Household food insecurity is associated with a higher burden of obesity and risk of dietary inadequacies among mothers in Beirut, Lebanon

Abstract

BackgroundMixed 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.MethodsA 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.ResultsHFIS 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.ConclusionsHigh 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.

Sex disparities in dietary intake across the lifespan: the case of Lebanon

“…Women may also "sacrifice" by eating less from certain foods groups, in favor of their children. A recent study by Jomaa et al (2017) showed that, in an effort to ensure that their children are well-fed, Lebanese mothers may consume less animal-based foods such as meats and may thus have an inadequate intake of several micronutrients including iron, zinc and vitamin B12 [65,66].…”

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

“…Studies from around the world show that food insecurity is associated with having low levels of education, weak social networks, less social capital, low household income, and being unemployed [13,[27][28][29]. In Lebanon, household income and women's education were inversely associated with HFI [11]. In Uruguay and Brazil, household income strongly correlated with food insecurity [30,31].…”

“…HFI affects women's and children's diet diversity which in turn shapes their nutritional outcomes [10]. Women and children in foodinsecure households often consume fewer fruits, vegetables, nuts, and protein-rich foods but more refined grains, bread, and sweets; they are therefore at risk for obesity and diabetes [11][12][13]. Malnutrition before and during pregnancy is associated with a range of health problems for the mother and the developing fetus [14].…”

Association Between Food Insecurity and Key Metabolic Risk Factors for Diet-Sensitive Non-Communicable Diseases in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

“…[4][5][6][7] The World Health Organization (WHO) and the United Nations General Assembly, among other professional organisations, recently identified food insecurity as an important proximate driver of the prevalence of metabolic risk factors on the causal pathway to diet-sensitive NCDs. 8 This premise is rooted in the hypothesis that exposure to food insecurity results in compensatory behaviours, which often includes less intake of fruit and vegetables, 9 skipping meals, or reducing portion sizes, 10 and overconsumption of low-cost foods that are high in calories yet deficient in nutritional value. 11 Over time, these compensatory behaviours, perceived as buffers against food insecurity, may lead to malnutrition, which, in turn, initiates a cascade of metabolic risk factors that ultimately precipitate diet-sensitive NCDs.…”