Food insecurity is associated with obesity and abdominal obesity among older adults: A cross-sectional analysis of ELSA study

Objectives: Food insecurity, defined as limited or uncertain access to adequate and nutritious food, is a significant public health issue, particularly among older adults. While often associated with undernutrition, food insecurity has also been linked to overweight and obesity due to economic constraints that drive reliance on inexpensive, energy-dense foods in younger people. The aim of this study was to assess the association between food insecurity and measures of adiposity, including body mass index (BMI), waist circumference, and waist-hip ratio, in older adults. Methods: This cross-sectional study utilized data from wave 2 of the English Longitudinal Study of Ageing – ELSA (2004–2005), including adults aged ≥50 years. Food insecurity was assessed through a single-question measure. Multivariable logistic regression models were used to examine the association between food insecurity and obesity-related outcomes, adjusting for potential confounders, and reporting the data as odds ratios (ORs) with their 95% confidence intervals (CIs). Results: Of 7219 participants, with a mean age of 66 years and mainly females (53.6%), 1.3% reported food insecurity, whilst obesity, according to BMI, was present in 28.9%. After adjusting for several potential confounders, food-insecure individuals had higher odds of obesity (OR = 1.55, 95% CI: 1.03–2.32, P = 0.034) and abdominal obesity (OR = 2.28, 95% CI: 1.45–3.60, P < 0.001). No association was found with the waist-hip ratio (P = 0.117). Conclusions: Food insecurity is significantly associated with obesity and central adiposity in older adults, highlighting the need for public health interventions addressing both food access and dietary quality. Further research should evaluate the long-term impact of food insecurity on metabolic health in aging populations.