The relationship between household food insecurity and quality of life among children aged 7–13 years: effects of parent-reported disordered eating, anxiety and depression

Abstract

BACKGROUND: Food insecurity (FI) has been linked to adverse child health outcomes, including developmental, physical, and psychological disorders. However, little is known about the impact of FI on Lebanese children, especially considering the daily social and economic challenges the population faces. These challenges heighten children's vulnerability, particularly with regard to disordered eating, anxiety, and depression, which may act as mediating factors affecting their overall quality of life. This study aims to assess the mediating effects of disordered eating, anxiety, and depression between FI and quality of life among Lebanese children aged 7-13 years. METHODS: A cross-sectional study was conducted among 504 Lebanese parents of children aged 7-13 years. FI was assessed using the Arab Family Food Security Scale (AFFSS), quality of life using the KIDSCREEN-10, disordered eating with the Eating Disorder Examination-Questionnaire Short-Parent version, anxiety with the Spence Children's Anxiety Scale-Parent, and depression with the Short Mood and Feelings Questionnaire-Parent version. Mediation analysis was performed using PROCESS MACRO v3.4 in SPSS, with 5000 bootstrapped samples. RESULTS: In total, 30.8% of parents reported severe levels of household FI. The results of the mediation analysis showed that disordered eating, depression and anxiety fully mediated the association between FI and quality of life. Higher FI was significantly associated with higher disordered eating/depression/anxiety, whereas higher disordered eating/depression/anxiety were significantly associated with lower quality of life. FI was not directly associated with quality of life. CONCLUSION: FI indirectly affects child's quality of life through its impact on disordered eating, anxiety, and depression. Addressing these psychological disorders in children from food-insecure households appears to be essential to improve their overall quality of life. The implications are specific to Lebanon but may provide valuable insights applicable to similar socio-economically and politically challenged areas.