The Association Between Food Insecurity and Adverse Health Outcomes in Adults: An Umbrella Review of Systematic Reviews and Meta-Analyses

Abstract

CONTEXT: An association of food insecurity (FI) with adverse health outcomes (AHOs) has been reported; however, the evidence in this context is still inconclusive. OBJECTIVE: The certainty and validity of all available meta-analyses were evaluated for the association between FI and AHOs among adults. DATA SOURCES: A comprehensive systematic search was done of the PubMed/MEDLINE, Web of Science, and Scopus databases up to August 20, 2024. DATA EXTRACTION: Two researchers independently extracted studies data. DATA ANALYSIS: Twenty-one meta-analyses were included in this study. Generally, there was a direct association between FI and 22 AHOs (73.3) in adults, including the risk of being overweight (odds ratio OR = 1.16; 95% CI, 1.06-1.27); binge eating (OR = 1.99; 95% CI, 1.58-2.51); stress (OR = 1.33; 95% CI, 1.24-1.43); anemia (OR = 1.34 95% CI, 1.19-1.50); long sleep duration (OR = 1.14; 95% CI, 1.03-1.26); suicide attempt (OR = 2.23; 95% CI, 1.81-2.76); obesity (OR = 1.42; 95% CI, 1.24-1.63); diabetes (OR = 1.48; 95% CI, 1.32-1.65); hypertension (OR = 1.20; 95% CI, 1.01-1.43); anxiety (OR = 1.61; 95% CI, 1.15-2.25); short sleep duration (OR = 1.14; 95% CI, 1.07-1.21); multimorbidity (OR = 2.17; 95% CI, 1.56-3.03); depression (OR = 2.26; 95% CI, 1.98-2.57); poor sleep quality (OR = 1.45; 95% CI, 1.24-1.70); suicidal ideation (OR = 1.65; 95% CI, 1.48-1.83); having opportunistic infection (OR = 4.09; 95% CI, 2.47-6.78); low CD4 count (OR = 1.38; 95% CI, 1.05-1.80); excessive gestational weight gain (OR = 1.17; 95% CI, 1.05-1.30); prepregnancy overweight (OR = 1.32; 95% CI, 1.12-1.54); prepregnancy obesity (OR = 1.58; 95% CI, 1.37-1.81); and inadequate gestational weight gain (OR = 1.40; 95% CI, 1.21-1.63). We found a significant reverse relation between FI and the risk of complete HIV viral suppression (OR = 0.71; 95% CI, 0.61-0.82). CONCLUSION: These findings demonstrated that prevention and management programs, which alleviate FI among adults, may also improve public health beyond promoting nutritional status. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration No. CRD42024582864.