Dietary restraint and emotional eating mediate the relationship between negative body image and diet quality in U.S....

Body composition requirements for U.S. Army Soldiers may increase risk of negative body image and unhealthy dietary behaviors, which may in turn lead to poor nutrition. This study aimed to determine whether negative body image was associated with worse diet quality in U.S. Army Soldiers and whether dietary restraint and emotional eating served as mediators. A cross-sectional study of U.S. Army Soldiers who completed the Military Eating Behavior Survey was conducted (N = 427, 93 % male, 23 ± 5 years of age). Diet quality was calculated using the Healthy Eating Index 2015 (HEI-2015) to assess total HEI, adequacy, and moderation components. Linear regression models were used to examine associations between body image, dietary restraint, emotional eating, and diet quality. Mediation models were tested to measure the indirect effect of dietary restraint and emotional eating on the association between body image and diet quality. Results demonstrated that higher concern with body image was associated with higher dietary restraint (B = 0.12, p < .0001) and higher emotional eating (B = 0.07, p = .0001). Dietary restraint was positively associated with Total HEI-2015 score (B = 1.10, p < .0001) and HEI-2015 moderation (B = 0.32, p < .0001) and adequacy (B = 0.78, p < .0001) scores. In mediation analyses, there was a significant indirect effect of body image on diet quality through restraint (a:0.25, b:0.41, c':-0.12, ab:0.10; 95 % bootstrap CI: 0.06, 0.15) and emotional eating (a:0.18, b:-0.15, c':0.05, ab:-0.04; 95 % bootstrap CI: -0.07, -0.01). Findings suggest that dietary restraint and emotional eating may be differentially associated with body image and diet quality. Whether these relationships persist over time is unclear.