Association between household food access insecurity and nutritional status indicators among children aged <5 years in Nepal: results from a national, cross-sectional household survey

Abstract

Objective: To examine the association between household food insecurity score and Z-scores of childhood nutritional status indicators. Design: Population-based, cross-sectional survey, Nepal Demographic and Health Survey 2011. Setting: A nationally representative sample of 11 085 households selected by a two-stage, stratified cluster sampling design to interview eligible men and women. Subjects: Children (n 2591) aged 0-60 months in a sub-sample of households selected for men's interview. Results: Prevalence of moderate and severe household food insecurity was 23·2 % and 19·0 %, respectively, for children aged 0-60 months. Weighted prevalence rates for stunting (height-for-age Z-score (HAZ) <−2), wasting (weight-for-height Z-score (WHZ) <−2) and underweight (weight-for-age Z-score (WAZ) <−2) were 41·6 % (95 % CI 38·9, 44·3 %), 11·5 % (95 % CI 9·8, 13·2 %) and 30·1 % (95 % CI 27·5, 32·8 %), respectively. Prevalences of stunting, severe stunting (HAZ <−3) and underweight by level of household food insecurity were statistically significant (P < 0·001). By multiple linear regression analyses and after adjustment for sociodemographic, child and environmental factors, household food access insecurity score was associated with HAZ (β = − 0·02, P = 0·01) and WAZ (β = − 0·01, P = 0·01) but was not associated with WHZ and BMI-for-age Z-score. A 10-point increase in household food access insecurity score was associated with a decrease in HAZ of 0·2 (95 % CI 0·05, 0·39) and decrease in WAZ of 0·1 (95 % CI 0·03, 0·27). Conclusions: Our results from a nationally representative sample confirm the previously reported association of household food insecurity with stunting and underweight. Community nutrition interventions may use household food insecurity scales for identifying those households where children may be at risk of growth faltering.

Association of adult tobacco use with household food access insecurity: results from Nepal demographic and health survey, 2011

“…Non-validation of modified HFIAS (7-items and 12 months recall period) and extending the period of recall from 30 days to adjust for seasonal variations in food supply in Nepal may have resulted in underestimation of HFI in NDHS 2011. Reporting biases of tobacco use, HFI due to cultural barriers and stigma have been discussed in detail elsewhere [34]. Notwithstanding above limitations, our study further strengthens the reported association of adult tobacco use with HFI, highlighting the previously less recognised non-health consequences of tobacco use on the poor households.…”

Adolescent food insecurity in rural Sindh, Pakistan: a cross-sectional survey

“…In adolescence, there is an increased demand for nutrients due to growth spurt and to attain puberty [3]. Studies have reported that food insecurity at adolescent stage (10)(11)(12)(13)(14)(15)(16)(17)(18)(19) years of age) can affect their linear growth [4], high risk of involving in violence perpetration [5] and are twice likely to develop cardiovascular diseases (2.27; 95% confidence interval [CI], 1.61-3.21) [6].…”

Food insecurity among women of reproductive age in Nepal: prevalence and correlates

“…It also has serious consequences for wellbeing. HFI is associated with adverse nutritional, physical and mental health outcomes for both children and adults [4,[6][7][8][9]. While all food insecurity is concerning, the implications for women of childbearing age are particularly acute due to the potential for intergenerational consequences.…”

“…HFI also adversely affects child wellbeing. Children from food insecure homes are more likely to suffer from stunting, underweight, and wasting [7][8][9][22][23][24][25]. In rural Indonesia, HFI was correlated with higher neonatal, infant and under-five child mortality [26].…”