The relationship between food security and quality of life among pregnant women

Farnoosh Moafi, Farideh Kazemi, Fatemeh Samiei Siboni, Zainab Alimoradi, Farnoosh Moafi, Farideh Kazemi, Fatemeh Samiei Siboni, Zainab Alimoradi

Abstract

Background: Household food insecurity through influencing the quality and sufficiency of nutrition can have considerable effects on individuals' health. Previous studies have shown the relationship between household food insecurity and quality of life among adults, infants, and people of minority ethnicity. However, no studies have been conducted on household food insecurity and quality of life among pregnant women. This study aimed to investigate the effect of food insecurity on quality of life among pregnant women in Qazvin city, Iran.

Methods: This cross-sectional study was conducted between May 2017 and November 2017 on 394 pregnant women. A random cluster sampling method was used to select eight urban health and medical centers from four geographical regions of Qazvin city, Iran. In the selected centers, pregnant women were recruited using eligibility inclusion criteria. Data was collected using the SF-36 Health-related Quality of Life, Household Food Insecurity Access Scale and a demographic questionnaire for recording the women's gestational and demographic information through interviews. Descriptive and inferential statistics including Chi-square test, one-way analysis of variance with Bonferroni post-hoc test and multiple linear regression were used for data analysis. P < 0.05 was considered statistically significant.

Results: Food insecurity was reported in 43.9% of the pregnant women. Overall pregnant women's quality of life had the highest score (Mean ± SD) in the domain of 'social performance' (76.4 ± 21) and the lowest one in the domain of 'role limitation due to physical reasons' (60.5 ± 43). Pregnant women with food insecurity had the lowest score in role limitation due to physical reasons domain of quality of life (68.6 ± 40.4, 61.3 ± 45.5 & 51.3 ± 47.7 respectively for mild, moderate and sever food insecurity). The results of multiple linear regression showed that one unit reduction of household food security significantly decreased the total quality of life score by 5.2 score (95% CI: -9.7, - 0.7) among the mild food insecure group, 10.8 score (95% CI: -17.1, - 4.6) among the moderate food insecure group and 14.1 score (95% CI: -19.7, - 8.5) among the sever food insecure group.

Conclusions: Screening of the household food security status during the primary prenatal care can identify high-risk pregnant women to improve the quantity and quality of their diet. Moreover multi-level actions including policy-making, supplying resources, and providing appropriate services are needed to ensure that pregnant women have access to high-quality foods.

Keywords: Food insecurity; Health-related quality of life; Pregnancy.

Conflict of interest statement

The research proposal was approved by the Research Review Board affiliated with Qazvin Faculty of Nursing and Midwifery (decree code: IR.QUMS.REC.1394.351 in the Ethics Committee affiliated with Qazvin University of Medical Sciences). Permissions to enter health and medical centers were obtained from authorities of Qazvin University of Medical Sciences. Next, the researcher introduced himself to the women. After expressing objectives, assuring the participants about confidentiality of their data and possibility of withdrawing from the study, the written informed consent form was signed by those women who were willing to participate in this research.

Not applicable.

The authors declare that they have no competing interests.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. Haen H, Huddleston B, Thomas H, Sharma R. Trade reforms and food security: conceptualizing the linkages. Food and Agriculture Organization of United Nations: Rome; 2003.
    1. Hasan-Ghomi M, Mirmiran P, Amiri Z, Asghari G, Sadeghian S, Sarbazi N, et al. The Association of Food Security and Dietary Variety in subjects aged over 40 in district 13 of Tehran. Iranian J Endocrinol Metab. 2012;14(4):360–367.
    1. FAO I, UNICEF . WFP and WHO (2017) The State of Food Security and Nutrition in the World 2017: Building Resilience for Peace and Food Security. Rome: Food and Agriculture Organization of the United Nations (FAO); 2018.
    1. Behzadifar M, Behzadifar M, Abdi S, Malekzadeh R, Arab Salmani M, Ghoreishinia G, et al. Prevalence of food insecurity in Iran: a systematic review and meta-analysis. Archives of Iranian Med. 2016;19(4):288–294.
    1. WFP . Food and Nutrition Security in Iran: summary report. Iran country office: World Food Program; 2016.
    1. Chinnakali P, Upadhyay RP, Shokeen D, Singh K, Kaur M, Singh AK, et al. Prevalence of household-level food insecurity and its determinants in an urban resettlement colony in north India. J Health, Popul, Nutr. 2014;32(2):227.
    1. Keino S, Plasqui G, van den Borne B. Household food insecurity access: a predictor of overweight and underweight among Kenyan women. Agri Food Secur. 2014;3(1):2. doi: 10.1186/2048-7010-3-2.
    1. Laraia BA, Siega-Riz AM, Gundersen C, Dole N. Psychosocial factors and socioeconomic indicators are associated with household food insecurity among pregnant women. J Nutr. 2006;136(1):177–182. doi: 10.1093/jn/136.1.177.
    1. Braveman P, Marchi K, Egerter S, Kim S, Metzler M, Stancil T, et al. Poverty, near-poverty, and hardship around the time of pregnancy. Matern Child Health J. 2010;14(1):20–35. doi: 10.1007/s10995-008-0427-0.
    1. Borders AEB, Grobman WA, Amsden LB, Holl JL. Chronic stress and low birth weight neonates in a low-income population of women. Obstetrics & Gynecology. 2007;109(2, Part 1):331–338. doi: 10.1097/01.AOG.0000250535.97920.b5.
    1. Carmichael SL, Yang W, Herring A, Abrams B, Shaw GM. Maternal food insecurity is associated with increased risk of certain birth defects. J Nutr. 2007;137(9):2087–2092. doi: 10.1093/jn/137.9.2087.
    1. Gillespie S, Kadiyala S. HIV/AIDS and food and nutrition security: from evidence to action: international food policy research institute. 2005.
    1. Holeye OO, Jeminusi OA, Orenuga A, Ogundipe O. Household food security among pregnant women in Ogun - east senatorial zone: a rural – urban comparison. J Public Health and Epidemiol. 2014;6(4):158–164.
    1. Sharkey JR, Johnson CM, Dean WR. Relationship of household food insecurity to health-related quality of life in a large sample of rural and urban women. Women Health. 2011;51(5):442–460. doi: 10.1080/03630242.2011.584367.
    1. Hromi-Fiedler A, Bermudez-Millan A, Segura-Perez S, Perez-Escamilla R. Household food insecurity is associated with depressive symptoms among low-income pregnant Latinas. Matern Child Nutr. 2011;7(4):421–430. doi: 10.1111/j.1740-8709.2010.00266.x.
    1. Gany F, Leng J, Ramirez J, Phillips S, Aragones A, Roberts N, et al. Health-related quality of life of food-insecure ethnic minority patients with Cancer. J Oncol Pract. 2015;11(5):396–402. doi: 10.1200/JOP.2015.003962.
    1. Hatsu I, Hade E, Campa A. Food insecurity is associated with health related quality of life in HIV infected adults (805.13). The FASEB Journal. 2014;28(1 Supplement)
    1. Casey PH, Szeto KL, Robbins JM, et al. Child health-related quality of life and household food security. Arch Pediatr Adolesc Med. 2005;159(1):51–56. doi: 10.1001/archpedi.159.1.51.
    1. Stuff JE, Casey PH, Szeto KL, Gossett JM, Robbins JM, Simpson PM, et al. Household food insecurity is associated with adult health status. J Nutr. 2004;134(9):2330–2335. doi: 10.1093/jn/134.9.2330.
    1. Fatemeh A, Azam B, Nahid M. Quality of life in pregnant women results of a study from Kashan, Iran. Pak J Med Sci July–September. 2010;26(3):692–697.
    1. Azizi A, Amirian F. Pashaei T, Amirian M. Prevalence of unwanted pregnancy and its relationship with health-related quality of life for pregnant Women’s in Salas city, Kermanshah- Iran. 2007. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2011;14(5):24–31.
    1. Jouybari L, Sanagu A, Chehregosha M. The quality of pregnant women life with nausea and vomiting. Qom Univ Med Sci J. 2012;6(2):88–94.
    1. Alimoradi Z, Kazemi F, Estaki T, Mirmiran P. Household food security in Iran: systematic review of Iranian articles. J Shahid Beheshti School of Nursing & Midwifery. 2015;24(87):9103.
    1. Coates J, Swindale A, Bilinsky P. Household food insecurity access scale (HFIAS) for measurement of food access: indicator guide. Washington, DC: Food and Nutrition Technical Assistance Project, Academy for Educational Development; 2007.
    1. Salarkia N, Abdollahi M, Amini M, Eslami AM. Validation and use of the HFIAS questionnaire for measuring household food insecurity in Varamin-2009. Iranian J Endocrinol Metab. 2011;13(4):374–383.
    1. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care. 1992:473–83.
    1. Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The short form health survey (SF-36): translation and validation study of the Iranian version. Qual Life Res. 2005;14(3):875–882. doi: 10.1007/s11136-004-1014-5.
    1. IBM Corp. Released 2012. IBM SPSS statistics for windows, version 21.0. Armonk, NY: IBM Corp.
    1. FAO, IFAD, WFP . The state of food insecurity in the world 2015: meeting the 2015 international hunger targets: taking stock of uneven progress. Food Agriculture Organization Of The United Nations: Rome; 2015.
    1. Sholeye OO, Jeminusi OA, Orenuga A, Ogundipe O. Household food security among pregnant women in Ogun - east senatorial zone: a rural - urban comparison. J Pub Health Epidemiol. 2014;6(4):158–164.
    1. Dixon L, Winkleby M, Radimer K. Dietary intakes and serum nutrients differ between adults from Foodinsufficient and food-sufficient families: third National Health and nutrition examination survey, 1988-1994. J Nutr. 2001;131:1232–1246. doi: 10.1093/jn/131.4.1232.
    1. Drewnowski A, Specter S. Poverty and obesity: the role of energy density and energy costs. Am J Clin Nutr. 2004;79:6–16. doi: 10.1093/ajcn/79.1.6.
    1. Kendell A, Olson C, Frongillo E. Relationship of hunger and food insecurity to food availability and consumption. J Am Diet Assoc. 1996;96:1019–1024. doi: 10.1016/S0002-8223(96)00271-4.
    1. Laraia BA, Siega-Riz AM, Gundersen C. Household food insecurity is associated with self-reported Pregravid weight status, gestational weight gain, and pregnancy complications. J Am Diet Assoc. 2010;110(5):692–701. doi: 10.1016/j.jada.2010.02.014.
    1. Mathews L, Morris MN, Schneider J, Goto K. The relationship between food security and poor health among female WIC participants. J Hunger Environ Nutr. 2010;5(1):85–99. doi: 10.1080/19320240903582679.

Source: PubMed

3
Abonnere