Do parents engage in weight- and health-focused conversations with their emerging adult children and are there cross-sectional associations with weight and well-being outcomes?

BACKGROUND: Research indicates harmful associations between parental weight-focused conversations and markers of pediatric health and well-being. However, little is known about the prevalence and consequences of parent conversations focused on weight or health behaviors (i.e., physical activity or nutrition) with emerging adult children. METHODS: Data are from the 2018 follow-up survey of the population-based EAT 2010-2018 (Eating and Activity over Time) in cohort from Minneapolis-St. Paul, MN. Participants were emerging adults at follow-up with ages 18-26. Regression models adjusted for sociodemographic characteristics were conducted. RESULTS: Over two-thirds (68%) of mothers and 44% of fathers engaged in weight-focused conversations with their emerging adult children; 25% of both parents reported engaging in conversations focused only on health behaviors; and 8% of mothers and 26% of fathers reported not engaging in either type of conversation. Health-focused conversations by both parents were associated with lower body mass index (BMI) and disordered eating behaviors, higher intake of fruit and vegetables, and psychosocial well-being in emerging adult children. Weight-focused conversations with both parents were associated with higher BMI and disordered eating behaviors in emerging adults. There were gender moderated associations of paternal conversations about weight and health with vegetable intake, binge eating, and depressive symptoms. DISCUSSION: The high prevalence and negative health outcomes associated with weight-focused conversations coupled with the low prevalence and positive health outcomes associated with health-focused conversations by parents suggests the need for public health messaging and intervention development aimed at reducing parental weight talk with emerging adult children.

Examining measurement invariance of appetitive trait and ARFID symptom measures by food security status.

OBJECTIVE: Measures assessing appetitive traits (i.e., individual differences in the desire to consume food) and disordered eating have generally been developed in predominantly food-secure populations. The current study aims to test measurement invariance (MI) for a measure of appetitive traits and a measure of Avoidant Restrictive Food Intake Disorder (ARFID) symptomology across food security status. METHOD: Data from a sample of mothers (n = 634) and two undergraduate samples (n = 945 and n = 442) were used to assess MI for the Adult Eating Behavior Questionnaire (AEBQ), which measures appetitive traits, and the Nine Item ARFID Screen (NIAS), which measures ARFID symptomology. Current food security was assessed using the 18-item USDA Household Food Security Survey Module, which was dichotomized into two groups: 1) the 'food insecure' group included marginal, low, and very low food security and 2) the 'food secure' group included high food security. Overall and multi-group confirmatory factor analyses were conducted separately for each measure in each sample. RESULTS: Results demonstrated scalar (i.e., strong) MI for both measures across samples, indicating that these measures performed equivalently across food-secure and food-insecure individuals. CONCLUSION: Findings suggest that differences in appetitive traits by food security status observed in prior research are not artifacts of measurement differences, but instead reflect true differences. Additionally, past mixed results regarding the relationship between food insecurity (FI) and ARFID symptomology are not likely driven by measurement error when using the NIAS.

Reported Intergenerational Transmission of Parent Weight Talk and Links with Child Health and Wellbeing.

OBJECTIVES: To examine if intergenerational transmission of parent weight talk occurs, the contextual factors prompting weight talk, and whether parent weight talk is associated with child weight, dietary intake, psychosocial outcomes, and food parenting practices. STUDY DESIGN: Children aged 5-9 years and their families (n = 1307) from 6 racial and ethnic groups (African-American, Hispanic, Hmong, Native American, Somali/Ethiopian, White) were recruited for a longitudinal cohort study through primary care clinics in Minneapolis/St. Paul, Minnesota from 2016 through 2019. Parents filled out surveys at 2 time points, 18 months apart. Adjusted regression models examined associations of interest. RESULTS: Intergenerational transmission of parent weight talk was observed. In addition, significant associations were found between parent engagement in weight talk and higher weight status and poorer psychosocial outcomes in children 18 months later. Parent engagement in weight talk was also associated with more restrictive food parenting practices 18 months later. CONCLUSIONS: Parents' exposure to weight talk as children increased the likelihood of engaging in weight talk with their own children and had harmful associations over time with parent restrictive feeding practices, child weight, and psychosocial wellbeing in children. Health care providers may want to consider both modeling positive health-focused conversations and educating parents about the potential harmful and long-lasting consequences of engaging in weight talk with their children.

Cross-sectional and longitudinal associations between higher weight and eating disorder risk among collegiate athletes.

OBJECTIVES: To examine whether higher weight status is associated with increased eating disorder risk in athletes. DESIGN: Study 1 used cross-sectional (N = 942) and longitudinal (N = 483) data collected over a five-year period from Division I athletes at a Midwestern university. Study 2 used cross-sectional data from athletes competing at various levels at universities across the United States (N = 825). METHODS: Weight and height were measured in Study 1 and self-reported in Study 2; higher weight was defined as body mass index ≥ 25 kg/m2. Eating disorder risk was assessed with preliminary (Study 1) and final (Study 2) versions of the Eating Disorders Screen for Athletes. Study 1 examined weight status in relation to both concurrent and one-year changes in Eating Disorder Screen for Athletes score. Study 2 examined weight status in relation to both the Eating Disorders Screen for Athletes score and elevated eating disorder risk using the established Eating Disorders Screen for Athletes cut-off. All models adjusted for gender and sport type; Study 2 additionally adjusted for race/ethnicity, age, and competition level. RESULTS: Across studies, higher weight status was significantly associated with increased eating disorder risk among athletes. This association was observed both cross-sectionally and longitudinally, and the prevelence of elevated eating disorder risk was 43 % greater among athletes with higher weight status than among those without higher weight status. CONCLUSIONS: Despite existing stereotypes that eating disorders tend to occur with low weight status, findings highlight the importance of screening all athletes for eating disorders, regardless of their weight status.

Past-Year Suicidal Ideation, Plans, and Attempts by Food Security Level in a Nationally Representative Sample of U.S. Adults.

OBJECTIVE: The Interpersonal Theory of Suicide posits that suicidal behavior results from thwarted belongingness, perceived burdensomeness, and capability for suicide. Considering that food insecurity (FI) may be linked to these constructs to differing extents based on severity of FI, this study examined cross-sectional associations between levels of FI and suicidal ideation, plans, and attempts in a nationally representative sample of adults in the United States. METHODS: Data for this study were collected in 2001-2003 from 5,552 participants in the National Comorbidity Survey Replication (Mage=44.8 ± 0.5 years; 53.8% female). Prevalence ratios (PRs) and 95% confidence intervals (CIs) were generated using modified Poisson regression to examine past-year ideation, plans, and attempts with intent of lethality by past-year FI level (assessed with a modified version of the Short Form U.S. Household Food Security Scale). RESULTS: After controlling for sociodemographic covariates, low food security was significantly associated with elevated prevalence of suicidal ideation, plans, and attempts (ideation: PR = 2.21, 95% CI 1.32-3.70; plans: PR = 5.42, 95% CI 2.71-10.83; attempts: PR = 5.35, 95% CI 2.38-12.03). Very low food security (i.e., more severe FI) exhibited stronger associations yet with suicidal ideation, plans, and attempts (ideation: PR = 6.99, 95% CI 4.10-11.92; plans: PR = 17.21, 95% CI 8.41-35.24; attempts: PR = 14.72, 95% CI 4.96-43.69). CONCLUSIONS: Findings indicative of a dose-response relationship between FI and suicidal ideation, plans, and attempts emphasize the need to increase reach of food assistance programs, increase availability of mental health services in food-insecure populations, and routinely screen for FI in mental health practice.

Cross-sectional data from nationally representative sample of U.S. adultsFood insecurity linked with suicidal ideation, plans, and attemptsDose-response relationship observed according to severity of food insecurity.

'Like fumbling around in the dark': Young people's perceptions and realities of healthy relationships.

Learning to negotiate relationships is a key feature of adolescence, yet insight into young people's perspectives on what constitutes healthy relationships is lacking. In this study, therefore, insights were sought on healthy relationship qualities, common issues encountered, and relevant educational experiences. Semi-structured interviews were undertaken with 18 young people (11 self-identified as female, 5 male, and 2 trans/gender-diverse) aged 14-20 years, residing in Adelaide, South Australia. Relationships with parents, siblings, peers and intimate partners were topics for discussion. Reflexive thematic analysis was utilised to generate codes and themes. The Five Cs of Positive Youth Development were used to aid understanding of findings. Young people's accounts suggested a disjuncture between desired relationship qualities, realities and education on relationships and sexual health. Young people articulated tensions navigating peer norms and societal expectations in relation to dating and sex, including unrealistic representations, gender stereotyping and strong 'sexpectations'. Participants in this study relied more heavily on personal experience and observation than formal education to develop an understanding of healthy relationships. Achieving healthy relationships was generally perceived to be complex and requiring skills or understanding informants were unsure about. Positive Youth Development could provide a framework for meeting the needs expressed by young people, notably by building communication skills, confidence and agency.

Weight-related Self-monitoring App Use Among Emerging Adults is Cross-sectionally Associated With Amount and Type of Physical Activity and Screen Time.

Weight-related self-monitoring (WRSM) apps are often used by emerging adults to assist in behavior change. However, little is known about the relationship between WRSM among the general population of emerging adults and various physical activity and screen time behaviors. This paper examines associations between WRSM app use and various forms of physical activity and screen time among a population-based sample of emerging adults. Data come from EAT 2018 (N = 1,568, mean age = 22.0 ± 2.0 years), a population-based sample of emerging adults from Minneapolis/St. Paul, Minnesota. Participants reported on the types of WRSM apps used (physical activity and/or dietary focused), in addition to how much time they spent doing physical activity, whether they practiced yoga, compulsive exercise, recreational screen time, social media use, and whether they viewed dieting/weight loss materials. Linear and logistic regressions were used to assess adjusted means and prevalences of outcomes. We found that physical activity-focused WRSM app users engaged in more hours of total (8.7 vs 7.2, P < .001), and moderate-to-vigorous (5.1 vs 4.3, P = .002) physical activity compared to non-users. Similar results were found for dietary WRSM app users compared to non-users. However, WRSM app users had higher levels of compulsive exercise and were more likely to view dieting/weight loss materials (Ps < .001). Findings suggest that although physical activity is higher among WRSM users, the types of physical activity and screen time behaviors WRSM users are engaging in may be harmful.

Longitudinal associations between family meal quality and quantity: Does one matter more for child, parent, and family health and well-being or are they synergistic?

It is unknown how family meal quantity (i.e., frequency) and quality (i.e., meal healthfulness and interpersonal quality) are associated with child, parent, and family health and well-being over time. This study aimed to examine longitudinal associations between family meal quantity and quality and child, parent, and family health and well-being and whether there was a synergistic effect between family meal quantity and quality. Children ages 5-9 and their parents from six racial/ethnic groups participated in this longitudinal cohort study. Regression models adjusted for socio-demographic characteristics examined family meal quantity, interpersonal quality, and nutritional quality at baseline and interactions between quantity and quality, in relation to changes in child, parent, and family health outcomes from baseline to 18-month follow-up. Higher family meal quantity predicted reduced obesity prevalence, improved diet quality and less food fussiness, food responsiveness, and conduct problems among children at follow-up. Higher family meal quality predicted improved diet quality, lower emotional problems, less food responsiveness, and fewer peer relationship problems among children, improved diet quality and reduced psychological distress for parents, and less family chaos at follow-up. One interaction between family meal quantity and quality was found for child peer relationship problems. Overall, family meal quantity and quality were independently important for child health and well-being and for some parent and family health outcomes. Clinicians working with families may want to emphasize the importance of both family meal quantity and quality, as these longitudinal findings suggest potential benefits for the entire family.

Early Human Pathophysiological Responses to Exertional Hypobaric Decompression Stress.

INTRODUCTION: Consistent blood biomarkers of hypobaric (altitude) decompression stress remain elusive. Recent laboratory investigation of decompression sickness risk at 25,000 ft (7620 m) enabled evaluation of early pathophysiological responses to exertional decompression stress.METHODS: In this study, 15 healthy men, aged 20-50 yr, undertook 2 consecutive (same-day) ascents to 25,000 ft (7620 m) for 60 and 90 min, breathing 100% oxygen, each following 1 h of prior denitrogenation. Venous blood was sampled at baseline (T0), immediately after the second ascent (T8), and next morning (T24). Analyses encompassed whole blood hematology, endothelial microparticles, and soluble markers of cytokine response, endothelial function, inflammation, coagulopathy, oxidative stress, and brain insult, plus cortisol and creatine kinase.RESULTS: Acute hematological effects on neutrophils (mean 72% increase), eosinophils (40% decrease), monocytes (37% increase), and platelets (7% increase) normalized by T24. Consistent elevation (mean five-fold) of the cytokine interleukin-6 (IL-6) at T8 was proinflammatory and associated with venous gas emboli (microbubble) load. Levels of C-reactive protein and complement peptide C5a were persistently elevated at T24, the former by 100% over baseline. Additionally, glial fibrillary acidic protein, a sensitive marker of traumatic brain injury, increased by a mean 10% at T24.CONCLUSIONS: This complex composite environmental stress, comprising the triad of hyperoxia, decompression, and moderate exertion at altitude, provoked pathophysiological changes consistent with an IL-6 cytokine-mediated inflammatory response. Multiple persistent biomarker disturbances at T24 imply incomplete recovery the day after exposure. The elevation of glial fibrillary acidic protein similarly implies incomplete resolution following recent neurological insult.Connolly DM, Madden LA, Edwards VC, D'Oyly TJ, Harridge SDR, Smith TG, Lee VM. Early human pathophysiological responses to exertional hypobaric decompression stress. Aerosp Med Hum Perform. 2023; 94(10):738-749.

How Parental Feeding Practices Relate to Young People's Intuitive Eating: Cross-Sectional and Longitudinal Associations by Gender and Weight Concern.

PURPOSE: To evaluate cross-sectional and longitudinal associations between controlling parental feeding practices in adolescence (i.e., restrictive feeding and pressure-to-eat [PE]) and intuitive eating (IE) in adolescence and emerging adulthood; and explore child gender and parental concern about child weight as moderators. METHODS: The sample included participants (N = 1,383) from the population-based EAT 2010-2018 study who provided data in adolescence (14.4 ± 2.0 years) and emerging adulthood (22.0 ± 2.0 years) and had at least one caregiver complete surveys in adolescence. Generalized estimating equations evaluated cross-sectional and longitudinal associations between restrictive feeding and PE in adolescence and IE in adolescence and emerging adulthood. Interactions with gender and parental concern over child weight in adolescence were explored. RESULTS: Restrictive feeding was cross-sectionally associated with lower IE in adolescence (b = -0.04), though evidence of moderation by parental weight concern indicated this association was only observed in the context of low parental weight concern. Greater PE was associated with lower adolescent IE among boys but higher IE among girls. Longitudinally, the association between PE in adolescence and IE in emerging adulthood differed by parental weight concern; greater PE predicted higher emerging adult IE at high parental weight concern, but lower IE at low parental weight concern. DISCUSSION: Controlling feeding practices in adolescence displayed differential associations with child IE in adolescence and emerging adulthood based on child gender and parental concern over child weight. Notably, PE was associated with greater IE among adolescent girls but lower IE among boys. Results suggest that parental feeding is a valuable intervention target.

The interplay between food insecurity and family factors in relation to disordered eating in adolescence.

This study examined the association between food insecurity and both binge eating and unhealthy weight-control behaviors (UWCBs) and assessed whether such associations differ by factors within the family environment. Data were collected from a diverse sample of adolescents (Mage = 14.5 years; 54.1% female) and their parents/guardians (N = 2137 dyads) participating in EAT 2010 (Eating and Activity over Time). Food-insecure adolescents were more likely to report binge eating (prevalence ratio [PR] = 1.94; 95% confidence interval [CI]: 1.41-2.69) and UWCBs (PR = 1.34; 95% CI: 1.21-1.49) than food-secure adolescents. Family meal importance (p = .03) and family communication (p < .001) significantly moderated the association between food insecurity and UWCBs, such that the association was weaker at lower levels of these factors. Significant interactions with parental weight talk/concern (p < .001) and weight teasing (p = .04) indicated a weaker association between food insecurity and UWCBs in the presence of these factors. Findings indicate that the association between food insecurity and UWCBs among youth is less salient in the absence of family protective factors and in the presence of family risk factors for UWCBs, indicating the importance of targeting food insecurity itself, regardless of the presence of family risk or protective factors for UWCBs.

Decompression Sickness Risk in Parachutist Dispatchers Exposed Repeatedly to High Altitude.

INTRODUCTION: Occurrences of severe decompression sickness (DCS) in military parachutist dispatchers at 25,000 ft (7620 m) prompted revision of exposure guidelines for high altitude parachuting. This study investigated residual risks to dispatchers and explored the potential for safely conducting repeat exposures in a single duty period.METHODS: In this study, 15 healthy men, ages 20-50 yr, undertook 2 profiles of repeated hypobaric chamber decompression conducting activities representative of dispatcher duties. Phase 1 comprised two ascents to 25,000 ft (7620 m) for 60 and then 90 min. Phase 2 included three ascents first to 25,000 ft for 60 min, followed by two ascents to 22,000 ft (6706 m) for 90 min. Denitrogenation was undertaken at 15,000 ft (4572 m) with successive ascents separated by 1-h air breaks at ground level.RESULTS: At 25,000 ft (7620 m), five cases of limb (knee) pain DCS developed, the earliest at 29 min. Additionally, multiple minor knee "niggles" occurred with activity but disappeared when seated at rest. No DCS and few niggles occurred at 22,000 ft (6706 m). Early, heavy, and sustained bubble loads were common at 25,000 ft, particularly in older subjects, but lighter and later loads followed repeat exposure, especially at 22,000 ft.DISCUSSION: Parachutist dispatchers are at high risk of DCS at 25,000 ft (7620 m) commensurate with their heavy level of exertion. However, the potential exists for repeated safe ascents to 22,000 ft (6706 m), in the same duty period, if turn-around times breathing air at ground level are brief. Older dispatchers (>40 yr) with functional right-to-left (intracardiac or pulmonary) vascular shunts will be at risk of arterialization of microbubbles.Connolly DM, D'Oyly TJ, Harridge SDR, Smith TG, Lee VM. Decompression sickness risk in parachutist dispatchers exposed repeatedly to high altitude. Aerosp Med Hum Perform. 2023; 94(9):666-677.

Adverse childhood experiences and food insecurity in emerging adulthood: findings from the EAT 2010-2018 study.

OBJECTIVE: Low childhood socio-economic status (SES) and adverse childhood experiences (ACE) are associated with poor health outcomes in adulthood. Determining how ACE may be linked to food insecurity among young people from socio-economically diverse households can inform health-protective strategies. This study examined if ACE are associated with food insecurity during the transition to adulthood and investigated prevalence differences across SES strata. SETTING: Participants were recruited from twenty secondary schools in Minneapolis-St. Paul, Minnesota. PARTICIPANTS: The analytic sample (n 1518) completed classroom surveys in 2009-2010 (mean age = 14·5 years) and follow-up surveys in 2017-2018 (mean age = 22·0 years). DESIGN: Past-year food insecurity was reported at both time points, and ACE were reported at follow-up. Logistic regression models were used to estimate emerging adult food insecurity prevalence by ACE exposure; models were stratified by childhood SES (low, middle and high). RESULTS: The adjusted prevalence of food insecurity was 45·3 % among emerging adults who reported three or more ACE compared with 23·6 % among those with one or two ACE and 15·5 % among those with no ACE (P < 0·001). All forms of ACE were related to an elevated prevalence of food insecurity in emerging adulthood. ACE-food insecurity associations were strongest for emerging adults from lower and middle SES households. Among emerging adults from low SES households, childhood experiences of emotional abuse and substance use by a household member were associated with the largest prevalence differences in food insecurity. CONCLUSIONS: Findings suggest a need for trauma-informed services within food assistance programs to better serve individuals with a history of ACE.

More Than Identity: An Intersectional Approach to Understanding Mental-Emotional Well-Being of Emerging Adults by Centering Lived Experiences of Marginalization.

Understanding social determinants that shape pertinent developmental shifts during emerging adulthood (i.e., ages 18-25 years) and their associations with psychological health requires a nuanced approach. In our exploratory study, we investigated how multiple social identities and lived experiences generated by systems of marginalization and power (e.g., racism, classism, sexism) intersect in connection to the mental-emotional well-being of emerging adults (EAs). Eating and Activity Over Time (EAT, 2010-2018) data were collected from 1,568 EAs (mean age = 22.2 (standard deviation, 2.0) years) recruited initially in 2010 from Minneapolis/St. Paul schools. Conditional inference tree analyses were employed to treat "social location" and systems of marginalization and power as interdependent social factors influencing EAs' mental-emotional well-being outcomes: depressive symptoms, stress, self-esteem, and self-compassion. Conditional inference tree analyses identified EAs' subgroups with differing mean levels of mental-emotional well-being outcomes, distinguished primarily by marginalized social experiences (e.g., discrimination, financial difficulties) rather than social identities themselves. The relative positioning of EAs' experiences of social marginalization (e.g., discrimination) to their social identities (e.g., race/ethnicity) suggests that the social experiences generated by systems of privilege and oppression (e.g., racism) are more adjacent social determinants of mental-emotional well-being than the social identities used in public health research to proxy the oppressive systems that give them social meaning.

Do the SCOFF items function differently by food-security status in U.S. college students?: Statistically, but not practically, significant differences.

Despite food insecurity (FI) being associated with eating disorders (EDs), little research has examined if ED screening measures perform differently in individuals with FI. This study tested whether items on the SCOFF performed differently as a function of FI. As many people with FI hold multiple marginalized identities, this study also tested if the SCOFF performs differently as a function of food-security status in individuals with different gender identities and different perceived weight statuses. Data were from the 2020/2021 Healthy Minds Study (N = 122,269). Past-year FI was established using the two-item Hunger Vital Sign. Differential item functioning (DIF) assessed whether SCOFF items performed differently (i.e., had different probabilities of endorsement) in groups of individuals with FI versus those without. Both uniform DIF (constant between-group difference in item-endorsement probability across ED pathology) and non-uniform DIF (variable between-group difference in item-endorsement probability across ED pathology) were examined. Several SCOFF items demonstrated both statistically significant uniform and non-uniform DIF (ps < .001), but no instances of DIF reached practical significance (as indicated by effect sizes pseudo ΔR2 ≥ 0.035; all pseudo ΔR2's ≤ 0.006). When stratifying by gender identity and weight status, although most items demonstrated statistically significant DIF, only the SCOFF item measuring body-size perception showed practically significant non-uniform DIF for perceived weight status. Findings suggest the SCOFF is an appropriate screening measure for ED pathology among college students with FI and provide preliminary support for using the SCOFF in individuals with FI and certain marginalized identities.

Exploring differences in disordered eating and related appetitive traits among women based on childhood and current food security status.

Despite emerging evidence that food insecurity (FI) is associated with elevated rates of eating pathology, little is known about the lasting impact of FI on eating behaviors. Studies that have explored the association between FI during childhood and eating behavior in adulthood have not accounted for current FI. The present study explored differences in disordered eating (DE) and related appetitive traits among four groups of cisgender female mothers: individuals who (1) endorsed childhood FI only (n = 96), (2) endorsed current FI only (n = 134), (3) endorsed both childhood and current FI (n = 257), and (4) denied both childhood and current FI (n = 146). Participants responded to online questionnaires including items from the USDA Household Food Security Survey Module, the 7-item Eating Disorder Examination-Questionnaire, the Eating Disorder Diagnostic Scale, and the Adult Eating Behavior Questionnaire. Adjusting for age and race/ethnicity, ANCOVAs explored mean differences between groups in DE and appetitive traits, and a modified Poisson regression model examined differences in binge-eating prevalence across the four FI groups. The "current FI only" group consistently endorsed the highest levels of DE and related appetitive traits followed by the "current and childhood FI" group, suggesting newly food-insecure women may be at highest risk for DE. Interestingly, across almost all constructs, the "childhood FI only" group did not differ significantly from the "no FI" group. These findings suggest that improved access to food may help offset risk for adult DE related to experiences of FI in childhood.

Household food insecurity is associated with greater prevalence and 18-month incidence of a range of disordered eating behaviors in a racially and ethnically diverse sample of parents.

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 (Mage = 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.

Is intuitive eating a privileged approach? Cross-sectional and longitudinal associations between food insecurity and intuitive eating.

OBJECTIVE: To examine: (1) cross-sectional and longitudinal associations between measures of food insecurity (FI; household status and youth-reported) and intuitive eating (IE) from adolescence to emerging adulthood; and (2) the association between FI persistence and IE in emerging adulthood. DESIGN: Longitudinal population-based study. Young people reported IE and FI (two items from the US Household Food Security Module) in adolescence and emerging adulthood. Parents provided data on household FI via the six-item US Household Food Security Module in adolescence. SETTING: Adolescents (Mage = 14·3 ± 2 years) and their parents, recruited from Minneapolis/St. Paul public schools in 2009-2010 and again in 2017-2018 as emerging adults (Mage = 22·1 ± 2 years). PARTICIPANTS: The analytic sample (n 1372; 53·1 % female, 46·9 % male) was diverse across race/ethnicity (19·8 % Asian, 28·5 % Black, 16·6 % Latinx, 14·7 % Multiracial/Other and 19·9 % White) and socio-economic status (58·6 % low/lower middle, 16·8 % middle and 21·0 % upper middle/high). RESULTS: In cross-sectional analyses, youth-reported FI was associated with lower IE during adolescence (P = 0·02) and emerging adulthood (P < 0·001). Longitudinally, household FI, but not adolescent experience of FI, was associated with lower IE in emerging adulthood (P = 0·01). Those who remained food-insecure (P = 0·05) or became food-insecure (P = 0·02) had lower IE in emerging adulthood than those remaining food-secure. All effect sizes were small. CONCLUSIONS: Results suggest FI may exert immediate and potentially lasting impacts on IE. As evidence suggests IE is an adaptive approach conferring benefits beyond eating, it would be valuable for interventions to address social and structural barriers that could impede IE.