<p>STROBE statement.</p>

However, evidence on the association between HFI and these outcomes in Mediterranean settings is scarce. This study assessed the association between HFI, dietary intake, and weight status in a socioeconomically diverse sample of children aged 3–12 years living in Madrid, Spain.</p> <p>Methods</p><p>We analyzed data from a citywide cross-sectional survey conducted in Madrid in 2017 (n = 5,144), including objective anthropometric measurements (height and weight) of children aged 3–12 years, and parent-reported information on HFI and children’s intake of fruits, vegetables, and sugar-sweetened beverages (SSBs).

We fitted Poisson regression models with robust standard errors to estimate prevalence ratios (PRs) for overweight and obesity, and multinomial logistic regression models to estimate odds ratios (ORs) for dietary intake outcomes, with corresponding 95% confidence intervals (CIs).</p> <p>Results</p><p>Overall, 18.1% of children experienced HFI. After adjustment for age, sex, and family affluence, HFI was associated with a higher prevalence of overweight (PR = 1.17; 95% CI: 1.04, 1.31), but not obesity (PR = 1.20; 95% CI: 0.97, 1.48).