Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK.
Department of Nutritional Sciences, King's College London, London, UK.
Obes Rev. 2024 Jul;25(7):e13753. doi: 10.1111/obr.13753. Epub 2024 May 1.
Food insecurity is a well-established obesity driver. Less is known about food insecurity during pregnancy. This review (PROSPERO:CRD42022311669) aimed to explore associations between food insecurity, maternal obesity, gestational weight gain (GWG), and nutrition. Searches included seven databases, gray literature, references, citations, and contacting authors. Observational studies reporting data from January 1st, 2008 to 21 November 2023 in high-income countries were included. Duplicate screening, data extraction, and quality assessments were performed. Random effects meta-analysis estimated odds ratios (OR), mean difference (MD), and 95% confidence intervals (CI). Narrative synthesis was conducted when data could not be pooled. Database searches identified 22,272 results; 20 studies were included (n = 19 North America, n = 1 Europe; n = 32,803 women). Food insecurity significantly increased obesity (OR 1.53 95%CI 1.39, 1.66), but not underweight (OR 1.12 95%CI 0.89, 1.34) or overweight (OR 1.18 95%CI 0.90, 1.46). Food insecurity significantly reduced GWG (MD -0.42 kg 95%CI -0.62, -0.22) and increased inadequate GWG (OR 1.16 95%CI 1.05, 1.28), but not excessive GWG (OR 1.04 95%CI 0.96, 1.13). Diet outcomes were inconsistent, with some evidence of reduced vitamin E and diet quality and increased red/processed meat consumption. Further studies outside of North America are needed to inform practice and policy to support maternal health.
食品不安全是一个公认的肥胖驱动因素。人们对怀孕期间的食品不安全问题了解较少。本综述（PROSPERO:CRD42022311669）旨在探讨食品不安全、母体肥胖、孕期体重增加（GWG）和营养之间的关联。检索包括七个数据库、灰色文献、参考文献、引文，并联系作者。纳入了 2008 年 1 月 1 日至 2023 年 11 月 21 日在高收入国家发表的报告数据的观察性研究。进行了重复筛选、数据提取和质量评估。使用随机效应荟萃分析估计了比值比（OR）、平均差异（MD）和 95%置信区间（CI）。当无法汇总数据时进行叙述性综合。数据库搜索确定了 22272 项结果；纳入了 20 项研究（n=19 项来自北美，n=1 项来自欧洲；n=32803 名女性）。食品不安全显著增加了肥胖的风险（OR 1.53，95%CI 1.39，1.66），但不会增加消瘦（OR 1.12，95%CI 0.89，1.34）或超重（OR 1.18，95%CI 0.90，1.46）。食品不安全显著减少了 GWG（MD-0.42kg，95%CI-0.62，-0.22）和增加了 GWG 不足（OR 1.16，95%CI 1.05，1.28），但不会增加 GWG 过多（OR 1.04，95%CI 0.96，1.13）。饮食结果不一致，有一些证据表明维生素 E 和饮食质量减少，以及红色/加工肉类消费增加。需要在北美以外的地区开展进一步的研究，以为实践和政策提供信息，以支持母婴健康。
