(P17-048-23) “When There Is No Water, We Buy Soda”: Water Insecurity Experiences and Dietary Impacts Among Adults on San Cristóbal Island, Ecuador

Objectives: Unreliable access to safe water undermines nutritional well-being through numerous pathways, but most research to date has only considered its role in sanitation and hygiene. Further, few studies have examined how issues with water may concurrently contribute to both over- and undernutrition. We therefore aimed to identify the ways by which water insecurity influences dietary decision-making and food preparation in a dual-burden setting.

Methods: Cross-sectional data were collected among 39 adults living on San Cristóbal Island in Galápagos, Ecuador in July-August 2022. Purposive sampling was used to maximize neighborhood representation given spatial variability of water issues and delivery schedules. Semi-structured interviews were conducted among 20 individuals and another 19 participated in focus group discussions. Interview guides prompted about timing, frequency, and types of household water issues and associated impacts on diet and feeding practices. Interviews were thematically analyzed using inductively developed codes.

Results: Water was universally identified as being important for growing, washing, and preparing foods. When it was in short supply or perceived to be of poor quality, participants primarily cooked foods that required less water (e.g., replaced soups with salads) or changed cooking techniques (e.g., fried instead of steamed foods) rather than purchasing expensive bottled water for cooking. Some reduced the total amount of food consumed, sharing instances when they had sufficient food but inadequate water to prepare it. When water issues prevented cooking or cleaning of dishes, many opted to eat meals away from home, although food quality from vendors was sometimes described as being poor. Regarding beverages, all individuals had access to piped water but most used bottled water for drinking, stating that municipal water could cause disease. Some individuals purchased sugar-sweetened beverages for hydration when piped water was limited or considered unsafe.

Conclusions: Water insecurity negatively impacts the quality and quantity of foods that households can prepare and should be further investigated as a risk factor for poor nutrition.

Funding Sources: Wong-Moulton Research Award, Center for Galápagos Studies, and UNC-the University of North Carolina at Chapel Hill