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Food Insecurity Is Associated with Body Dissatisfaction among Children in California

Emily A Altman, Lorrene D Ritchie, Edward A Frongillo

Journal of the Academy of Nutrition and Dietetics

|September 5, 2018

Insights

Food insecurity in children is linked to increased body dissatisfaction across all groups. This association is stronger in African-American children and those with normal weight, highlighting disparities in health outcomes.

Area of Science:

Childhood Health
Nutritional Psychiatry
Sociology of Health

Background:

Food insecurity affects millions of US children, while body dissatisfaction is also common.
Both issues are linked to poor health outcomes and disparities in body weight and race/ethnicity.
The connection between child food insecurity and body dissatisfaction remains understudied.

Purpose of the Study:

To investigate the relationship between child food insecurity and body dissatisfaction in 4th-8th graders.
To explore how body mass index (BMI), race/ethnicity, and sex modify this relationship.

Main Methods:

Cross-sectional study of 14,768 children (grades 4-8) in California public schools (2014-2016).
Validated questionnaires assessed child-reported food insecurity and body dissatisfaction.
Multivariable logistic regression analyzed associations, with effect modification by BMI, race/ethnicity, and sex.

Main Results:

Children experiencing food insecurity had higher odds of body dissatisfaction across all BMI categories and racial/ethnic backgrounds.
The association was strongest for African-American children (OR=2.32) and normal-weight children (OR=1.76).
Effect modification by BMI and race/ethnicity was significant.

Conclusions:

Childhood food insecurity is significantly associated with increased body dissatisfaction.
The strength of this association varies by body mass index and race/ethnicity, indicating complex interactions.

Read full analysis

Abstract

Background:

Food insecurity affects 13 million children in the United States. Body dissatisfaction is also prevalent, affecting up to 46% of children. Both food insecurity and body dissatisfaction are associated with poor health outcomes, and both are associated with body weight and racial/ethnic disparities. The association between food insecurity and body dissatisfaction among children has not been examined.

Objective:

The purpose of this study was twofold: to examine, in a sample of children in grades 4 through 8, the relationship of child food insecurity with body dissatisfaction and to gain an understanding of the interactive roles of body mass index (BMI), race/ethnicity, and sex in the relationship between food insecurity and body dissatisfaction.

Design:

This was a cross-sectional study.

Participants/Setting:

This study examined data obtained from 14,768 children in grades 4 through 8 from 54 public schools in California between 2014 and 2016.

Main Outcome Measures:

The primary outcome of interest was body dissatisfaction (five items converted to a binary indicator), and the exposure of interest was child-reported food insecurity (three items converted to a binary indicator). Subsets of validated questionnaires were used to assess body dissatisfaction and food insecurity.

Statistical Analyses Performed:

Data were analyzed using multivariable logistic regression, and effect modification was examined by BMI category (underweight, normal, overweight, obese), race/ethnicity, and sex.

Results:

In this large and diverse sample, after adjusting for cofounders, children experiencing food insecurity, in all BMI categories and from all racial/ethnic backgrounds, had higher odds of body dissatisfaction than their food-secure counterparts. The strength of the relationship differed by BMI and race/ethnicity, with the strongest associations observed for African-American children (odds ratio=2.32; P<0.001) and children with a normal children (odds ratio=1.76; P<0.001).

Conclusions:

Experiencing food insecurity was associated with greater body dissatisfaction, with the magnitude of the association modified by BMI and race/ethnicity.

Keywords:

Body mass index Body satisfaction Ethnicity Food insecurity Race

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