Resumen
Antecedentes: La inseguridad alimentaria es un problema global asociado con efectos negativos en la salud física y mental. En Chile, afecta a un número creciente de personas, y, pese a esto, su relación con el malestar psicológico, el sesgo de peso internalizado y el riesgo de trastornos de la conducta alimentaria no ha sido suficientemente estudiada. Objetivo: Este estudio busca explorar la relación entre los niveles de inseguridad alimentaria y los resultados psicológicos (malestar psicológico, riesgo de trastornos alimentarios y sesgo de peso internalizado) en adultos chilenos. Método: Se realizó un estudio transversal con 107 participantes adultos (83.5% mujeres), utilizando la escala FIES para medir la inseguridad alimentaria, la escala DASS-21 para evaluar el malestar psicológico, y el EDI-3 y WBIS-M para medir el riesgo de trastornos alimentarios y el sesgo de peso internalizado. Para evaluar el impacto de los niveles de inseguridad alimentaria en las variables psicológicas, se utilizó PERMANOVA. Las comparaciones entre los niveles de inseguridad alimentaria en cada variable dependiente se realizaron mediante análisis de Kruskal-Wallis. Resultados: El 62.6% de los participantes presentó inseguridad alimentaria moderada o severa. Los resultados mostraron que la inseguridad alimentaria severa se asocia significativamente con mayores niveles de malestar psicológico, insatisfacción corporal y sesgo de peso internalizado. La insatisfacción corporal emergió como el factor más relevante en la relación entre inseguridad alimentaria y riesgo de trastornos alimentarios Conclusiones: Este estudio proporciona evidencia relevante sobre la relación entre la inseguridad alimentaria y el malestar psicológico (depresión, ansiedad, estrés), el riesgo de trastornos alimentarios y el sesgo de peso internalizado. Los resultados subrayan la necesidad de abordar el impacto emocional y psicológico de la inseguridad alimentaria en las intervenciones dirigidas a poblaciones vulnerables. Se requiere más investigación longitudinal para comprender mejor las dinámicas entre estas variables y su influencia en la salud mental.
Citas
Abene, J. A., Tong, J., Minuk, J., Lindenfeldar, G., Chen, Y., & Chao, A. M. (2023). Food insecurity and binge eating: A systematic review and meta-analysis. The International Journal of Eating Disorders, 56(7), 1301-1322. https://doi.org/10.1002/eat.23956
Antúnez, Z., & Vinet, E. Z. (2012). Validation of the abbreviated version in Chilean university tudents. Terapia Psicológica, 30(3), 49-55. https://doi.org/10.4067/S0718-48082012000300005
Arenas, D. J., Thomas, A., Wang, J., & DeLisser, H. M. (2019). A systematic review and meta-analysis of depression, anxiety, and sleep disorders in US adults with food insecurity. Journal of General Internal Medicine, 34(12), 2874-2882. https://doi.org/10.1007/s11606-019-05202-4
Becker, C. B., Middlemas, K., Gomez, F., & Kilpela, L. S. (2021). An exploratory examination of internalized weight stigma in a sample living with food insecurity. Body Image, 37, 238-245. https://doi.org/10.1016/j.bodyim.2021.03.006
Becker, C. B., Middlemass, K., Taylor, B., Johnson, C., & Gomez, F. (2017). Food insecurity and eating disorder pathology. The International Journal of Eating Disorders, 50(9), 1031-1040. https://doi.org/10.1002/eat.22735
Bruening, M., Dinour, L. M., & Chavez, J. B. R. (2017). Food insecurity and emotional health in the USA: a systematic narrative review of longitudinal research. Public health nutrition, 20(17), 3200-3208. https://doi.org/10.1017/S1368980017002221
Carvajal-Aldaz, D., Cucalon, G., & Ordonez, C. (2022). Food insecurity as a risk factor for obesity: A review. Frontiers in Nutrition, 9, 1012734. https://doi.org/10.3389/fnut.2022.1012734
Coleman-Jensen, A., Rabbitt, M. P., Gregory, C. A., & Singh, A. (2022). Household food security in the United States in 2021. Economic Research Service. U.S. Department of Agriculture. https://bit.ly/4lNSKW7
Davis, H. A., Kells, M., Todorov, S., Kosmas, J., & Wildes, J. E. (2023). Comorbid eating, depressive, and anxiety psychopathology is associated with elevated shame in women with food insecurity. The International Journal of Eating Disorders, 56(6), 1087-1097. https://doi.org/10.1002/eat.23913
Dietz W. H. (1995). Does hunger cause obesity? Pediatrics, 95(5), 766-767. https://doi.org/10.1542/peds.95.5.766
Durso, L. E., & Latner, J. D. (2008). Understanding self-directed stigma: Development of the Weight Bias Internalization Scale. Obesity, 16(Suppl 2), S80-S86. https://doi.org/10.1038/oby.2008.448
Elgar, F. J., Pickett, W., Pförtner, T. K., Gariépy, G., Gordon, D., Georgiades, K., Davison, C., Hammami, N., MacNeil, A. H., Azevedo Da Silva, M., & Melgar-Quiñonez, H. R. (2021). Relative food insecurity, mental health and wellbeing in 160 countries. Social Science & Medicine, 268, 113556. https://doi.org/10.1016/j.socscimed.2020.113556
Food and Agricultural Organization. (1996). Declaración de Roma sobre la Seguridad Alimentaria Mundial. FAO.
Food and Agricultural Organization. (2021). The state of food security and nutrition in the world. FAO. https://bit.ly/3GEaAus
Food and Agricultural Organization. (2023). El estado de la seguridad alimentaria y la nutrición en el mundo 2023: Transformación de los sistemas agroalimentarios y dietas saludables a lo largo del continuo rural-urbano. Organización de las Naciones Unidas para la Alimentación y la Agricultura. https://bit.ly/4cPA584
Food and Agricultural Organization, International Fund for Agricultural Development, United Nations Children’s Fund, the World Food Programme, & World Health Organization (2022). The State of Food Security and Nutrition in the World 2022. Repurposing food and agricultural policies to make healthy diets more affordable. FAO. https://doi.org/10.4060/cc0639en
Fuente, M., Rodríguez-Fernández, A., Maury-Sintjago, E., Flores-Sepúlveda, J., Candía-Martínez, J., & Barrón-Pavón, V. (2023). Alta prevalencia de malnutrición por déficit e inseguridad alimentaria en pm institucionalizadas en establecimientos de larga estadía (ELEAM) de las comunas de Chillán y Chillán Viejo, Chile. Revista Chilena de Nutrición, 50(3), 312-319. https://doi.org/10.4067/s0717-75182023000300312
Gallegos, D., Booth, S., Pollard, C. M., Chilton, M., & Kleve, S. (2023). Food security definition, measures and advocacy priorities in high-income countries: a Delphi consensus study. Public Health Nutrition, 26(10), 1986-1996. https://doi.org/10.1017/S1368980023000915
Garner, D. M. (2004). EDI-3 Eating Disorders Inventory-3: Professional Manual. Psychological Assessment Resources, Inc.
Goode, R. W., Godoy, S. M., Olson, K., Berg, S., Agbozo, B., Gwira, R., Xu, Y., Wolfe, H., Bhutani, J., & Alexander, R. (2023). "If I start panicking over having enough, then I start eating too much": Understanding the eating behaviors of SNAP recipients in larger bodies during COVID-19. Eating behaviors, 49, 101741. https://doi.org/10.1016/j.eatbeh.2023.101741
Hazzard, V. M., Hooper, L., Larson, N., Loth, K. A., Wall, M. M., & Neumark-Sztainer, D. (2022). Associations between severe food insecurity and disordered eating behaviors from adolescence to young adulthood: Findings from a 10-year longitudinal study. Preventive Medicine, 154, 106895. https://doi.org/10.1016/j.ypmed.2021.106895
Hazzard, V. M., Loth, K. A., Hooper, L., & Becker, C. B. (2020). Food insecurity and EDs: A review of emerging evidence. Current Psychiatry Reports, 22(12), 74. https://doi.org/10.1007/s11920-020-01200-0
Helmi, N. Z., Isa, K. A. M., & Masuri, M. G. (2020). Exploratory factor analysis on Food Insecurity Experience Scale (FIES): Latest food insecurity measurement tool by FAO. Health Scope : The Official Journal of Faculty of Health Sciences, Universiti Teknologi MARA, 3(2), 31-34.
Joseph, C., Feiner, C., & Leung, C. W. (2022). Food insecurity is associated with serious psychological distress among low-income California adults. Journal of Health Psychology, 27(10), 2249-2260. https://doi.org/10.1177/13591053211028913
Kells, M. R., Davis, H. A., Todorov, S., & Wildes, J. E. (2023). Health literacy and eating disorder pathology in women with food insecurity: A preliminary cross-sectional study. Eating Behaviors, 49, 101727. https://doi.org/10.1016/j.eatbeh.2023.101727
Kirkpatrick, S. I., & Tarasuk, V. (2008). Food insecurity is associated with nutrient inadequacies among Canadian adults and adolescents. The Journal of Nutrition, 138(3), 604-612. https://doi.org/10.1093/jn/138.3.604
Kolovos, S., Zavala, G. A., Leijen, A. S., Melgar-Quiñonez, H., & van Tulder, M. (2020). Household food insecurity is associated with depressive symptoms: Results from a Mexican population-based survey. Food Security, 12(2), 407-416. https://doi.org/10.1007/s12571-020-01014-1
Leung, C. W., Kullgren, J. T., Malani, P. N., Singer, D. C., Kirch, M., Solway, E., & Wolfson, J. A. (2020). Food insecurity is associated with multiple chronic conditions and physical health status among older US adults. Preventive Medicine Reports, 20, 101211. https://doi.org/10.1016/j.pmedr.2020.101211
Lizana-Calderón, P., Cruzat-Mandich, C., Díaz-Castrillón, F., Alvarado, J. M., & Compte, E. J. (2022). Psychometric properties of the Eating Disorder Inventory-3 (EDI-3) in Chilean youth. Frontiers in Psychology, 13, 806563. https://doi.org/10.3389/fpsyg.2022.806563
Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales (2nd ed.). Psychology Foundation.
Lydecker, J. A., & Grilo, C. M. (2019). Food insecurity and bulimia nervosa in the United States. The International Journal of Eating Disorders, 52(6), 735-739. https://doi.org/10.1002/eat.23074
Makoukji, M., Amhez, N. E. H., Yehya, A. A. K., Ghattas, H., Abunnasr, Y., & Zurayk, R. (2024). Food systems under shock: The evolution of food security status of Karantina residents after the Beirut explosion. Frontiers in Sustainable Food Systems, 8, 1351541. https://doi.org/10.3389/fsufs.2024.1351541
Maynard, M., Andrade, L., Packull-McCormick, S., Perlman, C. M., Leos-Toro, C., & Kirkpatrick, S. I. (2018). Food insecurity and mental health among females in high-income countries. International Journal of Environmental Research and Public Health, 15(7), 1424. https://doi.org/10.3390/ijerph15071424
Men, F., Elgar, F. J., & Tarasuk, V. (2021). Food insecurity is associated with mental health problems among Canadian youth. Journal of Epidemiology and Community Health, 75(8), 741-748. https://doi.org/10.1136/jech-2020-216149
Men, F., Gundersen, C., Urquia, M. L., & Tarasuk, V. (2020). Association between household food insecurity and mortality in Canada: A population-based retrospective cohort study. Canadian Medical Association Journal, 192(3), E53-E60. https://doi.org/10.1503/cmaj.190385
Middlemass, K. M., Cruz, J., Gamboa, A., Johnson, C., Taylor, B., Gomez, F., & Becker, C. B. (2021). Food insecurity & dietary restraint in a diverse urban population. Eating disorders, 29(6), 616-629. https://doi.org/10.1080/10640266.2020.1723343
Ministerio de Desarrollo Social y Familia. (2017). Encuesta de caracterización socioeconómica nacional: Encuesta CASEN 2017 [National Socioeconomic Characterization Survey: CASEN Survey 2017]. https://www.mdsf.gob.cl/encuesta-casen-2017
Ministerio de Desarrollo Social y Familia. (2020). Encuesta Social COVID-19: Encuesta CASEN 2020 [COVID-19 Social Survey: CASEN Survey 2020]. https://www.mdsf.gob.cl/encuesta-social-covid-19
Ministerio de Desarrollo Social y Familia. (2024, December). Resultados Casen 2022: Evolución de los indicadores de inseguridad alimentaria antes, durante y después de la pandemia [Revised version December 2024]. Subsecretaría de Evaluación Social. https://bit.ly/4cMtE5O
Myers, C. A. (2020). Food insecurity and psychological distress: A review of the recent literature. Current Nutrition Reports, 9(2), 107-118. https://doi.org/10.1007/s13668-020-00309-1
Myers, C. A., Mire, E. F., & Katzmarzyk, P. T. (2020). Trends in adiposity and food insecurity among US adults. JAMA Network Open, 3(8), e2012767. https://doi.org/10.1001/jamanetworkopen.2020.12767
Na, M., Miller, M., Ballard, T., Mitchell, D. C., Hung, Y. W., & Melgar-Quiñonez, H. (2019). Does social support modify the relationship between food insecurity and poor mental health? Evidence from thirty-nine sub-Saharan African countries. Public health nutrition, 22(5), 874-881. https://doi.org/10.1017/S136898001800277X
Nagata, J. M., Weiser, S. D., Gooding, H. C., Garber, A. K., Bibbins-Domingo, K., & Palar, K. (2019). Association Between Food Insecurity and Migraine Among US Young Adults. JAMA neurology, 76(9), 1121-1122. https://doi.org/10.1001/jamaneurol.2019.1663
Nikolaus, C. J., An, R., Ellison, B., & Nickols-Richardson, S. M. (2020). Food insecurity among college students in the United States: A scoping review. Advances in Nutrition, 11(2), 327-348. https://doi.org/10.1093/advances/nmz111
Niles, M. T., Beavers, A. W., Clay, L. A., Dougan, M. M., Pignotti, G. A., Rogus, S., Savoie-Roskos, M. R., Schattman, R. E., Zack, R. M., Acciai, F., Allegro, D., Belarmino, E. H., Bertmann, F., Biehl, E., Birk, N., Bishop-Royse, J., Bozlak, C., Bradley, B., Brenton, B. P., … Yerxa, K. (2021). A multi-site analysis of the prevalence of food insecurity in the United States, before and during the COVID-19 pandemic. Current Developments in Nutrition, 5(12), nzab135. https://doi.org/10.1093/cdn/nzab135
Observatorio Social Ministerio de Desarrollo Social y Familia. (2021). Encuesta Social Covid-19: Resultados longitudinales de inseguridad alimentaria [COVID-19 Social Survey: Longitudinal Results of Food Insecurity]. https://www.mdsf.gob.cl/encuesta-social-covid-19-2021
Pearl, R. L., & Puhl, R. M. (2014). Measuring internalized weight attitudes across body weight categories: Validation of the modified Weight Bias Internalization Scale. Body Image, 11(1), 89-92. https://doi.org/10.1016/j.bodyim.2013.09.005
Pinheiro, A.C., Quintiliano-Scarpelli, D., Araneda-Flores, J., Oliveira, R.A., Pizarro, T., Suarez-Reyes, M., & Marques de Oliveira, M. R. (2022) Food insecurity and its determinants in a vulnerable area of Santiago, Chile. Frontiers in Sustainable Food System, 6, 924921. https://doi/10.3389/fsufs.2022.924921
Pryor, L., Lioret, S., van der Waerden, J., Fombonne, É., Falissard, B., & Melchior, M. (2016). Food insecurity and mental health problems among a community sample of young adults. Social Psychiatry and Psychiatric Epidemiology, 51(8), 1073-1081. https://doi.org/10.1007/s00127-016-1249-9
Puhl, R. M., Himmelstein, M. S., & Quinn, D. M. (2018). Internalizing Weight Stigma: Prevalence and Sociodemographic Considerations in US Adults. Obesity, 26(1), 167-175. https://doi.org/10.1002/oby.22029
Rezende Machado de Sousa, L., Saint-Ville, A., Samayoa-Figueroa, L., & Melgar-Quiñonez, H. (2019). Changes in food security in Latin America from 2014 to 2017. Food Security, 11(3), 503-513. https://doi.org/10.1007/s12571-019-00931-0
Rossi, M., Ferre, Z., Curutchet, M. R., Giménez, A., & Ares, G. (2017). Influence of sociodemographic characteristics on different dimensions of household food insecurity in Montevideo, Uruguay. Public Health Nutrition, 20(4), 620-629. https://doi.org/10.1017/S1368980016002548
Schvey, N. A., & White, M. A. (2015). The internalization of weight bias is associated with severe eating pathology among lean individuals. Eating Behaviors, 17, 1-5. https://doi.org/10.1016/j.eatbeh.2014.11.001
Sundermeir, S. M., Wolfson, J. A., Bertoldo, J., Gibson, D. G., Agarwal, S., & Labrique, A. B. (2021). Food insecurity is adversely associated with psychological distress, anxiety and depression during the COVID-19 pandemic. Preventive Medicine Reports, 24, 101547. https://doi.org/10.1016/j.pmedr.2021.101547
Tarasuk, V., & Mitchell, A. (2020). Household food insecurity in Canada, 2017-18. Research to identify policy options to reduce food insecurity. https://bit.ly/3EGmwLF
Van Lancker, W., & Parolin, Z. (2020). COVID-19, school closures, and child poverty: A social crisis in the making. The Lancet. Public Health, 5(5), e243-e244. https://doi.org/10.1016/S2468-2667(20)30084-0
Vinet, E., Rehbein, L., Román, F., & Saiz, J. (2008). Escalas abreviadas de depresión, ansiedad y estrés (DASS - 21). Versión chilena traducida y adaptada [Documento no publicado]. Universidad de La Frontera.
Weaver, L., & Fasel, C. (2018). A systematic review of the literature on the relationships between chronic diseases and food iColnsecurity. Food and Nutrition Sciences, 9, 519-541. https://doi.org/10.4236/fns.2018.95040
Zahidi, F., Khalid, M., Surkan, P. J., & Azadbakht, L. (2022). Associations between food insecurity and common mental health problems among reproductive-aged women in Kabul-Afghanistan. Frontiers in Nutrition, 8, 794607. https://doi.org/10.3389/fnut.2021.794607
