How food insecurity could lead to obesity in LMICs: When not enough is too much: a realist review of how food insecurity could lead to obesity in low- and middle-income countries. (24th May 2017)

• Record Type: Journal Article
• Authors: Farrell, Penny; Thow, Anne Marie; Abimbola, Seye; Faruqui, Neha; Negin, Joel
• Is Part Of: Health promotion international. Volume 33:Number 5(2018)
• Page Start: 812
• Page End: 826
• Publication Date: 2017-05-24
• Subjects: food insecurity -- obesity -- overweight -- low-income country -- middle-income country; Health promotion -- Periodicals; 362.1
• DOI: 10.1093/heapro/dax026
• Languages: English
• ISSNs: 0957-4824

Abstract

Summary: While food insecurity is a well-known cause of under-nutrition and stunting, in recent decades it has also been linked with obesity. Understanding and thus minimising the risk factors for obesity in low- and middle-income country contexts, which often lack the health system capacity to treat the consequent obesity-related illnesses, is crucial. This study adopted realist review methodology because it enabled us to analyse and organise the evidence from low- and middle-income countries into a coherent scheme. By comparing this evidence to existing theory on food security and nutrition, we aimed to provide a richer understanding of the nuances and the socio-demographic nature of the food insecurity–obesity relationship. The review generated 13 peer-reviewed articles which studied the relationship between food insecurity and overweight/obesity in low- and middle-income countries. Affordability of high-energy, processed foods was identified as a main mechanism, which determined whether or not food insecurity leads to obesity in low- and middle-income countries. Other mechanisms identified were: quantity and diversity of food consumed; spatial-temporal access to nutritious food; inter-personal food choice and distribution; and non-dietary behaviours. Despite the limited empirical evidence available, our review presents meaningful and policy-relevant insights into the food insecurity–obesity relationship in from low- and middle-income countries. Interventions to address the food insecurity–obesity link need to address diet quality, and demand a broad understanding across a variety of experiences.