Date of Award


Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Rafael Perez-Escamilla


Background: Limited research has examined the association between food insecurity and both dietary diversity and body mass index (BMI) in rural, Ecuador.

Methods: A cross-sectional analysis was conducted on a sample of 237 patients and family members visiting a primary care community clinic. To determine food security level, the Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA) was employed. Outcome was measured using the Household Dietary Diversity Score (HDDS) and BMI was deduced using measured height and weight. These measures were then evaluated in their associations with food security level, adjusting for wealth stratum for the HDDS variable.

Results: As severity of food insecurity increased, the prevalence of normal weight decreased and the prevalence of overweight increased. However, these findings did not reach statistical significance (p=0.316). A statistically significant association was found between HFI and HDDS: as severity of food insecurity increased, low HDDS increased substantially from 18.2% to 54.7%, while high HDDS decreased from 63.7% to 22.7% (p

Conclusions: Future studies should follow the impacts of food insecurity on both dietary diversity and BMI given the ongoing nutrition transition in Ecuador.

Open Access

This Article is Open Access