Food insecurity, dietary acid load, dietary energy density and anthropometric indices among Iranian children

Abstract

Objectives: Food insecurity significantly influences diet quality which in turn has an impact on individual health. This study aimed to determine the association of food insecurity, dietary energy density (DED), dietary acid load (DAL), and the anthropometric status of children.

Study design: A cross-sectional study.

Methods: This study was conducted in 788 6-year-old girls who were referred to health care centers affiliated with Tehran University of Medical Sciences in the south of Tehran from October 2017 to March 2018. Food frequency questionnaires (168 food items) were assessed to calculate DAL and DED. Food insecurity was assessed using the 18-item United States Department of Agriculture questionnaire. Weight and height of children were measured as anthropometric indices.

Results: Protein and energy intake were higher in participants with a higher DAL and DED, respectively. Energy, fat, carbohydrate, fiber, potassium, phosphorus, calcium, iron, folate, vitamin B12, mono- and poly-unsaturated fatty acid intake was inversely related to DAL. Children characterized as food insecure were more likely to be defined as thin (OR 5.36; 95% CI 3.41-8.40) than overweight (OR 0.18; 95% CI 0.12-027) and obese (OR 0.28; 95% CI 0.08-0.98, respectively). There was no significant association between DED, potential renal acid load (PRAL), and food security status. Moreover, there was no significant association between anthropometric measure and PRAL.

Conclusion: Findings from our study revealed that there was no association between DAL and food insecurity. However, food insecure children were more likely to be characterized as thin than children categorized as food secure. More studies need to be performed in both genders to confirm our findings.

Level of evidence: Level V cross-sectional descriptive study.

Keywords: Anthropometric; Children; Dietary acid load; Dietary energy density; Food insecurity.