Food insecurity severity, household food acquisition patterns, and food basket contraction in Peru: a national analysis of ENAHO 2025

Background Food insecurity may affect both access to food and the quantities acquired by households. However, evidence on its relationship with the acquisition of specific food groups in Peru remains limited. Objective To evaluate the association between food insecurity severity and the probability and quantity of food acquisition among Peruvian households. Methods A cross-sectional study was conducted using data from 32,053 households participating in the 2025 National Household Survey (ENAHO). Food insecurity was assessed using the Food Insecurity Experience Scale (FIES; 0–8 points). Per capita acquisition of fruits, vegetables, legumes, cereals, pseudocereals and cereal-based foods, fish and seafood, processed meats, and sugar-sweetened beverages was estimated. Modified Poisson regression models were used to estimate adjusted prevalence ratios (aPRs), and Gamma regression models with a log link were used to estimate adjusted mean ratios (aMRs), accounting for the complex survey design. Results Each 1-point increase in FIES was associated with 2.6% lower fruit acquisition (aMR = 0.974; 95% CI: 0.968–0.980) and 1.3% lower vegetable acquisition (aMR = 0.987; 95% CI: 0.982–0.992). Higher FIES severity was also associated with lower probabilities of acquiring fish and seafood, processed meats, and carbonated soft drinks. Cereals, pseudocereals, and cereal-based foods showed only minimal positive associations in continuous models, while categorical analyses showed no monotonic gradient across severity bands. Conclusion Greater food insecurity severity was associated with selective contraction of household food acquisition, particularly for fruits and vegetables, rather than a uniform shift across all food groups.