Food insecurity has increased over time in patients with CVD
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The prevalence of food insecurity rose over time in patients with CVD, researchers reported in JAMA Cardiology.
“Food insecurity is a common problem among people with cardiovascular disease, and we are seeing that issue become even more prevalent in recent years,” Eric J. Brandt, MD, MHS, FACC, a cardiologist at the University of Michigan Health Frankel Cardiovascular Center, said in a press release.
Brandt and colleagues conducted a serial cross-sectional study of 57,517 adults (mean age, 46 years; 52% women; 69% white) participating in the National Health and Nutrition Examination Survey from 1998 to 2018. They assessed food insecurity using the U.S. Department of Agriculture Adult Food Security Survey Module.
Among the cohort, 7.9% had CVD, 5.1% had CAD, 2.7% had stroke, 2.4% had HF, 49.6% had hypertension, 33.2% had obesity, 11.2% had diabetes and 30.8% had dyslipidemia.
Food insecurity was reported by 11.8% of participants, and it occurred more frequently in Hispanic (24%) and non-Hispanic Black (18.2%) individuals than in non-Hispanic Asian (8%) and non-Hispanic white (8.5%) adults.
Food insecurity and CVD
Except for CAD, all CVD and cardiometabolic diseases were more prevalent in adults with food insecurity than in adults without it, Brandt and colleagues found.
Among those with CVD, the prevalence of food insecurity rose from 16.3% in the 1999-2000 survey to 38.1% in the 2017-2018 survey (P for trend < .001), Brandt and colleagues wrote, noting the magnitude of change in food insecurity status did not differ between adults with and without food insecurity (interaction coefficient = 0.02; P for interaction = .05).
“We believe there is a two-way relationship here,” Brandt said in the release. “Individuals who are food insecure may have increased risk for cardiovascular disease, and vice versa. When one acquires heart disease, it impacts one’s risk for developing socioeconomic problems that could reduce access to adequate and quality food. Food insecurity can often occur with other social determinants of health, such as poor transportation access or access to health care, which further compounds this relationship.”
Among individual CVD conditions, food insecurity rose in those with CAD, stroke and HF, and among those with HF, magnitude of change in food insecurity status was greater than in those without CVD, according to the researchers.
Among individual cardiometabolic conditions, food insecurity rose in those with hypertension, diabetes, obesity and dyslipidemia, and among those with hypertension, magnitude of change in food insecurity status was greater than in those without it, Brandt and colleagues found.
Food insecurity and socioeconomic difficulties
Between 2011 and 2018, food insecurity declined in non-Hispanic Black adults with CVD (P for trend = .04), but did not change in adults of other races/ethnicities or in those with other conditions, according to the researchers.
Among those with food insecurity, Supplemental Nutrition Assistance Program (SNAP) participation was greater in those with CVD than in those without it (P = .01).
“Food insecurity has the potential to exacerbate existing racial and ethnic health disparities,” Brandt said in the release. “But there is also a public realization here that differences in cardiovascular outcomes across races and ethnicities aren’t related to the racial or ethnic origin of an individual, rather more to the social experience of an individual. In this broader viewpoint, having had a cardiovascular event could have a major impact on one’s social circumstance that places them at risk for food insecurity and other socioeconomic difficulties.”
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