Overvaluation of Eating and Satiation Explains the Association of Food Insecurity and Food Intake With Obesity and Cardiometabolic Diseases

Background: In developing countries, where energy-dense foods with low nutrient content are highly accessible, the fear of feeling hungry and the desire of prolonging satiation have been documented. Objective: To evaluate the role of valuation of eating and satiation in the relationship of food insecurity with diet, obesity, and cardiometabolic risk with structural equation modeling. Methods: A validated questionnaire that measures the value of eating and satiation (VES) as the basis of wealth was administered to 321 adult women from Queretaro, Mexico. Instruments for measurement of socioeconomic status, food insecurity, physical activity, and a semiquantitative food frequency questionnaire were also applied. Women were measured and weighed, and they provided a fasting blood sample to determine lipid profile, glucose, and insulin concentrations. Structural equation models were used for prediction of the homeostasis model assessment-insulin resistance (HOMA-IR) index and triglyceride/high-density lipoprotein (HDL) cholesterol index. Results: The models confirmed, with acceptable goodness-of-fit parameters, the mediation position of VES between past experiences of food insecurity and a greater intake of carbohydrates and its impact on obesity, and on the HOMA-IR and the triglyceride/HDL-cholesterol index. Conclusion: Experiences of food insecurity may increase VES in women and influence eating behavior, increasing intake of sugars and starches in their diet, thus increasing the risk of obesity and cardiometabolic diseases such as diabetes. The understanding of essential values that induce unfavorable eating behavior in a population that has experienced past food insecurity may help to develop public health strategies for prevention of cardiometabolic diseases.