# Food Insecurity Associated With Higher Odds of Hypertriglyceridemic Waist Phenotype in Women: A Cross‐Sectional Study

## TL;DR

Food insecurity increases the risk of a metabolic condition called hypertriglyceridemic waist in overweight and obese Iranian women.

## Contribution

This is the first study to directly link food insecurity to the hypertriglyceridemic waist phenotype in this population.

## Key findings

- Food-insecure women had over twice the odds of having the HTGW phenotype compared to food-secure women.
- The association remained significant after adjusting for age, BMI, energy intake, and physical activity.
- The study highlights food insecurity as a social determinant of metabolic risk in overweight and obese women.

## Abstract

Food insecurity has been linked to obesity, central adiposity, and dyslipidemia, with women particularly vulnerable. These consequences align with the hypertriglyceridemic waist (HTGW) phenotype, a determinant of visceral adiposity and cardiometabolic risk. Although prior studies suggest associations between FI, waist circumference, and triglyceride levels, direct evidence on FI and HTGW remains scarce, especially in Middle Eastern populations. The present investigation assessed the potential link between food insecurity and the hypertriglyceridemic waist phenotype among overweight and obese Iranian women. In this cross‐sectional study, 250 overweight and obese women dietary intake was assessed using a validated 147‐item (FFQ), and household food security was evaluated with the 18‐item USDA (HFSS). Anthropometric measures and body composition were obtained via bioelectrical impedance analysis. Physical activity was assessed using the validated IPAQ. Participants were grouped based on waist circumference and triglycerides: WC < 88 cm and TG < 150 mg/dL were classified as normal waist and triglycerides, while WC ≥ 88 cm and TG ≥ 150 mg/dL were considered to have the hypertriglyceridemic waist (HTGW) phenotype. Analyses were performed in SPSS version 25. A significant positive association was found between food insecurity and the HTGW phenotype. In unadjusted analysis, food‐insecure women had higher odds of HTGW compared to food‐secure women (OR = 2.24, 95% CI =1.19–4.20, p = 0.01). After adjustment for age, BMI, total energy intake, and physical activity, the association remained significant (OR = 2.13, 95% CI = 1.06–4.28, p = 0.03). The findings demonstrate that food insecurity is significantly associated with the HTGW phenotype among overweight and obese women. As the first study to specifically examine this relationship in this population, these findings underscore food insecurity as a critical social determinant of metabolic risk, highlighting the need for future longitudinal studies and targeted interventions.

In this cross‐sectional study of 250 overweight and obese Iranian women, food insecurity was significantly associated with higher odds of the hypertriglyceridemic waist (HTGW) phenotype. Women experiencing food insecurity had more than twice the likelihood of presenting the HTGW phenotype compared with food‐secure counterparts (adjusted OR = 2.13, 95% CI = 1.06–4.28). These findings highlight food insecurity as a social determinant of metabolic disruption and underscore the need for targeted nutritional and policy interventions. Graphical abstract illustrating behavioral and physiological pathways linking food insecurity to HTGW; adjusted (OR = 2.13 95% CI = 1.06–4.28). Adjusted for age, BMI, energy intake, and physical activity.