Household food insecurity: Associations with disordered eating behaviours and overweight in a population-based sample of adolescents

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OBJECTIVE: To examine how household food insecurity is related to adolescent weight status and disordered eating.

DESIGN: Cross-sectional, population-based study. Adolescents self-reported unhealthy weight control behaviours, binge eating and meal frequency; weight status was measured. Household food insecurity was assessed by asking parents to respond to the validated six-item US Household Food Security Survey Module.

SETTING: Adolescents surveyed within Minneapolis/St. Paul public middle and high schools completed surveys at school, and their parents/guardians were surveyed by mail during the 2009-2010 academic year.

PARTICIPANTS: Ethnically/racially diverse, primarily low-income adolescents (mean age: 14·4 years, range: 10-22 years) and their parents/guardians (n 2285 dyads).

RESULTS: More than one-third (38·9 %) of the adolescents experienced past-year household food insecurity, 43·2 % reported disordered eating and 39·6 % were overweight. Generalised regression models showed that food insecure (FI) compared with food secure (FS) adolescents had higher prevalence of overweight (FI: 42·3 % v. FS: 37·9 %, P = 0·039), lower breakfast consumption (FI: 4·1 times/week v. FS: 4·4 times/week, P = 0·005) and greater use of unhealthy weight control behaviours (FI: 49·0 % v. FS: 39·5 %, P < 0·001) in unadjusted models. Models adjusted for parental education, ethnicity/race, sex and age found that food insecurity was associated with higher prevalence of unhealthy weight control behaviours (FI: 44·5 % v. FS: 37·8 %, P = 0·007), but not with weight status or other eating behaviours.

CONCLUSIONS: These results suggest that food insecurity may be an independent risk factor for unhealthy weight control behaviours, indicating a need to approach these intersecting issues in a comprehensive manner.

Original languageEnglish (US)
Pages (from-to)3126-3135
Number of pages10
JournalPublic health nutrition
Issue number17
StatePublished - Dec 2020

Bibliographical note

Funding Information:
Acknowledgements: None. Financial support: This study was supported by grant numbers R01HL127077 and R35HL139853 from the National Heart, Lung, and Blood Institute (PI: D.N.-S.). L.H. was supported by grant number 5 T79MC00007-31-00 from Health Resources and Services Administration Maternal and Child Health Bureau. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute, the National Institutes of Health, or the Health Resources and Services Administration Maternal and Child Health Bureau. Conflicts of interest: None. Authorship: All authors helped conceptualise the analysis plan, assisted with interpretation of the results, contributed to writing the manuscript and thoroughly reviewed the final manuscript. In addition, L.H. formulated the research question, conducted statistical analysis and drafted the manuscript. S.T. oversaw the statistical analysis. N.L. helped with statistical analysis. S.M.M. helped formulate the research question. D.N.-S. conceptualised the larger Project EAT study design and oversaw data collection. Ethics of human subject participation: This study was conducted according to the guidelines laid down in the Declaration of Helsinki, and all procedures involving research study participants were approved by the University of Minnesota’s Institutional Review Board Human Subjects Committee. Written informed assent or consent was obtained from all participants.

Publisher Copyright:
© The Authors 2020.


  • Adolescents
  • Disordered eating
  • Eating behaviour
  • Food insecurity
  • Obesity


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