Association between food insecurity and metabolic syndrome in North West of Iran: Azar Cohort study

Faramarzi, Elnaz; Somi, Mohammad‐Hossein; Ostadrahimi, Alireza; Dastgiri, Saaed; Nahand, Mousa Ghayour; Jafarabadi, Mohammad Asgari; Sanaie, Sarvin

doi:10.15171/jcvtr.2019.33

Cited by 12 publications

(12 citation statements)

References 36 publications

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“…After analyzing odd ratios as the effect size, we next explored the five adult studies (n = 12,212) that contained sufficient data to calculate the standardized mean difference of systolic blood pressure between food secure and FIS patients [33,[50][51][52][53]. The results showed no difference in the systolic blood pressure readings of the food secure and food insecure groups: Meta-analysis as shown in Fig 4 yielded The number of adult studies offered the opportunity to explore further sub-group analyses based on patient characteristics and blood pressure cutoffs.…”

Section: Plos Onementioning

confidence: 99%

Food insecurity and hypertension: A systematic review and meta-analysis

et al. 2020

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Background Food insecurity (FIS) is an important public health issue associated with cardiovascular risk. Given the association of FIS with diets of poorer nutritional quality and higher salt intake as well as chronic stress, numerous studies have explored the link between FIS and hypertension. However, no systematic review or meta-analysis has yet to integrate or analyze the existing literature. Methods We performed a wide and inclusive search of peer-reviewed quantitative data exploring FIS and hypertension. A broad-terms, systematic search of the literature was conducted in PubMed, Embase, Scopus, and Web of Science for all English-language, human studies containing primary data on the relationship between FIS and hypertension. Patient population characteristics, study size, and method to explore hypertension were extracted from each study. Effect sizes including odds ratios and standardized mean differences were extracted or calculated based on studies’ primary data. Comparable studies were combined by the random effects model for meta-analyses along with assessment of heterogeneity and publication bias. Results A total of 36 studies were included in the final analyses. The studies were combined into different subgroups for meta-analyses as there were important differences in patient population characteristics, methodology to assess hypertension, and choice of effect size reporting (or calculability from primary data). For adults, there were no significantly increased odds of elevated blood pressures for food insecure individuals in studies where researchers measured the blood pressures: OR = 0.91 [95%CI: 0.79, 1.04; n = 29,781; Q(df = 6) = 7.6; I2 = 21%]. This remained true upon analysis of studies which adjusted for subject BMI. Similarly, in studies for which the standardized mean difference was calculable, there was no significant difference in measured blood pressures between food secure and FIS individuals: g = 0.00 [95%CI: -0.04, 0.05; n = 12,122; Q(df = 4) = 3.6; I2 = 0%]. As for retrospective studies that inspected medical records for diagnosis of hypertension, there were no significantly increased odds of hypertension in food insecure adults: OR = 1.11 [95%CI: 0.86, 1.42; n = 2,887; Q(df = 2) = 0.7; I2 = 0%]. In contrast, there was a significant association between food insecurity and self-reports of previous diagnoses of hypertension: 1.46 [95%CI: 1.13, 1.88; n = 127,467; Q(df = 7) = 235; I2 = 97%]. Only five pediatric studies were identified which together showed a significant association between FIS and hypertension: OR = 1.44 [95%CI: 1.16, 1.79; n = 19,038; Q(df = 4) = 5.7; I2 = 30%]. However, the small number of pediatric studies were not sufficient for subgroup meta-analyses based on individual study methodologies. Discussion In this systematic review and meta-analysis, an association was found between adult FIS and self-reported hypertension, but not with hypertension determined by blood pressure measurement or chart review. Further, while there is evidence of an association between FIS and hypertension among pediatric subjects, the limited number of studies precluded a deeper analysis of this association. These data highlight the need for more rigorous and longitudinal investigations of the relationship between FIS and hypertension in adult and pediatric populations.

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Section: Plos Onementioning

confidence: 99%

Food insecurity and hypertension: A systematic review and meta-analysis

et al. 2020

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“…One such factor is food insecurity, defined as the lack of access to nutritionally adequate foods caused by poverty and other socio-economic stressors. [4][5][6][7] The World Health Organization (WHO) and the United Nations General Assembly, among other professional organisations, recently identified food insecurity as an important proximate driver of the prevalence of metabolic risk factors on the causal pathway to diet-sensitive NCDs. 8 This premise is rooted in the hypothesis that exposure to food insecurity results in compensatory behaviours, which often includes less intake of fruit and vegetables, 9 skipping meals, or reducing portion sizes, 10 and overconsumption of low-cost foods that are high in calories yet deficient in nutritional value.…”

Section: Introductionmentioning

confidence: 99%

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

Nkambule

Moodley

Kuupiel

et al. 2020

Preprint

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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

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“…Of the final cohort of 49 studies, 46 presented data on adults (combined n = 258,250) 13 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 and three presented data on children (combined n = 10,280). 78 , 79 , 80 For adults, it was deemed that five meta‐analyses were possible: (a) ORs of FIS and self‐reported T2DM, (b) ORs of FIS and T2DM determined by FBG, (c) ORs of FIS and T2DM determined by HbA1c, (d) SMD of FBG, and (e) SMD of HbA1c.…”

Section: Resultsmentioning

confidence: 99%