Food Insecurity and Obesity in Brazil

Last week’s topic of household food insecurity (HFI) and obesity, and Secretary Vilsack’s veritable avoidance of the topic got me thinking about the HFI-obesity paradox and the way it functions in lower income countries in addition to in the United States. As this is also my final paper topic, I found it timely to take a look at an article from another part of the world where the paradox has been examined. 

In “Severe food insecurity is associated with obesity among Brazilian adolescent females” from 2012, researchers looked at the issue of the HFI-obesity paradox with special focus on Brazilian adolescent girls. There is inconclusive research linking moderate but not mild or severe food insecurity to obesity, but the authors hypothesized that the outcomes for adolescent girls would be different based on health data from the Brazil Demographic and Health Survey. This is one of the first studies examining the HFI-obesity relationship in less-developed countries. 

As BMI data was taken from the Demographic and Health Survey, and food insecurity data was taken from the Brazilian Food Security Scale, the study found that “food insecurity is significantly and independently associated with excessive weight” in adolescent girls, differing from the study of grown women showing a moderate food insecurity and excessive weight relationship. Adolescent girls in Brazil were almost two times more likely to have excess weight if they were food insecure than their food secure counterparts. 

The authors posit myriad reasons for this outcome, including:

• Do parents shield children from food insecurity by giving them the food they have?
• Is eating a coping mechanism for the stress of being hungry?
• Do families purchase more nutrient-dense foods if they are cheaper?
• How do the strong body image concerns of Brazilian adolescents contribute to adolescents eating more or grown women eating less?
• What role do social assistance programs play in the types of foods that families purchase?

Notable here is that all but one of the questions commonly asked to unpack the paradox are questions that US-based researchers ask as well. The uncommon question is the one about body image. Brazil has an intense female aesthetic culture, including a high participation in plastic surgery amongst Brazilian women. This would be an interesting dynamic to explore when considering contributing factors. 

The authors’ conclusion is: "It is possible that the hunger-obesity paradox may be directly related with the way different countries experience nutrition transition. It seems that only when the nutrition transition reaches a stage at which energy-dense foods become available at affordable prices does food insecurity become a risk factor for overweight and obesity” (p. 1857) They seem to suggest that price points play a major role in determining calorie consumption. 

I think this study is interesting on many fronts. Like nutrition itself, research around the HFI-obesity paradox is inconclusive and few solid statements can be made about why people who are food insecure seem to show a greater tendency to be overweight. As we know that poorer countries are not immune to obesity nor to the paradox, it’s encouraging that similar (although not identical) results are being found across cultures. I’m hoping in my future work to start to unpack some of the questions/considerations listed above in both the United States and abroad. 

Kac, G., Velásquez-Melendez, G., Schlüssel, M. M., Segall-Côrrea, A. M., Silva, A. A., & Pérez-Escamilla, R. (2012). Severe food insecurity is associated with obesity among Brazilian adolescent females. Public Health Nutrition, 15(10), 1854–1860. doi:10.1017/S1368980011003582