Food Insecurity and Cardiometabolic Risk among Turkish Adults: A Cross-Sectional Study
Article Sidebar
Issue
Vol. 19 No. 2 (2024)
Accepted
21 March 2024
Published
30 July 2024
Keywords:
-
cardiometabolic risk, diet quality, food insecurity, healthy eating index, obesity
Abstract
This study examined 175 volunteers aged 18‒64 to explore the connection between food insecurity and anthropometric measurements, diet quality scores and cardiometabolic risk factors. The design of the study is cross-sectional, and the data were obtained using a number of questionnaires applied to individuals who visited the diet clinic. Participants' diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015) and food security was evaluated using the Household Food Insecurity Access Scale. Cardiometabolic risk factors were determined based on HEI-2015 scores, Body Mass Index (BMI), waist circumference, waist/height ratio, physician-diagnosed diabetes, hypertension, dyslipidemia, regular physical activity status, and smoking habits. As a result of the study, 41.1% of the participants were found to be food-insecure, and 77.8% had diet quality that needed improvement. The average BMI value of food-insecure women was found to be higher than that of food-secure women (32.37±7.77 kg/m2 and 29.86±5.22 kg/m2, respectively) (p=0.003). Furthermore, food-insecure women had a higher average waist circumference (p=0.001). A significant negative relationship was determined between BMI value, waist circumference and waist/height ratio, which are among the cardiometabolic risk factors, and food insecurity.
References
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Berberich AJ, Hegele RA. 2022. A modern approach to dyslipidemia. Endocr Rev 43(4):611‒653. https://doi.org/10.1210/endrev/bnab037
Bergmans RS. 2019. Food insecurity transitions and smoking behavior among older adults who smoke. Prev Med 126:105784. https://doi.org/10.1016/j.ypmed.2019.105784
Cardoso Lde O, Carvalho MS, Cruz OG, Melere C, Luft VC, Molina MDCB, Faria CPD, Benseñor IM, Matos SMA, Fonseca MDJMD et al. 2016. Eating patterns in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): An exploratory analysis. Cad Saude Publica 32:e00066215. https://doi.org/10.1590/0102-311X00066215
Coates J, Swindale A, Bilinsky P. 2007. Household Food Insecurity Access Scale (HFIAS) for Measurement of Food Access: Indicator Guide (V.3). Washington (USA): FANTA.
Eicher-Miller HA, Zhao Y. 2018. Evidence for the age-specific relationship of food insecurity and key dietary outcomes among US children and adolescents. Nutr Res Rev 31(1):98‒113. https://doi.org/10.1017/S0954422417000245
Fan Y, Wang R, Ding L, Meng, Z, Zhang Q, Shen Y, Hu G, Liu M. 2020. Waist circumference and its changes are more strongly associated with the risk of type 2 diabetes than body mass index and changes in body weight in Chinese adults. J Nutr 150(5):1259‒1265. https://doi.org/10.1093/jn/nxaa014
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Farrelly MC, Shafer PR. 2017. Comparing trends between food insecurity and cigarette smoking among adults in the United States, 1998 to 2011. Am J Health Promot 31(5):413‒416. https://doi.org/10.1177/0890117116660773
Grimaccia E, Naccarato A. 2022. Food insecurity in Europe: A gender perspective. Soc Indic Res 161(2):649‒667. https://doi.org/10.1007/s11205-020-02387-8
Hackshaw A, Morris JK, Boniface S, Tang JL, Milenković D. 2018. Low cigarette consumption and risk of coronary heart disease and stroke: Meta-analysis of 141 cohort studies in 55 study reports. BMJ 360:j5855. https://doi.org/10.1136/bmj.j5855
Helmick M, Smith TM, Parks CA, Hill JL. 2018. Food insecurity increases odds of diabetes and hypertension, not obesity in medically underserved region. J Hunger Environ Nutr 15:128‒139. https://doi.org/10.1080/19320248.2018.1538921
Irving SM, Njai RS, Siegel PZ. 2014. Peer reviewed: Food insecurity and self-reported hypertension among Hispanic, black, and white adults in 12 states, Behavioral Risk Factor Surveillance System, 2009. Prev Chronic Dis 11:e161. https://doi.org/10.5888/pcd11.140190
Jones NR, McCormack T, Constanti M, McManus RJ. 2020. Diagnosis and management of hypertension in adults: NICE guideline update 2019. British J Gen Pract 70(691):90‒91. https://doi.org/10.3399/bjgp20X708053
Kılıçkap M, Barçın C, Göksülük H, Karaaslan D, Özer N, Kayikçioğlu M, Ural D, Yilmaz MB, Abaci A, Arici M et al. 2018. Data on prevalence of hypertension and blood pressure in Turkey: Systematic review, meta-analysis and meta-regression of epidemiological studies on cardiovascular risk factors. Turk Kardiyol Dern Ars 46(7):525‒545. https://doi.org/10.5543/tkda.2018.15679
Kim-Mozeleski JE, Pandey R, Tsoh JY. 2019. Psychological distress and cigarette smoking among U.S. households by income: Considering the role of food insecurity. Prev Med Rep 16:100983. https://doi.org/10.1016/j.pmedr.2019.100983
Kim JE, Flentje A, Tsoh JY, Riley ED. 2017. Cigarette smoking among women who are homeless or unstably housed: Examining the role of food insecurity. J Urban Health 94:514‒524. https://doi.org/10.1007/s11524-017-0166-x
Kontas M, Ergüder T, Tello J, Loring B, Hawkins L, Jakab M. 2014. Better noncommunicable disease outcomes: Challenges and opportunities for health systems: Turkey: Country assessment. World Health Organization. Regional Office for Europe. https://iris.who.int/handle/10665/350492 [Accessed 10th September 2023]
Krebs-Smith SM, Pannucci TE, Subar AF, Kirkpatrick SI, Lerman JL, Tooze JA, Wilson MM, Reedy J. 2018. Update of the healthy eating index: HEI-2015. J Acad Nutr Diet 118(9):1591‒1602. https://doi.org/10.1016/j.jand.2018.05.021
La Mantia C. 2020. Diet quality in relation to income, education, and food insecurity among Canadian adults [Thesis]. Canada: University of Toronto
Landry MJ, van den Berg AE, Asigbee FM, Vandyousefi S, Ghaddar R, Davis JN. 2019. Child-report of food insecurity is associated with diet quality in children. Nutrients 11(7):1574. https://doi.org/10.3390/nu11071574
Laraia BA. 2013. Food insecurity and chronic disease. Adv Nutr 4(2):203‒212. https://doi.org/10.3945/an.112.003277
Larson N, Laska MN, Neumark-Sztainer D. 2020. Food insecurity, diet quality, home food availability, and health risk behaviors among emerging adults: findings from the EAT 2010–2018 study. American journal of public health, 110(9):1422‒1428. https://doi.org/10.2105/AJPH.2020.305783
Levine MD, Bush T, Magnusson B, Cheng Y, Chen X. 2013. Smoking-related weight concerns and obesity: Differences among normal weight, overweight, and obese smokers using a telephone tobacco quit line. Nicotine Tob Res 15(6):1136‒1140. https://doi.org/10.1093/ntr/nts226
Lopez-Gambino, L, Castro-Acosta, M-L, Zepeda-Gomez E, Angulo-Leyva E, Galindo P. 2020. Food insecurity and cardiometabolic disease risk factors in Mexican women from Sinaloa. Curr Dev Nutr 4:nzaa043_082.
Maiangwa M, Omolehin R, Adeniji O, Mohammed US. 2010. Food insecurity: challenges of agricultural extension in developing countries. J Agric Ext 14(2). https://doi:10.4314/jae.v14i2.64126
Murillo-Castillo K-D, Frongillo E-A, López-Teros V, Haby MM, Corella-Madueño MA, Díaz-Zavala RG, Porquen-Plata T. 2018. Food insecurity was associated with low quality diet and low HDL level in mothers of Northwest Mexico relying on fisheries for livelihood. Nutr Hosp 35(6):1379‒1386. http://dx.doi.org/10.20960/nh.1923
Nettle D, Andrews C, Bateson M. 2017. Food insecurity as a driver of obesity in humans: The insurance hypothesis. Behav Brain Sci 40:e105. https://doi.org/10.1017/S0140525X16000947
Nkonge KM, Nkonge DK, Nkonge TN. 2020. The epidemiology, molecular pathogenesis, diagnosis, and treatment of maturity-onset diabetes of the young (MODY). Clinical Diabetes and Endocrinology 6(1):1‒10. https://doi.org/10.1186/s40842-020-00112-5
Pan A, Wang Y, Talaei M, Hu FB, Wu T. 2015. Relation of active, passive, and quitting smoking with incident type 2 diabetes: A systematic review and meta-analysis. Lancet Diabetes Endocrinol 3(12):958‒967. https://doi.org/10.1016/S2213-8587(15)00316-2
Rangel-Baltazar E, Cuevas-Nasu L, Shamah-Levy T, Shamah-Levy T, Rodríguez-Ramírez S, Méndez-Gómez-Humarán I, Rivera JA. 2019. Association between high waist-to-height ratio and cardiovascular risk among adults sampled by the 2016 half-way national health and nutrition survey in Mexico (ENSANUT MC 2016). Nutrients 11(6):1402. https://doi.org/10.3390/nu11061402
Rasmusson G, Lydecker JA, Coffino JA, Whote MA, Grilo CM. 2018. Household food insecurity is associated with binge-eating disorder and obesity. Int J Eat Disor 52(1):28‒35. https://doi.org/10.1002/eat.22990
Samp Size Calculator. 2023. https://sampsize.sourceforge.net/iface/ [Accessed 29th February 2024].
Shin JI, Bautista LE, Walsh MC, Malecki C, Nieto FJ. 2015. Food insecurity and dyslipidemia in a representative population-based sample in the US. Prev Med 77:186‒190. https://doi.org/10.1016/j.ypmed.2015.05.009
Twyman L, Bonevski B, Paul C, Bryant J. 2014. Perceived barriers to smoking cessation in selected vulnerable groups: A systematic review of the qualitative and quantitative literature. BMJ Open 4(12):e006414. http://dx.doi.org/10.1136/bmjopen-2014-006414
Wang DD, Li Y, Chiuve SE, Hu FB, Willett WC. 2015. Improvements in US diet helped reduce disease burden and lower premature deaths, 1999‒2012; Overall Diet Remains Poor. Health Aff (Millwood) 34(11):1916‒1922. https://doi.org/10.1377/hlthaff.2015.0640
[WHO] World Health Organization. 1995. Physical status: The use and interpretation of anthropometry. Report of a WHO expert committee Geneva: WHO. https://www.who.int/publications/i/item/9241208546 [Accessed 10th February 2024]
[WHO] World Health Organization 2000. Obesity: Preventing and managing the global epidemic: Report of a WHO consultation on obesity. https://iris.who.int/handle/10665/42330 [Accessed 20th December 2023]
[WHO] World Health Organization. 2022. Physical activity. https://www.who.int/news-room/fact-sheets/detail/physical-activity [Accessed 10th September 2023].
Beltrán S, Arenas D-J, Pharel M, Montgomery C, Lopez-Hinojosa I, DeLisser HM. 2022. Food insecurity, type 2 diabetes, and hyperglycaemia: A systematic review and meta-analysis. Endocrinol Diabetes Metab J 5(1):e00315. https://doi.org/10.1002/edm2.315
Berberich AJ, Hegele RA. 2022. A modern approach to dyslipidemia. Endocr Rev 43(4):611‒653. https://doi.org/10.1210/endrev/bnab037
Bergmans RS. 2019. Food insecurity transitions and smoking behavior among older adults who smoke. Prev Med 126:105784. https://doi.org/10.1016/j.ypmed.2019.105784
Cardoso Lde O, Carvalho MS, Cruz OG, Melere C, Luft VC, Molina MDCB, Faria CPD, Benseñor IM, Matos SMA, Fonseca MDJMD et al. 2016. Eating patterns in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): An exploratory analysis. Cad Saude Publica 32:e00066215. https://doi.org/10.1590/0102-311X00066215
Coates J, Swindale A, Bilinsky P. 2007. Household Food Insecurity Access Scale (HFIAS) for Measurement of Food Access: Indicator Guide (V.3). Washington (USA): FANTA.
Eicher-Miller HA, Zhao Y. 2018. Evidence for the age-specific relationship of food insecurity and key dietary outcomes among US children and adolescents. Nutr Res Rev 31(1):98‒113. https://doi.org/10.1017/S0954422417000245
Fan Y, Wang R, Ding L, Meng, Z, Zhang Q, Shen Y, Hu G, Liu M. 2020. Waist circumference and its changes are more strongly associated with the risk of type 2 diabetes than body mass index and changes in body weight in Chinese adults. J Nutr 150(5):1259‒1265. https://doi.org/10.1093/jn/nxaa014
[FAO] Food and Agriculture Organization. 1996. World food summit. Rome declaration and world food summit plan of action. http://www.fao.org/3/w3613e/w3613e00.htm [Accessed 9th September 2023]
[FAO] Food and Agriculture Organization. 2022. The state of food security and nutrition in the World. https://data.unicef.org/resources/sofi-2022/ [Accessed 9th September 2023]
Farrelly MC, Shafer PR. 2017. Comparing trends between food insecurity and cigarette smoking among adults in the United States, 1998 to 2011. Am J Health Promot 31(5):413‒416. https://doi.org/10.1177/0890117116660773
Grimaccia E, Naccarato A. 2022. Food insecurity in Europe: A gender perspective. Soc Indic Res 161(2):649‒667. https://doi.org/10.1007/s11205-020-02387-8
Hackshaw A, Morris JK, Boniface S, Tang JL, Milenković D. 2018. Low cigarette consumption and risk of coronary heart disease and stroke: Meta-analysis of 141 cohort studies in 55 study reports. BMJ 360:j5855. https://doi.org/10.1136/bmj.j5855
Helmick M, Smith TM, Parks CA, Hill JL. 2018. Food insecurity increases odds of diabetes and hypertension, not obesity in medically underserved region. J Hunger Environ Nutr 15:128‒139. https://doi.org/10.1080/19320248.2018.1538921
Irving SM, Njai RS, Siegel PZ. 2014. Peer reviewed: Food insecurity and self-reported hypertension among Hispanic, black, and white adults in 12 states, Behavioral Risk Factor Surveillance System, 2009. Prev Chronic Dis 11:e161. https://doi.org/10.5888/pcd11.140190
Jones NR, McCormack T, Constanti M, McManus RJ. 2020. Diagnosis and management of hypertension in adults: NICE guideline update 2019. British J Gen Pract 70(691):90‒91. https://doi.org/10.3399/bjgp20X708053
Kılıçkap M, Barçın C, Göksülük H, Karaaslan D, Özer N, Kayikçioğlu M, Ural D, Yilmaz MB, Abaci A, Arici M et al. 2018. Data on prevalence of hypertension and blood pressure in Turkey: Systematic review, meta-analysis and meta-regression of epidemiological studies on cardiovascular risk factors. Turk Kardiyol Dern Ars 46(7):525‒545. https://doi.org/10.5543/tkda.2018.15679
Kim-Mozeleski JE, Pandey R, Tsoh JY. 2019. Psychological distress and cigarette smoking among U.S. households by income: Considering the role of food insecurity. Prev Med Rep 16:100983. https://doi.org/10.1016/j.pmedr.2019.100983
Kim JE, Flentje A, Tsoh JY, Riley ED. 2017. Cigarette smoking among women who are homeless or unstably housed: Examining the role of food insecurity. J Urban Health 94:514‒524. https://doi.org/10.1007/s11524-017-0166-x
Kontas M, Ergüder T, Tello J, Loring B, Hawkins L, Jakab M. 2014. Better noncommunicable disease outcomes: Challenges and opportunities for health systems: Turkey: Country assessment. World Health Organization. Regional Office for Europe. https://iris.who.int/handle/10665/350492 [Accessed 10th September 2023]
Krebs-Smith SM, Pannucci TE, Subar AF, Kirkpatrick SI, Lerman JL, Tooze JA, Wilson MM, Reedy J. 2018. Update of the healthy eating index: HEI-2015. J Acad Nutr Diet 118(9):1591‒1602. https://doi.org/10.1016/j.jand.2018.05.021
La Mantia C. 2020. Diet quality in relation to income, education, and food insecurity among Canadian adults [Thesis]. Canada: University of Toronto
Landry MJ, van den Berg AE, Asigbee FM, Vandyousefi S, Ghaddar R, Davis JN. 2019. Child-report of food insecurity is associated with diet quality in children. Nutrients 11(7):1574. https://doi.org/10.3390/nu11071574
Laraia BA. 2013. Food insecurity and chronic disease. Adv Nutr 4(2):203‒212. https://doi.org/10.3945/an.112.003277
Larson N, Laska MN, Neumark-Sztainer D. 2020. Food insecurity, diet quality, home food availability, and health risk behaviors among emerging adults: findings from the EAT 2010–2018 study. American journal of public health, 110(9):1422‒1428. https://doi.org/10.2105/AJPH.2020.305783
Levine MD, Bush T, Magnusson B, Cheng Y, Chen X. 2013. Smoking-related weight concerns and obesity: Differences among normal weight, overweight, and obese smokers using a telephone tobacco quit line. Nicotine Tob Res 15(6):1136‒1140. https://doi.org/10.1093/ntr/nts226
Lopez-Gambino, L, Castro-Acosta, M-L, Zepeda-Gomez E, Angulo-Leyva E, Galindo P. 2020. Food insecurity and cardiometabolic disease risk factors in Mexican women from Sinaloa. Curr Dev Nutr 4:nzaa043_082.
Maiangwa M, Omolehin R, Adeniji O, Mohammed US. 2010. Food insecurity: challenges of agricultural extension in developing countries. J Agric Ext 14(2). https://doi:10.4314/jae.v14i2.64126
Murillo-Castillo K-D, Frongillo E-A, López-Teros V, Haby MM, Corella-Madueño MA, Díaz-Zavala RG, Porquen-Plata T. 2018. Food insecurity was associated with low quality diet and low HDL level in mothers of Northwest Mexico relying on fisheries for livelihood. Nutr Hosp 35(6):1379‒1386. http://dx.doi.org/10.20960/nh.1923
Nettle D, Andrews C, Bateson M. 2017. Food insecurity as a driver of obesity in humans: The insurance hypothesis. Behav Brain Sci 40:e105. https://doi.org/10.1017/S0140525X16000947
Nkonge KM, Nkonge DK, Nkonge TN. 2020. The epidemiology, molecular pathogenesis, diagnosis, and treatment of maturity-onset diabetes of the young (MODY). Clinical Diabetes and Endocrinology 6(1):1‒10. https://doi.org/10.1186/s40842-020-00112-5
Pan A, Wang Y, Talaei M, Hu FB, Wu T. 2015. Relation of active, passive, and quitting smoking with incident type 2 diabetes: A systematic review and meta-analysis. Lancet Diabetes Endocrinol 3(12):958‒967. https://doi.org/10.1016/S2213-8587(15)00316-2
Rangel-Baltazar E, Cuevas-Nasu L, Shamah-Levy T, Shamah-Levy T, Rodríguez-Ramírez S, Méndez-Gómez-Humarán I, Rivera JA. 2019. Association between high waist-to-height ratio and cardiovascular risk among adults sampled by the 2016 half-way national health and nutrition survey in Mexico (ENSANUT MC 2016). Nutrients 11(6):1402. https://doi.org/10.3390/nu11061402
Rasmusson G, Lydecker JA, Coffino JA, Whote MA, Grilo CM. 2018. Household food insecurity is associated with binge-eating disorder and obesity. Int J Eat Disor 52(1):28‒35. https://doi.org/10.1002/eat.22990
Samp Size Calculator. 2023. https://sampsize.sourceforge.net/iface/ [Accessed 29th February 2024].
Shin JI, Bautista LE, Walsh MC, Malecki C, Nieto FJ. 2015. Food insecurity and dyslipidemia in a representative population-based sample in the US. Prev Med 77:186‒190. https://doi.org/10.1016/j.ypmed.2015.05.009
Twyman L, Bonevski B, Paul C, Bryant J. 2014. Perceived barriers to smoking cessation in selected vulnerable groups: A systematic review of the qualitative and quantitative literature. BMJ Open 4(12):e006414. http://dx.doi.org/10.1136/bmjopen-2014-006414
Wang DD, Li Y, Chiuve SE, Hu FB, Willett WC. 2015. Improvements in US diet helped reduce disease burden and lower premature deaths, 1999‒2012; Overall Diet Remains Poor. Health Aff (Millwood) 34(11):1916‒1922. https://doi.org/10.1377/hlthaff.2015.0640
[WHO] World Health Organization. 1995. Physical status: The use and interpretation of anthropometry. Report of a WHO expert committee Geneva: WHO. https://www.who.int/publications/i/item/9241208546 [Accessed 10th February 2024]
[WHO] World Health Organization 2000. Obesity: Preventing and managing the global epidemic: Report of a WHO consultation on obesity. https://iris.who.int/handle/10665/42330 [Accessed 20th December 2023]
[WHO] World Health Organization. 2022. Physical activity. https://www.who.int/news-room/fact-sheets/detail/physical-activity [Accessed 10th September 2023].
Authors
BozdemirE., & YukselA. (2024). Food Insecurity and Cardiometabolic Risk among Turkish Adults: A Cross-Sectional Study . Jurnal Gizi Dan Pangan, 19(2), 69-78. https://doi.org/10.25182/jgp.2024.19.2.69-78
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