Food Insecurity is Associated with Poor Diet Quality Among Pregnant Adolescents and Adolescent Mothers in Ghana

Abstract Background Food insecurity is a global health problem and a likely determinant of poor diet quality. However, the relationship between food insecurity and diet quality among adolescents remains under-researched. This study examined the association between food insecurity and diet quality among pregnant adolescents and adolescent mothers in Ghana. Methods A cross-sectional survey was conducted among pregnant adolescents (n=216) and adolescent mothers (n=206) aged 12-19 years in Cape Coast, Ghana. Diet Quality indicators including Food Group Diversity Score (FGDS), Minimum Diet Diversity for women (MDD-W), ALL-5 indicator and dietary factors for Non-Communicable Diseases (NCD-Protect and NCD-risk) were assessed using the Global Diet Quality Questionnaire (DQQ). Food Insecurity was measured using the Child Food Insecurity Experience Scale (CFIES). Linear and logistic regression were used to examine the association between binary food insecurity and diet quality indicators, adjusting for relevant covariates. Results Participants had a mean age of 18±1.2 years. Most were out of school (70.50%) and unemployed (82.0%). Participants consumed 5 out of 10 food groups (FGDS 4.9±1.7) and 56.8% met the MDD-W. The mean CFIES score was 9.5±6.4 with 87.2% reporting some food insecurity in the past 30 days. Food insecurity was significantly associated with FGDS and MDD-W but not the ALL-5 indicator. Participants who experienced food insecure were less likely to meet the MDD-W (OR: 0.39; 95% CI: 0.20, 0.77), consume NCD protective foods (β±SE = -0.59±0.22, P=0.0078) and consume foods linked to NCD risk (-0.74±0.26, P=0.004). Conclusion Food insecurity was significantly associated with poor diet quality among pregnant adolescents and adolescent mothers in Ghana. Interventions addressing food insecurity may improve diet quality in this population.