FI 和 SNAP/WIC 的参与情况，以及过去一年的限制体重控制行为（WCB；例如，禁食）、补偿性 WCB（例如，自我诱导呕吐）和暴食在基线和 18 个月随访时。调整社会人口统计学因素的修正泊松回归分析了基线家庭 FI 与基线患病率和每种 DEB 的 18 个月发病率（即新发病例）之间的关系。还测试了 SNAP/WIC 参与的调节作用。家庭 FI 影响了 29.6%的参与者，与每种 DEB 的基线患病率（患病率比范围为 1.38 至 2.69）和 18 个月发病率（风险比范围为 1.63 至 2.93）显著相关。家庭 FI 与新发性补偿性 WCBs 的关联因 SNAP/WIC 的参与而显著不同，即仅在参与 SNAP/WIC 的人群中，家庭 FI 显著预测了随访时新发性补偿性 WCBs。本研究的结果首次表明，FI 与限制和补偿性 DEB 呈纵向关联，从而强调 FI 不仅是暴食的风险因素，也是一系列 DEB 的风险因素。这些发现强调了在临床环境中筛查 FI 的重要性，以及解决食品安全结构性障碍的必要性。
