Original Article

Nutritional Education and Its Effects on Household Food Insecurity in Southeastern Iran


Background: Food insecurity can affect health directly or indirectly through its impact on nutritional status. We aimed at determining the effects of nutrition education intervention on household food insecurity in Zahedan, southeast Iran.

Methods: The study was conducted using multi-stage sampling method. The first stage was a cross-sectional investigation whereby 2,160 households were studied in Zahedan in 2015. The prevalence of food insecurity was determined and food-insecure households were identified. Household food security status was assessed through the 18-item US Household Food Security Survey Module. In the second stage, based on the determined sample size of 150 households in each group, eligible households were randomly divided into the intervention and control groups. Before the educational intervention, questionnaires including demographic and socioeconomic information were completed for both groups. Then, data analysis was performed and the intervention was conducted on the intervention group. Six months post-intervention, a final assessment was made by interviewing the two groups to complete demographic, socioeconomic, and household food security questionnaires.

Results: The prevalence of food insecurity in the 2,160 households was 58.8%. After the intervention, the number of food-insecure households diminished by 22% in the intervention group, and these households were assigned to the food secure category. After controlling the confounding variables, the educational intervention was significantly effective in reducing food insecurity score (P<0.001).

Conclusion: The findings demonstrated the beneficial role of nutritional education and the skills of resource management in modifying nutritional behaviors and improving food security in the study population.

1. Eicher-Miller H, Mason A, Weaver C, et al (2009). Food insecurity is associated with iron deficiency anemia in US adolescents. Am J Clin Nutr, 90(5):1358-71.
2. National Research Council (2006). Food insecurity and hunger in the United States: An assessment of the measure. National Academies Press.
3. Rychetnik L, Webb K, Story L, Katz T (2003). Food Security Options Paper: A planning framework and menu of options for policy and practice interventions. NSW Centre for Public Health Nutrition.
4. Mello J, Gans K, Risica P, et al (2010). How is food insecurity associated with dietary behaviors? An analysis with low-income, ethnically diverse participants in a nutrition intervention study. J Am Diet Assoc, 110(12):1906-11.
5. Mohamadpour M, Sharif Z, Keysami M (2012). Food insecurity, health and nutritional status among sample of palm-plantation households in Malaysia. J Health Popul Nutr, 30(3):291-302.
6. Hadley C, Lindstrom D, Tessema F, et al (2008). Gender bias in the food insecurity experience of Ethiopian adolescents. Soc Sci Med, 66(2):427-438.
7. Ivers LC, Cullen KA (2011). Food insecurity: special considerations for women .Am J Clin Nutr, 94(6):1740S-1744S.
8. Vuong TN, Gallegos D, Ramsey R (2015). Household food insecurity, diet, and weight status in a disadvantaged district of Ho Chi Minh City, Vietnam: a cross-sectional study. BMC Public Health, 15:232.
9. Ramsey R, Giskes K, Turrell G, Gallegos D (2012). Food insecurity among adults residing in disadvantaged urban areas: potential health and dietary consequences. Public Health Nutr, 15(2):227-37.
10. Stuff J, Casey P, Szeto K, et al (2004). Household food insecurity is associated with adult health status. J Nutr, 134(9):2330-5.
11. Lindberg R, Lawrence M, Gold L, Friel S, Pegram O (2015). Food insecurity in Australia: Implications for general practitioners. Aust Fam Physician, 44(11):859-62.
12. Gundersen C, Kreider B, Pepper J (2011). The economics of food insecurity in the United States. Applied Economic Perspectives and Policy, 33(3):281-303.
13. Pan L, Sherry B, Njai R, Blanck H (2012). Food insecurity is associated with obesity among US adults in 12 states. J Acad Nutr Diet, 112(9):1403-1409.
14. Lee SE, Song YJ, Kim Y, et al (2016). Household food insufficiency is associated with dietary intake in Korean adults. Public Health Nutr, 19(6):1112-21.
15. Lent MD, Petrovic LE, Swanson JA, et al (2009). Maternal mental health and the persistence of food insecurity in poor rural families. J Health Care Poor Underserved, 20(3):645-61.
16. Dollahite J, Olson C, Scott-Pierce M (2003). The impact of nutrition education on food insecurity among low- income participants in EFNEP. Journal of Family and Consumer Sciences, 32(2):127-139.
17. Eicher-Miller HA, Mason AC, Abbott AR, et al (2009). The effect of Food Stamp Nutrition Education on the food insecurity of low-income women participants. J Nutr Educ Behav, 41(3):161-8.
18. Melchior M, Caspi A, Howard LM, et al (2009). Mental health context of food insecurity: a representative cohort of families with young children. Pediatrics, 124(4):e564-72.
19. Nord M, Andrews M, Carlson S (2009). Household food security in the United States. Economic Research Report, 83.
20. Rafiei M, Nord M, Sadeghizadeh A, Entezari MH (2009). Assessing the internal validity of a household survey-based food security measure adapted for use in Iran. Nutr J, 8:28.
21. Ramesh T (2009). The Prevalence of food insecurity and some associated factors among Shirazian households in 2009. Unpublished master’s thesis, Shahid Beheshti University of Medical Sciences, Tehran, Iran (in Persian).
22. Mortazavi Z, Dorosty AR, Eshraghian MR, et al (2017). Household Food Insecurity and Its Association with Self-reported Infectious and Parasitic Diseases Among Household Mothers in Southeast of Iran. Health Scope, 6:e15125.
23. Mortazavi Z, Dorosty AR, Eshraghian MR, et al (2017). Household Food Insecurity in Southeastern Iran: Severity and Related Factors. Int J Food Sci, DOI 10.1155/2017/7536024.
24. Rivera RL, Maulding MK, Abbott AR, et al (2016). SNAP-Ed (Supplemental Nutrition Assistance Program–Education) increases long-term food security among Indiana households with children in a randomized controlled study. J Nutr, 146(11):2375-2382.
25. Rivera RL, Maulding MK, Eicher-Miller HA (2019). Effect of Supplemental Nutrition Assistance Program–Education (SNAP-Ed) on food security and dietary outcomes. Nutr Rev, 77(12):903-921.
26. Pardilla M, Prasad D, Suratkar S, Gittelsohn J (2014). High levels of household food insecurity on the Navajo Nation. Public Health Nutr, 17(1):58-65.
27. Mazur RE, Marquis GS, Jensen HH (2003). Diet and food insufficiency among Hispanic youths: acculturation and socioeconomic factors in the third National Health and Nutrition Examination Survey. Am J Clin Nutr, 78(6):1120-7.
IssueVol 50 No 4 (2021) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v50i4.6006
Food insecurity Nutrition education Intervention Iran

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How to Cite
Mortazavi Z, Dorosty A, Eshraghian M, Ghaffari M, Ansari-Moghaddam A. Nutritional Education and Its Effects on Household Food Insecurity in Southeastern Iran. Iran J Public Health. 50(4):798-805.