Affordability of nutrient-adequate diets as an indicator for food and nutrition security. Evidence from fill the nutrient gap analyses

We conducted an ecological study using data from 373 subnational units in 32 countries collected from 2011 to 2020, to explore the associations of non-affordability of nutrient-adequate diets and of food insecurity (percentage of people with poor or borderline Food Consumption Score) with indicators measuring dietary quality and nutritional status. We found a strong negative monotonic correlation between non-affordability of nutrient-adequate diets and minimum dietary diversity in children 6–23 months ($r_s=-0.65,p<0.01$), and a weaker correlation between poor or borderline Food Consumption Score with the same dietary diversity indicator ($r_s=-0.39,p<0.01$). The relations between non-affordability and nutrition outcomes (prevalence of stunting and the composite indicator of ‘people deprived in nutrition’) were also highly significant at the subnational level, and had larger coefficients than indicators focusing on caloric adequacy. Examining these relations subnationally could provide relevant information for policies and programs aiming to address the risk of nutrition insecurity due to economic inaccessibility. Compared to dietary quality indicators, non-affordability is a relatively easy indicator to calculate and has the potential to use secondary data already captured through existing government systems.