Association between food insecurity and chronic noncommunicable diseases in Brazil: a systematic review

Laurentino, Jackson Silva Lima; Brito, Renatha Celiana da Silva; Oliveira-Silva, Rônisson Thomas de; Soares, Amanda; Pereira, Thaís da Conceição; Lima, Elisiandre Martins de; Santos, Ana Beatriz Macêdo Venâncio dos; Palmeira, Poliana de Araújo

doi:10.1590/1980-549720240041

Acessibilidade / Reportar erro

Brasil

Revista Brasileira de Epidemiologia

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Rev. bras. Epidemiol. 27 • 2024 • https://doi.org/10.1590/1980-549720240041 copy

Association between food insecurity and chronic noncommunicable diseases in Brazil: a systematic review

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To analyze the association of food insecurity (FI) with chronic noncommunicable diseases (NCDs) in the Brazilian context.

Methods:

The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO). The searches were conducted in LILACS and PubMed databases (September/2022). Observational studies carried out in the Brazilian population published since 2003 were included, in which: (1) the association of FI with NCDs was analyzed; and (2) the Brazilian Food Insecurity Scale was used. Studies on pregnant women and those that associated FI with cancer, sexually transmitted infections, and musculoskeletal and respiratory diseases were excluded. The studies were subjected to methodological quality assessment.

Results:

A total of 27 cross-sectional studies were included; nine used secondary data from national surveys, and the others used primary data. An association between FI and overweight and obesity in different age groups was verified in the studies.

Conclusion:

The included articles did not produce evidence on other NCDs of interest to health in Brazil such as diabetes and high blood pressure. However, they corroborate the already-known relationship between obesity and FI. Studies on the topic, with a longitudinal design, should be encouraged.

Keywords:
Food insecurity; Chronic noncommunicable diseases; Brazil; Review

Study	Study population and location	Data source and sample	Statistical analysis	Main results	QATFQS
Kac et al.²²22 Kac G, Velásquez-Melendez G, Schlüssel M, Segall-Côrrea A, Silva A, Pérez-Escamilla R. Severe food insecurity is associated with obesity among Brazilian adolescent females. Public Health Nutr 2012; 15(10): 1854-60. https://doi.org/10.1017/S1368980011003582 https://doi.org/10.1017/S136898001100358...	Female teenagers. Brazil (urban and rural areas).	Secondary data and probabilistic sample (PNDS).	Multivariate Poisson regression. Association between FI (FS x mild FI x moderate FI x severe FI) and overweight in female adolescents. Overweight: BMI-for-age (categorical variable: BMI ≥85th percentile for adolescents aged 15–18 years and BMI≥25 kg/m² for >19 years old) (measurement taken).	Severe FI was associated with overweight in female adolescents. Adjusted PR (95%CI): 1.96 (1.18–3.27) p=0.007.	Strong
Santos et al.²⁴24 Santos NF, Lira PIC, Tavares FCLP, Leal VS, Oliveira JS, Pessoa JT, et al. Overweight in adolescents: food insecurity and multifactoriality in semiarid regions of Pernambuco. Rev Paul Pediatr 2019; 38: e2018177. https://doi.org/10.1590/1984-0462/2020/38/2018177 https://doi.org/10.1590/1984-0462/2020/3...	Adolescents. Pernambuco (PE) (urban and rural areas).	Primary data and probabilistic sample.	Poisson regression. Association between mild FI (FS/mild FI x moderate/severe FI) and overweight in adolescents. Overweight: BMI-for-age (categorical variable: > +1 Z-score and ≤ +2 Z-score) (measurement taken).	Mild FI (FS+mild FI) was associated with overweight in adolescents (10 to 19 years of age). Adjusted PR (95%CI): 1.08 (1.0–1.17) p=0.03.	Strong
Santana et al. ²³23 Santana DD, Barros EG, Salles-Costa R, Veiga GV. Mudanças na prevalência de excesso de peso em adolescentes residentes em área de alta vulnerabilidade à insegurança alimentar. Ciênc Saúde Colet 2021; 26(12): 6189-98. https://doi.org/10.1590/1413-812320212612.26092020 https://doi.org/10.1590/1413-81232021261...	Adolescents. Duque de Caxias (RJ).	Primary data and probabilistic sample.	Simple logistic regression. Association between FI (FS x mild FI x moderate/severe FI) and overweight in male adolescents. Overweight (overweight + obesity): BMI-for-age (categorical variable: overweight: ≥Z-score=+1 and <Z-score=+2; and obesity: ≥Z-score=+2) (measurement taken).	Moderate/severe FI was associated with overweight in male adolescents. p<0.05.	Strong
Schlüssel et al.⁵5 Schlüssel MM, Silva AAM, Pérez-Escamilla R, Kac G. Household food insecurity and excess weight/obesity among Brazilian women and children: a life-course approach. Cad Saude Pública 2013; 29(2): 219-26. https://doi.org/10.1590/S0102-311X2013000200003 https://doi.org/10.1590/S0102-311X201300...	Female adolescents and adult women. Brazil (urban and rural areas).	Secondary data and probabilistic sample (PNDS).	Poisson regression. Association between FI (FS x mild FI x moderate FI x severe FI) and overweight in female adolescents. Association between severe FI and obesity in adult women. Overweight: BMI-for-age (categorical variable: BMI ≥85th percentile for adolescents aged 15–18 years and BMI≥25 kg/m² for >19 years old) (measurement taken). Obesity: BMI (categorical variable: BMI ≥ 30 kg/m²) (measurement taken).	Overweight was associated with severe FI in female adolescents. Obesity was associated with moderate FI in adult women. Female teenagers: PR (95%CI): 1.96 (1.18–3.27) Adult women: PR (95%CI): 1.49 (1.17–1.90)	Moderate
Pequeno et al.²⁶26 Pequeno NPF, Cabral NLA, Oliveira AGRC, Crispim SP, Rocha C, Marchioni DM, et al. Chronic diseases and emotional disorders are associated with low perception of quality of life in food insecurity/security. Front Public Health 2022; 10: 893601. https://doi.org/10.3389/fpubh.2022.893601 https://doi.org/10.3389/fpubh.2022.89360...	Adults and older adults. Natal (RN).	Primary data and probabilistic sample.	χ² test. Association between FI (FS x FI) and overweight in adults and older adults. Overweight: BMI (categorical variable: BMI ≥25 kg/m²) (measurement taken).	FI was associated with overweight in adults and older adults. p=0.046.	Moderate
Costa et al.²⁵25 Costa NS, Santos MO, Carvalho CPO, Assunção ML, Ferreira HS. Prevalence and factors associated with food insecurity in the context of the economic crisis in Brazil. Curr Dev Nutr 2017; 1(10): e000869. https://doi.org/10.3945/cdn.117.000869 https://doi.org/10.3945/cdn.117.000869...	Women. State of Alagoas (urban and rural areas).	Primary data and probabilistic sample.	Poisson regression. Association between FI (FS x FI) and overweight. Overweight: BMI (categorical variable: BMI ≥25 kg/m²) (measurement taken).	Overweight was associated with FI in women. Adjusted PR (95%CI): 1.14 (1.07–1.21) p<0.001.	Strong
Velásquez-Melendez et al.²⁸28 Velásquez-Melendez G, Schlüssel MM, Brito AS, Silva AA, Lopes-Filho JD, Kac G. Mild but not light or severe food insecurity is associated with obesity among Brazilian women. J Nutr 2011; 141(5): 898-902. https://doi.org/10.3945/jn.110.135046 https://doi.org/10.3945/jn.110.135046...	Women. Brazil (urban and rural areas).	Secondary data and probabilistic sample (PNDS).	Multivariate Poisson regression. Association between FI (FS x moderate FI) and obesity in women. Obesity: BMI (categorical variable: BMI ≥30 kg/m²) (measurement taken).	Moderate FI was associated with obesity in women. Adjusted PR (95%CI): 1.49 (1.17–1.90) p= 0.010.	Strong
Dias et al.²⁹29 Dias MS, Dumith SC, Vaz JS, Susin LRO. Insegurança alimentar em um município do extremo sul do Rio Grande do Sul, 2016: um estudo de base populacional. Epidemiol Serv Saúde 2020; 29(2): e2019204. https://doi.org/10.5123/S1679-49742020000200007 https://doi.org/10.5123/S1679-4974202000...	Adults. Rio Grande (RS) (urban area).	Primary data and probabilistic sample.	Poisson regression, with robust adjustment for variance. Association between FI (yes or no) and households managed by obese individuals. Obesity: BMI (categorical variable: BMI ≥30 kg/m²) (self-reported measurement).	Obesity was associated with FI in household heads. Adjusted PR (95%CI): 1.39 (1.13–1.71) p=0.031.	Strong
Souza and Marín-León³⁰30 Souza BFNJ, Marín-León L. Insegurança alimentar em idosos: estudo transversal com usuários de restaurante popular. Rev Nutr 2013; 26(6): 679-91. https://doi.org/10.1590/S1415-52732013000600007 https://doi.org/10.1590/S1415-5273201300...	Older adults. Campinas (SP), 2019.	Primary data and probabilistic sample.	Multivariate multinomial logistic regression. Association between mild FI (FS x mild FI) and obesity in older adults. Obesity: BMI (categorical variable: BMI ≥28 kg/m²) (measurement taken).	Obesity was associated with mild FI in older adults. OR (95%CI): 2.01 (1.04–3.87) p=0.036.	Moderate
Domingos et al.²⁷27 Domingos T, Sichieri R, Salles-Costa, R. Sex differences in the relationship between food insecurity and weight status in Brazil. Br J Nutr 2022; 1-19. https://doi.org/10.1017/S0007114522001192 https://doi.org/10.1017/S000711452200119...	Adults. Brazil (urban and rural areas).	Secondary data and probabilistic sample (POF-IBGE).	Multivariate multinomial logistic regression. Association between FI (FS x mild FI x moderate FI x severe FI) and obesity in women. Obesity: BMI (categorical variable: BMI ≥30 kg/m²) (self-reported measurement).	Obesity was associated with all levels of FI in women. OR: >1.00. p<0.05.	Strong
Gubert et al.³¹31 Gubert MB, Spaniol AM, Segall-Corrêa AM, Pérez-Escamilla R. Understanding the double burden of malnutrition in food insecure households in Brazil. Matern Child Nutr 2017; 13(3): e12347. https://doi.org/10.1111/mcn.12347 https://doi.org/10.1111/mcn.12347...	Women with children. Brazil (urban and rural areas).	Secondary data and probabilistic sample (PNDS).	Hierarchical multivariable logistic regression. Association between FI (FS x mild FI x moderate FI x severe FI) and the presence of the Double Burden of Malnutrition. Double burden of malnutrition: BMI for mothers (categorical variable: BMI ≥25 kg/m²), short stature for children (categorical variable: height-for-age: ≤2 Z-scores) (measurements taken).	Severe FI was associated with the presence of the Double Burden of Malnutrition. Adjusted OR (95%CI): 3.33 (1.41–7.84)	Strong
Vicenzi et al.³²32 Vicenzi K, Henn RL, Weber AP, Backes V, Paniz VMV, Donatti T, et al. Insegurança alimentar e excesso de peso em escolares do primeiro ano do Ensino Fundamental da rede municipal de São Leopoldo, Rio Grande do Sul, Brasil. Cad Saúde Pública 2015; 31(5): 1084-94. https://doi.org/10.1590/0102-311X00055914 https://doi.org/10.1590/0102-311X0005591...	Children >5 years of age. São Leopoldo (RS).	Primary data and non-probabilistic sample.	Poisson regression, with robust adjustment for variance. Association between FI (yes or no) and lower probability of overweight in schoolchildren. Overweight: BMI-for-height (categorical variable: BMI-for-height: >1 Z-score) (measurement taken).	FI was associated with a lower probability of overweight in schoolchildren. Adjusted PR (95%CI): 0.78 (0.64–0.96)	Moderate
Poblacion et al.³³33 Poblacion AP, Cook JT, Marín-León L, Segall-Corrêa AM, Silveira JAC, Konstantyner T, et al. Food insecurity and the negative impact on Brazilian children's health-why does food security matter for our future prosperity? Brazilian National Survey (PNDS 2006/07). Food Nutr Bull 2016; 37(4): 585-98. https://doi.org/10.1177/0379572116664167 https://doi.org/10.1177/0379572116664167...	Children <5 years of age. Brazil (urban and rural areas).	Secondary data and probabilistic sample (PNDS).	Poisson regression, with robust adjustment for variance. Association between FI (FS x moderate/severe FI) and underweight in children <5 years old. Underweight: weight-for-age (categorical variable: weight-for-age: ≤2 Z-score) (measurement taken).	Underweight was associated with moderate/severe FI in children <5 years. Adjusted PR (95%CI): 1.4 (1.1–1.7) p=0.008.	Strong
Vasconcelos et al.⁹9 Vasconcelos SML, Torres NCP, Silva PMC, Santos TMP, Silva JVL, Omena CMB, et al. Insegurança alimentar em domicílios de indivíduos portadores de hipertensão e/ou diabetes. Int J Cardiovasc Sci 2015; 28(2): 114-21.	Adults and older adults diagnosed with SAH and/or DM seen at UBS. Maceió (AL).	Primary data and probabilistic sample.	Simple logistic regression. Association between FI (yes or no) and lower prevalence of central obesity and hypertriglyceridemia in UBS users. Central obesity: WC (categorical variable: yes or no) (measurement taken). Hypertriglyceridemia: Triglycerides >200 mg/dL (categorical variable: yes or no) (measurement taken).	Lower prevalence of central adiposity and hypertriglyceridemia in UBS users was associated with FI. Hypertriglyceridemia: OR (95%CI): 0.74 (0.67–0.82), p=0.001. Central adiposity: OR (95%CI): 0.12 (0.29–0.52), p=0.004.	Strong

Associação Brasileira de Saúde Coletiva Av. Dr. Arnaldo, 715 - 2º andar - sl. 3 - Cerqueira César, 01246-904 São Paulo SP Brasil , Tel./FAX: +55 11 3085-5411 - São Paulo - SP - Brazil
E-mail: revbrepi@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] CORRESPONDING AUTHOR:
Jackson Silva Lima Laurentino. Universidade Federal de Campina Grande, Centro de Educação e Saúde, Núcleo de Estudos e Pesquisa em Nutrição e Saúde Coletiva, Sítio Olho d’Água da Bica, CEP: 58.175-000, Cuité (PB), Brazil. Email: jacksonnut@gmail.com