What's on the Plate? Unveiling Food Insecurity and Nutritional Risk Among Preschool-Aged Children in Türkiye

Despite growing attention to early childhood nutrition, limited research has investigated the connection between food insecurity and nutritional risk in preschool-aged children. This cross-sectional study aimed to evaluate the prevalence of nutritional risk using the Nutrition Screening for Toddlers and Preschoolers (NutriSTEP) tool and to investigate its association with household food insecurity and malnutrition. The study included 358 preschool children and their mothers, recruited from seven distinct Mother-Child Education Centers in Istanbul, Türkiye. Data collection included anthropometric measurements, the Household Food Security Survey-Short Form, and the NutriSTEP questionnaire, along with maternal and household characteristics. Findings revealed that 31.6% of households experienced some degree of food insecurity. Children from food-insecure households had significantly higher NutriSTEP scores (25.3 ± 7.0) compared to those from food-secure households (23.4 ± 7.1, p = 0.018), indicating elevated nutritional risk. Children identified as high nutritional risk had significantly lower weight (17.8 ± 3.1 vs. 18.8 ± 2.9 kg, p = 0.002), height (105.4 ± 4.7 vs. 106.9 ± 4.3 cm, p = 0.003), mid-upper arm circumference (MUAC), and waist circumference. Their z-scores for weight-for-age, height-for-age, and weight-for-height were also significantly lower, and the prevalence of malnutrition was higher (4.2% vs. 0.4%, p = 0.016). Additionally, maternal education, parity, and perceived economic status were significantly associated with both food insecurity and nutritional risk. This study highlights the critical role of food insecurity in shaping early childhood nutritional outcomes, even without evident malnutrition. Combining NutriSTEP with food security tools supports early detection and intervention for at-risk children.