Association between household food insecurity and quality of life: a longitudinal study in Northeast Brazil, 2014-2019

There are still some gaps in the knowledge about food insecurity (FI) as a determinant of quality of life (QoL); for example, it is not known whether there is a dose‒response relationship, whether these associations occur longitudinally, and how they behave in a population where the target audience is not composed of people affected by health problems.

This work prospectively analyzed the association between QoL and FI in individuals living in a socioeconomically disadvantaged Brazilian municipality between 2014 and 2019. This was a longitudinal prospective cohort study involving 225 individuals from families residing in a municipality with high social vulnerability in the northeast semiarid region of Brazil. The present study considered QoL as the dependent variable and food insecurity (FI) as the main independent variable. Multivariate analyses were conducted using mixed-effects regression, separately for each QoL domain.

Baseline results showed mean QoL domain scores of 70.62 for Social Relationships, 69.42 for Physical Health, 64.77 for the Psychological domain, and 57.55 for the Environmental domain. Among these, only the Physical Health domain exhibited a statistically significant change at follow-up, with a mean reduction of 2.9 points. Multivariate analysis demonstrated an inverse association between FI and QoL scores in the Psychological and Environmental domains. Under conditions of moderate FI, scores declined by 4.728 points in the Psychological domain (p = 0.041) and 7.610 points in the Environmental domain (p = 0.000) over time. At the severe FI level, these reductions were more pronounced, reaching 9.465 points (p = 0.003) and 10.138 points (p = 0.000), respectively.

The results presented in this cohort support the hypothesis that the phenomenon of FI was associated with poorer QoL outcomes over time.