Sensitivity and specificity of a short questionnaire for food insecurity surveillance in Iran

Food insecurity is frequent in both developed and developing countries, affecting from 5% to 25% of the general population. It has considerable health impacts on the physical, social, and psychological status of individuals in communities suffering from food insecurity.

The aim of this study was to document the epidemiologic features of food insecurity in the northwest region of Iran and to evaluate the sensitivity and specificity of a short-form (six items) questionnaire for screening of food insecurity in the region.

This cross-sectional study was conducted on 300 subjects (132 male and 168 female) selected randomly in the Asadabadi area of the northwest of Iran. Information on food consumption was obtained by a 24-hour food-recall questionnaire for 3 days in a week. This information was compared with the data from the Household Food Security Scale (six-item short questionnaire) to assess the applicability of this short scale for the surveillance of food insecurity. Hunger was defined as inadequate intake of energy. Hidden hunger was defined as adequate intake of energy and inadequate intake of one (or more) of four key nutrients (protein, calcium, vitamin A, and vitamin B2).

The prevalence of hunger and hidden hunger in the area according to the 24-hour food-recall questionnaire was 26% and 42%, respectively. Only 32% of the study population was secure in terms of having access to all key nutrients. The sensitivity, specificity, and accuracy of the short questionnaire for screening for hunger in the population were 98.7%, 85.5%, and 89%, respectively; and the corresponding values for hidden hunger were 23.5%, 96.9%, and 56.3%.

Our findings indicate that food insecurity is prevalent in the northwest of Iran. The short questionnaire (six items) may be used as a simple, low-cost, rapid, and useful tool for the screening of food insecurity and energy intake in similar areas.