Food insecurity and cardiovascular disease: Current trends and future directions

Chang, Ryan; Javed, Zulqarnain; Taha, Mohamad; Yahya, Tamer; Brandt, Eric; Cainzos‐Achirica, Miguel; Mahajan, Shiwani; Ali, Hyeon-Ju; Nasir, Khurram

doi:10.1016/j.ajpc.2021.100303

Cited by 15 publications

(16 citation statements)

References 83 publications

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“…These findings were somewhat surprising given the greater prevalence of food insecurity in Black and Hispanic adults than in White adults in the US. 3,14 It is widely accepted that food insecurity is associated with negative health outcomes largely through its effects on diet quality, 21,22 whereas this pathway may vary widely across racial and ethnic groups. Two previous studies from NHANES found that significant associations of food insecurity with poor-quality diet were observed in White individuals but not in Black and Hispanic individuals.…”

Section: Discussionmentioning

confidence: 99%

“…The above information was self-reported and collected by standardized questionnaires. Previous studies have shown that food insecurity is associated with negative health outcomes through nutritional/anthropometric (body mass index [BMI] and diet quality), behavioral (smoking, heavy drinking, and physical inactivity), mental health (access to a mental health professional), access to care (routine place to go for health care), and chronic disease (diabetes, hypertension, CVD, and cancer) pathways 21,22 ; thus, it is not appropriate to adjust for the above factors in the analysis. However, as an exploratory analysis, we further adjusted the above potential mediators in multivariable analyses.…”

Section: Assessments Of Covariatesmentioning

confidence: 99%

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Food Insecurity and Premature Mortality and Life Expectancy in the US

Ma,

Wang,

et al. 2024

JAMA Intern Med

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ImportanceFood insecurity has been linked to multiple causes of disease and premature mortality; however, its association with mortality by sex and across racial and ethnic groups remains unknown in the US.ObjectiveTo investigate the associations of the entire range of food security with all-cause premature mortality and life expectancy across racial and ethnic and sex groups in US adults.Design, Setting, and ParticipantsThis cohort study included adults (aged ≥18 years) who participated in the National Health and Nutrition Examination Survey from 1999 to 2018, with linkage to the National Death Index through December 31, 2019. Data analysis was performed from August to November 2023.ExposuresLevels of food security were assessed with the US Department of Agriculture Adult Food Security Survey Module (full, marginal, low, and very low).Main Outcomes and MeasuresAll-cause premature mortality (death that occurs before age 80 years) and life expectancy.ResultsThe study included 57 404 adults (weighted mean [SE] age, 46.0 [0.19] years; 51.8% female; 12 281 Black individuals [21.4%]; 10 421 Mexican individuals [18.2%]; 4627 Other Hispanic individuals [8.1%]; 24 817 White individuals [43.2%]; and 5258 individuals of other races, including multiracial [9.2%]). During a median (IQR) of 9.3 (5.0-14.3) years of follow-up, 4263 premature deaths were documented. Compared with the full food security group, the adjusted hazard ratios were 1.50 (95% CI, 1.31-1.71), 1.44 (95% CI, 1.24-1.68), and 1.81 (95% CI, 1.56-2.10) across marginal, low, and very low food security groups, respectively (P &lt; .001 for trend). The corresponding life expectancy at age 50 years in each group was 32.5 (95% CI, 32.4-32.6), 29.9 (95% CI, 28.9-30.9), 30.0 (95% CI, 28.9-31.0), and 28.0 (95% CI, 26.8-29.2) years. Equivalently, adults with marginal, low, or very low food security lived on average 2.6 (95% CI, 1.5-3.7), 2.5 (95% CI, 1.4-3.7), or 4.5 (95% CI, 3.2-5.8) fewer years at age 50 years, respectively, compared with those with full food security. The associations appeared to be stronger in women than in men (hazard ratios comparing very low food security with full food security, 2.29 [95% CI, 1.83-2.86] in women and 1.46 [95% CI, 1.19-1.78] in men; P = .009 for interaction) and stronger in White adults than in Black adults (hazard ratios comparing very low food security with full food security, 2.07 [95% CI, 1.70-2.53] in White adults and 1.33 [95% CI, 1.01-1.75] in Black adults; P &lt; .001 for interaction) or in Hispanic adults (hazard ratios comparing very low food security with full food security, 1.06 [95% CI, 0.71-1.58]; P &lt; .001 for interaction).Conclusions and RelevanceIn this cohort study, although the association of food security and life expectancy varied across sex and racial and ethnic groups, overall, lower levels of food security were associated with a higher risk of premature mortality and a shorter life expectancy. The findings of this study highlight the potential importance of improving food security in promoting population health and health equity.

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Section: Discussionmentioning

confidence: 99%

Section: Assessments Of Covariatesmentioning

confidence: 99%

Food Insecurity and Premature Mortality and Life Expectancy in the US

Ma,

Wang,

et al. 2024

JAMA Intern Med

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“…La población de estudio presentó altas prevalencias de SP + OB, incluso por arriba de la media nacional (86.2% vs 72.4%) (Shamah et al, 2021). Con respecto a la malnutrición por exceso, evidenciado por indicadores antropométricos como el IMC, la circunferencia de cintura, cadera e índice de cintura talla, mostraron valores por arriba a los reportados en algunos otros estudios (Monroy 2021; Chang, 2022;Gómez, 2020;Liu, 2020;Raccanello, 2020). Aunque no se encontraron diferencias estadísticamente significativas entre niveles de IA y medidas antropométricas, se logró observar que la tendencia en la población fue que aquellas personas con inseguridad severa, tenían un IMC, circunferencia de cintura y un ICT mayores, lo cual es similar a lo observado en otros reportes de América Latina (Ruderman et al,2021) incrementando su RCV.…”

Section: Discussionunclassified

Nivel de percepción de inseguridad alimentaria, estado nutricional y factores sociodemográficos asociados en pobladores de Oaxaca, México.

Díaz¹,

Hernández²,

López³

et al. 2023

RESPYN

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Introducción: La inseguridad alimentaria impacta el estado nutricional de las poblaciones, siendo la falta de disponibilidad y accesibilidad de alimentos derivada de la pobreza, uno de los principales factores que contribuyen a su aparición. Objetivo: Identificar el nivel de inseguridad alimentaria, estado nutricional y factores sociodemográficos asociados en pobladores de Oaxaca, México. Material y método: : Estudio transversal en 297 personas. Se aplicó la Escala Latinoamericana y Caribeña de Seguridad Alimentaria, se recolectaron datos sociodemográficos, antropométricos y se compararon entre niveles de inseguridad alimentaria. Se calcularon razones de prevalencia para identificar factores sociodemográficos asociados a mayor riesgo de inseguridad alimentaria. Resultados: Se encontró una alta prevalencia de sobrepeso + obesidad e inseguridad alimentaria de 86.4% y 76.1% respectivamente. Las personas con inseguridad grave presentaron mayor índice de masa corporal, índice cintura/talla y circunferencia de cintura; así como menor nivel socioeconómico y escolaridad del jefe del hogar. La presencia de menores de 18 años aumentó el riesgo de inseguridad alimentaria en 27% [RP=1.27; IC:1.02-1.58)]. Conclusiones: Los bajos ingresos económicos, la baja escolaridad del jefe del hogar y tener menores de 18 años incrementan la probabilidad de que los hogares se posicionen en alguna clasificación de inseguridad alimentaria.

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“…Social determinants of health (SDOH) include poverty level, food security level, home ownership, household education, access to a routine place for health care, health insurance status, and household head relationship status (Connolly et al, 2022). An inverse association has been found between CVD and adversity in each of these SDOHs (Singh et al, 2015), (Sims et al, 2020) (Chang et al, 2021), (Alcalá et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Low Positive Social Determinants of Health Exposure Amplifies the Association between Allostatic Load and Risk of Cardiovascular Mortality in Cancer and Non-Cancer Patients

Bhave,

Reddy,

Moore

et al. 2023

Preprint

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BackgroundHigh allostatic load (AL) is associated with an increased risk of cardiovascular death (CVD), but little is known about how social determinants moderate this relationship.MethodsWe conducted a retrospective cohort analysis of the National Health and Nutrition Examination Survey years 1999-2010 linked with the National Death Index. We fit age, race, and sex-adjusted Fine & Gray models to calculate sub-distribution hazard ratios (SHR) of CVD among adults exposed to high versus low levels of positive social determinants of health (PSDOH), stratified by high and low AL status.ResultsAmong 22,775 participants, 1,939 (8.5%) had a cancer history. In the full cohort, low PSDOH was associated with 38% increased risk of CVD among high AL adults (SHR: 1.38, 95% CI: 1.22 - 1.56) and 57% increased risk among low AL adults (SHR: 1.57, 95% CI: 1.32 - 1.87). Among adults with no cancer history, low PSDOH was associated with 36% increased risk among high AL adults (SHR: 1.36, 95% CI: 1.19 – 1.55) and 59% increased risk among low AL adults (SHR: 1.59, 95% CI: 1.32 – 1.92). In the cancer cohort, low PSDOH was associated with 77% increased risk among high AL adults (SHR: 1.77, 95% CI: 1.32 – 2.37) and 73% increased risk among low AL adults (SHR: 1.73, 95% CI: 1.02 – 2.94).ConclusionsLow PSDOH amplified the association between AL and CVD in all cohorts, with the highest risk increases among adults with cancer history. This suggests that socioeconomic-related distress supersedes biological changes from AL in relation to CVD.

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Food insecurity and cardiovascular disease: Current trends and future directions

Abstract: Highlights Food insecurity and CVD share a circular association. Association may be stronger for racial/ethnic minorities and single mothers. Greater investment and organization are needed to address this association. Targeting food insecurity may reduce the nationwide burden of CVD.

Cited by 15 publications

References 83 publications

Food Insecurity and Premature Mortality and Life Expectancy in the US

Food Insecurity and Premature Mortality and Life Expectancy in the US

Nivel de percepción de inseguridad alimentaria, estado nutricional y factores sociodemográficos asociados en pobladores de Oaxaca, México.

Low Positive Social Determinants of Health Exposure Amplifies the Association between Allostatic Load and Risk of Cardiovascular Mortality in Cancer and Non-Cancer Patients

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