Date of Award

January 2014

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Rafael Perez-Escamilla

Second Advisor

Guilherme de Sousa Ribeiro


Background: The prevalence of obesity is growing among the poor. Household food insecurity (HFI) may partly explain this trend as individuals experiencing it may cope by consuming low-cost high calorie meals with little nutritive value. This study aimed to estimate the prevalence of HFI, identify its risk factors, and assess the relationship with obesity among adults in an urban slum community in Salvador, Brazil.

Design: This cross-sectional study interviewed participants at home to assess socioeconomic status, demographics, HFI (measured by the Brazilian Food Insecurity Scale (EBIA)), and health. Anthropometric measurements (height, weight, waist circumference) of each respondent were taken to assess obesity status. Per WHO guidelines, overweight/obesity was defined as BMI ≥ 25 kg/m2, and abdominal obesity as > 88 cm for women and > 102 cm for men.

Participants/setting: A convenience sample of 171 adult respondents from a slum community in Salvador, Brazil, with ≥ 1 child < 18 years old were enrolled in the study. A total of 147 interviews were conducted with the individual responsible for food preparation.

Analysis: The association between HFI and obesity was examined after adjusting for demographic, socioeconomic and health variables. Logistic regression modeled the associations between severe HFI and overweight/obesity and abdominal obesity through adjusted odd ratios (aOR) with 95% confidence intervals (CI).

Results: The prevalence of HFI was 82.3%, with 38.1% of households experiencing mild, 23.8% moderate and 20.4% severe HFI. The odds of experiencing overweight/obesity were 2.31 times higher (95% CI 0.78-6.88) and the odds of abdominal obesity were 3.29 times higher (95% CI 1.02-10.51) among those severely HFI compared with less food insecure households.

Conclusions: Findings suggest the residents of households experiencing severe food insecurity, particularly women, are at an increased risk for both overweight/obesity and abdominal obesity.


This is an Open Access Thesis.