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Research ArticleOriginal Research

A Systematic Review and Meta-Analysis of Food Insecurity and Dyslipidemia

Daniel J. Arenas, Sourik Beltrán, Canada Montgomery, Marissa Pharel, Itzel Lopez-Hinojosa, Gilberto Vilá-Arroyo and Horace M. DeLisser
The Journal of the American Board of Family Medicine July 2022, 35 (4) 656-667; DOI: https://doi.org/10.3122/jabfm.2022.04.210413
Daniel J. Arenas
From Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (DJA, SB, CM, HMD); Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA (SB); Rush Medical College, Rush University, Chicago, IL (MP); Pritzker School of Medicine, University of Chicago, Chicago, IL (IL-H); Podiatric Residency Program, Tower Health, West Reading, PA (GV-A).
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Sourik Beltrán
From Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (DJA, SB, CM, HMD); Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA (SB); Rush Medical College, Rush University, Chicago, IL (MP); Pritzker School of Medicine, University of Chicago, Chicago, IL (IL-H); Podiatric Residency Program, Tower Health, West Reading, PA (GV-A).
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Canada Montgomery
From Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (DJA, SB, CM, HMD); Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA (SB); Rush Medical College, Rush University, Chicago, IL (MP); Pritzker School of Medicine, University of Chicago, Chicago, IL (IL-H); Podiatric Residency Program, Tower Health, West Reading, PA (GV-A).
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Marissa Pharel
From Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (DJA, SB, CM, HMD); Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA (SB); Rush Medical College, Rush University, Chicago, IL (MP); Pritzker School of Medicine, University of Chicago, Chicago, IL (IL-H); Podiatric Residency Program, Tower Health, West Reading, PA (GV-A).
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Itzel Lopez-Hinojosa
From Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (DJA, SB, CM, HMD); Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA (SB); Rush Medical College, Rush University, Chicago, IL (MP); Pritzker School of Medicine, University of Chicago, Chicago, IL (IL-H); Podiatric Residency Program, Tower Health, West Reading, PA (GV-A).
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Gilberto Vilá-Arroyo
From Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (DJA, SB, CM, HMD); Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA (SB); Rush Medical College, Rush University, Chicago, IL (MP); Pritzker School of Medicine, University of Chicago, Chicago, IL (IL-H); Podiatric Residency Program, Tower Health, West Reading, PA (GV-A).
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Horace M. DeLisser
From Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (DJA, SB, CM, HMD); Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA (SB); Rush Medical College, Rush University, Chicago, IL (MP); Pritzker School of Medicine, University of Chicago, Chicago, IL (IL-H); Podiatric Residency Program, Tower Health, West Reading, PA (GV-A).
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    Figure 1.

    Meta-analysis of adult studies investigating increased odds of elevated low-density lipoprotein (LDL) for food-insecure patients. Synthesis of the 5 studies resulted in a nonsignificant combined odds ratio of 1.18 [95% CI, 0.90-1.56, n = 22,746, Q(df = 4) = 5.5, I2 = 27%].

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    Figure 2.

    Meta-analysis of adult studies investigating food insecurity and low-density lipoprotein (LDL) measurement. Hedges' g, standardized mean differences with a small size correction, were calculated from the primary data of the 5 studies. Meta-analysis resulted in a nonsignificant effect: gLDL = -0.02 [95% CI, -0.28, 0.25, n = 1,143, Q(df = 4) = 17, I2 = 76%].

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    Figure 3.

    Meta-analysis of adult studies investigating increased odds of low high-density lipoprotein (HDL) for food-insecure patients. Synthesis of the 6 studies resulted in a nonsignificant combined odds ratio of ORHDL = 1.02 [95% CI, 0.98, 1.06, n = 28,557, Q(df = 5) = 2.7, I2 = 0%].

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    Figure 4.

    Meta-analysis of adult studies investigating food insecurity and high-density lipoprotein (HDL) levels. Hedges' g, standardized mean differences with a small size correction, were calculated from the primary data of the 6 studies. Meta-analysis resulted in a nonsignificant effect: gHDL = -0.01 [95% CI, -0.07, 0.04, n = 7,096, Q(df = 5) = 3.20, I2 = 0%].

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    Figure 5.

    Meta-analysis of adult studies investigating increased odds of elevated total cholesterol for food-insecure patients. Synthesis of the 6 studies resulted in a nonsignificant combined odds ratio of ORTC = 1.00 [95% CI, 0.95, 1.05, n = 28,225, Q(df = 5) = 4.3, I2 = 0%].

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    Figure 6.

    Meta-analysis of adult studies investigating food insecurity and total cholesterol levels. Hedges' g, standardized mean differences with a small size correction, were calculated from the primary data of the 5 studies. Meta-analysis resulted in a nonsignificant effect: gTC = 0.02 [95% CI, -0.20, 0.24, n = 1,614, Q(df = 4) = 13, I2 = 70%].

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    Figure 7.

    Meta-analysis of adult studies investigating increased odds of elevated triglycerides for food-insecure patients. Synthesis of the 4 studies resulted in a nonsignificant combined odds ratio of ORTG = 1.13 [95% CI, 0.80, 1.61, n = 16,107, Q(df = 3) = 3.29, I2= 10%].

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    Figure 8.

    Meta-analysis of adult studies investigating food insecurity and triglycerides levels. Hedges' g, standardized mean differences with a small size correction, were calculated from the primary data of the 5 studies. Meta-analysis resulted in a nonsignificant effect: gTG = 0.02 [95% CI, -0.22, 0.27, n = 958, Q(df = 4) = 10.2, I2 = 61%].

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    Figure 1.

    Flow chart displaying the study selection process.

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    Figure 2.

    Meta-analysis of adult studies (n = 9,212) investigating increased odds of self-reported dyslipidemia for food insecure patients. Synthesis of the three studies resulted in a significant combined odds ratio of 1.15 [95%CI: 1.08–1.22, n = 9212, Q (df = 2) = 2.2, I2 = 10%].

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The Journal of the American Board of Family     Medicine: 35 (4)
The Journal of the American Board of Family Medicine
Vol. 35, Issue 4
July/August 2022
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A Systematic Review and Meta-Analysis of Food Insecurity and Dyslipidemia
Daniel J. Arenas, Sourik Beltrán, Canada Montgomery, Marissa Pharel, Itzel Lopez-Hinojosa, Gilberto Vilá-Arroyo, Horace M. DeLisser
The Journal of the American Board of Family Medicine Jul 2022, 35 (4) 656-667; DOI: 10.3122/jabfm.2022.04.210413

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A Systematic Review and Meta-Analysis of Food Insecurity and Dyslipidemia
Daniel J. Arenas, Sourik Beltrán, Canada Montgomery, Marissa Pharel, Itzel Lopez-Hinojosa, Gilberto Vilá-Arroyo, Horace M. DeLisser
The Journal of the American Board of Family Medicine Jul 2022, 35 (4) 656-667; DOI: 10.3122/jabfm.2022.04.210413
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Keywords

  • Cholesterol
  • Chronic Disease
  • Cross-Sectional Studies
  • Dyslipidemias
  • Food Insecurity
  • Hunger
  • LDL Triglyceride
  • Risk Factors
  • Social Determinants of Health

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