Understanding the association between household food insecurity and diet quality: The role of psychological distress, food choice motives and meal patterning

Household food insecurity - a lack of reliable access to food that is safe, nutritious, and sufficient for normal growth - is associated with physical and mental ill-health. In the UK and many countries worldwide, food insecurity has been exacerbated by the cost-of-living crisis and is a major public health concern. To identify potential points of intervention, it is important to understand how food insecurity is associated with individual-level factors, including behaviours and motivations towards food. This study therefore examined the associations between household food insecurity (HHFI), psychological distress, motives underlying food choices and meal patterning behaviours in a sample of UK adults (N = 594, mean age = 40.6 years, 96 % female). Key variables were quantified using questionnaires and structural equation modelling was used to determine the associations between them. HHFI was directly associated with higher food choice motives based on price, but not directly with other food choice motives. HHFI was indirectly associated with poorer diet quality via price motives. There were also significant serial indirect associations between HHFI and diet quality via distress and food choice motives. Specifically, HHFI was associated with greater distress, which in turn was associated with higher convenience motives and lower health motives, which were then both associated with poorer diet quality. Exploratory analyses indicated that HHFI was directly associated with lower meal frequency, and this in turn was associated with poorer diet quality. Findings demonstrate how experiences of general psychological distress, certain food choice motives, and meal frequency may play a role in the relationship between food insecurity and diet quality.