Is Obesity the Cost of Being Food Insecure? An Analysis of Food Environments and Behaviors in Rural Guatemala




Project Summary

As a part of Penn Medicine’s Guatemala Health Initiative, I spent ten weeks during the summer of 2016 in Santiago Atitlán, where I supported Hospital Atitlán, a local NGO, and its community-based diabetes prevention programs.  Many studies have shown that diabetes mellitus (DM), specifically type 2 diabetes, has been rising in low and middle income countries like Guatemala at alarming rates – a statistic that had become more real to me as I tended to long lines of community members, eagerly waiting to get their blood glucose levels checked.

My time in Guatemala last summer had come to an end, but my curiosity in Santiago and its nutritional landscape had not. I was stuck with the questions: What in the community, whose nutritional foundation was corn for countless generations, was causing these diet-related diseases? What are the implications of inculcating changes in food behaviors in such a community? What are the obstacles that individuals face when trying to achieve this? I harbored in my mind these questions which, inevitably, were actualized into a new research proposal and another trip to Guatemala.

This summer, I spent six weeks in Santiago Atitlán exploring food behaviors and food insecurity as a barrier to what is perceived as good nutrition and/or good health. Using random sampling methods, I conducted a door-to-door survey of 250 adults. This survey assessed food security status and calculated body mass index (BMI). All of the information collected from the survey was kept on a REDCap database, and I was able to create three categories of participants: 1) Food Insecure with Obesity, 2) Food Insecure without Obesity, and 3) Food Secure with Obesity.  I returned to 20 of the survey participants who were placed in these groups (10 from group 1 and 5 from groups 2 and 3 each) and conducted semi-structured interviews about their food behaviors while using a translator, who was translating from Tz’utujil, the indigenous Mayan language, to Spanish for a majority of the interviews.

Back in Philadelphia, I am currently in the process of learning to analyze the interview data I have on a program called NVivo so that I may be able to identify salient themes and the effects of food insecurity on the diet and health.  I will present my findings later this fall semester.     

I learned a lot this summer: I learned how to conduct interviews and manage survey data, I learned about the obstacles of using door-to-door sampling methods, and I also learned that 47.4% of the 250 people I surveyed in Santiago are food insecure.  With this remarkably high prevalence of food insecurity will come many challenges, especially when trying to address the specific issues of diet-related diseases.  However, I am beyond grateful to have been able to take the first step in pursuing this project – and I remain confident, inspired, and hopeful about how its results may inform our understanding of poverty and food insecurity, with the hopes of lowering the cost of good health.  

Is Obesity the Cost of Being Food Insecure? An Analysis of Food Environments and Behaviors in Rural Guatemala