Food insecurity and physical multimorbidity among adults aged ≥ 50 years from six low- and middle-income countries

Lee Smith, Jae Il Shin, Louis Jacob, Guillermo F López Sánchez, Felipe Schuch, Mark A Tully, Hans Oh, Nicola Veronese, Pinar Soysal, Laurie Butler, Yvonne Barnett, Ai Koyanagi

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
29 Downloads (Pure)


Purpose: Food insecurity and multimoribidity (i.e., ≥ 2 chronic conditions) may be linked bidirectionally, but there are no studies on this topic from LMICs. Therefore, the aim of the present study was to examine the association between food insecurity and physical multimorbidity in a large representative sample of older adults from six LMICs. Methods: Cross-sectional, community-based data on adults aged ≥ 50 years from the World Health Organization’s Study on Global AGEing and Adult Health (SAGE) conducted in China, Ghana, India, Mexico, Russia, and South Africa were analyzed. A total of 11 chronic physical conditions were assessed. Past 12 month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable logistic regression analysis was conducted to assess the associations. Results: Data on 34,129 adults aged ≥ 50 years [mean (SD) age 62.4 (16.0) years; age range 50–114 years; 47.9% males] were analyzed. After adjustment for potential confounders, in the overall sample, compared to being food secure, moderate and severe food insecurity were associated with 1.29 (95% CI 1.06–1.56) and 1.56 (95% CI 1.13–2.16) times higher odds for multimorbidity, respectively Conclusion: Food insecurity was associated with greater odds for multimorbidity in older adults from LMICs.

Original languageEnglish
Pages (from-to)489-497
Number of pages9
JournalEuropean Journal of Nutrition
Issue number1
Early online date21 Sept 2022
Publication statusPublished (in print/issue) - 28 Feb 2023

Bibliographical note

Funding Information:
Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. Dr. Guillermo F. López Sánchez is funded by the European Union—Next Generation EU.

Funding Information:
This paper uses data from WHO’s Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08-CN-0020, Y1-AG-1005–01 and through research grants R01-AG034479 and R21-AG034263.

Publisher Copyright:
© 2022, The Author(s).


  • Low- and middle-income countries
  • Older adults
  • Food insecurity
  • Chronic disease
  • Multimorbidity


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