Nutrition/Obesity
Food Insecurity and Body Image Concerns in College Students: The Mediating Role of Diet Quality Chidimma Okoli* Chidimma Okoli Department of Epidemiology and Community Health, University of North Carolina at Charlotte
Food insecurity (FI) is prevalent among college students and has been associated with poor diet quality and adverse psychosocial outcomes, including body image concerns. However, whether diet quality explains the relationship between FI and body image–related restrictive eating remains unclear. We examined whether diet quality mediates the association between FI and body image–related restrictive eating behaviors among college students. FI was assessed using the 18-item USDA Food Security Survey Module. Diet quality was measured using minimum dietary diversity (MDD), defined as consumption of ≥5 of 10 food groups based on the Diet Quality Questionnaire. Body image concerns were defined as intentionally cutting meal size or skipping meals to lose weight or achieve body image goals. Logistic regression models estimated the total effect of FI on body image concerns, the association between FI and MDD, and the association between MDD and body image concerns, adjusting for FI. Mediation was evaluated using nonparametric bootstrapping with 1,000 iterations. Models adjusted for age, sex, race/ethnicity, BMI, perceived stress, dietary supplements, and meal plan. Among 539 participants, 34.3% were food insecure, 43.2% reported body image–related restrictive eating, and 68.8% met MDD. Food-insecure students were less likely to meet MDD than food-secure students (28.6% vs. 47.0%). After adjustment, FI was associated with lower odds of meeting MDD (OR=0.45; 95% CI=0.28–0.73). Meeting MDD was independently associated with higher odds of body image concerns (OR=1.65; 95% CI=1.05–2.61). The total effect of FI and body image concerns was not statistically significant (OR=1.13; 95% CI=0.72–1.78), and mediation analyses showed no statistically significant indirect effect. Findings suggest diet quality may be an important correlate of body image concerns among food-insecure students. Longitudinal studies are needed to clarify temporal pathways and inform equity-focused interventions.