Economic Hardship, Mental Health, and Food Choices: A Mediation Analysis of Food Insecurity’s Impact on Dietary Decisions in Hauts-de-France

Food insecurity is a multifaceted issue encompassing not only economic constraints but also psychological burdens such as stress and cognitive load, which may impair dietary decision-making and exacerbate nutrition-related health inequalities. This study employs a structural equation mediation model to analyze how perceived stress and cognitive load mediate the relationship between food insecurity and food choice values among 618 participants from Hauts-de-France, one of France's most deprived regions in terms of poverty and obesity prevalence. We measure food insecurity using the Food Insecurity Index, perceived stress with the Perceived Stress Scale (PSS), cognitive load via an adapted NASA-TLX instrument focused on food shopping and preparation, and food choice motivations with the Food Choice Values Scale. Our econometric approach quantifies direct and indirect effects to unravel the psychological mechanisms linking economic hardship to dietary preferences. Results indicate that food insecurity is significantly associated with higher preferences for convenience, accessibility, and emotional comfort foods, and negatively related to organic, safety-conscious, and weight-control motivations. Both perceived stress and cognitive load significantly mediate these relationships: cognitive load during shopping increases preference for ease and sensory appeal, while cognitive load during preparation reduces health-focused choices. Stress further amplifies emotional and impulsive food motivations. These findings underscore the critical role of psychosocial factors in shaping food choices among economically vulnerable populations. Integrating stress reduction and cognitive load management into nutrition policies is essential, alongside structural interventions targeting the root causes of food insecurity, to promote healthier dietary behaviors.