(P24-064-24) Adolescent Food Insecurity at Home and at School Is Related to Diet Quality Among Ghanaian Adolescents

Objectives: Household food insecurity is related to diet quality but parents may be less aware of how food insecurity affects adolescent food choices away from home. The objective of this study was to understand how adolescent and parental reports of food insecurity are related to diet quality outcomes.

Methods: We randomly selected 89 adolescent/parent pairs from 4 schools in the Cape Coast metropolitan area, Ghana. Adolescents and their parents responded to the Child Food Insecurity Experiences Scale (CFIES) twice, separately about experiences at home and at school. Answers for each were totaled (0-20) and collapsed into categories (none, few, several, or many experiences). Adolescents also responded to the Diet Quality Questionnaire (DQQ) for Ghana. A score for each of the following diet quality outcomes was calculated: Food Group Diversity, NCD-protect, NCD- risk, and All-5. We used linear regression to assess the relationship between food insecurity and continuous scores of Food Group Diversity, NCD-protect, NCD- risk and logistic regression for food insecurity and the binary All-5 score, adjusting for relevant covariates.

Results: Adolescent report of food insecurity at home as a continuous score was associated with lower food group diversity scores (p=0.032). As a categorical predictor, it was associated with a lower food group diversity score (p < 0.001) and NCD-protect score (p=0.005) and lower odds of meeting All-5 (p=0.035). Adolescent report of food insecurity at school as a continuous score was associated with lower NCD-risk scores (p=0.047) and food group diversity scores (p=0.013). As a categorical predictor, it was associated with a higher NCD-risk score (p=0.032). Parental reports of adolescent food insecurity were not associated with any diet quality outcomes.

Conclusions: Adolescent reports of food insecurity experiences were related to multiple dimensions of diet quality, while parental reports were not. Food insecurity at home and at school may impact diet differently and parents may not be fully aware of their children’s experiences.

Funding Sources: NIH FIC & OBSSR, UC Global Health Institute, Fulbright US Student Program