Food Insecurity and its relation to Socioeconomic Inequities, Food Diversity and Obesity: A Cross-sectional Pilot Study among Indigenous Women in the Lake Atitlán Area, Guatemala

Abstract

Background: Guatemala faces several challenges related to high levels of poverty, malnutrition, and food insecurity, despite being classified as an upper-middle-income country. These problems are a reflection of the country's historical inequalities and the perpetuation of conditions that affect the health and economic development of the most vulnerable populations. Aim: The present study aimed to assess food insecurity in households of Tz'utujil Maya women living around Lake Atitlán, in Guatemala, and to relate it to socioeconomic factors, dietary diversity, and anthropometric measures. Methods: This cross-sectional pilot study investigated the subsample of women responsible for food provision in their households, who had previously participated in the Respiratory Health in the Lake Atitlan (2021). Data were collected via digital questionnaires using the Kobotoolbox software. The assessed variables included food insecurity, measured by the Household Food Insecurity Access Scale (HFIAS), socio-demographic information, dietary diversity assessed by the Minimum Dietary Diversity for Women (MDD-W), and levels of general and abdominal obesity, evaluated through anthropometric measures. The study population comprised 86 Tz'utujil Mayan women aged 18-49 years who were recruited over a three-week period in the municipality of San Pablo la Laguna, Guatemala. Results: The prevalence of severe food insecurity stood at 64%, with only one household (1.2%) reported as food secure. Notably, 28% experienced moderate food insecurity, and 7% faced mild insecurity. However, economic hardship was widespread, as 97% of households experienced monetary poverty, and educational attainment was relatively low, with 64% having incomplete or only primary education. Furthermore, just 12.8% of households could afford the daily food basket per household size. Despite these health concerns, the majority (92%) achieved minimum dietary diversity. The average body mass index (BMI) was 30.1 kg/m², with 49% classified as obese. Additionally, 59% had high waist circumference, with 50% showing increased central adiposity, and 29% displaying high central adiposity based on the waist-to-height ratio. Conclusions: This study reveals the worrying reality for indigenous Mayan Tz'utujil women in San Pablo, Guatemala, with two-thirds of the assessed households facing severe food insecurity. A complexity of factors relevant for community health were found, such as high levels of poverty, low levels of schooling, as well as high levels of both obesity and stunting.