Abstract
Objectives: To investigate lipid and diabetic profiles of school teachers in Kabul, Afghanistan, who face food insecurity, and examine the association of those with the teachers’ knowledge of non-communicable diseases (NCDs). Methods: A survey to examine biochemical indicators of NCDs (triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), hemoglobin A1c (HbA1c), blood pressure, height, weight, waist circumference), food insecurity, lifestyle and knowledge of NCDs was conducted among 600 school teachers. Analyses were made of biochemical indicators of NCDs, blood pressure, metabolic syndrome, obesity, and subject’s lifestyle in relation to food security and the subject’s knowledge of NCDs. Results: Thirty-nine percent of school teachers experienced food insecurity. The percentage of TC ≥ 200 mg/dL; HbA1c ≥ 5.5%; hypertension and metabolic syndrome were 20.2%, 29.7%, 32.2% and 33.7%, respectively. Food insecurity was associated with lower fruit and vegetable consumption and higher potato consumption. Food insecurity was associated with increased TC (AOR 2.03; 95%CI: 1.23 - 3.34), decreased HDL (AOR 1.70; 95%CI: 1.12 - 2.58), increased HbA1c (AOR 1.73; 95%CI: 1.14 - 2.64), hypertension (AOR 1.68; 95%CI: 1.01 - 2.80) and diagnosis of metabolic syndrome (AOR 1.78; 95%CI: 1.18 - 2.68), after adjustment by demographic, socioeconomic and lifestyle variables. Among people living under condition of food insecurity, greater NCD knowledge was associated with smaller prevalence of TG ≥ 150 mg/dL, HDL < 40 mg/dL, and diagnosis of metabolic syndrome. Conclusions: Under conditions of food insecurity, diets have less variety and individuals are more likely to exhibit biomedical risk factors of NCDs. Even under conditions of food insecurity, people with knowledge of NCDs may have better coping strategies for their choice of lifestyles and exhibited a lower percentage of risk factors of NCDs.
Highlights
Food insecurity is defined as the lack of secure access to sufficient amounts of safe and nutritious food for normal growth and development and an active and healthy life [1]
A survey to examine biochemical indicators of non-communicable diseases (NCDs) (triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), hemoglobin A1c (HbA1c), blood pressure, height, weight, waist circumference), food insecurity, lifestyle and knowledge of NCDs was conducted among 600 school teachers
Among people living under condition of food insecurity, greater NCD knowledge was associated with smaller prevalence of TG ≥ 150 mg/dL, HDL < 40 mg/dL, and diagnosis of metabolic syndrome
Summary
Food insecurity is defined as the lack of secure access to sufficient amounts of safe and nutritious food for normal growth and development and an active and healthy life [1]. 124 million people undergoing crises, emergencies, and famines are in need of urgent action against food insecurity [1]. Afghanistan is a country struggling with food insecurity as a consequence of long-term conflicts; its situation is regarded as extremely fragile [2] and expected to be exacerbated [1]. It is reported that 8 million people in Afghanistan (27% of the population) are very severe or severe food insecure and 5 million (17% of the population) are moderately food insecure [3]. Compared to 2011-2012 statistics showing 18% very severe or severe food insecure and 12.2% moderately food insecure, food insecurity in the country has become worse by 2017 [3]. Food insecurity still needs significant attention in Afghanistan, a country facing conflicts for more than 30 years
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