Household Food Insecurity and Psychosocial Dysfunction in Ecuadorian Elementary Schoolchildren

Abstract

Household food insecurity (HFI) is a major global public health and pediatric concern due to its reported association with adverse child nutrition, growth, and health outcomes. Psychosocial dysfunction is a major cause of childhood disability. US and Canadian studies have linked HFI to poorer overall psychosocial dysfunction and specific dysfunction types in school-aged children, i.e., internalizing, externalizing, and attention behaviors. However, it is uncertain whether prior findings are generalizable to low- and middle-income country (LMIC) settings. We conducted a cross-sectional study to explore the association of HFI with psychosocial dysfunction in 6-12-year-old public elementary schoolchildren (n=279) residing in low-income neighborhoods in Quito, Ecuador. Maternal caregivers were interviewed to obtain data on child psychosocial dysfunction (Pediatric Symptom Checklist, PSC), food security (Household Food Security Survey Module), and maternal mental health (SF-36 Mental Composite Summary). Capillary blood samples were obtained from child participants to measure hemoglobin levels. The data were analyzed using general linear models with adjustment for covariates. The results revealed that HFI was associated with significantly higher overall average PSC scores (p=0.002) and with internalizing (p=0.001) and externalizing (p=0.03) but not attention subscale scores. However, anemia was independently associated with PSC attention subscale scores (p=0.015). This is the first study to report on the relationship between HFI and psychosocial dysfunction in school-aged children in a LMIC setting. It highlights the importance of improving policies and programs protecting vulnerable households from HFI. In addition to improving health and nutrition, such improvements could potentially reduce the burden of child psychosocial dysfunction.

Dietary Inflammatory Index and Cardiometabolic Risk in Ecuadorian Women

“…We analyzed data collected during a previous study of maternal-child dyads in Quito, Ecuador. The sampling methods and participant inclusion criteria used in the survey-design study have been previously described in detail [ 44 ]. Briefly, 279 primary school children and their mothers or other adult maternal caregivers living in the same home were recruited from local public schools.…”

“…A structured questionnaire, validated in prior nutritional and health studies in Ecuador was used to collect data on the sociodemographic characteristics of the women participants and their households [ 42 , 44 ]. These included age, birthplace, ethnicity, marital status, education, current employment status, occupation, monthly household income, family size, place and length of residence.…”

Transient food insecurity during the juvenile-adolescent period affects adult weight, cognitive flexibility, and dopamine neurobiology

“…3,4 After COVID-19, numbers have increased worldwide. 4 The epidemiological literature shows that children and adolescents who have experienced food insecurity are at higher risk for a number of mental health and behavioral problems, [5][6][7][8][9][10][11] including internalizing and externalizing behaviors 7,10,12 and issues with self-control. 10,13 Food insecurity is also associated with differences in learning, 14 lower IQ metrics, 15 and worse math, reading, and vocabulary scores.…”

Food insecurity is associated with self-reported oral health in school-age Ecuadorian children and is mediated by dietary and non-dietary factors

“…For example, children living in food insecure homes, especially those more severely affected, may eat fewer meals/day or skip eating which may cause them to brush less frequently or influence their parents to remind them to do so. Since food insecurity has been linked to increased stress, anxiety, depressive symptoms, and psychosocial dysfunction in both children and mothers, (29) this could cause children to be less likely to perform self-care including regular toothbrushing and also reduce maternal caregiver ability to provide adequate care including regular tooth brushing.…”