Journal Article

Food insecurity, food choices, and body mass index in adults: nutrition transition in Trinidad and Tobago

Martin C Gulliford, Deepak Mahabir and Brian Rocke

in International Journal of Epidemiology

Published on behalf of International Epidemiological Association

Volume 32, issue 4, pages 508-516
Published in print August 2003 | ISSN: 0300-5771
Published online August 2003 | e-ISSN: 1464-3685 | DOI:
Food insecurity, food choices, and body mass index in adults: nutrition transition in Trinidad and Tobago

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Background This study evaluated whether food insecurity and obesity were associated in a population sample in Trinidad.

Methods A sample was drawn of 15 clusters of households, in north central Trinidad. Resident adults were enumerated. A questionnaire was administered including the short form Household Food Security Scale (HFSS). Heights and weights were measured. Analyses were adjusted for age, sex, and ethnic group.

Results Data were analysed for 531/631 (84%) of eligible respondents including 241 men and 290 women with a mean age of 47 (range 24–89) years. Overall, 134 (25%) of subjects were classified as food insecure. Food insecurity was associated with lower household incomes and physical disability. Food insecure subjects were less likely to eat fruit (food insecure 40%, food secure 55%; adjusted odds ratio [OR] = 0.60, 95% CI: 0.36–0.99, P = 0.045) or green vegetables or salads (food insecure 28%, food secure 51%; adjusted OR = 0.46, 95% CI: 0.27–0.79, P = 0.005) on ≥5–6 days per week. Body mass index (BMI) was available for 467 (74%) subjects of whom 41 (9%) had BMI <20 kg/m2, 157 (34%) had BMI 25–29 kg/m2, and 120 (26%) had BMI ≥30 kg/m2. Underweight (OR = 3.21, 95% CI: 1.17–8.81) was associated with food insecurity, but obesity was not (OR = 1.08, 95% CI: 0.55–2.12).

Conclusions Food insecurity was frequent at all levels of BMI and was associated with lower consumption of fruit and vegetables. Food insecurity was associated with underweight but not with present obesity.

Keywords: Obesity; body mass index; food insecurity; socioeconomic status; food intake; Trinidad and Tobago; West Indies

Journal Article.  5594 words. 

Subjects: Public Health and Epidemiology

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