Food Insecurity and Cardiovascular Disease Risk

Abstract

Purpose of Review This review examines the current epidemiological evidence for the relationship between levels of food insecurity and cardiovascular disease (CVD) outcomes among US adults > 17 years. Recent Findings Review of recent literature revealed that reduced food security was associated with decreased likelihood of good self-reported cardiovascular health and higher odds of reporting CVD-related outcomes such as coronary heart disease, angina, heart attack, peripheral arterial disease, and hypertension. Summary Existing evidence suggests a compelling association between each level of reduced food security and CVD risk with a particularly strong association between very low food security and CVD risk. Policies and public health-based strategies are needed to identify the most vulnerable subgroups, strengthen and enhance access to food assistance programs, and promote awareness and access to healthful foods and beverages to improve food security, nutrition, and cardiovascular health.

Feasibility of a Home-Delivery Produce Prescription Program to Address Food Insecurity and Diet Quality in Adults and Children

“…Despite a number of initiatives such as bolstering child tax credits, developing the Pandemic Electronic Benefit Transfer (P-EBT) program, strengthening the pre-existing Federal nutrition assistance programs (i.e., Supplemental Nutrition Assistance Program (SNAP, formerly food stamps) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)), and even strengthening the charitable food system [ 1 ], FI remains a public health problem. Addressing FI should be a public health priority because it is associated with poor diet quality [ 2 ] and health and social outcomes across the lifespan, including increased cardiometabolic disease risk [ 3 ], reduced quality of life [ 4 ], social stressors [ 5 , 6 ], and poor mental health [ 7 ], including symptoms of depression and anxiety [ 8 , 9 ]. Recently, FI has become more of a national priority, with US President Biden’s administration committing USD 5 billion to domestic FI solutions that are science-based and improve access to food and healthy eating [ 10 ].…”

Food insecurity and cardiovascular disease: Current trends and future directions

“…Notably, FI is associated with various cardiovascular risk factors – such as hypertension, dyslipidemia, diabetes, obesity, physical inactivity, and smoking – CVD, and cardiovascular mortality. FI is more common among ASCVD patients than in the general population, suggesting a possible bidirectional relationship between FI and CVD [ 11 , 41 ]. This association is likely due to FI's negative impact on behavioral risk factors, stress levels, and nutritional quality, as well as the financial burden of CVD treatment that may increase risk of being food insecure ( Fig.…”

“…An important component of referral and education by providers is to improve patient understanding of healthy foods and encourage them to consume more fruits and vegetables. Despite the well-documented impact of diet and food access on cardiovascular health, studies suggest nutrition is not sufficiently integrated into medical school curricula, with many medical students reporting inadequate nutrition knowledge or scoring poorly on nutrition-related tests [ 41 , 103 ]. Physicians have also reported uncertainty in how to navigate conversations following a positive FI screening, revealing the importance of properly educating care providers on nutrition and food access programs [ 104 ].…”

Women’s health: optimal nutrition throughout the lifecycle

“…Fewer women with incomes below 1.3 of the poverty income ratio met the Estimated Average Requirements for calcium, folate, magnesium, and vitamins A, C, D, and E compared with higher income women [ 12 ] and similarly, fewer food insecure women met the Estimated Average Requirement for magnesium and vitamins B6, C, and D, compared with food secure women [ 43 ] and also had lower intakes of calcium, zinc, and vitamins A and B6 [ 78 ]. Accordingly, several risk factors and chronic health outcomes are also more prevalent in low-income and food insecure groups including poor or fair health, physical function, glycemic control, greater hypertension, cancer, cardiovascular and heart disease, diabetes, and obesity [ 19 , 56 , 74 , 105 , 159 , 177 ].…”