Assessment of Food Insecurity and Nutritional Outcomes in Bachok
Total Page：16
File Type：pdf, Size：1020Kb
ition & F tr oo u d N f S o c Naser et al., J Nutr Food Sci 2015, 5:3 l i e a n n c r e DOI: 10.4172/2155-9600.1000373 u s o J Journal of Nutrition & Food Sciences ISSN: 2155-9600 Thesis Open Access Assessment of Food Insecurity and Nutritional Outcomes in Bachok, Kelantan Ihab AN1*, Rohana AJ2, Wan Manan WM3, Wan Suriati WN3, Zalilah MS4 and Mohamed Rusli A2 1Program of Clinical Nutrition, Faculty of Pharmacy, Al Azhar University, Gaza Strip, Palestine 2Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian,16150 Kelantan, Malaysia 3Program of Nutrition & Dietetics, School of Health Sciences, Health Campus, Universiti Sains Malaysia Kubang Kerian, 16150 Kelantan, Malaysia 4Program of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400 Selangor, Malaysia Abstract Aim: This study is to examine the association between food insecurity and nutritional outcomes among children and adults and its impact on the quality of life of the mother in rural sample in Bachok-Kelantan. Method: A cross-sectional survey of low income households was conducted and 223 households of mothers aged 18-55 years old, non-lactating, non-pregnant mother and having at least one child in 2-12 years range were purposively selected. A questionnaire was administered including the Radimer/Cornell scale; items on socio- demographic characteristics, anthropometric measurements and quality of life tool (SF36). Results: The study reported that 16.1% of the households were food secure, while 83.9% experienced some kind of food insecurity, (29.6% households were food insecure, 19.3% individuals were food insecure and 35.0% fell into the child hunger category). The prevalence of underweight, stunting and wasting among the food insecure children were 61.0%, 61.4% and 30.6% respectively, and the prevalence of weight-for-height (overweight) was 1.3%. Based on multinomial logistic regression, larger household size (OR=1.776; 95%C.I, 1.35, 2.32; p<0.001), number of children in the household ( OR=1.20; 95%CI,1.025, 1.42; p=0.024), total monthly income (OR=0.977; 95% CI, 0.995, 0.998; p<0.001), income per capita (OR=0.98; 95% CI, 0.97, 0.98; p<0.001) and food expenditure (OR=0.977; 95% CI, 0.99, 1.00; p=0.049) were found to be significant risk factors for household food insecurity. This study showed there was an association between food insecurity and Diet Dietary score and dietary pattern. Furthermore, food insecure households had lower intake of animal protein, fruits and vegetables compared to their counterparts in the food secure group. The findings of the study reveal that the children in the food insecure were 2.15 times more likely to be underweight and 3 times more likely to be stunted than the children in the food secure households, while no association with wasting was reported. Although, the study reported higher prevalence of overweight and obese mothers (52%) and (47.1%) at-risk WC (≥80 cm), no significant association has been found between food insecurity, BMI and waist circumferences. The score for all the eight domains of quality of life were negatively associated with food insecurity. Conclusion: Our study showed that food insecurity in low income households from Bachok´ is highly prevalent and associated with poor living conditions and it highlighted the pervasive vulnerability of individuals living in food insecure households. In addition to nutritional problems, food insecure households in Bachok- Kelantan struggle with a broad spectrum of health- related problems. Introduction nutrition, and poor physical health and poor mental health. On a household level, existence of food insecurity suggests a high degree Food security is a situation that exists when all people, at all of vulnerability to a broad spectrum of consequences including poor times, have physical, social and economic access to sufficient, safe and health status [12]. nutritious food that meets their dietary needs and food preferences for an active and healthy life [1]. In Malaysia, many studies have been carried out to assess the socioeconomic profile, nutritional status and dietary intake of The definition of food security not withstand reference to food individuals and households as direct indicators of individual or supply at global, regional, national, community, household or household food insecurity [13-17], one of these studies on food security individual levels, has been extended to include accessibility, adequacy, levels among low income households in Kuala Lumpur reported that stability and sustainability of food supply [2]. At the household level, 65.7% of these households experienced some kind of food insecurity, food insecurity has always been linked with low socio-economic status, 27.7% households were food insecure 10,9% individual insecure and inadequate dietary intake, anxiety and uncertainty about the supply of food, and experiences of food insecurity include running out of food, running out of money to buy food, skipping meals, experiencing hunger and being unable to buy food, or buying cheaper food items *Corresponding author: Dr. Ihab A. Naser, Associate Professor, Department of Community Medicine, Universiti Sains Malaysia (USM), Malaysia, Tel: 60 4-653 because of financial constraints [3-6], leading to poor health status, 3888; E-mail: [email protected] inadequate food intake, lower cognitive and academic attainments, and Received February 28, 2015; Accepted April 23, 2015; Published April 27, 2015 psychosocial problems among children [7-10]. Campbell [11] asserted that possible consequences of food insecurity may include heightened Citation: Naser IA, Jalil RA, Abdullah MR (2015) Assessment of Food Insecurity and Nutritional Outcomes in Bachok, Kelantan. J Nutr Food Sci 5: 373. vulnerability to poor health outcomes in long term, suboptimal quality doi:10.4172/2155-9600.1000373 of life and health (physical, social, and mental well-being). Copyright: © 2015 Naser IA, et al. This is an open-access article distributed under On an individual level, potential biological and stress mechanisms the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and have been proposed to explain a relation among food insecurity, poor source are credited. J Nutr Food Sci, an open access journal ISSN: 2155-9600 Volume 5 • Issue 3 • 1000373 Citation: Naser IA, Jalil RA, Abdullah MR (2015) Assessment of Food Insecurity and Nutritional Outcomes in Bachok, Kelantan. J Nutr Food Sci 5: 373. doi:10.4172/2155-9600.1000373 Page 2 of 20 27.0% felt into child hunger [17], a recent Malaysian study showed that Historically food security linked to the overall regional, national, 58% of the household in rural community samples experienced some or even global food supply and shortfalls in supply compared to kind of food insecurity [18]. requirements. But, with increased observations of insufficient food intake by certain groups (despite overall adequacy of supply), the term Many of these undernourished children lived in rural communities has been used more recently mostly at a local, household, or individual with a high poverty index. The most affected states are those located on level [22]. Further, the term has been broadened beyond concept of food the east coast and northeast areas of peninsular Malaysia, particularly in Kelantan [19], which in 2002 had the second highest poverty index supply to include elements of access (determined by food entitlements, with 12% of households below poverty line, compared with the national [2] vulnerability [23], and sustainability [24,25]. level of 5% [20]. The Bachok District in the state of Kelantan - Malaysia To set up a conceptual frame work for food security, definite was chosen for this study because earlier researches have indicated that concepts must be taken into account such as; availability, access, Kelantan has the highest prevalence of moderate malnutrition (24%) utilization and stability or sustainability (Figure 1). The food security and severe malnutrition (5.9%) [19]. Between 1999 and 2000, Kelantan conceptual framework suggests a hierarchy of causal factors which was placed as one of the top five states that received the most assistance ultimately influence the various dimensions of food insecurity: in the Food Basket Program, between 800 and 1600 cases per year [21]. adequate food availability at the aggregate level is a necessary, although The food insecurity levels in rural areas in Malaysia generally not sufficient, condition to attain adequate food access at the household and in Kelantan particularly is attracting the nutritionists and health level, which in turn, is necessary but not sufficient for adequate food professionals and in order to manage food insecurity and food inequity, utilization at the individual level [26]. several strategies were developed. These included: small livestock Determinants of the food security status and the outcomes raising, food assistance and food intervention, and community awareness programs. Many variables considered as risk factors are involved in the occurrence of each dimension of food security. However, this study The present study addresses the following four principal questions: focused on food security at the household level and discussed what are 1. What are the determinants of household food insecurity in rural the variables related to food access dimension? and what is the impact and poor community? of food insecurity on the nutritional status of the child as well as quality of life of the mother ? 2. What are its nutritional consequences? A conceptual framework has been drawn (Figure 2) taking into 3. Is food security status associated with the quality of life? account the study setting and considered the following three sets of 4. How we can improve the nutritional status of malnourished variables as determinants of the food security status of household: children? Characteristics of the household head: gender, educational level Information on food security determinants provide a better and occupation and marital status.