Association Between Food Insecurity and Body Composition: Systematic Review and Meta-Analysis

Food insecurity (FI) is a serious public health problem with wide-ranging biopsychosocial repercussions, including changes in body composition.

To review evidence from the literature on the association between FI and body composition.

Observational studies investigating the relationship between FI and body composition in individuals of any age group were eligible. The searches took place on July 7, 2024, in the MEDLINE, Web of Science, Embase, and LILACS databases, in addition to the grey literature accessed through Google Scholar.

Two independent reviewers selected the studies based on eligibility criteria. Titles and abstracts were analyzed, and the selected studies were then read in full. The risk of bias was assessed using the tools recommended by the JBI.

The systematic review and meta-analysis are reported according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A descriptive summary of the data was conducted, and a meta-analysis was performed, using random effects models. A total of 19 studies were included in the systematic review and 4 in the meta-analysis. Most studies used a cross-sectional approach. Percentage of body fat (BF%) was the most commonly assessed indicator of body composition. In the meta-analysis, there was no association between FI and BF% in the overall analysis (pooled mean difference [MD] = 0.09; 95% CI, -0.05 to 0.22). In the subgroup analyses, there was an association when stratified by sex (MD = 0.43; 95% CI, 0.18-0.69), method of assessing BF% (MD = 0.43; 95% CI, 0.20-0.66), and degree of FI (MD = 0.42; 95% CI, 0.0-0.76).

There was no association between FI and BF% in the overall analysis. In the subgroup analyses, an positive association was observed when assessing both sexes, using bioelectrical impedance analysis and moderate to severe FI.

PROSPERO registration no. CRD42023441310.