War-Induced Disrupted Eating Behaviors in Ukrainian School-Aged Children ^†

Abstract

Background and objectives: Russian military aggression in Ukraine has exposed children to extremely high levels of acute and chronic stressors that are incomparable to stress levels in peaceful countries. Such stressors can impact children’s eating behavior, for example, by altering the psychological climate within families. We aimed to determine the prevalence of war-induced, stress-related disruptions in the eating behavior of Ukrainian children. Methods: We used a cross-sectional survey to determine stress-related disordered eating behavior among school-aged children under conditions of stress caused by the war in Ukraine. A total of 5162 parents or guardians used an electronic questionnaire to report changes in the children’s eating behavior (EB) in various stressful conditions, including being in close proximity to the combat zone, residing in occupied or peaceful territories, displacement from homes, abroad, and other. 311 (6%) of participants did not report the age of the child or reported on behalf of a child who was younger than 5 years or older than 17 years, and were thus excluded. Thus, the final sample included 4854 (94%) parents. Results: of the guardians, 63% reported changes in children’s EBs during the war, with the highest frequency observed among 5 to 10-year-olds. The most common EB changes observed during wartime included food cravings (38%), food fussiness (37%), aversion to certain foods (29%), and decreased appetite (24%). 40% of the reported EB changes were long-term, lasting over a month and related to altered attitudes towards food. Food insecurity, residing in occupied territories, and displacement emerged as the most influential determinants of EB changes. Discussion: The findings underscore a significant and robust association between various war-related exposures and an increased risk of frequent eating behavior changes. As healthy eating behaviors are learned during childhood and have been shown to track into adulthood, the identified disruptions in eating behavior may have significant long-term consequences for the physical and mental health of the Ukrainian children. More research is needed to determine whether the intensity of the identified changes in children’s eating habits is linked to the severity of the stressors.