Diet and Food and Nutrition Insecurity and Cardiometabolic Disease

Abstract

Poor nutrition is the leading cause of poor health, health care spending, and lost productivity in the United States and globally, which acts through cardiometabolic diseases as precursors to cardiovascular disease, cancer, and other conditions. There is great interest in how the social determinants of health (the conditions in which people are born, live, work, develop, and age) impact cardiometabolic disease. Food insecurity is an example of a powerful social determinant of health that impacts health outcomes. Nutrition insecurity, a distinct but related concept to food insecurity, is a direct determinant of health. In this article, we provide an overview of how diet in early life relates to cardiometabolic disease and then continue to focus on the concepts of food insecurity and nutrition insecurity. In the discussions herein we make important distinctions between the concepts of food insecurity and nutrition insecurity and provide a review of their concepts, histories, measurement and assessment devices, trends and prevalence, and links to health and health disparities. The discussions here set the stage for future research and practice to directly address the negative consequences of food and nutrition insecurity.

Addressing Social Determinants of Health via Food as Medicine Interventions to Improve Cardiometabolic Health

“…4 More broadly, nutrition security includes having equitable and stable availability, access, affordability, and utilization of foods and beverages that promote well-being and prevent and treat disease, and, conversely, nutrition insecurity is the lack of consistent access, availability, and affordability of nourishing foods and beverages. [5][6][7] Both are distinct but related and complimentary concepts that highlight the health consequences of poor nutrition, especially on cardiometabolic health, that goes beyond simple access to food (Figure). 7 Importantly, food and nutritional insecurity are linked to poor health outcomes, including obesity and diabetes, and the results demonstrated by Hager et al showed the attenuation of this relationship via participation in a produce prescription program.…”

“…[5][6][7] Both are distinct but related and complimentary concepts that highlight the health consequences of poor nutrition, especially on cardiometabolic health, that goes beyond simple access to food (Figure). 7 Importantly, food and nutritional insecurity are linked to poor health outcomes, including obesity and diabetes, and the results demonstrated by Hager et al showed the attenuation of this relationship via participation in a produce prescription program. Specifically, they found improvements in fruit and vegetable intake, food security, self-reported health, HbA1c, blood pressure, and BMI in adults.…”

Food Insecurity and Premature Mortality and Life Expectancy in the US

“…A large body of evidence has shown that food insecurity is strongly associated with numerous adverse health outcomes, including diabetes, cardiovascular disease (CVD), death, and others . Position papers from the American College of Physicians and the American Heart Association have acknowledged the important role of food security in preventing diet-related chronic diseases and improving health equity …”

“…[4][5][6][7][8][9][10] Position papers from the American College of Physicians and the American Heart Association have acknowledged the important role of food security in preventing dietrelated chronic diseases and improving health equity. [11][12][13] However, major gaps in knowledge exist regarding the association between food insecurity and health. First, evidence is scarce linking food insecurity and life expectancy, the mostused aggregate measure of a population's overall health.…”

Introduction to the Compendium on Early Cardiovascular Disease

“…The third segment of the Compendium features 4 articles aimed at modifiable behaviors and risk factors integral to promoting CVH. Brandt et al 23 review the relationship of diet with CVH and discuss recent evidence regarding optimal dietary patterns for CVH. The authors importantly touch on the relevance of both food and nutritional insecurity in contributing to cardiometabolic disease and poor CVH, especially in younger individuals.…”