Abstract
BackgroundFood insecurity is related to risk of adverse health outcomes such as obesity, but the explanatory factors underlying this association are still unclear. This study aimed to assess the association between food insecurity and obesity, and to explore potential mediation by sociodemographic and lifestyle factors.MethodsThis cross-sectional study was conducted among 250 participants in a deprived urban area in the Netherlands. Data on sociodemographic and lifestyle factors, food insecurity status and diet quality were collected using questionnaires. Diet quality was determined based on current national dietary guidelines. BMI was calculated from self-reported height and weight. Regression analyses were performed to explore the association between food insecurity and BMI status. Mediation analyses were performed to estimate the total-, direct-, and indirect effect and proportion of total effect mediated of the food insecurity-obesity association.ResultsThe overall prevalence of food insecurity was 26%. Food insecurity was associated with obesity (OR = 2.49, 95%CI = 1.16, 5.33), but not with overweight (OR = 1.15, 95%CI = 0.54, 2.45) in the unadjusted model. The food insecurity-obesity association was partially mediated by living situation (proportion mediated: 15.4%), diet quality (− 18.6%), and smoking status (− 15.8%) after adjustment for other covariates.ConclusionsThe findings of this study suggest an association between food insecurity and obesity. Living situation, diet quality and smoking status explained part, but not all, of the total association between food insecurity and obesity. Future longitudinal studies are warranted to examine the temporal order of the food insecurity-obesity association and potential mediators in this relationship. In addition, food insecurity and its potential consequences need to be taken into account in obesity prevention programs and policies.
Highlights
Food insecurity is related to risk of adverse health outcomes such as obesity, but the explanatory factors underlying this association are still unclear
Compared to food secure (FS) participants, food insecure (FI) participants more often had an income below the basic needs budget, had a lower educational level, and were less often currently employed
The average TOT-Diet score and FIN-Diet score varied across food insecurity status categories, with the lowest scores obtained by participants with a very low food security status
Summary
Food insecurity is related to risk of adverse health outcomes such as obesity, but the explanatory factors underlying this association are still unclear. A previous study by Neter et al (2014) found a food insecurity prevalence of 70% among adult Dutch food bank recipients [4]. The latter target group is a selection of extremely disadvantaged individuals, poverty rates are monitored regularly in the Netherlands and indicate that more than 5% of the Dutch population have an income below the basic needs limit, which includes only minimal expenses to cover fundamental needs like food, clothing and housing [5]. It is reasonable to expect that other disadvantaged groups in the Netherlands, for example those that are not fully eligible to access food bank services, might be affected by food insecurity and its consequences
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