(P17-033-23) Intersections Among Body Mass Index, Food Insecurity, and Water Insecurity for Mexican Adult Women and Men Using ENSANUT 2021 Data

Objectives: Food insecurity is positively associated with body mass index (BMI), particularly among women in middle- and high-income settings. Water insecurity has also been associated with food insecurity. Little is known about the connections between food insecurity, water insecurity, and BMI, although there are many possible intersections. We sought to understand the relationship between water insecurity and BMI and whether water insecurity moderated the association between food insecurity and BMI.

Methods: We used nationally representative data collected among non-pregnant adults (≥20 years) in the 2021 Mexican National Health and Nutrition Survey. Key variables included BMI, water insecurity (measured with the Household Water Insecurity Experiences Scale), and food insecurity (measured with the Latin American and Caribbean Food Security Scale) (n= 3,329 men and 5,328 women). Weighted multivariable linear and logistic regression tested whether BMI and the odds of being overweight or obese were related to food insecurity and water insecurity, adjusting for demographic covariates, including region, urbanicity, socioeconomic status, and household size.

Results: Among women, moderate to severe food insecurity was associated with 0.74 kg/m² (95% CI: 0.11 to 1.37) higher BMI and a 1.30 (95% CI: 1.04 to 1.62) times higher odds of BMI ≥ 30 kg/m2 relative to being food secure. Among men, moderate to severe food insecurity was associated with 0.84 kg/m2 (95% CI: -1.52 to -0.17) lower BMI and a lower odds (OR=0.71, 95% CI: 0.54 to 0.93) of BMI ≥ 25 kg/m² relative to being food secure. No independent relationships were found between water insecurity and BMI for women or men, and water insecurity did not moderate the relationship between food insecurity and BMI.

Conclusions: Food insecurity was associated with higher BMI among women and lower BMI among men. Water insecurity was not associated with BMI in this context. However, there are many plausible pathways by which water insecurity can shape nutrition and health; these should be explored in other contexts.

Funding Sources: Carnegie Corporation, Northwestern University, United States Agency for International Development Cooperative Agreement, and Northwestern’s Baker Undergraduate Research Grant and Institute for Policy Research. The data are publicly available from the National Public Health Institute of Mexico.