Food insecurity, SNAP participation tied to suboptimal CV health
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Key takeaways:
- People with food insecurity and those in the Supplemental Nutrition Assistance Program are less likely to achieve ideal CV health.
- Policy interventions may be needed to reduce these disparities.
Food insecurity and participation in the Supplemental Nutrition Assistance Program may be related to failure to achieve ideal CV health, according to a research letter published in JAMA Network Open.
“Few studies have examined food insecurity in relation to multidimensional cardiovascular outcomes,” Cindy W. Leung, ScD, MPH, assistant professor of public health nutrition at Harvard T.H. Chan School of Public Health, and colleagues wrote. “Furthermore, this association may be complicated by participation in the Supplemental Nutrition Assistance Program (SNAP), which aims to alleviate food insecurity and also targets populations most vulnerable to poverty and poor health. This study examined the associations among household food security, SNAP participation, and [the American Heart Association’s Life’s Essential 8] as a measure of ideal CV health.”
Data were derived from Leung CW, et al. JAMA Netw Open. 2023;doi:10.1001/jamanetworkopen.2023.21375.
Leung and colleagues analyzed 11,520 nonpregnant adults aged 20 years or older (mean age, 48 years; 52% women) from the 2013-2018 National Health and Nutrition Examination Survey. Participants were stratified by household food security (high, marginal, low or very low) as measured by the U.S. Household Food Security Survey Module, and by whether they participated in SNAP in the prior 12 months. The primary outcomes were the Life’s Essential 8 measures — diet, physical activity, tobacco use, sleep health, BMI, BP, serum glucose levels and serum lipid levels.
Among the cohort, 9.9% had marginal food security, 10.2% had low food security and 6.5% had very low food security.
Compared with adults with high food security, who had a mean Life’s Essential 8 score of 66.9, adults in the other food security groups had worse scores in a dose-response manner (marginal, 65.4; low, 63.9; very low, 62.3; P for trend < .001), Leung and colleagues found.
Greater degree of food insecurity was associated with worse scores for diet, tobacco use, sleep health, BMI and serum glucose (P for trend for all < .05), according to the researchers.
Participants in SNAP had a mean Life’s Essential 8 score of 62.8, worse than nonparticipants with low income (65.5) and higher income (65.4), Leung and colleagues found. In addition, SNAP participation was associated with worse scores for diet, tobacco use, sleep health and BMI (P for trend for all except SNAP vs. higher-income nonparticipants in diet score < .05).
The group with the lowest probability of moderate to ideal CV health was SNAP participants with very low food security (74.9%; 95% CI, 66.4-81.8), according to the researchers.
“SNAP participants with very low food security had the lowest probability of moderate to ideal CV health, suggesting nutrition-forward policies may improve food security and CV health among program participants,” Leung and colleagues wrote. “Programmatic and policy interventions should consider more holistic approaches to improve behavioral disparities among populations at risk of food insecurity.”
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