Caribbean Food Security Scale Research Articles

A surge in food insecurity during the COVID-19 pandemic in a cohort in Mexico City.

The COVID-19 pandemic has not only caused tremendous loss of life and health but has also greatly disrupted the world economy. The impact of this disruption has been especially harsh in urban settings of developing countries. We estimated the impact of the pandemic on the occurrence of food insecurity in a cohort of women living in Mexico City, and the socioeconomic characteristics associated with food insecurity severity. We analyzed data longitudinally from 685 women in the Mexico City-based ELEMENT cohort. Food insecurity at the household level was gathered using the Latin American and Caribbean Food Security Scale and measured in-person during 2015 to 2019 before the pandemic and by telephone during 2020-2021, in the midst of the pandemic. Fluctuations in the average of food insecurity as a function of calendar time were modeled using kernel-weighted local polynomial regression. Fixed and random-effects ordinal logistic regression models of food insecurity were fitted, with timing of data collection (pre-pandemic vs. during pandemic) as the main predictor. Food insecurity (at any level) increased from 41.6% during the pre-pandemic period to 53.8% in the pandemic stage. This increase was higher in the combined severe-moderate food insecurity levels: from 1.6% pre-pandemic to 16.8% during the pandemic. The odds of severe food insecurity were 3.4 times higher during the pandemic relative to pre-pandemic levels (p<0.01). Socioeconomic status quintile (Q) was significantly related to food insecurity (Q2 OR = 0.35 p<0.1, Q3 OR = 0.48 p = 0.014, Q4 OR = 0.24 p<0.01, and Q5 OR = 0.17 p<0.01), as well as lack of access to social security (OR = 1.69, p = 0.01), and schooling (OR = 0.37, p<0.01). Food insecurity increased in Mexico City households in the ELEMENT cohort as a result of the COVID-19 pandemic. These results contribute to the body of evidence suggesting that governments should implement well-designed, focalized programs in the context of economic crisis such as the one caused by COVID-19 to prevent families from the expected adverse health and well-being consequences associated to food insecurity, especially for the most vulnerable.

Factorial effects contributing to food security in Mexico during COVID-19 context

The COVID-19 pandemic has altered the social, economic and environmental order of the world, and it wreaked havoc in many aspects of the life of societies, including the food insecurity (FI) rates in the regions. Due to the multifaceted nature of this phenomenon, it is required a better understanding of the associated variables that contribute to food security (FS), such as the socioeconomic and demographic variables for designing effective and efficient policy interventions. In this sense, this study describes an innovative way of interpreting the causal influence of the interaction effects between the socioeconomic and demographic variables on the level of FS experienced by Mexican households during the pandemic crisis. The period from March to May of 2021, a digital survey was applied to 630 households to analyze the harmonized version of the Latin American and Caribbean Food Security Scale (ELCSA). For this, a factorial regression model was used to estimate the factorial effects contribution of the mentioned variables under study, obtaining important results on the level of FS in two Mexican states: Nayarit and the State of Mexico. The obtained model shows the contribution factors, involved on the level of FS, are the following: mother's job, household incomes, the portion of income destined for food, the interaction between the family members with the place of residence, the interaction of the gender of the household head with the place of residence, the interaction of the mother's job with the father's schooling, and the interaction of the father's schooling with the portion of income spent on food. These findings offer essential insights for identifying vulnerable groups susceptible to experiencing food insecurity, in order to facilitate effective intervention in the multiple areas that require improvement, thus enhancing food security in the regions and contributing to the achievement of the SDG.

Seguridad alimentaria en familias de Yurimaguas, Perú: Características y factores asociados

Food security is sufficient access to safe and nutritious foods to satisfy nutritional needs and personal preferences, and to lead a healthy and active life. Objectives. To determine food security in 160 households of human settlement of Yurimaguas district, Loreto department, Perú and factors associated with it. Methods. The selected households had among their members at least one child under 18 years of age and an unmet basic need, which for all of them, did not have the sewage service. In these households, the Latin American and Caribbean Food Security Scale (ELCSA) was applied, consisting of 15 items and a sociodemographic and socioeconomic survey. The households were classified as food secure, or mildly, moderately or severely food insecure. Results. Among households, 3.1% were classified as food secure and 96.9% as food insecure (78.8% as mildly insecure, 16.9% as moderately insecure and 1.2% as severely insecure). Food- insecure households had a greater number of minors, mothers with a lower educational level and the daily expenditure in food was lower in comparison with food-secure households. Conclusions. A very high percentage of the households surveyed in the study area were food insecure, although mostly mild. Associated with the number of minors in the home, the mother's education and daily spending on food purchases.

Risk factors for household food insecurity in the Eastern Caribbean Health Outcomes Research Network cohort study.

Globally, 1.3 billion people were considered food insecure as of 2022. In the Caribbean region, the prevalence of moderate or severe food insecurity was 71.3% as of 2020, the highest of all subregions in Latin America. Experienced based measurement scales, like the Latin American and Caribbean Food Security Scale, are efficient measurement tools of food insecurity used globally. The Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study is a population-based longitudinal cohort study in the two Caribbean U.S. territories of Puerto Rico and the U.S. Virgin Islands, as well as in Barbados and Trinidad & Tobago. The purpose of this research was to examine the demographic, psychosocial, behavioral, and environmental risk factors associated with household food insecurity (HFI) among adults ≥40 years of age in the ECHORN cohort. A cross-sectional analysis of baseline ECHORN cohort study data was conducted. The primary outcome was household food insecurity (none, mild, moderate/severe). A total of 16 known and potential risk factors were examined for their association with HFI. The ANOVA and chi-square statistics were used in bivariate analysis. Ordinal logistic regression was used for the multivariable and sex stratified analyses. More than one-quarter of the sample (27.3%) experienced HFI. In bivariate analyses, all risk factors examined except for sex, were significantly associated with HFI status. In the multivariable analysis, all variables except sex, education, marital status, smoking status, and residing in Puerto Rico were significant predictors of HFI in the adjusted model. In sex stratified analysis, depression, food availability, self-rated physical health, and island site were significantly associated with increased odds of worsening HFI for women, but not for men. Source of potable water was an important risk factor for both men and women. The prevalence of HFI in the ECHORN cohort study is comparable to other studies conducted in the region. While women did not have an increased risk of HFI compared to men, a different set of risk factors affected their vulnerability to HFI. More research is needed to understand how water and food security are interrelated in the ECHORN cohort.

Food Insecurity During the Covid-19 Confinement in Ecuador, Estimated by the Latin American and Caribbean Food Security Scale - A Cross-sectional Study

Food Insecurity During the Covid-19 Confinement in Ecuador, Estimated by the Latin American and Caribbean Food Security Scale - A Cross-sectional Study

Food Insecurity is Associated with Low Dietary Diversity in Rural Women in Mexico: Results from the Mexican National Health and Nutrition Survey, ENSANUT 2018

ABSTRACT Rural women suffer greater vulnerability to food insecurity (FI) compared to their urban or male counterparts. We analyzed the association between food security (FS) status and dietary diversity (DD) in rural women through data from the Mexican National Health and Nutrition Survey (ENSANUT) 2018 from 2,099 rural women. DD was measured using a semi-quantitative food frequency questionnaire. FS was measured using the Latin America and Caribbean Food Security Scale (ELCSA). The prevalence of any level of FI was 70.1%. Mean DD score was 3.8. Mild FI was associated with low DD (OR 1.49, 95% CI 1.06, 2.10). Results highlight the need for government strategies targeted to this population sector to improve their diet quality.

Prevalence of food insecurity and its association with depressive and anxiety symptoms in older adults during the COVID-19 pandemic in Mexico: A secondary analysis of ENCOVID-19 survey.

COVID-19 infection has caused high rates of morbi-mortality in older adults (OAs). In addition, conditions such as depression, anxiety, unemployment, and poverty frequently contribute to this population being at higher risk of food insecurity (FI) during the COVID-19 pandemic. This study aimed to analyze the prevalence of FI and its association with depressive and anxiety symptoms in Mexican OAs during the COVID-19 pandemic. This study involved a secondary analysis of the National Survey on the Effects of COVID-19 on the Wellbeing of Mexican Households (ENCOVID-19), a series of cross-sectional telephone surveys conducted between April and October 2020. The OA subsample was 1,065. FI was measured by using the Latin American and Caribbean Food Security Scale (ELCSA), and depression and anxiety symptoms were measured by using the Depression Scale of the Center for Epidemiological Studies (CESD-7) and the Generalized Anxiety Disorder Scale (GAD-2), respectively. Socioeconomic status (SES), occupation, schooling, and pension were also evaluated. ANOVA was used to compare the variables between the different FI groups, and logistic regression was used to analyze the risk between FI and the anxiety and depression variables. The mean age of the participants was 67.31 ± 6.4 years, and FI was classified as mild, moderate, and severe, with prevalences of 38.6, 15.04, and 8.16%, respectively. Overall, 28.01% of the OAs presented symptoms of anxiety and 39.09% of depression. In the comparison between groups, a higher prevalence of depressive symptoms was observed with a higher degree of FI, with 65.75% in moderate-to-severe, 10.39% in mild, and 9.40% without FI, p ≤ 0.000. Regarding anxiety symptoms, 48% of the OAs showed moderate-to-severe, 30.05% showed mild, and 15.38% were without FI, p ≤ 0.000. Using multiple logistic regression, an OR of 5.50 (95% CI 2.74-11.04) was observed for depressive symptoms when moderate-to-severe FI is present. In the case of the risk of anxiety symptoms, it was significant in all degrees of FI, in mild (OR = 2.43, 95% CI 1.66-3.59) and in moderate-to-severe (OR = 5.32, 95% CI 3.45-8.19). There is a high prevalence of FI in Mexican OAs during the COVID-19 pandemic. FI increases the risk of other conditions such as depression and anxiety. It is important to design and implement programs aimed at OAs with these conditions to reduce or prevent FI.

Abstract P426: Food Insecurity is Associated With Insomnia Among Men in the Echorn Cohort

Background: Food insecurity (FI), defined as lack of consistent access to enough food for an active, healthy lifestyle, affects 40% of people across the Caribbean and is associated with adverse cardiovascular outcomes. Despite evidence that suggests an association between FI and sleep health and FI prevalence in the Caribbean, few studies have been conducted. We aimed to examine the relationship between FI and sleep health in the Eastern Caribbean.We hypothesized that FI would be negatively associated with sleep health. Methods: Baseline data from the Eastern Caribbean Health Outcomes Research Network Cohort Study (ECS) were analyzed (2013-2018). Participants (n= 2,961) are community-dwelling individuals 40 years or older residing in Barbados, Puerto Rico, Trinidad and Tobago, or U.S. Virgin Islands. Participants completed a questionnaire including the 9-item Latin American and Caribbean Food Security Scale. Responses were summed to create a score (0-9) and create four categories: 0 no FI, 1-3 mild FI, 4-6 moderate, and 7-9 severe FI. FI was also operationalized as a binary variable (yes/no). Sleep outcomes included adequate sleep and insomnia. Sleep variables were measured by the items, “how many hours of sleep do you usually get at night,” and “has a doctor or other health professional has ever told you that you have insomnia.” Adequate sleep was defined as 7+ hours (yes/no) and insomnia was also operationalized as binary variable (yes/no). Other variables included sex and age. Chi-square tests and multivariable logistic regression modeling were used for the analysis. Results: Analyses included 2,321 participants. Sixty-five percent were women, and the mean age was 57 years. Findings showed 28% (644 of 2,321) of participants experienced food insecurity: 17.1% (397 of 2,321) mild, 6.2% (144 of 2,321) moderate, and 4.4% (103 of 2,321) severe. Fifty-five percent (1279 of 2,321) of participants had inadequate sleep (&lt;7 hours) and five percent reported insomnia. FI was not significantly associated with inadequate sleep in bivariate or multivariable analyses. Bivariate results for insomnia showed statistically significant associations with FI (p=0.0002). Multivariable results showed moderate and severe FI were associated with 2 (CI=1.01-4.16) and 4 (CI=1.95-7.05) times greater odds of insomnia compared to those who were food secure. Sex-stratified results showed men with severe FI had 9 times greater odds of insomnia (CI=3.2-23.7). Results were not statistically significant for women. Conclusions: Future research should examine mechanisms that explain sex differences in the relationship between FI and insomnia.

Consideraciones sobre la seguridad alimentaria en hogares mexicanos durante la pandemia de Covid-19

This study determined the level of food security in Mexican households in the COVID-19 pandemic according to the characteristics of the members. To this end, the harmonized version of the Latin American and Caribbean Food Security Scale was applied between May and August 2020. It was detected that 16.0% of households had food security (FS), FS was higher in households with persons aged 26 to 64 years (16.2%) and 65 years and older (15.2%). The prevalence of severe food insecurity was higher (26.3%) in households where three or more persons under 15 years of age lived and in households where the number of economic contributors decreased. These results provide useful information on the HS situation prevailing during COVID-19. They suggest that the most vulnerable households in post-pandemic times will be those in which there are more minors and in which the number of economically active persons decreases.

Pre and Post COVID19 Pandemic Household Food Insecurity and Diet of Urban Children From Querétaro, Mexico

ObjectivesTo evaluate the changes in Household Food Insecurity (HFI) and diet in children pre and post COVID-19 pandemic in a group of children living in an urban area in Querétaro, Mexico. MethodsA total of 67 children (mean age = 11 years, range = 9–13 years) participated in this longitudinal study. HFI and diet were measured in-person, before the COVID-19 pandemic (December 2019) and by phone, after the COVID-19 pandemic (March 2021). HFI was assessed using the Latin American and Caribbean Food Security Scale (ELCSA) while diet was assessed using a previously validated food frequency questionnaire. Differences in HFI and diet were tested using McNemar’s and T-student tests, respectively. ResultsHalf of the children that participated in the study were female. HFI increased from 44.8% in December 2019 to 56.7% in March 2021. 22.4% of households changed from food secure to food insecure. Moderate food insecurity post COVID19 pandemic increased compared to pre pandemic levels (<0.05). Changes in diet included a decrease in vegetables, fruits, dairy products, meats, sausages and cereal intake, and an increase in high-calorie beverage intake (p < 0.05). ConclusionsThe COVID-19 pandemic and lockdown measures may affect children’s diet and increase the risk of HFI. Our findings highlight the need for further investment in targeted nutritional strategies as part of multisectoral solutions to improve HFI during and after COVID-19 pandemic. Funding SourcesPartially funded by FOFI, UAQ.

Individual and Household Food Insecurity Reports by Adolescents and Parents Lack Agreement in Rural and Urban Mexican Settings

ObjectivesTo evaluate the degree of agreement between adolescents’ reported individual food insecurity (FI) with their parents reported household FI. MethodsThis is a cross-sectional study with 118 adolescents (15.76 ± 1.65 y) and their parents who were recruited from a rural area in Oaxaca (n = 60) and an urban area in Queretaro (n = 58), Mexico. Household FI was assessed in parents using the Latin American and Caribbean Food Security Scale (ELCSA), whereas individual adolescents’ FI was assessed with a scale specific for children/adolescents. Cohen’s Kappa estimates were calculated to measure agreement between parents’ and adolescents’ FI, and using Landis and Koch criteria for interpretation. ResultsHousehold FI reported by the parents was 47.5% (34.7% mild and 17.8% moderate + severe), compared to 83.1% (43.3% mild and 39.9% moderate + severe) among adolescents. In both Querétaro and Oaxaca, reported individual FI on the adolescents (75.9% and 90%, respectively) was higher than parents’ reported household FI (37.9% and 67%, respectively). Overall, the Kappa score showed a lack of agreement between the reported parents’ household FI and the adolescents’ individual FI (mild FI, κ = 0.04; moderate FI, κ = 0.02; severe FI κ = 0.16; p > 0.05). Similarly, a lack of agreement between the reported FI of the parents and the reported FI of the adolescents was found separately in Queretaro (mild FI, κ = 0.001; moderate FI, κ = .06; p > 0.05) and Oaxaca (mild FI κ = 0.10; moderate FI κ = –0.06; severe FI κ = 0.10; p > 0.05). ConclusionsThe findings of the present study suggest that the experience of FI in adolescents lacks agreement with the household experience, even when assessed in different contexts (rural/urban), and that adolescents FI experiences might be higher than their parents’. Funding SourcesNo funding sources.

Water Insecurity Is Differentially Associated With Food Insecurity Across Seasons: Evidence From the Galápagos

ObjectivesUnreliable access to adequate water for household use (i.e., water insecurity) undermines well-being by limiting safe food preparation, yet few nutrition studies concurrently measure experiences of suboptimal water use and objective water quality. We therefore aimed to categorize individuals based on their water environments and assess whether food insecurity and its subdomains differed across groups. MethodsData are from the Healthy Families Study, a cohort study on San Cristóbal Island, Ecuador. All members within 115 participating households were interviewed during the cool season (July-October 2018) and at a follow-up visit during the warm season (March-May 2019). We first used latent class analysis to identify households with common water characteristics (e.g., water source, water treatment methods, experiences with water inadequacy). Classifications were then included in multivariable models of food insecurity in the prior 3 months (measured using the Latin American and Caribbean Food Security Scale), stratified by season. ResultsA two-class solution best fit the data (60.5% in class 1 for the cool season, 91.4% for the warm season). Across seasons, a lower proportion of individuals in class 1 than class 2 reported water issues. In the cool season, fewer households in class 2 had detectable E. coli in their primary water source compared to those in class 1, but this was reversed in the warm season. Adjusting for sociodemographic characteristics, being in class 2 relative to class 1 was associated with 1) higher odds of being food secure in the cool season (OR: 3.64, 95% CI: 1.48, 8.93) but lower odds in the warm season (OR: 0.09, 95% CI: 0.02, 0.55); 2) greater experiences with poor diet quality during the warm (B = 2.15, 95% CI: 0.35, 3.95) but not the cool season; and 3) fewer experiences of suboptimal food access during the cool season (B = –1.44, 95% CI: –2.78, –0.10) but more during the warm season (B = 1.36, 95% CI: 0.03, 2.69). ConclusionsAccess to safe water can create an enabling environment for good nutrition, although the relative importance of water availability and quality may vary across seasons. Funding SourcesThis research is funded by NIH/FIC and received support from the Population Research Infrastructure Program awarded to the Carolina Population Center at UNC Chapel Hill by the Eunice Kennedy Shriver NICHD.

Collective Empowerment and Influential Group Membership Matter for Household Food Security

ObjectivesReducing the gender gap in empowerment within households is associated with indicators of improved diet. This study developed a household-level empowerment measure and then examined its association with food security. MethodsThis analysis used baseline data from a nutrition-sensitive agriculture intervention in rural Ghana (ClinicalTrials.gov NCT03869853). Only 198 of the 330 households with complete paired empowerment data for one female and one male were included. The household empowerment measure was constructed in two stages. First, the individual empowerment score was assessed using the project-level Women’s Empowerment in Agriculture Index (pro-WEAI) with its 12 indicators (e.g., influential group membership, access to financial services). Participants were classified as empowered (≥75%, 9 out of 12 indicators) or disempowered (<75%). Then, the household was categorized as empowered (both members empowered; 50.5%), semi-empowered (only one member empowered; 34.9%) or disempowered (both members not empowered; 14.6%). Two of the pro-WEAI indicators were assessed also at the household level using the same technique. Food security was assessed with the 15-item Latin American and Caribbean Food Security Scale; a binary variable was created: food secure (0), food insecure (FIS; >0). Cluster-adjusted logistic regression models examined the relationship between FIS and household empowerment. ResultsOver half (58%) of households were FIS. Empowered compared to disempowered households had a lower odds of being FIS (aOR = 0.50, 95% CI [0.29, 0.86]). The model for influential group membership showed that empowered were less likely than disempowered households to be FIS (aOR = 0.27, 95% CI [0.13, 0.58]) while the model for access to financial services showed the opposite (aOR = 3.15, 95% CI [1.80, 5.51]). ConclusionsThese results highlight the complexity of empowerment measures and support empowerment approaches that target different members of the household. Funding SourcesThe Canadian Queen Elizabeth II Diamond Jubilee Scholarships (QES) is managed through a unique partnership of Universities Canada, RHF, CFC, and Canadian universities. The QES-AS is made possible with financial support from IDRC and SSHRC.

Importance of Purchasing Power and Education in the Food Security of Families in Rural Areas—Case Study: Chambo, Ecuador

Food security is a condition that allows people permanent access to food for a better quality of life; therefore, it is a priority for the economic development of countries. In this context, this research aims to determine the importance of purchasing power and education in the food security of families in rural environments using Chambo canton, Ecuador as a case study. Considering the deductive method, the research is descriptive correlational, with a qualitative and quantitative approach. For data collection, a questionnaire based on the Latin American and Caribbean Food Security Scale was applied to 230 households out of a total of 3585 households. The results showed that the variables of number of income earners and total family income have a high relationship with food security, unlike level of schooling. It was concluded that education does not represent a decisive factor for food security in rural environments, although its incorporation as a variable is important for improving quality of life.

Niveles de inseguridad alimentaria y características asociadas en mujeres gestantes de Colombia en el 2015

IntroductionFood insecurity is the inability of households to acquire safe, nutritionally adequate food that meets physiological needs for leading a healthy and active life. ObjectiveTo describe the levels of food insecurity and associated factors in pregnant women in Colombia. MethodologyCross-sectional-analytical study; is a secondary analysis of the 2015 Nutritional Situation Survey of Colombia. 1393 pregnant women between 12 and 48 years old were examined. Food insecurity was assessed using the Latin American and Caribbean Food Security Scale. Sociodemographic, anthropometric and micronutrient characteristics were evaluated. The description of food insecurity distribution was made for each of the selected variables, through absolute and percentage frequencies. To estimate the association between the different variables and food insecurity, we used multivariate Poisson regression models. Results60.4% (CI95% 55.6%–64,7%) of pregnant women resided in homes with some degree of food insecurity; severe: 9.4% (CI95% 7.4%–11.9%), moderate: 17.6% (CI95% 13.5%–22.8%) and light: 33.2% (CI95% 28.9%–37.8%); we found that Black/Mulatto/Afro-descendant pregnant women (PR 1.22 CI95% 1.01–1.47), belong to quartile 1 of wealth (PR 2.23 CI95% 1.41–3.68), and residing in the región Atlántica (PR 1.34 CI95% 1.08–1.67), was associated with some food insecurity level. ConclusionA high proportion of pregnant women living in households with some food insecurity level. The pregnant women of low socioeconomic levels and those belonging to the black/mulatto/Afro-descendant ethnic group showed to be the main characteristics associated with residing in households with some degree of food insecurity.

On distinguishing food insecurity levels with the Latin American and Caribbean Food Security Scale

On distinguishing food insecurity levels with the Latin American and Caribbean Food Security Scale

Food insecurity and the double burden of malnutrition in Colombian rural households.

This study aimed to examine in Colombian rural households the association between different severity levels of household food insecurity and the presence of the double burden of malnutrition (SCOWT), defined as the coexistence of a stunted child under 5 years of age and an overweight or obese (OWOB) mother. A secondary data analysis was conducted using cross-sectional data from the Colombian National Nutritional Survey (ENSIN) 2015. Household food insecurity status was assessed by using the Latin-American and Caribbean Food Security Scale (ELCSA). The household SCOWT status (child stunting and OWOB mother) was determined using anthropometric data from a mother and her child. Rural Colombia. Totally, 2·350 mother-child pairs living in the same household. Sixty-two per cent of the households were food-insecure and SCOWT was present in 7·8 % of the households. Moderate (OR: 2·39, 95 % CI (1·36, 4·21)) and severe (OR: 1·86, 95 % CI (1·10, 3·15)) food insecurity was associated with SCOWT in an unadjusted logistic regression. Only moderate food insecurity remained significantly associated with SCOWT in a multivariate logistic regression (adjusted OR: 2·41, 95 % CI (1·24, 4·68)). Colombian rural areas are not exempt from the worldwide concern of increasing OWOB rates while stunting is still persistent. These results highlight the need of implementing double-duty rural actions targeting the most vulnerable households to SCOWT, particularly in terms of overcoming food insecurity beyond hunger satisfaction to prevent all forms of malnutrition.

Food Insecurity, Food Environment and Obesity Among Urban School-Aged Children in Queretaro, Mexico

Abstract Objectives To evaluate the relationship between food insecurity, food environment and obesity in school-aged children in Queretaro. Methods In this cross-sectional study, weight, height and body fat % (BF%) were measured in 122 school-aged children (8.1 ± 1.5 y) from an urban area in Queretaro, Mexico. Additionally, household food insecurity was assessed using the Latin American and Caribbean Food Security Scale (ELCSA). Geolocation data of both food establishments (FE) and participants’ households (HH) were collected and uploaded into a GIS database. The distance to the closest FE within a 300 m radius from each participant's household was calculated using GIS. FE were categorized as follows: (1) FEPF, which mainly sold processed foods (e.g., convenient stores); and (2) FEnPF, which mainly sold non-processed foods (e.g., fruterías – only fruits and vegetables). Univariate analysis was used to assess the interaction of BF%, food insecurity and FE categories using SPSS v23.0. Results Almost half of the children showed high BF% (48%), while 43% lived in HH with some degree of food insecurity. Children in moderately/severely food insecure HH and who lived close to FEnPF had significantly lower BF% (18.9 ± 4.7%), compared to children in food secure HH (24.4 ± 2.5%) or HH experiencing mild food insecurity (25.0 ± 2.6%) (P &amp;lt; 0.05). However, children in moderately/severely food insecure HH, who lived close to FEPF had significantly higher BF% (29.4 ± 2.7%), compared to those experiencing mild food insecurity (23.7 ± 1.5%), or who were food secure (22.8 ± 1.1%) (P &amp;lt; 0.05). Conclusions Children living in moderately/severely food insecure HH showed an opposite BF% pattern when compared to those in food secure or mildly food insecure HH, depending on how close they live to FE that either mainly sold processed foods or unprocessed foods, indicating the potential relationship of food environment to childhood obesity mediated by food insecurity. Funding Sources Partially funded by FOFI, UAQ.

Abstract P094: Food Insecurity And Elevated Blood Pressure In The Eastern Caribbean

Background: Food insecurity (FI), an economic or social condition of limited or uncertain access to adequate food, has emerged as a contributing factor in the development and poor management of chronic diseases. The Caribbean region faces serious challenges from FI that threaten the sustainability of food systems and health of populations. Increased FI has led to greater consumption of unhealthy, cheap, and calorie dense foods that are associated with elevated blood pressure. The demonstrated challenges with FI, increased prevalence of elevated blood pressure, and dearth of evidence in part of the region make it imperative to understand the relationship between FI and elevated blood pressure. Methods: We used baseline data (2013-2018) from the Eastern Caribbean Health Outcomes Research Network Cohort Study (ECS), a population-based cohort of 2,961 community-dwelling individuals 40 years or older residing in Barbados, Puerto Rico, Trinidad and Tobago, or U.S. Virgin Islands. Participants with complete FI and blood pressure data were included. Household FI within the past 90 days was measured using the 9-item Latin American and Caribbean Food Security Scale. Responses were summed for participants to create a score (0-8) and create four categories: 0 no FI, 1-6 -mild FI, and 7-8 severe FI. The outcome, elevated blood pressure, was defined as self-report of hypertension diagnosis or systolic blood =&gt;140 mm Hg or diastolic pressure =&gt;90 mm Hg. Chi-square tests, analysis of variance, and multivariable logistic regression was used for analyses. We hypothesized that FI was greater among women compared to men, those with lower versus higher educational attainment, and that FI was associated with elevated blood pressure. Results: A total of 2942 participants were included in analyses. Mean age of participants was 57, 65 percent were women, and 36 percent had less than a high school education. Results showed that 27 percent of participants experienced FI, women, younger persons, and those with lower educational attainment were more likely to experience low, moderate or severe FI. Forty-one percent of those with low FI had elevated blood pressure compared to 40 percent among those with moderate, and 40 percent with severe FI. Logistic model results showed that mild (OR=1.04, CI=0.74-1.47), moderate (OR=1.01, CI=0.60-1.7), and severe FI (OR=1.38, CI=0.64-2.95) was not associated with elevated blood pressure after adjusting for demographic and clinical covariates. Post-hoc analysis showed that that moderate/severe FI was associated elevated blood pressure among women (OR=1.50, CI=1.02-2.20). Conclusions: Findings for FI and elevated blood pressure among women is consistent with prior research conducted in other contexts. Findings have implications for safety net programs and targeted efforts to reduce FI overall and among women.

A self-applied valid scale for rapid tracking of household food insecurity among pregnant women in Sri Lanka.

Rapid household food insecurity (HFI) tracking has been identified as a priority in the context of the COVID‐19 pandemic and its aftermath. We report the validation of the Latin American and Caribbean Food Security Scale (Escala Latinoamericana y Caribena de Seguridad Alimentaria [ELCSA]) among pregnant women in Sri Lanka. The eight‐item adult version of the ELCSA was translated from English to Sinhala and Tamil. Cognitive testing (on 10 pregnant women and five local experts) and psychometric validation of the self‐administered HFI tool were conducted among pregnant women (n = 269) attending the special clinics of the Rajarata Pregnancy Cohort (RaPCo) in Anuradhapura in February 2020. We assessed the psychometric properties and fit using a one parameter logistic model (Rasch model analysis) using STATA Version 14 and WINSTEP software Version 4.3.4. Concurrent validity was tested using psychological distress. The scale was internally consistent (Cronbach's alpha = 0.79) and had a good model fit (Rasch items infit statistic range: 0.85 to 1.07). Item 8 (‘did not eat for the whole day’) was removed from the model fit analysis, as it was not affirmed by respondent. Item severity scores ranged from −2.15 for ‘not eating a diverse diet’ to 4.43 for ‘not eating during the whole day’. Concurrent validity between HFI and psychological distress was confirmed (r = 0.15, p < 0.05). The self‐applied version of ELCSA‐pregnancy in Sri Lanka (ELCSA‐P‐SL) is a valid and feasible valid tool. We recommend it to track HFI among pregnant women in lower income countries during the COVID‐19 pandemic.