Association Between Food Insecurity and Key Metabolic Risk Factors for Diet-Sensitive Non-Communicable Diseases in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Abstract

BackgroundIn previous studies, food insecurity has been hypothesised to promote the prevalence of metabolic risk factors on the causal pathway to diet-sensitive non-communicable diseases (NCDs). This prevalence has been shown to differ between gender and populations. However, evidence of this association in resources-limited settings with high levels of food insecurity such as sub-Saharan African countries remains elusive. PurposeWe aimed to identify the association between food insecurity and key metabolic risk factors on the causal pathway to diet-sensitive NCDs in sub-Saharan African population. MethodsWe did a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Relevant studies published between January 2015 and October 2019 were searched in PubMed, Web of Science (SCiELO Citation Index), and five other databases followed by explicit and reproducible hand-searches of included studies which were peer-reviewed epidemiological studies conducted in sub-Saharan Africa, directly measured food insecurity, and compared food insecurity to a metabolic risk factor outcome. Two reviewers extracted all the necessary data from individual studies independently and employed the Mixed Methods Appraisal Tool (MMAT) -Version 2018 to evaluate the risk of bias. Prevalence estimates from individual studies were pooled using the random-effect model. ResultsThe initial searches yielded 11 803 articles, 22 were eligible for inclusion, presenting data from 26 609 food-insecure participants and 11 545 incident of metabolic risk factor cases. Most studies confirmed an adverse association between food insecurity and key metabolic risk factors for dietsensitive NCDs. The Meta-analysis showed a significantly high pooled prevalence estimate of key metabolic risk factors at 41.8 per cent (95% CI: 33.2% to 50.8%, I 2 = 99.5% p-value < 0.00). The most prevalent type of metabolic risk factors was dyslipidaemia 27.6 per cent (95% CI: 6.5% to

The association of food insecurity and cardiometabolic risk factors was independent of body mass index in Iranian women

“…Food insecure participants had higher BMI and waist circumference, blood pressure, fasting glucose, triglycerides, and LDL cholesterol, and lower HDL cholesterol. These findings are in agreement with findings of recent systematic reviews [10] and meta-analyses [24] indicating a direct relationship of food insecurity (assessed by either food insecurity questionnaires or diet adequacy/diversity) with cardiometabolic risk factors, especially excess weight, hypertension, and dyslipidemias. These abnormalities in metabolic and cardiovascular risk markers gradually progress during the lifespan and eventually lead to chronic cardiovascular diseases [6], which results in increased rates of mortality from these diseases in food insecure groups [25,26].…”

“…Participant's characteristics based on food insecurity levelsScores of food insecurity are as follows: food secure (0-1), mild food-insecure (2-8), moderate/severe food-insecure(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) Data are expressed as n (%) or means ± SD a P value was determined by one-way analysis of variance for age and by chi-square for other variables…”

“…Scores of food insecurity are as follows: food secure (0-1), mild food-insecure(2)(3)(4)(5)(6)(7)(8), moderate/severe food-insecure(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) Data are presented as means ± SD with the exception of BMI which has also been reported by number and percentage a P values were determined by one-way analysis of variance (except for categorical BMI, for which chi-square was used)…”

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

“…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].…”

Food Insecurity in Portugal during the COVID-19 Pandemic: Prevalence and Associated Sociodemographic Characteristics

“…Traditionally present in low- and middle-income countries, FI is also of concern among high-income countries [ 2 , 3 ]. FI has been shown to lead to adverse health outcomes [ 4 , 5 , 6 ], such as mental health issues [ 7 , 8 , 9 ], poor diet quality, and non-communicable diseases, such as diabetes and cardiovascular diseases [ 10 ].…”