Association between food insecurity and cardiometabolic risk in adults and the elderly: A systematic review

Miguel, Elizangela da Silva; Lopes, Sílvia Oliveira; Araújo, Susilane Pereira; Priore, Sílvia Eloíza; Alfenas, Rita de Cássia Gonçalves; Hermsdorff, Helen Hermana Miranda

doi:10.7189/jogh.10.020402

Cited by 22 publications

(24 citation statements)

References 31 publications

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“…Food insecure participants had higher BMI and waist circumference, blood pressure, fasting glucose, triglycerides, and LDL cholesterol, and lower HDL cholesterol. These ndings are in agreement with ndings of recent meta-analyses indicating a direct relationship of food insecurity with cardiometabolic risk factors, especially excess weight, hypertension, and dyslipidemias [12,34]. These abnormalities in metabolic and cardiovascular risk markers gradually progress during the lifespan and eventually leads to cardiovascular and other chronic diseases [7].…”

Section: Food Insecurity and Cardiometabolic Risk Factorssupporting

confidence: 91%

“…The questionnaire contains 9 items and has been translated and validated for use in Iranian community [20]. The HFIAS scale scores the food insecurity from 0 to 27 and categorizes it into 4 levels of food secure (0-1), and mild (2-8), moderate (9)(10)(11)(12)(13)(14), and severe (15-27) food insecure conditions. Anthropometric measurements.…”

Section: Page 3/18mentioning

confidence: 99%

“…Cardiovascular mortality is an important cause of death in food insecure population, with a hazard ratio of 1.75 for cardiovascular mortality compared to the hazard ratio of 1.45 for all-cause mortality [11]. A number of investigations have indicated the association between cardiovascular disease risk and food insecurity (reviewed by Miguel et al) [12]. However, none, except one of these studies has examined a wide range of cardiometabolic risk factors [13].…”

Section: Introductionmentioning

confidence: 99%

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The Association of Food Insecurity and Cardiometabolic Risk Factors May Be Independent of Body Mass Index

Hashemzadeh

Teymouri

Fararouei

et al. 2021

Preprint

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Background: Investigations on food insecurity have shown that food insecurity is negatively associated with health. We examined the association of food insecurity, cardiometabolic risk factors, and dietary patterns in women. Methods: The cross-sectional study was performed on 190 females referred to primary health care centers in Shiraz, Iran. Food insecurity was assessed by Household Food Insecurity Access Scale. Cardiometabolic risk factors including anthropometric characteristics, blood pressure, and serum glucose and lipids were measured. Diet was assessed with a semi-quantitative food frequency questionnaire. Results: Cardiometabolic risk factors increased across food insecurity levels (P<0.001 to 0.009). Two healthy and 1 unhealthy dietary patterns were extracted. Food insecure participants consumed less meats, dairy, fruit, and vegetables but more processed meats (P<0.001). Intake of fat, cholesterol, and sodium increased and that of fiber, vitamins A and C, folic acid, potassium, and calcium decreased along with increasing food insecurity. Food secure individuals had better eating habits than food insecure participants. Cardiometabolic risk factors except triglycerides had inverse associations with heathy and positive associations with unhealthy dietary patterns (P<0.05). The associations between food insecurity and cardiometabolic risk factors were independent of age, sex, education level, and body mass index (BMI).Conclusions: Overall, food insecurity was associated with increased cardiometabolic risk and less healthier dietary patterns. The association between food insecurity and cardiometabolic risk was independent of demographic factors and BMI, suggesting that other factors such as diet and eating habits may have contributed to the exacerbated cardiometabolic risk factors in food insecure individuals.

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Section: Food Insecurity and Cardiometabolic Risk Factorssupporting

confidence: 91%

Section: Page 3/18mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Association of Food Insecurity and Cardiometabolic Risk Factors May Be Independent of Body Mass Index

Hashemzadeh

Teymouri

Fararouei

et al. 2021

Preprint

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“…Our study found more obesity in urban areas (37.45%) than in rural areas (18%), while dyslipidemia was diagnosed more commonly in rural areas (44.54%) than in urban areas (13.51%). These results may reflect the finding that, although in general individuals of urban and rural areas have similar eating habits in our study, there were more men who eat fast food in rural areas.This agrees with the fact that the consumption of unsaturated fats is related to the suffering of dyslipidemia [9].…”

Section: Concomitant Diseases and Conditionssupporting

confidence: 90%

Impact of social and medical factors on routine clinical practice in prostate exams of asymptomatic males

Bravo-Grande¹,

Padilla‐Fernández²,

Flores-Fraile³

et al. 2021

JOMH

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Objectives: To examine routine clinical practice in prostate health exams in asymptomatic males, and to identify which factors inﬂuence it. Materials and methods: Multicentre cross-sectional study in 1068 asymptomatic men aged 51-72. Groups: GA (n = 518): urban areas; GB (n = 550): rural areas. GA subgroups: GA1 (n = 364): prostate speciﬁc antigen (PSA) measured; GA2 (n = 154): PSA not measured. GB subgroups: GB1 (n = 346): PSA measured; GB2 (n = 204): PSA not measured. Variables: age, body mass index (BMI), digital rectal examination (DRE), PSA, prostate diagnosis, eating habits, physical exercise, marital status, number of children, occupational status, working hours, concomitant diseases and conditions, family history, attending physician. Descriptive statistics, Student's t-test, chi-square test, Fisher's exact test, ANOVA, Pearson and Spearman correlations were used. Results: Mean age 62.3 years (standard deviation: SD 5.12). Age in GA (60.89, SD 5.53) was lower than in GB (65.10, SD 5.03); age was higher in GA1 (61.22, SD 5.49) than in GA2 (59.04, SD 5.37). There was no difference in BMI between GA and GB. DRE: No exams were performed without prior PSA. No DRE were performed in GA; 11 (3.18%) were performed in GB1. GA1: 53 had PSA > 4 ng/mL, of whom 28 had no prostate disease, 17 had benign prostatic hyperplasia (BPH) and 8 had prostate cancer (PCa). PCa prevalence in men with PSA > 4 ng/mL was 9.24% in GA and 5.19% in GB. GA1: higher PSA was correlated with lower BMI, lower age, higher occupational status, and morning shifts; lower PSA was correlated with higher alcohol consumption; older patients worked shifts and consumed more alcohol; men with higher occupational status consumed less alcohol; more men were married in GA1 (n = 343, [94.23%]) than in GA2 (n = 100, [64.93%]). In GA1, there were more non-smoking men (n = 291, [80.11%]) and men who smoked < 5 cigarettes/day (n = 23, [6.37%]), 6-10 cigarettes/day (n = 15, [4.05%]), and 11.20 cigarettes/day (n = 27, [7.33%]) than in GA2. Older men and men with higher occupational status consumed fewer cigarettes. Men who worked rotating shifts smoked more. There was no relationship between smoking and PSA level. There were more university-educated men in GA (n = 309, [59.65%]) than in GB (n = 110, [20%]). More men did not take physical exercise in GA2 (n = 49, [31.81%]) than in GA1 (n = 75, [23.90%]). GB1: PSA > 4 ng/mL in 89 patients, of whom 32 had PCa; younger men had higher PSA. PSA was higher in GB1 (mean 18.95 ng/mL, SD 12.93) than in GA1 (mean 1.61, SD 1.63). Men in GB ate more fast food than GA, with no difference between GA1 and GA2, or between GB1 and GB2. In GA there was variability in approach among the attending physicians; in GB there was no variability among attending physicians. Conclusions: PSA tests are routinely given to 70.27% of asymptomatic men who consult a doctor in urban environments and to 62.09% of men in rural environments. In urban areas, the decision is affected by the preferences of the attending physician and by whether the patient is married. Occupational category, working hours and educational level have no impact. The decision to undergo a prostate health exam is associated with healthy habits such as physical exercise. No relationship was found between prostate disorders in asymptomatic men and high BMI, dyslipidemia or diet.

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“…A systematic review by da Silva Miguel et al that evaluated the association between food insecurity and cardiometabolic risk factors concluded that there was a direct association between food insecurity and hypertension after adjusting for sociodemographic, economic, and lifestyle characteristics [ 24 ]. We did not identify longitudinal or interventional studies regarding food insecurity and hypertension.…”

Section: Resultsmentioning

confidence: 99%

Food Insecurity and Cardiometabolic Conditions: a Review of Recent Research

et al. 2021

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Purpose of Review To understand recent literature that examines associations between food insecurity and cardiometabolic conditions and risk factors. We included original research, systematic reviews, and meta-analyses on the topic of food insecurity and cardiometabolic risk published from January 1, 2017, to December 31, 2020. Editorials, perspectives, and case reports were excluded. After the initial search, 3 reviewers selected studies for inclusion based on relevance and methods. Ultimately, fifty studies were included. Recent Findings We included 35 studies of adults (20 cross-sectional observational studies, 5 longitudinal observational studies, 5 interventional studies, and 5 meta-analyses/reviews). In adults, food insecurity is associated with greater prevalence of overweight/obesity (especially for women). It is also associated with hypertension, diabetes (including worse glycemic control and more diabetes complications), coronary heart disease, congestive heart failure, stroke, and chronic kidney disease. We included 15 studies of children (11 cross-sectional observational studies and 4 longitudinal observational studies). In children, findings were more nuanced, and in particular, many studies did not find an association between food insecurity and overweight/obesity. However, authors noted that these conditions may not have had time to develop. With notable exceptions, many studies were cross-sectional, and there were few interventions. Summary There is a robust association between food insecurity and cardiometabolic conditions and risk factors in adults, but the picture is less clear in children. Overt cardiometabolic clinical conditions develop more rarely in children, but childhood experiences may set a trajectory for worse health later in life. Detailed life course epidemiologic studies are needed to better understand this relationship. Future interventions should examine how to reduce the prevalence of food insecurity, and how best to improve health for those who experience food insecurity.

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Association between food insecurity and cardiometabolic risk in adults and the elderly: A systematic review

Cited by 22 publications

References 31 publications

The Association of Food Insecurity and Cardiometabolic Risk Factors May Be Independent of Body Mass Index

The Association of Food Insecurity and Cardiometabolic Risk Factors May Be Independent of Body Mass Index

Impact of social and medical factors on routine clinical practice in prostate exams of asymptomatic males

Food Insecurity and Cardiometabolic Conditions: a Review of Recent Research

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