Vol.:(0123456789) 1 3 Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity https://doi.org/10.1007/s40519-020-00921-8 ORIGINAL ARTICLE Food insecurity, dietary acid load, dietary energy density and anthropometric indices among Iranian children Elnaz Daneshzad 1  · Ahmadreza Dorosty‑Motlagh 1  · Nick Bellissimo 2  · Katherine Suitor 2  · Leila Azadbakht 1,3 Received: 27 February 2020 / Accepted: 5 May 2020 © Springer Nature Switzerland AG 2020 Abstract Objectives Food insecurity signifcantly infuences diet quality which in turn has an impact on individual health. This study aimed to determine the association of food insecurity, dietary energy density (DED), dietary acid load (DAL), and the anthropometric status of children. Study design A cross-sectional study. Methods This study was conducted in 788 6-year-old girls who were referred to health care centers afliated with Tehran University of Medical Sciences in the south of Tehran from October 2017 to March 2018. Food frequency questionnaires (168 food items) were assessed to calculate DAL and DED. Food insecurity was assessed using the 18-item United States Department of Agriculture questionnaire. Weight and height of children were measured as anthropometric indices. Results Protein and energy intake were higher in participants with a higher DAL and DED, respectively. Energy, fat, carbo- hydrate, fber, potassium, phosphorus, calcium, iron, folate, vitamin B12, mono- and poly-unsaturated fatty acid intake was inversely related to DAL. Children characterized as food insecure were more likely to be defned as thin (OR 5.36; 95% CI 3.41–8.40) than overweight (OR 0.18; 95% CI 0.12–027) and obese (OR 0.28; 95% CI 0.08–0.98, respectively). There was no signifcant association between DED, potential renal acid load (PRAL), and food security status. Moreover, there was no signifcant association between anthropometric measure and PRAL. Conclusion Findings from our study revealed that there was no association between DAL and food insecurity. However, food insecure children were more likely to be characterized as thin than children categorized as food secure. More studies need to be performed in both genders to confrm our fndings. Level of evidence Level V cross-sectional descriptive study. Keywords Food insecurity · Dietary acid load · Dietary energy density · Anthropometric · Children Introduction Periods of childhood growth are sensitive, yet there are critical windows that are widely infuenced by nutritional status. They require more energy and nutrients such as iron and zinc to support adequate growth [1]. It has been previously reported in Iranian children aged 2–5 years old that the prevalence of stunted childhood growth was 7.5%, rates of underweight and overweight 6.9% and 17.8% in boys and 4.7% and 11.7% in girls, respectively [2]. It is well understood that weight and height development at an early age can critically impact health quality in later life. While childhood overweight or obesity has been associ- ated with comorbidities such as asthma, diabetes, meta- bolic disease, hypertension and cardiovascular diseases (CVD) later in life [3], children and adolescents who fall Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40519-020-00921-8) contains supplementary material, which is available to authorized users. * Leila Azadbakht azadbakhtleila@gmail.com 1 Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran 2 School of Nutrition, Ryerson University, Toronto, Canada 3 Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran