Association between Food Insecurity and Overweight: a Systematic Review based on Intersectionality of Gender and...

The relationship between Food Insecurity (FI) and health conditions such as chronic diseases, including obesity, has been discussed in the literature. However, discourse on the association of FI with other social vulnerabilities is a relatively new and less elucidated area.

Considering the evidence that gender and race/color are factors of interest in the relationship between FI and overweight, in this study we aimed to carry out a systematic review to analyze the state of knowledge about this relationship and how the intersectionality of these factors permeates the association of FI and overweight in the Brazilian population.

We performed this review according to the methodological criteria recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four electronic databases were used to search for articles reporting observational studies in Brazil published between 2003 and 2023. Eligible articles reported studies that evaluated the association between nutritional status and FI based on the Brazilian Food Insecurity Scale (Escala Brasileira de Insegurança Alimentar [EBIA]).

We used the most relevant terms frequently observed in the literature to locate the most significant possible number of studies related to the topic. Articles were selected using prespecified inclusion criteria. Four independent researchers carried out data screening.

Initially, the search resulted in 568 articles. After review of the articles found in the initial search, 22 articles were included in the review, of which 45% (n = 10) reported studies that showed a statistically significant association between FI and overweight. In 5 of these articles the studies also showed an association with gender, and 4 studies showed an association with gender and race/color.

Black women with low income, limited educational levels, and lack of social security and protection revealed a high vulnerability to overweight and its comorbidities. There is an urgent need for inclusive strategies that consider not only the physical dimension but also the social, historical, and cultural factors that permeate the scenario of obesity in women and the Black population, based on deeper understanding of the theoretical basis for these findings that culminates in the formulation of more effective and equitable policies.

PROSPERO registration No. CRD42023427239.