Household Food Insecurity is Associated with a Higher Burden of Obesity and Risk of Dietary Inadequacies Among Mothers in Beirut, Lebanon

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2017 Jun 14

PMID 28606120

Citations 33

Authors

Lamis Jomaa

Farah Naja

Ruba Cheaib

Nahla Hwalla

Affiliations

Soon will be listed here.

Abstract

Background: Mixed evidence exists with respect to the association between household food insecurity (HFIS) and obesity in low-to-middle income countries (LMICs), particularly among women. This study aimed to measure socioeconomic correlates of HFIS and explores its association with dietary intake and odds of obesity among mothers in Lebanon, a middle-income country undergoing nutrition transition.

Methods: A cross-sectional study was conducted among a representative sample of households (n = 378) in Beirut, Lebanon. Surveys were completed with mothers of children <18 years. HFIS was measured using a locally-validated, Arabic-translated Household Food Insecurity Access Scale (HFIAS). Dietary intake was assessed using the multiple pass 24-h recall method. Associations between HFIS (food vs food insecure) and socio-demographic characteristics were reported using crude and adjusted odds ratios. The odds of consuming <2/3rd Dietary Reference Intakes (DRIs) for nutrients among mothers from food secure and food insecure households were explored. In addition, logistic regression analyses were conducted to explore the association of HFIS with obesity (BMI ≥ 30 kg/m2) and at-risk waist circumference (WC ≥ 80 cm) among mothers.

Results: HFIS was found among 50% of study sample and was inversely associated with household income and mother's educational level, even after adjusting for other socioeconomic variables (p < 0.01). Mothers in food insecure households reported consuming significantly less dairy products, fruits, and nuts yet more breads and sweets; and they had higher odds of consuming <2/3rd the DRI's for key micronutrients (potassium, folate, and vitamin C) compared to secure ones. Adjusting for socioeconomic correlates, food insecure mothers had 1.73 odds of obesity (95% CI: 1.02-2.92) compared to food secure mothers.

Conclusions: High HFIS prevalence was reported among urban Lebanese households. Mothers from food insecure households had a high risk of dietary inadequacy and obesity. Adequate evidence-based public health strategies are needed to reduce the vulnerability of mothers to food insecurity in LMIC settings and alleviate their risk of a high burden of nutrient insecurity and obesity.

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References

Vuong T, Gallegos D, Ramsey R . Household food insecurity, diet, and weight status in a disadvantaged district of Ho Chi Minh City, Vietnam: a cross-sectional study. BMC Public Health. 2015; 15:232. PMC: 4358861. DOI: 10.1186/s12889-015-1566-z. View

Rose D, Oliveira V . Nutrient intakes of individuals from food-insufficient households in the United States. Am J Public Health. 1998; 87(12):1956-61. PMC: 1381236. DOI: 10.2105/ajph.87.12.1956. View

Okamoto K, Ohsuka K, Shiraishi T, Hukazawa E, Wakasugi S, Furuta K . Comparability of epidemiological information between self- and interviewer-administered questionnaires. J Clin Epidemiol. 2002; 55(5):505-11. DOI: 10.1016/s0895-4356(01)00515-7. View

Popkin B . The nutrition transition and its health implications in lower-income countries. Public Health Nutr. 1999; 1(1):5-21. DOI: 10.1079/phn19980004. View

Nasreddine L, Naja F, Chamieh M, Adra N, Sibai A, Hwalla N . Trends in overweight and obesity in Lebanon: evidence from two national cross-sectional surveys (1997 and 2009). BMC Public Health. 2012; 12:798. PMC: 3527186. DOI: 10.1186/1471-2458-12-798. View

Na M, Mehra S, Christian P, Ali H, Shaikh S, Shamim A . Maternal Dietary Diversity Decreases with Household Food Insecurity in Rural Bangladesh: A Longitudinal Analysis. J Nutr. 2016; 146(10):2109-2116. DOI: 10.3945/jn.116.234229. View

Klein S, Allison D, Heymsfield S, Kelley D, Leibel R, Nonas C . Waist Circumference and Cardiometabolic Risk: a Consensus Statement from Shaping America's Health: Association for Weight Management and Obesity Prevention; NAASO, the Obesity Society; the American Society for Nutrition; and the American Diabetes.... Obesity (Silver Spring). 2007; 15(5):1061-7. DOI: 10.1038/oby.2007.632. View

McIntyre L, Glanville N, Raine K, Dayle J, Anderson B, Battaglia N . Do low-income lone mothers compromise their nutrition to feed their children?. CMAJ. 2003; 168(6):686-91. PMC: 154913. View

Mohammadi F, Omidvar N, Houshiar-Rad A, Khoshfetrat M, Abdollahi M, Mehrabi Y . Validity of an adapted Household Food Insecurity Access Scale in urban households in Iran. Public Health Nutr. 2011; 15(1):149-57. DOI: 10.1017/S1368980011001376. View

10.

Rodriguez L, Mundo-Rosas V, Mendez-Gomez-Humaran I, Perez-Escamilla R, Shamah-Levy T . Dietary quality and household food insecurity among Mexican children and adolescents. Matern Child Nutr. 2016; 13(4). PMC: 6866226. DOI: 10.1111/mcn.12372. View

11.

Perez-Escamilla R, Segall-Correa A, Maranha L, Sampaio Md M, Marin-Leon L, Panigassi G . An adapted version of the U.S. Department of Agriculture Food Insecurity module is a valid tool for assessing household food insecurity in Campinas, Brazil. J Nutr. 2004; 134(8):1923-8. DOI: 10.1093/jn/134.8.1923. View

12.

Ivers L, Cullen K . Food insecurity: special considerations for women. Am J Clin Nutr. 2011; 94(6):1740S-1744S. PMC: 3226027. DOI: 10.3945/ajcn.111.012617. View

13.

Shim J, Oh K, Kim H . Dietary assessment methods in epidemiologic studies. Epidemiol Health. 2014; 36:e2014009. PMC: 4154347. DOI: 10.4178/epih/e2014009. View

14.

Oldewage-Theron W, Dicks E, Napier C . Poverty, household food insecurity and nutrition: coping strategies in an informal settlement in the Vaal Triangle, South Africa. Public Health. 2006; 120(9):795-804. DOI: 10.1016/j.puhe.2006.02.009. View

15.

Campbell R, Talegawkar S, Christian P, LeClerq S, Khatry S, Wu L . Seasonal dietary intakes and socioeconomic status among women in the Terai of Nepal. J Health Popul Nutr. 2014; 32(2):198-216. PMC: 4216957. View

16.

Turrell G . Income non-reporting: implications for health inequalities research. J Epidemiol Community Health. 2000; 54(3):207-14. PMC: 1731636. DOI: 10.1136/jech.54.3.207. View

17.

Gulliford M, Mahabir D, Rocke B . Food insecurity, food choices, and body mass index in adults: nutrition transition in Trinidad and Tobago. Int J Epidemiol. 2003; 32(4):508-16. DOI: 10.1093/ije/dyg100. View

18.

Fukuoka Y, Rankin S, Carroll D . Systematic bias in self-reported annual household incomes among unpartnered elderly cardiac patients. Appl Nurs Res. 2007; 20(4):205-9. DOI: 10.1016/j.apnr.2007.01.010. View

19.

Scagliusi F, Polacow V, Artioli G, Benatti F, Lancha Jr A . Selective underreporting of energy intake in women: magnitude, determinants, and effect of training. J Am Diet Assoc. 2003; 103(10):1306-13. DOI: 10.1016/s0002-8223(03)01074-5. View

20.

Sahyoun N, Nord M, Sassine A, Seyfert K, Hwalla N, Ghattas H . Development and validation of an Arab family food security scale. J Nutr. 2014; 144(5):751-7. DOI: 10.3945/jn.113.187112. View