Exploring the association between food insecurity and overweight/obesity among adults in low- and middle-income countries: A systematic review protocol

BackgroundIn low- and middle-income countries (LMICs), food insecurity has traditionally been associated with undernutrition. However, as many LMICs undergo a rapid nutrition transition, greater access to inexpensive, energy-dense, and nutrient-poor foods is contributing to rising rates of overweight and obesity. These shifts may be altering the relationship between food insecurity and excess weight, a link that has been more widely documented in high-income countries. This systematic review aims to synthesize evidence on the association between food insecurity and overweight/obesity among adults in LMICs, and to identify proposed mechanisms and contextual factors that may influence this relationship. MethodsPrimary observational studies focused on the association between food insecurity and overweight/obesity among adults in LMICs will be systematically searched from multiple electronic databases, including PubMed, EMBASE, Global Health, Scopus, and LILACS. Grey literature will be explored using Google Scholar and ProQuest Dissertations & Theses Global. Reference lists of included studies and relevant reviews will also be manually screened to identify additional studies. Extracted data will include measures of food insecurity, overweight/obesity outcomes, and any reported mechanisms or contextual factors influencing their relationship. DiscussionThis review will contribute to a deeper understanding of the complex and evolving relationship between food insecurity and overweight/obesity in LMICs. Where data allow, we will explore how this association varies across country income levels, urban and rural settings, sex, age groups, and exposure to extreme events. Identified mechanisms and contextual modifiers will be synthesized to provide insights into the pathways that may underlie these associations. The findings will help identify knowledge gaps and inform future research and policy efforts aimed at addressing the dual burden of malnutrition in LMICs. RegistrationThis systematic review protocol is registered in PROSPERO under the registration number: CRD420251076653.