bjective: Our objective was to test whether food insecurity mediates cross-
sectional associations between social disadvantage and body composition among
older adults (aged 501) in India (n 5 6556).
Methods: Adjusting for key sociodemographic and dietary variables, we examined
whether markers of social disadvantage (lower educational attainment, lower house-
hold wealth, belonging to a disadvantaged caste/tribe, and belonging to a minority
religion) were associated with food insecurity. We then examined whether food inse-
curity, in turn, was associated with anthropometric measures of body composition,
body mass index (BMI), and waist circumference (WC). We also tested whether food
insecurity mediated the relationship between social disadvantage and body
Results: In adjusted models, lower household wealth [lowest quintile (Q5) vs highest
quintile (Q1): odds ratio (OR) 5 13.57, P < .001], having less than a high-school
education (OR 5 2.12. P < .005), being Muslim (OR 5 1.82, P < .001), and being in
a scheduled caste (historically marginalized) (OR 5 1.49, P < .005) were associated
with greater food insecurity. Those who were severely food insecure had greater
odds of being underweight (OR 5 1.36, P < .01) and lower odds of high WC
(OR 5 0.70, P < .01). Mediation analyses estimated that food insecurity explained
4.7%–29.7% of the relationship between social disadvantage and body composition,
depending on the variables considered.
Conclusions: Our results are consistent with the hypothesis that food insecurity is a
mechanism linking social disadvantage and body composition among older adults in
India. These analyses contribute to a better understanding of processes leading to var-
iation in body composition, which may help enhance the design of interventions
aimed at improving population nutritional status.