Assessing Factors Associated with Food Insecurity and Cardiometabolic Risk Factors by Household Head Gender in Nepal Open Access

Mpitu, Fabien (Summer 2023)

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Background and aims

Food insecurity is one of the most significant public health issues nowadays, and several studies have found that it is associated with poor cardiometabolic risk (CMR). However, none of those studies have determined the role that could play in the household head gender (HHG) in the association between food insecurity and CMR. This study aimed to explore that gap.


This study is cross-sectional using the 2016 Nepal Demographic and Health Survey dataset. Hypertension and Body Mass Index (BMI) were our outcomes and were measured. Food insecurity was our exposure and was obtained from responses to the survey. We used multilevel multivariate logistic regression to estimate the relationship between food insecurity, CMR, and HHG. Odds ratios were reported, along with a 95% confidence interval and p-values (<0.05).


There were more overweight/obese (O/B) in FS households compared to FI households, no matter the gender of the household heads [in male-headed households (MHH): 65.75% FS-34.25% FI, and in female-headed households (FHH): 60.66 FS -39.34 FI]. In logistic regression, an unadjusted model between food insecurity and household head gender showed that in MHHs, the odds of food insecurity was 19.2% less likely [0.808 (95%CI 0.662-0.985)] than the odds of food insecurity in FHHs. This remained the case even after adjusting for age, BMI, and hypertension [0.790 (95%CI 0.646-0.965)]. In fully adjusted models, including food security status and all relevant covariates, individuals living in MHHs were less likely to be O/B than those living in FHHs [0.757 (95%CI 0.659-0.869)] and more likely to have hypertension than those living in FHHs [1.049 (95%CI 0.895-1.229)].


Awareness of the benefits of healthy food and physical activity on CMR reduction should be raised in Nepal, and even more among food-secure people who were found as at high risk of cardiometabolic risk in this study.

Table of Contents

    I.         Chapter One: Introduction 1

    II.        Chapter Two: Literature Review/Background 2

Food insecurity in general and in LMICs 2

Food insecurity and cardiometabolic risks 3

Household-head gender and food insecurity in LMICs 4

Global Burden of food insecurity and cardiometabolic risk factors in Nepal 5

   III.         Chapter Three: Materials and Methods 7

Data source 7

Study design and sample 7

Study Variables 8

Dependent variable (Outcome variable): 8

Key Independent variable (exposure): 9

Moderator variable: 9

Control variables: 9

Descriptive and Analytical Strategies 11

  IV.         Chapter Four: Results 11

Description of study population participants 11

Regression analysis 15

Models Interpretation: 19

    V.         Chapter Five: Discussion/Limitations and Strengths/Conclusion and Recommendations 20

Discussion 20

Limitations and Strengths 22

Limitations: 23

Strengths: 23

Conclusion and Recommendations 23

  VI.         References 24

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