Abstract 11081: Measures of Food Inadequacy and Cardiovascular Disease Risk in Black Americans: The Jackson Heart Study

Abstract

Introduction: Food insecurity is common in the U.S. and disproportionately impacts Black Americans, but its association with risk of heart failure (HF) and coronary heart disease (CHD) is unclear. We evaluated the associations of economic food insecurity and proximity to unhealthy food options with risk of incident HF and CHD, and assessed the potential impact of diet quality and stress on these associations. Methods: Among 3,024 Black adult participants in the community-based Jackson Heart Study (JHS) without prevalent HF or CHD who attended visit 1 (2000-2004), the associations of economic food insecurity (receiving food stamps, self-reported ‘not enough money for groceries’) and proximity to unhealthy food stores (>2.5 unfavorable food stores [fast food restaurants, convenience stores] within 1 mile) with incident HF hospitalization and CHD were assessed using multivariable Cox proportional hazard models. Adjustment covariates included age, sex, BMI, hypertension, and diabetes in the initial model and diet quality (Healthy Eating Index) and perceived stress (total Global Perceived Stress score) in the extended model. Results: Mean age was 54±12 years, 34% were men, 630 (21%) were economically food insecure, and 1,512 (50%) had >2.5 unfavorable food stores within 1 mile. In multivariable models, economic food insecurity was associated with a heightened risk of incident HF and of incident CHD, which persisted with minimal attenuation after further adjustment for diet quality and perceived stress (Table). Limited physical food access was not associated with heightened risk of incident HF or CHD after accounting for demographics. Conclusions: Economic food insecurity, but not proximity to unhealthy food options, is associated with HF and CHD risk independent of traditional cardiovascular risk factors. Increased perceived stress and worse diet quality do not appear to account for these associations.