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
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Biography
E. A. Altman is a graduate student, University of California, Berkeley, School of Public Health, Berkeley.
Biography
K. A. Madsen is an associate professor, University of California, Berkeley, School of Public Health, Berkeley.
Biography
L. D. Ritchie is director and cooperative extension specialist, Nutrition Policy Institute, University of California, Division of Agriculture and Natural Resources, Oakland.
Biography
E. A. Frongillo is a professor, Arnold School of Public Health, University of South Carolina, Columbia.
Article info
Publication history
Published online: September 01, 2018
Accepted:
July 5,
2018
Received:
November 9,
2017
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT K. A. Madsen was supported by a National Institutes of Health/National Heart, Lung, and Blood Institute grant R01HD074759.
Identification
Copyright
© 2019 by the Academy of Nutrition and Dietetics.
