Food insecurity and anaemia risk: a systematic review and meta-analysis

Increasing evidence has suggested an association between food insecurity and the risk of anaemia. Therefore, a systematic review and meta-analysis were performed to examine the associations between food insecurity and anaemia risk. Pertinent studies were identified by searching PubMed and EMBASE databases up to August 2017. Data were available from nineteen studies; seventeen studies were cross-sectional and two studies were longitudinal. Risk ratios of 95993 individual participants from twelve different countries in these studies were pooled for the meta-analysis. The results showed that there was an overall positive relationship between food insecurity and anaemia risk (OR=1·27; 95 % CI 1·13, 1·40). Similar results were observed for Fe-deficiency anaemia (OR=1·45; 95 % CI 1·04, 1·86). These results revealed that food insecurity at two levels, including mild food insecurity (OR=1·15; 95 % CI 1·00, 1·31) and moderate food insecurity (OR=1·36; 95 % CI 1·23, 1·48), increased the risk of anaemia. In addition, it was found that age had an impact on the associations between food insecurity and anaemia risk (OR=1·22; 95 % CI 1·09, 1·36). Age subgroup analysis indicated that food insecurity significantly increased the risk of anaemia among infants/toddlers (OR=1·17; 95 % CI 1·05, 1·29) and adult women (OR=1·35; 95 % CI 1·16, 1·54). It seems that infants, toddlers and adult women in food-insecure households are at a higher risk of anaemia. To prevent anaemia in food-insecure households, these age groups may require more nutritional support.