Household Food Security is Associated with Central Obesity but Not with Overweight and Obesity in Early Adolescence in the City of Colombo in Sri Lanka: A Cross Sectional Study

Abstract

Background: The prevalence of overnutrition among early adolescents in the city of Colombo, the capital of Sri Lanka is rising steeply and the precise reason for the epidemic remains unclear. According to the insurance hypothesis, proximate driver of obesity could be food insecurity rather than food abundance per se. Aim: This study was conducted to investigate the association between household food security status and overweight, obesity and central obesity in early adolescence in the city of Colombo. Methods: A cross sectional study was conducted using 634 randomly selected adolescents aged 11-13 years in the city of Colombo, in which subjects were recruited using multistage stratified cluster sampling technique. Household food security score was assessed using USDA 18 Item Household Food Security/ Hunger Survey Module, while height, weight and waist circumference were measured. BMI-for-age Z score was calculated using WHO AnthroPlus software and waist: height ratio was calculated. Partial correlation between household food security score and BMI-for-age Z score and waist:height ratio were analyzed, after adjusting for daily energy intake, physical activity level, pubertal stage, birth weight and age. Results: Household food security score was not associated with BMI-for-age Z score (p>0.05). Household food security score was inversely and weakly (r=-0.373) associated with waist:height ratio (p = 0.002) in girls but not in boys. Conclusion: Overweight and obesity are not associated with food security status, however food secure girls tend to have more fat distribution in the abdominal area.