Food insecurity and body mass index among older people: A systematic review and meta-analysis
Vincenza Gianfredi, Daniele Nucci, Roberta Lattanzio, Sara Piccinelli, Giovanni Cicconi, Sheila Jackeline Santisteban Farfan, Alessandro Berti, Marilena D'Amico, Noemi Sabatelli, Fabio Guzzardi, Laura Bronzini, F. Pregliasco, Stefania Maggi, Nicola Veronese, Pinar Soysal
Abstract
• Food insecurity significantly associated with higher BMI in older adults. • Meta-analysis included 13 studies with 49,402 participants globally. • Food-insecure older individuals more likely to be overweight or obese. • Variation in tools and definitions used to assess food insecurity. Food insecurity, characterized by inadequate access to sufficient and nutritious food, poses a significant challenge to the health and well-being of older adults. This systematic review and meta-analysis was aimed to examine the association between food insecurity and body mass index (BMI) in older people, i.e., aging 60 and above. PRISMA 2020 guidelines were followed. The protocol was registered in PROSPERO in advance (ID CRD 42024543271). PubMed/MEDLINE, and Scopus were searched up to February 2024. Out of 5834 retrieved article, a total of 13 studies met the inclusion criteria, encompassing diverse geographic regions and socioeconomic contexts. The meta-analysis revealed a significant association between food insecurity and higher BMI (both obesity and overweight) in older adults. Pooled estimates indicated that food-insecure older individuals were more likely to be overweight or obese (combined) compared to their food-secure counterparts [OR= 1.29 (95% CI= 1.28-1.30), p<0.001; I 2 = 94.92]. Results were also confirmed for overweight or obesity alone. Notably, food insecurity was linked to increased consumption of energy-dense, nutrient-poor foods, contributing to higher BMI. These findings underscore the complex relationship between food insecurity and BMI among older adults, emphasizing the need for targeted interventions to address food access and nutritional quality.