The Direct and Moderating Effect of Food Insecurity on Obesity-A Cross-Sectional Study

Although a substantial body of evidence indicates that food insecurity is positively associated with obesity, the underlying mechanisms of this relationship remain unclear. This cross-sectional study, conducted on 859 individuals, aimed to examine the association between food insecurity and obesity. Food insecurity was assessed using the Household Food Insecurity Access Scale (HFIAS), which was developed by the Food and Nutrition Technical Assistance (FANTA) project under the United States Agency for International Development (USAID). Factors influencing food insecurity and the role of food insecurity in obesity were evaluated. The mean age of the participants was 34.70 ± 13.84 years (range: 18-85). The prevalence of obesity was 4.5% in the mildly food-insecure group, 12% in the moderately food-insecure group, and 11.3% in the severely food-insecure group (p = 0.013). The odds of obesity were 2.075 times higher among those experiencing severe food insecurity. The odds of severe food insecurity were 1.59 times higher in men and 2.50 times higher in rural residents, but 2.8 times lower in households with an income above the poverty line (Odds Ratio [OR] = 0.356) and 1.87 times lower in those receiving social support (OR = 0.532). Individuals with moderate and severe food insecurity were found to consume less protein-rich foods and more grain-based (carbohydrate) and snack products daily (p < 0.001). Food insecurity was found to be a significant moderator in the relationship between protein intake and body mass index, with a stronger association observed at lower levels of food insecurity and a weaker association at higher levels. Food insecurity was associated with higher obesity prevalence, and this association was moderated by dietary patterns, specifically lower intake of protein-rich foods and higher consumption of cereals and snack foods. Providing social support to at-risk groups may help reduce obesity risk.