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

Seyedeh Parisa Moosavian; Farhang Hameed Awlqadr; Sanaz Mehrabani; Kimia Mazinani; Maede Sadat Hosseini; Shirley Hodder; Seyed Mojtaba Ghoreishy; Faramarz Jalili; Mohammad Ali Hojjati Kermani; Sajjad Moradi

doi:10.1093/nutrit/nuaf136

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

Nutr Rev. 2025 Jul 23:nuaf136. doi: 10.1093/nutrit/nuaf136. Online ahead of print.

Authors

Affiliations

¹ Department of Community Nutrition, Vice-Chancellery for Health, Shiraz University of Medical Sciences, Shiraz, Iran.
² Department of Food Science and Quality Control, Halabja Technical College, Sulaimani Polytechnic University, Sulaymaniyah, Kurdistan Region, Iraq.
³ Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
⁴ Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran.
⁵ Department of Nutrition and Food Science, Maragheh University of Medical Sciences, Maragheh, Iran.
⁶ School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, Canada.
⁷ Department of clinical Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
⁸ Student Research Committee, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
⁹ Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

PMID: 40700684
DOI: 10.1093/nutrit/nuaf136

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.

Keywords: adults; adverse health outcomes; food insecurity; umbrella review.

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