Shariff Zalilah Mohd, Sulaiman Norhasmah, Jalil Rohana Abdul, Yen Wong Chee, Yaw Yong Heng, Taib Mohd Nasir Mohd, Kandiah Mirnalini, Lin Khor Geok
Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang Selangor, Malaysia.
Asia Pac J Clin Nutr. 2014;23(1):138-47. doi: 10.6133/apjcn.2014.23.1.05.
This cross-sectional study examined the relationship between household food insecurity and the metabolic syndrome (MetS) among reproductive-aged women (n=625) in low income communities. The Radimer/Cornell Hunger and Food Insecurity instrument was utilized to assess food insecurity. Anthropometry, diet diversity, blood pressure and fasting venous blood for lipid and glucose profile were also obtained. MetS was defined as having at least 3 risk factors and is in accordance with the Harmonized criteria. The prevalence of food insecurity and MetS was 78.4% (household food insecure, 26.7%; individual food insecure, 25.3%; child hunger, 26.4%) and 25.6%, respectively. While more food secure than food insecure women had elevated glucose (food secure, 54.8% vs food insecure, 37.3-46.1%), total cholesterol (food secure, 54.1% vs food insecure, 32.1-40.7%) and LDL-cholesterol (food secure, 63.7% vs food insecure, 40.6-48.7%), the percentage of women with overweight/ obesity, abdominal obesity, hypertension, high triglyceride, low HDL-cholesterol and MetS did not vary significantly by food insecurity status. However, after controlling for demographic and socioeconomic covariates, women in food insecure households were less likely to have MetS (individual food insecure and child hunger) (p<0.05), abdominal obesity (individual food insecure and child hunger) (p<0.01), elevated glucose (household food insecure), total cholesterol (child hunger) (p<0.05) and LDL-cholesterol (household food insecure and child hunger) (p<0.05) compared to food secure women. Efforts to improve food insecurity of low income households undergoing nutrition transition should address availability and accessibility to healthy food choices and nutrition education that could reduce the risk of diet-related chronic diseases.
这项横断面研究调查了低收入社区中育龄妇女（n = 625）的家庭粮食不安全状况与代谢综合征（MetS）之间的关系。采用拉迪默/康奈尔饥饿与粮食不安全测评工具来评估粮食不安全状况。还获取了人体测量数据、饮食多样性、血压以及用于血脂和血糖检测的空腹静脉血样。代谢综合征被定义为至少具有3种风险因素，且符合统一标准。粮食不安全和代谢综合征的患病率分别为78.4%（家庭粮食不安全占26.7%；个人粮食不安全占25.3%；儿童饥饿占26.4%）和25.6%。虽然粮食安全的妇女比粮食不安全的妇女有更高比例的血糖升高（粮食安全组为54.8%，粮食不安全组为37.3 - 46.1%）、总胆固醇升高（粮食安全组为54.1%，粮食不安全组为32.1 - 40.7%）以及低密度脂蛋白胆固醇升高（粮食安全组为63.7%，粮食不安全组为40.6 - 48.7%），但超重/肥胖、腹型肥胖、高血压、高甘油三酯、低高密度脂蛋白胆固醇以及代谢综合征的女性比例在粮食不安全状况方面并无显著差异。然而，在控制了人口统计学和社会经济协变量后，与粮食安全的妇女相比，粮食不安全家庭中的妇女患代谢综合征（个人粮食不安全和儿童饥饿）（p<0.05）、腹型肥胖（个人粮食不安全和儿童饥饿）（p<0.01）、血糖升高（家庭粮食不安全）、总胆固醇升高（儿童饥饿）（p<0.05）以及低密度脂蛋白胆固醇升高（家庭粮食不安全和儿童饥饿）（p<0.05）的可能性更低。改善处于营养转型期的低收入家庭粮食不安全状况的努力应着眼于提供健康食物选择的可得性和可及性，以及开展能降低饮食相关慢性病风险的营养教育。
