Food insecurity: a driver of gender disparity in elevated blood pressure among adults in Ondo State, Nigeria: a cross sectional study

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Introduction: food insecurity is increasing at an alarming rate, contributing to gender variation in illness and undermining the 2030 nutrition goals. Evaluating its components could aid interventions aimed at addressing gender-specific diseases such as hypertension. This study assessed gender differences in food insecurity and its association with elevated blood pressure (EBP) in Ondo State, Nigeria. Methods: this community-based cross-sectional study used a four-stage systematic random sampling to select 769 adults aged 18 years and older. Food insecurity experience scale survey module components (Worried, Healthy, Fewfoods, Skipped, Ateless, Ranout, Hungry, and Wholeday) were defined, and participants were categorized into: food secure (0 point) and food insecure (≥1 point). Obesity and abdominal adiposity were determined by body mass index (≥30kg/m2) and waist-height ratio (≥0.5), respectively. The EBP was defined as BP≥140/90mmHg. Multivariable logistic regression was performed at p<.05 Results: a proportion of 54.9% men and 45.1% women participated in the study. Their mean ages and monthly incomes (±standard deviation) were 32.3±11.6 years, 33.9±11.7 years, and $51.1±41.0, $46.9±37.3, respectively. Women were more food insecure (44.1%, 35.8%) and experienced Worried (34.9%, 23.9%), Healthy (34.3%, 25.8%), Fewfoods (22.8%, 18.0%), Skipped (36.0%, 26.3%), Ateless (25.4%, 20.4%), Ranout (14.4%, 10.2%), Hungry (11.8%, 10.1%) and Wholeday (5.8%, 4.5%) than men, respectively. Men (9.2%) had EBP more than women (8.6%). The EBP was associated with marital status (aOR=2.53, CI=1.09, 5.87, p=.03), worried (aOR=6.33, CI=2.25, 17.78, p=<.001), ranout (aOR=5.98, CI=1.02, 35.01, p=.04) and abdominal adiposity (aOR=2.44, CI=1.38, 5.31, p=.03) among men, but occupation (aOR=1.41, CI=1.04, 1.91, p=.03) and physical inactivity (aOR=3.63, CI=1.04, 14.30, p=0.04) among women. Conclusion: gender difference was observed in food insecurity, which significantly contributed to EBP among men, while occupation and physical inactivity predisposed women to EBP. Interventions in controlling hypertension should incorporate schemes that address lack and inadequate access to food, and maintain a healthy body weight through a quality diet and physical exercise among Nigerian adults.

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