title: Food insecurity with hunger is associated with obesity among HIV-infected and at risk women in Bronx, NY.
abstract: BACKGROUND
  Food insecurity, insufficient quality and quantity of nutritionally adequate food, affects millions of people in the United States (US) yearly, with over 18 million Americans reporting hunger. Food insecurity is associated with obesity in the general population. Due to the increasing prevalence of obesity and risk factors for cardiovascular disease among HIV-infected women, we sought to determine the relationship between food insecurity and obesity in this cohort of urban, HIV-infected and -uninfected but at risk women.
  
  
  METHODS
  Using a cross-sectional design, we collected data on food insecurity, body mass index and demographic and clinical data from 231 HIV-infected and 119 HIV-negative women enrolled in Bronx site of the Women's Interagency HIV Study (WIHS). We used multivariate logistic regression to identify factors associated with obesity.
  
  
  RESULTS
  Food insecurity was highly prevalent, with almost one third of women (110/350, 31%) reporting food insecurity over the previous six months and over 13% of women reported food insecurity with hunger. Over half the women were obese with a Body Mass Index (BMI) of ≥ 30. In multivariate analyses, women who were food insecure with hunger had higher odds of obesity (Adjusted odds ratio [aOR] =  2.56, 95% Confidence Interval [CI]  =  1.27, 5.20) after adjusting for HIV status, age, race, household status, income, drug and alcohol use.
  
  
  CONCLUSIONS
  Food insecurity with hunger was associated with obesity in this population of HIV-infected and -uninfected, urban women. Both food insecurity and obesity are independent markers for increased mortality; further research is needed to understand this relationship and their role in adverse health outcomes.
authors.affiliation: Department of Medicine, Weill Cornell Medical College, New York, New York, United States of America.
authors.forename: Nicole
authors.initials: N
authors.lastname: Sirotin
authors.affiliation: Department of Statistics and Biostatistics, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey, United States of America.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Hoover
authors.affiliation: Department of Epidemiology and Community Health, New York Medical College, Valhalla, New York, United States of America.
authors.forename: Qiuhu
authors.initials: Q
authors.lastname: Shi
authors.affiliation: Departments of Medicine and Epidemiology and Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, United States of America.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Anastos
authors.affiliation: Division of HIV/AIDS, San Francisco General Hospital, University of California, San Francisco (UCSF), San Francisco, California, United States of America.
authors.forename: Sheri D
authors.initials: SD
authors.lastname: Weiser
mesh_terms: D000328:Adult; D044383:Black People; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000150:complications / Q000191:economics / Q000453:epidemiology* / Q000208:ethnology; D006801:Humans; D006815:Hunger; D007182:Income / Q000706:statistics & numerical data; D016015:Logistic Models; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D009765:Obesity / Q000150:complications / Q000191:economics / Q000453:epidemiology* / Q000208:ethnology; D016017:Odds Ratio; D011203:Poverty / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D014505:Urban Population; D044465:White People; D001741:Black or African American