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Inability to afford food today may cause heart disease tomorrow, scientist says

STRUGGLING to afford food today could mean heart problems tomorrow. Young adults experiencing food insecurity have a 41 percent greater risk of developing heart disease in midlife, even after accounting for demographic and socioeconomic factors, according to a Northwestern University School of Medicine, United States, study published recently.

Food insecurity—struggling to get enough nutritious food to stay healthy—affects one in eight households in the United States each year, the study added.

“We’ve known that food insecurity and heart disease often go hand in hand, but this study shows, for the first time, that food insecurity comes first,” said Dr Jenny Jia, an instructor of general internal medicine and preventive medicine at Northwestern University Feinberg School of Medicine and a Northwestern Medicine internist.

“That makes it a clear target for prevention—if we address food insecurity early, we may be able to reduce the burden of heart disease later.”

How the study was conducted

Jia and her colleagues analyzed data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a long-term cohort study that has followed Black and white US adults since the mid-1980s.

The scientists identified participants who reported food insecurity in 2000-2001, when they were in their early 30s to mid-40s, and compared their health outcomes over the next 20 years to those who were food secure.

Among the 3,616 study participants, those experiencing food insecurity were 41 percent more likely to develop cardiovascular disease than their food-secure counterparts. Over the study period, 11 percent of food-insecure individuals developed heart disease, compared to 6 percent of those with adequate food access.

“For a long time, there was this chicken-or-the-egg question—does food insecurity cause heart disease, or does heart disease make food insecurity worse because of the high cost of healthcare?” Jia said.

“By following people over two decades, we were able to show that food insecurity, on its own, significantly increases the risk of developing cardiovascular disease,” the scientist added.

At baseline, participants with food insecurity were more likely to identify as Black and had lower educational attainment than those who were food secure.

Screening for food insecurity

Jia said the findings highlight the need for healthcare providers to be savvy in how to best screen for food insecurity and connect patients with community resources.

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

Jia also stressed that food security screenings could extend to emergency rooms and specialties like cardiology, and can be done by nurses, medical assistants or even patients themselves filling out forms.

“The more we screen for it, the better,” Jia said, adding that “we need better strategies to help people once they screen positive. Do we connect them to social workers who can refer them to existing community programmes? Should healthcare systems 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 effects of food insecurity. “It’s surprising to see heart disease in this group, which doesn’t include those 65 or older,” Jia said.

“As they near 80, we plan to revisit the study to explore the evolving link to heart disease,” Jia stated.