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AIMS Medical Science

2021, Volume 8, Issue 3: 175-188. doi: 10.3934/medsci.2021016
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Research article

Association between food insecurity and obesity in an agricultural community of women from El Jadida, Morocco

  • 1.
    Laboratory of Biotechnology, Biochemistry and Nutrition, Training and Research Unit on Nutrition and Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida 24 000, Morocco
  • 2.
    Upper Normal School, Hassan II University, Casablanca, Morocco
  • Received: 18 April 2021 Accepted: 24 June 2021 Published: 01 July 2021

  • Background

    Food insecurity (FI) has received much attention in the last decades due to its strong association with obesity. Indeed, it has begun to be a serious concern, especially in developing countries undergoing a nutritional transition.

     Objective

    The aim of this study was to examine the association between FI, food intake and the risk of obesity in an agricultural community of women from El Jadida Province in Morocco.

     Materials and methods

    The survey included a sample of 214 women. Weight and height were measured, and the body mass index was calculated. FI was measured using a household FI access scale. Food intake was evaluated using two 24-hour dietary recalls. Variance tests and Chi-square tests are applied for means ± standard deviations comparisons and proportions with percentages of continuous and categorical variables, respectively.

     Results

    The female population surveyed had an average age of 44 ± 13 years, 42% were obese, 36% were overweight, and 86% were centrally obese (CO). FI was observed in 78% of the sample, and it is found to be associated with both overweight, general obesity (GO) and CO (P ≤ 0.001). The risk of GO was extremely high in women with mild FI (unadjusted OR = 31.33, 95% CI: 7.01, 140.06). This association remained high after adjustment for socio-demographic variables (adjusted OR = 24.98, 95% CI: 5.36, 116.35). Compared with food secure women, the risk of CO was significantly higher in women with moderate FI (unadjusted OR = 16.44, 95% CI: 3.56, 75.91). This association remained significant after adjustment for socio-demographic variables (OR adjusted = 36.51, 95% CI: 4.81, 276.7). FI was associated with high daily energy (P < 0.013) and low iron intakes (P < 0.019).

     Conclusion

    There is a high prevalence of FI associated with overweight, GO and CO and with high energy intake among the rural female population. Hence, intervention programs must consider food security in the fight against obesity and its associated problems, by ensuring women's access to a variety of high quality foods and the achievement of a balanced diet at the local and national levels.

    Citation: Sanaa El-Jamal, Mohamed Mziwira, Houda Elfane, Khadija Sahel, Imane Barakat, Adil Kalili, Kaoutar Naciri, Nadia Mahri, Rachida Moustakim, Rachida El Ouafi, Loubna Arkoubi Idrissi, Rekia Belahsen. Association between food insecurity and obesity in an agricultural community of women from El Jadida, Morocco[J]. AIMS Medical Science, 2021, 8(3): 175-188. doi: 10.3934/medsci.2021016

    Related Papers:

  • Background

    Food insecurity (FI) has received much attention in the last decades due to its strong association with obesity. Indeed, it has begun to be a serious concern, especially in developing countries undergoing a nutritional transition.

     Objective

    The aim of this study was to examine the association between FI, food intake and the risk of obesity in an agricultural community of women from El Jadida Province in Morocco.

     Materials and methods

    The survey included a sample of 214 women. Weight and height were measured, and the body mass index was calculated. FI was measured using a household FI access scale. Food intake was evaluated using two 24-hour dietary recalls. Variance tests and Chi-square tests are applied for means ± standard deviations comparisons and proportions with percentages of continuous and categorical variables, respectively.

     Results

    The female population surveyed had an average age of 44 ± 13 years, 42% were obese, 36% were overweight, and 86% were centrally obese (CO). FI was observed in 78% of the sample, and it is found to be associated with both overweight, general obesity (GO) and CO (P ≤ 0.001). The risk of GO was extremely high in women with mild FI (unadjusted OR = 31.33, 95% CI: 7.01, 140.06). This association remained high after adjustment for socio-demographic variables (adjusted OR = 24.98, 95% CI: 5.36, 116.35). Compared with food secure women, the risk of CO was significantly higher in women with moderate FI (unadjusted OR = 16.44, 95% CI: 3.56, 75.91). This association remained significant after adjustment for socio-demographic variables (OR adjusted = 36.51, 95% CI: 4.81, 276.7). FI was associated with high daily energy (P < 0.013) and low iron intakes (P < 0.019).

     Conclusion

    There is a high prevalence of FI associated with overweight, GO and CO and with high energy intake among the rural female population. Hence, intervention programs must consider food security in the fight against obesity and its associated problems, by ensuring women's access to a variety of high quality foods and the achievement of a balanced diet at the local and national levels.

    Abbreviations

    FI

    Food insecurity

         GO

    General obesity

         CO

    Central obesity

         OR

    Odds ratio

         CI

    Confidence interval

         FAO

    Food and Agriculture Organization

         WHO

    World Health Organization

         WC

    Waist circumference

         BMI

    Body mass index

         HFIAS

    Household Food Insecurity Access Scale

         USAID

    United States Agency for International Development

         SPSS

    Statistical package for the social sciences

         SD

    Standard deviations
    加载中

    Acknowledgments


    The authors wish to thank the participants to this study, the local authorities of El Jadida Province and the Ministry of Interior for their help with the data collection and their cooperation. The survey was supported by the Moroccan Ministry of Higher Education and Research.

    Funding source(s)


    This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

    Conflicts of interest


    The authors declare that they have no competing interest.

    [1] FAO, IFAD and WFP (2013)  The state of food insecurity in the world: the multiple dimensions of food security Rome: FAO, Available from: http://www.fao.org/3/i3434e/i3434e.pdf.
    [2] FAO, IFAD, UNICEF, WFP and WHO (2020)  The state of food security and nutrition in the world: transforming food systems for healthy and affordable food Rome: FAO, Available from: https://doi.org/10.4060/ca9692fr,http://www.fao.org/3/ca9692fr/ca9692fr.pdf.
    [3] FAO (2017)  Near East and North Africa regional overview of food insecurity 2016 Cairo: pp. 35Available from: http://www.fao.org/3/i6860e/i6860e.pdf.
    [4] Zolfaghari M, Jariani F (2021)  Food security in the Middle East and North Africa (MENA) Germany: University Library of Munich, Available from: https://mpra.ub.uni-muenchen.de/id/eprint/105078.
    [5] UNECA: United Nations. Economic Commission for Africa. Subregional Office North Africa (SRO-NA) Food security in North Africa situation analysis and reactions from the states over the instability of agricultural markets (2012) .Addis Ababa:.© UN. ECA. Available from: https://repository.uneca.org/handle/10855/22265.
    [6] Chinnakali P, Upadhyay RP, Shokeen D, et al. (2014) Prevalence of household-level food insecurity and its determinants in an urban resettlement colony in north India. J Health Popul Nutr 32: 227-236.
    [7] Keino S, Plasqui G, Van Den Borne B (2014) Household food insecurity access: a predictor of overweight and underweight among Kenyan women. Agric Food Secur 3: 1-8. doi: 10.1186/2048-7010-3-2
    [8] Ramakrishnan U (2004) Nutrition and low birth weight: from research to practice. Am J Clin Nutr 79: 17-21. doi: 10.1093/ajcn/79.1.17
    [9] Austin OC, Nwosu AC, Baharuddin AH (2011) Rising food insecurity: dimensions in farm households. Am J Agric Biol Sci 6: 403-409. doi: 10.3844/ajabssp.2011.403.409
    [10] McIntyre L, Glanville NT, Raine KD, et al. (2003) Do low-income lone mothers compromise their nutrition to feed their children? Can Med Assoc J 168: 686-691.
    [11] Ivers LC, Cullen KA (2011) Food insecurity: special considerations for women. Am J Clin Nutr 94: 1740S-1744S. doi: 10.3945/ajcn.111.012617
    [12] WHO (2017)  The double burden of malnutrition Geneva: Policy brief, Available from: https://apps.who.int/iris/bitstream/handle/10665/255413/WHO-NMH-NHD-17.3-eng.pdf?sequence=1 /.
    [13] Jafri A Double burden of malnutrition in South-East Casablanca and the role of nutrition education in the fight against overweight (PhD thesis) (2013) .Available from: https://www.academia.edu/25322222/Double_fardeau_de_la_malnutrition_dans_le_Sud_Est_de_Casablanca_et_r%C3%B4le_de_l%C3%A9ducation_nutritionnelle_dans_la_lutte_contre_la_surcharge_pond%C3%A9rale.
    [14] Pan L, Sherry B, Njai R, et al. (2012) Food insecurity is associated with obesity among US adults in 12 states. J Acad Nutr Diet 112: 1403-1409. doi: 10.1016/j.jand.2012.06.011
    [15] Franklin B, Jones A, Love D, et al. (2012) Exploring mediators of food insecurity and obesity: a review of recent literature. J Community Health 37: 253-264. doi: 10.1007/s10900-011-9420-4
    [16] World Health Organization Obesity and overweight (2016) .Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
    [17] Ministry of Health Report of the national survey on common risk factors for non communicable diseases, STEPS, Morocco (2017–2018) .Available from: https://www.who.int/ncds/surveillance/steps/STEPS-REPORT-2017-2018-Morocco-final.pdf.
    [18] Papan AS, Clow B (2012)  The food insecurity-obesity paradox as a vicious cycle for women: a qualitative study Halifax, NS: Atlantic Centre of Excellence for Women's Health, Canada. Available from: https://cwhn.ca/sites/default/files/Full%20Plate-Oct12.pdf.
    [19] Food Research and Action Center Understanding the connections: food insecurity and obesity (2015) .Available from: https://frac.org/research/resource-library/understanding-connections-food-insecurity-obesity.
    [20] Mohammadi F, Omidvar N, Harrison GG, et al. (2013) Is household food insecurity associated with overweight/obesity among women? Iran J Public health 42: 380-390.
    [21] Gubert MB, Spaniol AM, Segall-Corrêa AM, et al. (2017) Understanding the double burden of malnutrition in food-insecure households in Brazil. Matern Child Nutr 13: e12347. doi: 10.1111/mcn.12347
    [22] Rutten LF, Yaroch AL, Patrick H, et al. (2012) Obesity prevention and national food security: a food systems approach. ISRN Public Health, 1-10. doi: 10.5402/2012/539764
    [23] Crawford PB, Webb KL (2011) Unraveling the paradox of concurrent food insecurity and obesity. Am J Prev Med 40: 274-275. doi: 10.1016/j.amepre.2010.11.003
    [24] Purnell JQ (2000) Definitions, classification, and epidemiology of obesity. [Updated 2018 Apr 12]. Endotext [Internet] South Dartmouth (MA): MDText.com, Inc, Available from: https://www.ncbi.nlm.nih.gov/books/NBK279167.
    [25] National Institute of Health (1998) Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. Obes Res 6: 51S-209S.
    [26] World Health Organization Body mass index—BMI (2014) .Available from: https://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi.
    [27] Gooloo S. Wunderlich, Janet L. NorwoodNational Research Council (2006) Food insecurity and hunger in the united states: an assessment of the measure. Committee on National Statistics, Division of Behavioral and Social Sciences and Education Washington, DC: The National Academies Press, Available from: https://www.nap.edu/read/11578/chapter/1#ii.
    [28] Bilinsky P, Swindale A, Coates J (2007)  Household Food Insecurity Access Scale (HFIAS) for measurement of food access: indicator guide Washington, DC: Technical Assistance Project for Food and Nutrition, Academy for Educational Development, Available from: https://www.academia.edu/32819965/Household_Food_Insecurity_Access_Scale_HFIAS_for_Measurement_of_Food_Access_Indicator_Guide_VERSION_3.
    [29] Report Ministry of Health Morocco National nutrition strategy 2011–2019, Rabat (2011) .Available from: https://extranet.who.int/nutrition/gina/sites/default/filesstore/MAR%202011%20Strategie%20Nationale%20de%20Nutrition.pdf.
    [30] Belahsen R, Mziwira M, Fertat F (2004) Anthropometry of women of childbearing age in Morocco: body composition and prevalence of overweight and obesity. Public Health Nutr 7: 523-530. doi: 10.1079/PHN2003570
    [31] Belahsen R, Bermudez OI, Mziwira M, et al. (2005) Obesity and related metabolic disorders are prevalent in Moroccan women of child-bearing age. Int J Diabetes Metabolism 13: 159-166. doi: 10.1159/000497585
    [32] Rguibi M, Belahsen R (2004) Overweight and obesity among urban Sahraoui women of south Morocco. Ethn Dis 14: 542-547.
    [33] Belahsen R (2014) Nutrition transition and food sustainability. Proc Nutr Soc 73: 385-388. doi: 10.1017/S0029665114000135
    [34] Shariff ZM, Khor GL (2008) Household food insecurity and coping strategies in a poor rural community in Malaysia. Nutr Res Pract 2: 26-34. doi: 10.4162/nrp.2008.2.1.26
    [35] Mango N, Zamasiya B, Makate C, et al. (2014) Factors influencing household food security among smallholder farmers in Mudzi district of Zimbabwe. Dev South Afr 31: 625-640. doi: 10.1080/0376835X.2014.911694
    [36] Naser IA, Jalil R, Muda WMW, et al. (2014) Association between household food insecurity and nutritional outcomes among children in Northeastern Peninsular Malaysia. Nutr Res Pract 8: 304-311. doi: 10.4162/nrp.2014.8.3.304
    [37] Dharod JM, Croom JE, Sady CG (2013) Food insecurity: its relationship to dietary intake and body weight among Somali refugee women in the United States. J Nutr Educ Behav 45: 47-53. doi: 10.1016/j.jneb.2012.03.006
    [38] Loopstra R, Tarasuk V (2013) Severity of household food insecurity is sensitive to change in household income and employment status among low-income families. J Nutr 143: 1316-1323. doi: 10.3945/jn.113.175414
    [39] Dachner N, Ricciuto L, Kirkpatrick SI, et al. (2010) Food purchasing and food insecurity among low-income families in Toronto. Can J Diet Pract Res 71: e50-e56.
    [40] Lofgren H, Richards A (2003)  Food security, poverty and economic policy in the Middle East and North Africa Washington, U.S.A: Trade and Macroeconomics Division, International Food Policy Research Institute, TMD Discussion Papers no. 111.
    [41] Kimani-Murage EW, Schofield L, Wekesah F, et al. (2014) Vulnerability to food insecurity in urban slums: experiences from Nairobi, Kenya. J Urban Health 91: 1098-1113. doi: 10.1007/s11524-014-9894-3
    [42] Wilde PE, Peterman JN (2006) Individual weight change is associated with household food security status. J Nutr 136: 1395-1400. doi: 10.1093/jn/136.5.1395
    [43] Fischer NC, Shamah-Levy T, Mundo-Rosas V, et al. (2014) Household food insecurity is associated with anemia in Mexican adult women of childbearing age. J Nutr 144: 2066-2072. doi: 10.3945/jn.114.197095
    [44] Shariff ZM, Sulaiman N, Jalil RA, et al. (2014) Food insecurity and the metabolic syndrome among women from low income communities in Malaysia. Asia Pac J Clin Nutr 23: 138-147.
    [45] Martin MA, Lippert AM (2012) Feeding her children, but risking her health: the intersection of gender, household food insecurity and obesity. Soc Sci Med 74: 1754-1764. doi: 10.1016/j.socscimed.2011.11.013
    [46] Jomaa L, Naja F, Cheaib R, et al. (2017) Household food insecurity is associated with a higher burden of obesity and risk of dietary inadequacies among mothers in Beirut, Lebanon. BMC Public Health 17: 1-14. doi: 10.1186/s12889-017-4317-5
    [47] Kirkpatrick SI, Tarasuk V (2008) Food insecurity is associated with nutrient inadequacies among Canadian adults and adolescents. J Nutr 138: 604-612. doi: 10.1093/jn/138.3.604
    [48] Zizza CA, Duffy PA, Gerrior SA (2008) Food insecurity is not associated with lower energy intakes. Obesity 16: 1908-1913. doi: 10.1038/oby.2008.288
    [49] Bocquier A, Vieux F, Lioret S, et al. (2015) Socio-economic characteristics, living conditions and diet quality are associated with food insecurity in France. Public Health Nutr 18: 2952-2961. doi: 10.1017/S1368980014002912
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