November 2020

Food insecurity in Salvadoran communities: the double burden of malnutrition

During the 1996 World Food Summit, the Food and Agriculture Organization of the United Nations (FAO) defined for the first time the concept of Food Security as the stage in which “all people at all times have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life”. Despite the time elapsed, the right to food is not universally guaranteed, and in fact, one of the sustainable development goals in Agenda 2030 is to eradicate all forms of malnutrition in the world.

Although the current situation would allow the production of the food necessary to meet the needs of the entire world population, the FAO report on Food Security 2019 reports that approximately 2 billion people are moderately or severely food insecure in the world. This means that their diets are deficient in terms of quantity, variety, and quality, leading to adverse nutritional conditions.  Here it should be noted that food insecurity contributes to a known double burden of malnutrition, causing both undernutrition and obesity as a result of the intake of cheap, often satiating, high-energy-density foods of low nutritional value.

Through funding from the Complutense University of Madrid (UCM), the EPINUT Research Group analyzed the food security and nutritional status of the school population in the human communities settled in the Bajo Lempa region (Tecoluca, El Salvador).  This is a rural and coastal region, whose economic activity is focused on the primary sector, which is threatened by the regularity of floods that occur as a combined effect of heavy rains, tides, and river overflows. It should also be noted that it was populated relatively recently, as the current communities were established after the end of the war with the signing of the Peace Accords (1992), by which the Government of El Salvador and the European Economic Community bought lands in several municipalities to hand it over to the families of former combatants, the Armed Forces of El Salvador (FAES), the Farabundo Martí National Liberation Front (FMLN), and others repatriated and displaced from the conflict through the Land Transfer Plan.

To synthesize in a single figure the situation of malnutrition and taking into account that several types of malnutrition can coexist simultaneously in the same subject, the Extended Composite Index of Anthropometric Failure (ECIAF) was calculated in a sample of 660 school children between 5 and 16 years old. This index allows the identification of those nutritional situations related to overweight and its eventual combination with retarded growth or stunting.

The food security level of 151 households was estimated through the Food Security Perception Survey (FSPS). This survey consists of a total of 12 questions that refer to the availability of economic resources, and the feeding of adults and children during the last 30 days. It also allows households to be classified into four different categories: food-secure household, mild, moderate, or severe food insecurity.

The prevalence of anthropometric failure was 36.3%, mainly due to a high proportion of individuals with overweight (overweight and obesity) (24.5%) and chronic undernutrition or low height for age (6.3%).  Six out of ten households were found to be food insecure and one out of four was severely insecure. In the last thirty days before the survey, 28 percent of adults and 11.9 percent of children missed some of the main meals because of lack of food.  Twenty-one percent of the former and 13 percent of the latter declared that they had gone to bed hungry, which shows that parents prioritized feeding their children to their own detriment.

It should be noted that food insecurity was greater in families with younger children, possibly because older children contribute to the care of the young and the maintenance of the family. Households where women have no, or only primary, education were also more insecure.

The study shows the double burden of malnutrition associated with poverty in Bajo Lempa communities and highlights that factors such as maternal education can help reduce food insecurity and malnutrition. The latest floods in June 2020 and the mandatory quarantine due to the coronavirus pandemic have further strained the struggling economy of these populations. Unfortunately, we cannot expect the situation to improve in the short term.


Roberto Pedrero Tomé has a degree in Biology from the Universidad Complutense of Madrid (UCM) and a postgraduate degree in Physical Anthropology: Human Evolution and Biodiversity from the UAM-UCM-UAH. He is studying a Master’s Degree in Biostatistics and Bioinformatics at the Universitat Oberta de Catalunya (Open University of Catalonia, UOC) and is developing his Ph.D. at the Department of Biodiversity, Ecology, and Evolution of the Faculty of Biological Sciences at the UCM with the EPINUT Research Group. His doctoral thesis (“Growth and nutritional condition as an expression of food security and quality of life in Salvadoran communities of the Bajo Lempa”), from which the present contribution to the Virtual Museum of Human Ecology is derived, is part of a Cooperation Project for Sustainable Development (ref. 17/19, 18/11) promoted by the Department of Biodiversity, Ecology and Evolution of the UCM in collaboration with the Universidad Paracentral del Salvador and other institutions such as the Municipality of Tecoluca, the Fundación del Valle and Asociación-Fundación para la Cooperación y el Desarrollo Comunal de El Salvador (CORDES).