Household Food Security Status, Food Purchasing, and Nutritional Health of Saudi Girls Aged 6-12 Years

Main Article Content

Walaa A. Mumena
Hebah A. Kutbi


girls, weight status, stunting, nutrient intake, household food purchasing, food insecurity


Background/Aim: To assess the prevalence of food insecurity at the household level and to investigate its relationship with anthropometric measurements, dietary intake, and frequency of food purchasing among Saudi girls.

Material and Methods: This cross-sectional study included 119 girls aged 6-12 years and their mothers who were recruited from four public schools in Madinah, Saudi Arabia. Sociodemographic data, anthropometric measurements (height and weight) for both mothers and girls, dietary intake of girls (energy-adjusted nutrient intake calculated from single 24-hr dietary recall), and frequency of household food purchasing were evaluated. The Food Insecurity Experience Scale was utilized to evaluate the food security status. 

Results: Nearly one-quarter of the participants were experiencing food insecurity, wherein fathers education level, household income, and household crowding were negatively associated with food security status (p< .05). Household food security status was not linked to weight status or height of girls. However, food security status was positively associated with energy-adjusted vitamin D intake (B= 2.02 (SE= 0.86), [95% CI 0.31 to 3.72], p= .021). Additionally, significantly lower frequencies of purchasing fruits and vegetables, milk and dairy products, and meat were observed among food insecure households compared to food secure households (p< .05).

Conclusion: The high prevalence of food insecurity observed among our sample is concerning. Household food insecurity was linked to lower vitamin D intake among Saudi girls as well as lower purchasing of healthy foods. Interventions are needed to increase the accessibility of healthy food options among children experiencing food insecurity.


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1. WHO. World Health Organization. Early child development-nutrition and the early years [Internet]. 2020 [cited 2020 Apr 23]. Available from:
2. Olofin I, McDonald CM, Ezzati M, Flaxman S, Black RE, Fawzi WW, et al. Associations of suboptimal growth with all-cause and cause-specific mortality in children under five years: a pooled analysis of ten prospective studies. PLoS One. 2013. https://doi:10.1371/journal.pone.0064636.
3. Rytter MJH, Kolte L, Briend A, Friis H, Christensen VB. The immune system in children with malnutrition - A systematic review. PLoS One. 2014. https://doi:10.1371/journal.pone.0105017.
4. Casale D, Desmond C, Richter L. The association between stunting and psychosocial development among preschool children: a study using the South African Birth to Twenty cohort data. Child Care Health Dev. 2014. https://doi:10.1111/cch.12143.
5. Ginsburg AS, Izadnegahdar R, Berkley JA, Walson JL, Rollins N, Klugman KP. Undernutrition and pneumonia mortality. The Lancet Global Health. 2015. https://doi:10.1016/S2214-109X(15)00222-3.
6. UNICEF. The State of Food Security and Nutrition in the World 2018 - UNICEF DATA. UNICEF Data: Monitoring the situation of children and women. 2018.
7. Christian AK, Marquis GS, Colecraft EK, Lartey A, Soueida R. Household food insecurity but not dietary diversity is associated with children’s mean micronutrient density adequacy in rural communities across Ghana. Nutrition. 2019. https://doi:10.1016/j.nut.2019.03.006.
8. Hasan MT, Soares Magalhaes RJ, Williams GM, Mamun AA. The role of maternal education in the 15-year trajectory of malnutrition in children under 5 years of age in Bangladesh. Matern Child Nutr. 2016. https://doi:10.1111/mcn.12178.
9. Lawson DW, Mulder MB, Ghiselli ME, Ngadaya E, Ngowi B, Mfinanga SGM, et al. Ethnicity and child health in northern tanzania: Maasai pastoralists are disadvantaged compared to neighbouring ethnic groups. PLoS One. 2014. https://doi:10.1371/journal.pone.0110447.
10. McDonald CM, McLean J, Kroeun H, Talukder A, Lynd LD, Green TJ. Household food insecurity and dietary diversity as correlates of maternal and child undernutrition in rural Cambodia. Eur J Clin Nutr. 2015. https://doi:10.1038/ejcn.2014.161.
11. McDonald CM, McLean J, Kroeun H, Talukder A, Lynd LD, Green TJ. Correlates of household food insecurity and low dietary diversity in rural Cambodia. Asia Pac J Clin Nutr. 2015. https://doi:10.6133/apjcn.2015.24.4.14.
12. Wong HJ, Moy FM, Nair S. Risk factors of malnutrition among preschool children in Terengganu, Malaysia: a case control study. BMC Public Health. 2014. https://doi:10.1186/1471-2458-14-785.
13. Summit WF. Rome Declaration on World Food Security and World Food Summit Plan of Action Rome Declaration on World Food Security. World Food Summit. 1996;
14. Jones AD. Food Insecurity and Mental Health Status: A Global Analysis of 149 Countries. Am J Prev Med. 2017. https://doi:10.1016/j.amepre.2017.04.008.
15. Coleman-Jensen A, Rabbitt M, Gregory C, Singh A. Household food security in the United States in 2015 [Internet]. 2016. Available from:
16. Statistics Canada. Household food insecurity, 2011-2012. Data from the 2011-2012 Canadian Community Health Survey. 2012.
17. Sahyoun NR, Nord M, Sassine AJ, Seyfert K, Hwalla N, Ghattas H. Development and Validation of an Arab Family Food Security Scale. J Nutr. 2014. https://doi:10.3945/jn.113.187112.
18. Tappis H, Doocy S, Paul A, Funna S. Food security and development in South Sudan: A call to action. Public Health Nutr. 2013. https://doi:10.1017/S1368980013000669.
19. Kendall A, Olson CM, Frongillo EA. Relationship of hunger and food insecurity to food availability and consumption. J Am Diet Assoc. 1996. https://doi:10.1016/S0002-8223(96)00271-4.
20. Kirkpatrick SI, Tarasuk V. Food Insecurity Is Associated with Nutrient Inadequacies among Canadian Adults and Adolescents. J Nutr. 2008. https://doi:10.1093/jn/138.3.604.
21. Mark S, Lambert M, O’Loughlin J, Gray-Donald K. Household income, food insecurity and nutrition in Canadian youth. Can J Public Heal. 2012. https://doi:10.1007/bf03404210.
22. Rammohan A, Pritchard B, Dibley M. Home gardens as a predictor of enhanced dietary diversity and food security in rural Myanmar. BMC Public Health. 2019. https://doi:10.1186/s12889-019-7440-7.
23. Whitaker RC, Phillips SM, Orzol SM. Food insecurity and the risks of depression and anxiety in mothers and behavior problems in their preschool-aged children. Pediatrics. 2006. https://doi:10.1542/peds.2006-0239.
24. Alaimo K, Olson CM, Frongillo EA. Food insufficiency and American school-aged children’s cognitive, academic, and psychosocial development. Pediatrics. 2001;
25. Ryu JH, Bartfeld JS. Household food insecurity during childhood and subsequent health status: The Early Childhood Longitudinal Study - Kindergarten Cohort. Am J Public Health. 2012. https://doi:10.2105/AJPH.2012.300971.
26. Cordeiro LS, Wilde PE, Semu H, Levinson FJ. Household food security is inversely associated with undernutrition among adolescents from Kilosa, Tanzania. J Nutr. 2012. https://doi:10.3945/jn.111.155994.
27. Hackett M, Melgar-Quiñonez H, Álvarez MC. Household food insecurity associated with stunting and underweight among preschool children in Antioquia, Colombia. Rev Panam Salud Publica/Pan Am J Public Heal. 2009. https://doi:10.1590/S1020-49892009000600006.
28. Isanaka S, Mora-Plazas M, Lopez-Arana S, Baylin A, Villamor E. Food Insecurity Is Highly Prevalent and Predicts Underweight but Not Overweight in Adults and School Children from Bogotá, Colombia. J Nutr. 2007. https://doi:10.1093/jn/137.12.2747.
29. Cordeiro M de M, Monego ET, Martins KA. Overweight in Goiás’ quilombola students and food insecurity in their families. Rev Nutr. 2014. https://doi:10.3945/jn.111.155994.
30. Bhargava A, Jolliffe D, Howard LL. Socio-economic, behavioural and environmental factors predicted body weights and household food insecurity scores in the Early Childhood Longitudinal Study-Kindergarten. Br J Nutr. 2008. https://doi:10.1017/S0007114508894366.
31. Eisenmann JC, Gundersen C, Lohman BJ, Garasky S, Stewart SD. Is food insecurity related to overweight and obesity in children and adolescents? A summary of studies, 1995-2009. Obesity Reviews. 2011. https://doi:10.1111/j.1467-789X.2010.00820.x.
32. Food and Agriculture Organization of the United Nations. The food insecurity experience scale [Internet]. 2020 [cited 2020 Apr 27]. Available from:
33. Naja F, Hwalla N, Fossian T, Zebian D, Nasreddine L. Validity and reliability of the Arabic version of the Household Food Insecurity Access Scale in rural Lebanon. Public Health Nutr. 2015. https://doi:10.1017/S1368980014000317.
34. Food and Agriculture Organization of the United Nations. Rural transformation-key for sustainable development in the near east and North Africa. Overview of food security and nutrition 2018 [Internet]. Cairo; 2019. Available from:
35. Food and Agriculture Organization of the United Nations. Applying the FIES [Internet]. 2020 [cited 2020 Apr 27]. Available from:
36. Onis Bm de, Blössner M. WHO Global Database on Child Growth and Malnutrition. World Heal Organ. 2016;
37. WHO. World Health Organization. Growth reference data for 5-19 years. WHO. 2007. https://doi:10.1002/mds.26203
38. Food and Agriculture Organization of the United Nations. Food and agriculture organization statistics [Internet]. 2020 [cited 2020 Apr 27]. Available from:
39. Fiaz S, Noor MA, Aldosri FO. Achieving food security in the Kingdom of Saudi Arabia through innovation: Potential role of agricultural extension. Journal of the Saudi Society of Agricultural Sciences. 2018.
40. Alharthi S, Alharthi A, Alharthi M. Sustainable development goals in the Kingdom of Saudi Arabia’s 2030 vision. WIT Trans Ecol Environ. 2019;238:455–67. https://doi:10.2495/SC190401.
41. Food and Agriculture Organization of the United Nations. Partnering for strengthened food security and sustainable agricultural and rural development [Internet]. 2007 [cited 2020 Apr 27]. Available from:
42. Orr CJ, Ben-Davies M, Ravanbakht SN, Yin HS, Sanders LM, Rothman RL, et al. Parental Feeding Beliefs and Practices and Household Food Insecurity in Infancy. Acad Pediatr. 2019. https://doi:10.1016/j.acap.2018.09.007.
43. Jamaluddine Z, Choufani J, Sahyoun N, Ghattas H. A child-administered food security scale is associated with household socio-economic status, household food security and diet diversity. FASEB J. 2017;31:297–302.
44. Nguyen BT, Ford CN, Yaroch AL, Shuval K, Drope J. Food security and weight status in children: interactions with food assistance programs. Am J Prev Med. 2017. https://doi:10.1016/j.amepre.2016.09.009.
45. Papas MA, Trabulsi JC, Dahl A, Dominick G. Food insecurity increases the odds of obesity among young hispanic children. J Immigr Minor Heal. 2016. https://doi:10.1007/s10903-015-0275-0.
46. Htet MK, Dibley M, Rammohan A, Vicol M, Pritchard B. Factors Associated with Stunting of Under Five-year Children: Findings from Panel Surveys in Mountains, Dry Zone and Delta Regions of Rural Myanmar (2016–17) (P04-039-19). Curr Dev Nutr. 2019. https://doi:10.1093/cdn/nzz051.p04-039-19.
47. Saxe-Custack A, Lachance J, Hanna-Attisha M, Ceja T. Fruit and vegetable prescriptions for pediatric patients living in flint, Michigan: a cross-sectional study of food security and dietary patterns at baseline. Nutrients. 2019. https://doi:10.3390/nu11061423.
48. Rossen LM, Kobernik EK. Food insecurity and dietary intake among US youth, 2007-2010. Pediatr Obes. 2016. https://doi:10.1111/ijpo.12044.
49. Alsubaie, ASR. Intake of fruit, vegetables and milk products and correlates among school boys in Saudi Arabia. Int J Adolesc Med Health. 2018. https://doi:10.1515/ijamh-2018-0051.
50. Black AP, Brimblecombe J, Eyles H, Morris P, Vally H, O Dea K. Food subsidy programs and the health and nutritional status of disadvantaged families in high income countries: a systematic review. BMC public health. 2012. https://doi:10.1186/1471-2458-12-1099.
51. Beaton G, Milner J, McGuire V, Feather T, Little J. Source of variance in 24-hour dietary recall data: Implications for nutrition study design and interpretation. carbohydrate sources, vitamins, and minerals. Am J Clin Nutr. 1983;37(6):986–95. https://doi: 10.1093/ajcn/37.6.986.