Economic food insecurity is a risk factor for coronary heart disease (CHD) and heart failure with reduced ejection fraction (HFrEF) in black adults in the United States, according to an analysis from the Jackson Heart Study.
This study suggests that risk persisted even after accounting for traditional cardiovascular risk factors and socioeconomic status such as income and education.
“These findings support economic food insecurity, which disproportionately affects black communities, as an important driver of well-documented racial disparities in CV health and as a promising potential target for intervention. supportive,” writes lead author Amil M. Shah, MD, MPH. , Cardiology, Brigham and Women’s Hospital.
Food insecurity is often caused by a lack of physical access to nutritious food, known as food deserts or swamps, and affects approximately 13.5 million people across the United States. Evidence suggests that food insecurity and limited access to food are associated with prevalence of hypertension, diabetes and obesity, especially in areas with majority black residents.
Both food insecurity and poor dietary quality are associated with risk factors for cardiovascular comorbidities and heart failure, suggesting a relationship between diet and the incidence of food insecurity comorbidities.
The current cohort study was an event-onset analysis of 3024 black adult participants without CVD of the Jackson Heart Study who were originally recruited for their first study visit in Mississippi between 2000 and 2004. . Data analysis was performed by investigators from September 2020 to November 2021.
Economic food insecurity was assessed by self-report at the first survey visit and defined in the analysis as having received food stamps in the previous year. Patients were also asked to rate the severity of the stress they felt regarding having enough money to buy basic things, including food. Defined as convenience stores and fast food restaurants, 2.5 or more were considered high.
Participants in the Jackson Heart Study were followed for CV events, death, and loss to follow-up from baseline examination in 2000-2004. Associations between economic food insecurity and incident CV events were assessed using multivariable Cox proportional hazards regression models adjusted for baseline demographic characteristics, comorbidities, and socioeconomic status .
In the analysis, the survey sample consisted of 3024 adults without HF and CHD at baseline who had adequate food storage and food insecurity data. Compared with those who were not financially food insecure, individuals experiencing financial insecurity were younger, more likely to be female, and had higher prevalence of hypertension and BMI.
Demographic-adjusted models show that economic food insecurity is associated with increased risk of CHD, HF and HFrEF. No association was found between economic food insecurity and the incidence of HFpEF or stroke.
An analysis adjusted for cardiovascular and socioeconomic factors revealed that economic food insecurity was associated with a higher risk of developing CHD (hazard ratio [HR]1,76; 95% CI, 1.06 – 2.91) and incident HFrEF (HR, 2.07; 95% CI, 1.16 – 3.70).
This association persisted after further adjustment for physical activity, smoking, diet quality, and perceived stress. Demographic analyzes further indicate that economic food insecurity is associated with higher sensitive C-reactive protein and renin concentrations.
A multivariate cox proportional hazards regression model suggests that a high frequency of unfavorable grocery stores within one mile is not associated with CHD, heart failure, or stroke. No association was observed after adjusting for clinical comorbidities and socioeconomic status.
“Our findings are observational and further prospective intervention studies are needed to define whether interventions for economic food insecurity result in reduced risk of CHD and/or HFrEF. “However, our findings provide grounds for hope that targeting food insecurity will help reduce the incidence of CHD and HF and mitigate the marked racial disparities in the burden of CVD in the United States. To do.”
The study, “Food Insufficiency and Cardiovascular Disease Risk Measurements in Black Individuals in the United States from the Jackson Heart Study,” JAMA network open.