Long-term effect of food insecurity on body weight gain and metabolic risk in a context of high socioeconomic vulnerability in a medium-income country: the SANCuité cohort, Brazil, 2011-2022.

Objective: Using longitudinal data from a study conducted in an area of high socioeconomic vulnerability in Brazil, we examined the long-term effects of food insecurity (FI) and social determinants on body weight gain (body weight, BMI) and metabolic risk (waist circumference - WC, waist-to-height ratio - WHtR) over 11 years of follow-up, conducted between 2011 and 2022. Methods: Face-to-face household interviews were conducted using the Brazilian Food Insecurity Scale to measure FI, and anthropometric measurements of weight, height, and WC were taken. Data analysis was performed in STATA 15.0 using multilevel mixed-effects regression with covariate adjustment and predicted marginal means with marginal differences. Results: Among the 210 individuals followed over 11 years, high prevalence of FI was observed (2011: 51.8%; 2022: 45.9%), central adiposity (2011: 83.8%; 2022: 88.6%), as well as a significant increase in the prevalence of high BMI (2011-2022: +16.7 Conclusion: FI is a risk factor for long-term weight gain and obesity, particularly in vulnerable populations, highlighting the need for intersectoral public policies to ensure food and nutrition security, combat obesity, and combat the structural causes of poverty and FI.