Associations between food addiction symptoms, food intake and BMI-for-age in children from a low-income region: A structural equation modeling approach

BACKGROUND/OBJECTIVES: Food addiction (FA) is characterized by the presence of dependence symptoms associated with the consumption of calorie-rich, sugary, and fatty foods, typical of ultra-processed foods. The growing prevalence of childhood obesity has been linked to the increased consumption of ultra-processed foods. This study aimed to analyze the direct and indirect associations between FA symptoms, food consumption, and body mass index for age (BMI-for-age) in children from 7 to 10 years of age from a Brazilian low-income region. SUBJECTS/METHODS: A cross-sectional study was conducted, including 259 children of both genders, enrolled in public schools in the municipality of Vitória de Santo Antão, Pernambuco, Brazil. The Yale Food Addiction Scale for Children (YFAS-C) was used to assess FA symptoms. A food frequency questionnaire assessed food consumption, and the BMI-for-age was used to evaluate nutritional status. Structural equation analysis was employed for data analysis. The measurement model incorporated the seven FA symptoms from the YFAS-C, yielding favorable fit indices. RESULTS: FA symptoms had an inverse direct effect on the consumption of in natura and minimally processed foods (β = -10.878; SE = 4.919; p = 0.027), while exhibiting a positive direct impact on the consumption of ultra-processed foods (β = 10.025; SE = 4.898; p = 0.001). The relationship between FA symptoms and BMI-for-age was not mediated by the consumption of ultra-processed foods (β = -0.054; SE = 0.081; p = 0.041). CONCLUSION: FA symptoms are associated with an increase in ultra-processed food consumption and a decrease in healthy food consumption among children from low-income families.