Food insecurity is associated with an increased risk of developing heart disease in middle age

If you struggle to buy food today, tomorrow can mean heart problems. A new Northwest Medicine study shows that young adults experiencing food insecurity are at a 41% higher risk of developing heart disease in middle age, even after accounting for demographic and socioeconomic factors. Food insecurity – struggling to get enough nutritious foods to stay healthy – affects one in eight US households each year.

We know that food anxiety and heart disease often go hand in hand, but this study shows for the first time that food anxiety comes first. That is a clear goal for prevention – dealing with food insecurity early may help reduce the burden of heart disease later. ”

Dr. Jenny Zia, general medicine and preventive medicine instructor at Northwestern University Feinberg School of Medicine, and Northwestern Medicine, and Internal Medicine, Northwestern Medicine

This survey will be published on Wednesday (March 12th) Jama Cardiology.

How to carry out research

JIA and her colleagues analyzed data from coronary risk development in the Young Adult (Cardia) study, a long-term cohort study that has been following black and white US adults since the mid-1980s. Scientists identified participants who reported food insecurity between 2000 and early 40s, when they were in their early 40s, and compared food in their health outcomes over the next 20 years with safe people.

Of the 3,616 study participants, those experiencing food anxiety were 41% more likely to develop cardiovascular disease than their food secure counterparts. During the study period, 11% of food-instability individuals developed heart disease, compared to 6% of people with appropriate food access.

“For a long time, I've had this chicken or egg question – does food anxiety cause heart disease or does heart disease exacerbate food anxiety due to the high cost of medical care?” Zia said. “Tracing people for over 20 years has shown that in itself significantly increases the risk of developing cardiovascular disease.”

At baseline, food insecurity participants were more likely to identify food as black than safe people, and had lower educational achievement.

Food insecurity screening

Jia says the findings underscore the need for healthcare providers to be familiar with how best to screen for food insecurity and connect patients with community resources.

She says primary care settings for physicians, pediatricians and family doctors are ideal for screening for food insecurity “as there tends to be a lot of trust between primary care providers and patients.”

Jia also emphasizes that food security screening could extend to specialist areas such as emergency rooms and heart disease, allowing nurses, medical assistants and even patients themselves to fill out the form.

“The more we screen it, the better,” Zia said, “we need a better strategy to help with positive screening. Do you want them to connect with social workers who can refer you to existing community programs? Should the healthcare system develop their own interventions? These are the next big questions.”

Next Steps

Jia and her team plan to continue tracking this group to understand the long-term impact of food insecurity. “It's amazing to see heart disease in this group. This doesn't include those over 65,” says Jia. “With nearly 80 they are, we're planning to revisit our research and explore the evolving connections to heart disease.”

Cardia's research was conducted and supported by the US National Heart, Lung, and the Blood Institute (NHLBI), in collaboration with Northwestern University (75N92023D00004), University of Minnesota (75N92023D0006), 75N92023D0006, and the University of Alabama (75N92023D00002 and 75N92023D00005) at Ady of Birmingham. Research Institute (75N92023D00003). Dr. JIA is supported by NHLBI's Grant K23HL173655. Dr. Kandula (another study author) is supported by Grant K24HL155897 from NHLBI.