Food Insecurity in Peru: Measurement Properties of the FIES and Prevalence Estimates from the 2025 Household Survey

Background/Objectives: Food insecurity (FI) is a major public health challenge and is monitored globally using the Food Insecurity Experience Scale (FIES). In Peru, the recent incorporation of the FIES into the National Household Survey (ENAHO) enables the generation of nationally representative estimates. This study evaluated the statistical validity of the FIES and estimated the prevalence of food insecurity among Peruvian households. Methods: A cross-sectional study was conducted using ENAHO 2025 data. FI was assessed using the eight-item FIES. Rasch analysis evaluated item fit, severity ordering, reliability, residual correlations, and differential item functioning. National prevalence estimates of moderate-or-severe and severe FI were calculated using the Food and Agriculture Organization of the United Nations (FAO) FIES methodology and household sampling weights. Results: The study included 32,041 households, representing approximately 9.9 million households nationwide. The FIES demonstrated satisfactory statistical validity, with a Rasch reliability of 0.796. Item severities followed the expected progression of FI, residual correlations remained below the recommended threshold, and no substantial differential item functioning was observed. The prevalence of moderate-or-severe FI was 30.9%, while severe FI affected 4.0% of households. Higher prevalence was observed among households living in extreme poverty, with unmet basic needs, lower educational attainment, permanent functional limitations, and in rural and Amazonian areas. Conclusions: The FIES demonstrated adequate validity for household-level monitoring of FI in Peru. Nearly one-third of households experienced moderate-or-severe FI, and prevalence varied across socioeconomic and geographic groups. The integration of the FIES into ENAHO provides a valuable platform for routine monitoring and food security policymaking.