Asociación entre la inseguridad alimentaria del hogar y la prevalencia de desnutrición crónica en niños menores de 2 años en Ecuador (ENDI 2023-2024).

Abstract

Chronic child malnutrition and food insecurity are priority public health problems in Ecuador, particularly among children under two years of life, a critical window for physical growth and cognitive development. Therefore, we set out to determine the association between household food insecurity and the prevalence of chronic malnutrition in children under two years of age in Ecuador. An analytical cross-sectional study was conducted using data from the ENDI 2023–2024 (Round 2), compiled by the National Institute of Statistics and Censuses (INEC), with a sample of 8,323 children under two years of age, selected using the survey’s complex sampling design. Food insecurity was measured using the Food Insecurity Experience Scale (FIES, 8 items); chronic malnutrition was defined as height-for-age < −2 standard deviations (WHO standards). We conducted weighted descriptive analyses accounting for the complex sampling design and logistic regression models with stepwise adjustment for sociodemographic, socioeconomic, and territorial variables were performed. The analysis incorporated the survey’s complex sampling design and was performed using weighted descriptive statistics and adjusted binary logistic regression models, with results expressed as odds ratios (OR) with 95% confidence intervals. The weighted prevalence of chronic malnutrition was 19.2% (95% CI: 17.9–20.6). 69.7% of the children belonged to households with some degree of food insecurity. Moderate and severe food insecurity were associated with a higher probability of DCI in the unadjusted analysis and in the model adjusted for sociodemographic and geographic characteristics (OR 1.55 and 1.63, respectively); however, when socioeconomic conditions and access to water were incorporated, the association weakened and ceased to be statistically significant (OR 1.27 and 1.30). It is concluded that food insecurity is associated with chronic child malnutrition and exhibits a gradient according to its severity, although this association is closely intertwined with the household’s socioeconomic status.