How is household food insecurity and maternal nutritional status associated in a resource-poor setting in Ghana?

Abstract

Population-based studies show household food insecurity is associated with increased body mass index (BMI) and an increased risk of overweight in adult women in developed countries. However, there is insufficient empirical evidence of the association between food insecurity and maternal nutritional status in resource-poor settings. This study investigated the relationship between household food insecurity (HFI) and maternal nutritional status in a resource-poor setting of Ghana, where some households suffer from some form of food insecurity during the year. A community-based cross-sectional cluster study was conducted in June 2015. The study communities were selected using probability proportionate to size. The study population comprised non-lactating and non-pregnant women who were selected using a two-stage cluster sampling procedure. HFI was quantified using the Household Hunger Scale. Multiple regression analysis was conducted to test whether HFI significantly predicts maternal nutritional status, controlling for potential confounding factors. BMI was used to assess the nutritional status. The prevalence of moderate to severe household hunger was 46.9 %. In analysis of covariance, while adjusting for household size, place of residence and household wealth index, the mean BMI for women from food-secure households was 1.4 kg/m2 significantly higher than the mean BMI for women from food-insecure households (25.7 ± 5.3 vs. 24.3 ± 4.0) (95 % CI 0.54–2.35), p = 0.002. Multivariable regression analysis showed that, after adjusting for potential confounders, there was a significant negative association between moderate to severe household hunger and BMI (β = −0.16, p < 0.001). In conclusion, food insecurity in the study population was prevalent and was associated with low maternal BMI. Household food insecurity was negatively associated with maternal overweight and obesity. Women in food-secure households were more likely than food-insecure households to consume milk, pulses, oily and sugar-based foods.