Laurentino Jackson Silva Lima, Martins-Costa Isadora Macedo de Oliveira, de Oliveira-Silva Rônisson Thomas, Dos Santos Ana Beatriz Macêdo Venâncio, Palmeira Poliana de Araújo
Graduate Program in Science of Nutrition (PPGCN), Federal University of Paraíba, João Pessoa, Brazil.
Nutrition and Public Health Studies and Research Group (Núcleo PENSO), Federal University of Campina Grande, Cuité, Brazil.
Front Public Health. 2025 Apr 4;13:1574499. doi: 10.3389/fpubh.2025.1574499. eCollection 2025.
Using longitudinal data from a study conducted in an area of high socioeconomic vulnerability in Brazil, we examined the long-term effects of food insecurity (FI) and social determinants on body weight gain (body weight, BMI) and metabolic risk (waist circumference - WC, waist-to-height ratio - WHtR) over 11 years of follow-up, conducted between 2011 and 2022.
Face-to-face household interviews were conducted using the Brazilian Food Insecurity Scale to measure FI, and anthropometric measurements of weight, height, and WC were taken. Data analysis was performed in STATA 15.0 using multilevel mixed-effects regression with covariate adjustment and predicted marginal means with marginal differences.
Among the 210 individuals followed over 11 years, high prevalence of FI was observed (2011: 51.8%; 2022: 45.9%), central adiposity (2011: 83.8%; 2022: 88.6%), as well as a significant increase in the prevalence of high BMI (2011-2022: +16.7 < 0.00), general obesity (2011-2022: +15.2 < 0.00), and abdominal obesity (2011-2022: +0.5 0.02) over time. Multivariate analysis showed a positive association between BMI and body weight with mild, moderate, and severe FI after 8 and 11 years of follow-up among adults. A progressive increase in predicted body weight and BMI scores was observed among adults, with an increase of +5.6 ( 0.02) and + 2.3 ( 0.01) at the end of the follow-up, respectively, being higher in individuals with severe FI compared to those with food security. Among people ≥60 years old, WC and WHtR mean varied according to time and FI categories, with a positive association observed in mild and moderate FI, and an inverse association with severe FI at the end of the follow-up.
FI is a risk factor for long-term weight gain and obesity, particularly in vulnerable populations, highlighting the need for intersectoral public policies to ensure food and nutrition security, combat obesity, and combat the structural causes of poverty and FI.
利用在巴西社会经济高度脆弱地区开展的一项研究的纵向数据，我们在2011年至2022年进行的11年随访中，研究了粮食不安全（FI）和社会决定因素对体重增加（体重、BMI）和代谢风险（腰围 - WC、腰高比 - WHtR）的长期影响。
使用巴西粮食不安全量表进行面对面的家庭访谈以测量FI，并对体重、身高和WC进行人体测量。在STATA 15.0中进行数据分析，采用多水平混合效应回归并进行协变量调整，以及带有边际差异的预测边际均值分析。
在随访11年的210名个体中，观察到FI的高患病率（2011年：51.8%；2022年：45.9%）、中心性肥胖（2011年：83.8%；2022年：88.6%），以及高BMI患病率（2011 - 2022年：+16.7 <0.00）、一般肥胖患病率（2011 - 2022年：+15.2 <0.00）和腹部肥胖患病率（2011 - 2022年：+0.5 0.02）随时间显著增加。多变量分析显示，在成年人随访8年和11年后，BMI和体重与轻度、中度和重度FI之间存在正相关。在成年人中观察到预测体重和BMI评分逐渐增加，随访结束时分别增加了+5.6（ 0.02）和 +2.3（ 0.01），与粮食安全的个体相比，重度FI个体增加得更高。在60岁及以上人群中，WC和WHtR均值随时间和FI类别而变化，随访结束时在轻度和中度FI中观察到正相关，与重度FI呈负相关。
FI是长期体重增加和肥胖的危险因素，特别是在弱势群体中，这凸显了需要跨部门公共政策来确保粮食和营养安全、对抗肥胖，并消除贫困和FI的结构性原因。
