Examining Water Insecurity as a Driver of Nutrition Transition Among Tsimane' Adults in Lowland Bolivia

Open Access
- Author:
- Deshpande, Siddhi
- Area of Honors:
- Biobehavioral Health
- Degree:
- Bachelor of Science
- Document Type:
- Thesis
- Thesis Supervisors:
- Asher Yoel Rosinger, Thesis Supervisor
Helen Marie Kamens, Thesis Honors Advisor - Keywords:
- water insecurity
nutrition
sugary drinks
hydration strategies
market integration
nutrition transition
global health - Abstract:
- Water insecurity has emerged as an additional driver of food insecurity, overnutrition, and nutrition transition because sugary beverages may serve as an alternative to consuming contaminated water. This study examined how water insecurity is associated with hydration strategies in response to water insecurity. We analyzed data collected in summer 2019 among Tsimane’ forager-horticulturalists (n=455) living in hot-humid, lowland Bolivia. Using logistic regression with robust standard errors clustered by community residence, we found that higher water insecurity in adults was associated with increased odds of consuming non-water beverages. For men and women, each point higher water insecurity score (using the Household Water Insecurity Experiences (HWISE) scale) was associated with 24% (OR=1.24; 95% CI=1.01-1.51; P=0.037) and 27% (OR=1.27; 95% CI=1.06-1.52; p < 0.01) higher odds of consuming a sugar-sweetened beverage, respectively. Consumption of traditional beverages chicha dulce (a sweet manioc-based drink) and chicha fuerte (fermented manioc-based drink), in addition to liquor, were also studied. For men, each point higher HWISE score was associated with 13% (OR=1.13; 95% CI=1.11-1.16; P<0.001) higher odds of drinking chicha fuerte. Each point higher HWISE score was also associated with 16% (OR=1.16; 95% CI=1.02-1.32; P=0.022) higher odds of consuming liquor in the past week. Household income in the past month was also strongly associated with consumption of sugary drinks, but was inversely associated with chicha fuerte for men. These findings suggest that higher water insecurity is associated with consumption of sugar-sweetened beverages and chicha. Consumption of non-water beverages is a coping strategy to water insecurity that may have unintended nutritional consequences of excess calorie consumption, cardiometabolic risk, changes in body composition, which accelerates nutrition transition.