A methodological proposal for assessing food insecurity from a multidimensional perspective

The aim of this study was to develop a methodological proposal for the assessment of food and nutritional insecurity (FNiS) in adults and older adults (Vigi-FNiS). The proposal was developed using data from the BRAZUCA Natal survey, a cross-sectional study with 411 people living in Natal in the state of Rio Grande do Norte, Brazil. The association between sociodemographic, health and nutrition variables and food insecurity (FI) was tested using Poisson multiple regression. Overall prevalence of FI was 42.1% (37.4%-46.9%) and was higher in women (47.5%), adults (48.2%) and black people (52.7%). The following variables were included in the Vigi-FNiS: people aged <18 years living in the household (A) (AdjPR=1.3; 1.1-1.6); family income (B) in quintiles (Q1: AdjPR=5, 4; 2.5-11.7; Q2: AdjPR=4.8; 2.2-10.5; Q3: AdjPR=3.8; 1.8-8.5; Q4 AdjPR=2.2; 1.0-5.1); inadequate treatment of drinking water (C) (AdjPR=1.3; 1.1-1.5); presence of chronic non-communicable diseases (D) (AdjPR=1.3; 1.1-1.7); not eating fruit for breakfast (E) (AdjPR=1.7; 1.3-2.5);eating meals on the couch or in bed (F) (AdjPR=1.3; 1.1-1.6); and skipping either lunch or dinner or dinner (G) (AdjPR=1.4; 1.2-1.7). A cutoff point for FNiS of 2.3 was adopted (Kappa=0.47; sensitivity=0.82; specificity=0.67; PPV=0.64; NPV=0.83).