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Underweight status, household food security and associated characteristics among women ≥18y in Bình Phước province, Vietnam Brown, Matthew Ryan


Background: Chronic malnutrition among women is a significant issue in rice exporting Vietnam. In 2000, underweight prevalence (BMI<18.5 kg/m²) among women (20-49y) was 26.3% and was associated with maternal and infant mortality and intra-uterine-growth-restrition. Known risk factors of underweight are poverty, rural-living and ethnicity but are insufficient to explain the causes of these high rates. Food insecurity, nutritional knowledge, dietary diversity, and cultural dietary behaviours may contribute to underweight prevalence in Vietnam. The province of Bình Phước was selected to explore determinants of high underweight status in a productive agrarian region. Objective: The primary objective was to assess underweight status and household food insecurity among non-pregnant women in Bình Phước. Secondary regression analysis of both underweight status and household food insecurity determined associated risk factors including psychosocial dietary behaviours, household demographics, dietary diversity and nutrition knowledge. Methods: A cross-sectional survey was conducted among non-pregnant women (n=397),≥8y, in 10 villages. The Household-Food-Insecurity-Access-Scale (HFIAS) classified food insecurity and anthropometric data classified underweight. Further survey questions assessed dietary diversity, demographics, nutrition knowledge and dietary behaviours. Results: In 2006, 24.4% (97/397) of women were underweight (95% CI; [20.2 to 28.7]). Food insecurity (HFIAS) scores were 6.7 (5.7 SD) out of 27 classifying 51% (204/397) as having severe, 15% (61/397) as moderate and 19% (77/397) as mild food insecurity. Logistic regression predicting underweight (vs. non-underweight) found that participants with mild food insecurity had a one-in-three odds of being underweight compared with those severely food insecure (OR 0.35, 95% CI; [0.17 to 0.75], p<0.001). Participants with no children (<5y) had lower odds of underweight compared to participants with ≥2 children (<5y) (OR 0.30, 95% CI; [0.14 to 0.65], P<0.01). The odds of higher food insecurity was lower among participants with moderate nutrition knowledge (OR 0.52, [95%CI, 0.29 to 0.92], P<0.05), higher education (grade 7-9) (OR 0.59, [95%CI, 0.36 to 0.97], P<0.05) and higher dietary diversity (OR 0.32, [(95% CI; 0.18 to 0.58], P<0.001). Conclusion: High levels of underweight were associated with HFIAS food insecurity and with having higher numbers of children (<5y). Significant predictors of food insecurity were education, nutrition knowledge and dietary diversity.

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