Cardiovascular
Joint Association of Food Insecurity and Overweight/Obesity on Hypertension Risk among Guatemalan Women Paola Arevalo, MSc* Paola Arevalo Amy Auchincloss, PhD, MPH Fernanda Kroker, PhD, MSc Felice Le-Scherban, PhD, MPH
Objective: Examine the association between food insecurity and overweight/obesity (OWT/OB) on hypertension among Guatemalan women. Methods: Data came from Guatemala’s 2018-2019 Health and Nutrition Epidemiological Surveillance System Survey (SIVESNU), including 1538 women aged 15-49 years. Blood pressure was measured and classified as normo-tension, pre-hypertension and hypertension, according to standard protocols. Food security was assessed via the 8-item Food Insecurity Experience Scale and dichotomized (yes/no). Using measured weight and height, OWT/OB was classified as yes/no. The exposure was a 4-category cross-classification of food insecurity and OWT/OB. Multinomial logistic regression was used, adjusting for confounders. Results: Mean age was 30 years, with nearly 40% of the sample having elevated blood pressure (28% pre-hypertension/11% hypertension). About 44% experienced the ‘double burden’ of OWT/OB and food insecurity. Significant positive associations with pre-hypertension and hypertension were found for ‘only OWT/OB’ and ‘double burden’. Women experiencing ‘double burden’ had 66% (OR=1.66 [1.05-2.62]) and 297% (OR=3.97 [1.53-10.30]) higher odds of pre-hypertension and hypertension, respectively, compared to those experiencing none. Discussion: Food insecurity alone may not independently increase hypertension risk, but its interaction with metabolic factors like OWT/OB could exacerbate cardiovascular risk. While OWT/OB alone had a stronger association with hypertension, the increased risk observed in the ‘double burden’ group, along with the high prevalence of elevated blood pressure in our sample, reinforces the need for targeted preventive health strategies. Conclusion: OWT/OB and its ‘double burden’ with food insecurity are associated with increased odds of hypertension. Future research should explore longitudinal trends to better understand its causal pathways and design culturally appropriate interventions for low-income settings.
