Wang SY, et al. Abstract 239. Presented at: American Heart Association Scientific Sessions; Nov. 13-17, 2020 (virtual meeting).
Food insecurity may confer higher CV death risk in younger adults
Although food insecurity in the U.S. has improved since 2011, adults aged younger than 65 years impacted by food security continue to experience elevated risk for CV death.
In a study reported at the virtual American Heart Association Scientific Sessions, food insecurity did not affect CV mortality in adults aged 65 years or older. In that population, CV mortality declined regardless of changes in food insecurity.
Approximately 10% of U.S. adults are food insecure, meaning they lack immediate access to fresh, healthy and affordable foods. Additionally, the stress of food insecurity or the regular consumption of cheap, processed foods may adversely affect CV health.
Using National Center for Health Statistics data and food insecurity rates obtained from the Map the Meal Gap project, investigators evaluated the association between longitudinal changes in food insecurity and CV mortality rates among individuals aged 20 to 64 years, after accounting for time-varying demographic, economic and health care access variables. Trends in mortality were evaluated based on quartile of county level annual percent change in food insecurity.
From 2011 to 2017, food insecurity rates dropped from 14.7% to 13.3% in the U.S.
Investigators observed that younger individuals in counties with the highest quartile of annual percent change of food insecurity had increased risk for CV death, rising from 82.2 to 87.4 to per 100,000 people (P .001), compared with those living in counties within the lowest quartile, where CV mortality barely changed (from 60.8 per 100,000 people to 60 per 100,000 people; P = .64).
Moreover, for each percentage point increase in food insecurity, adults younger than 65 years had a 0.83% greater risk for CV death (95% CI, 0.42-1.25; P < .001).
“The take-home message for clinicians is that economic factors beyond the clinic can have important implications for our patients,” Sameed Khatana, MD, MPH, instructor in cardiovascular medicine at the Perelman School of Medicine at the University of Pennsylvania, told Healio. “Economic stress, and particularly food insecurity, which is a form of economic stress, has a clear and significant relationship on CV health and CV mortality.
“Other studies have noted that food insecurity can impact medication adherence, as well as prevalence of risk factors such as diabetes and obesity,” Khatana said in an interview. “Additionally, other studies have noted how socioeconomic stress can lead to upregulation of inflammation in the body that can impact CVD.”
Among adults aged 65 years or older, CV mortality declined from 1,643.3 to 1,542.7 per 100,000 people in the highest quartiles of percent change in food insecurity (P < .001) and dropped from 1,408.3 to 1,338.6 per 100,000 people in the lowest quartile (P < .001).
The association between CV death and each percentage point increase in food insecurity was not significant among older adults (–0.06%; 95% CI, –0.39 to –0.28).
“The largest government program to address food insecurity is the Supplemental Nutrition Assistance Program which provides food assistance to low-income individuals in the U.S.,” Khatana told Healio. “Other programs such as home food delivery programs and food vouchers have also shown to impact food insecurity. Further work is needed to study whether interventions that improve food insecurity also have a positive impact on health outcomes such as CV health and mortality.”