Start with an instantaneous: adults without reliable access to nutrients are more likely to have heart disease than adults who have no trouble eating well. But who comes first, food insecurity or disease? Heart attacks or heart failure do not develop overnight, so determining the chain of events means being visible for the long view.
A new analysis did it, depending on the people who did not have a heart disease at the end of the thirties or at the start of the forties to see how their access to food could be linked to their heart health 20 years later. The results of the cohort study, published Wednesday in Jama cardiology, show that people with food insecurity had a risk of 41% higher to develop heart disease at the middle age compared to people with a source of safe food. This association resisted after taking into account other influences, such as race or education.
“Even once we take into account socio-economic factors, we always see that food insecurity itself gives an increased risk of developing heart disease,” the author Jenny Jia, an internist at Northwestern Medicine, told Stat. “These adults have not reached the age group of 65 and over when heart disease is more likely to be diagnosed, so they are not even at the age of cutting -edge diagnosis, but we are already starting to see that they diverge.”
JIA and her colleagues analyzed the data of the participants registered around 18 years old in a current study called Cardia. Led since 1986 in Birmingham, Ala.; Oakland, California; Chicago; And Minneapolis, 48% of his 3,616 volunteers were black. The new study did not look until the study is leaving, because the questions about the difficulties of affording that it is not to ask yourself until 2000, reflecting the relatively recent attention given to food as a drug or as a prevention pillar.
The day before Jama’s Cardiology article, an influential health policies group made its decision that food insecurity was not well defined enough to suggest include in the reports of the primary care doctor’s office. The recommendation is publishing a project published in June 2024, which cited the complexity of social problems involved in food availability.
“The US preventive services working group (USPSTF) concludes that current evidence is insufficient to assess the balance of advantages and food insecurity misdeeds on health results in primary care,” he said in Jama on Tuesday.
The data of the survey collected by the USPSTF estimate that 13% of American households experienced food insecurity in 2022, 8% of which have low food security and 5% with very low food security. Among households with income below the federal poverty line, almost a third had food insecure.
To establish who had food insecurity in the Cardia study, the participants were invited to know which of these descriptions corresponded to their household the previous year. A “yes” answer only to the first question qualified as secure food:
- We have enough food to eat and the types of food we want.
- We have enough food to eat, but not always the food we want to eat.
- Sometimes we don’t have enough food to eat.
- Often we don’t have enough food to eat.
After following these people from 2000 to 2020, 11% of those who were not in safety of food developed heart disease, against 6% of those who had adequate access to food. Cardiac disease measures were serious: a deadly and not fatal heart attack; Hospitalization for angina or acute coronary syndrome; heart failure; stroke; or per
These differences in food security and heart disease was true after taking into account race and education, that the authors qualified a more coherent measure than income.
Khurram Nasir, cardiologist and preventive researcher affiliated with the Weill Cornell Medical College and the Houston Methodist Debakey Heart & Vascular Center, was not surprised by the connection, but he found the extent of the risk concerning. He was not involved in the study.
“Food insecurity is not only a question of hunger, it is a major cardiovascular risk factor,” he told Stat in an e-mail interview. “An increased risk of cardiovascular diseases due to food insecurity, even after adjustment for traditional risk factors, is amazing. This tells us that the fight against cholesterol and blood pressure is not alone – we must approach the motors upstream of diseases, such as economic instability, neighborhood deprivation and access to affordable and nutritious foods. »»
Having established a chronology showing food insecurity comes first, followed by a heart disease, Jia said that the sequence was not always so clear.
“Over time, there is a differential rate for the development of heart disease,” she said. “There is probably a certain bidirectionality because we know that having chronic diseases creates additional socio -economic pressure on the household because health care is expensive, unfortunately.”
Food insecurity can be cyclical, said Nasir. “Residents of food insecurity households are more likely to consume processed, high sodium foods, developing frenzy-eating behaviors and feeling chronic stress, which accelerate all cardiovascular disease,” he said. “Food insecurity does not exist in a vacuum. It is linked to income, housing stability, neighborhood infrastructure and even access to transport. »»
Many experts recommend adding food security issues to primary care visits, but JIA, which is also an instructor of general internal medicine and preventive medicine at the Northwestern University Feinberg School of Medicine, also expands this to emergency rooms and specialties, including cardiology. Nurses and medical assistants could question patients – or patients themselves could fill out forms.
If in need, people could be connected to existing community resources, said JIA, such as the charity of food banks and pantry across the country. “Many of these strategies are really focused on, how to make a healthy choice the easy choice,” she said.
Health care systems should adopt an integrated approach, said Jia and Nasir. This could mean extending custom meals medically and “food pharmacies” in hospitals and clinics. In terms of politics, Nasir would plead for Stronger nutritional aid programs, incentives for the development of grocery store in food deserts and healthier food subsidies.
“If we are not talking about systemic barriers,” he said, “we will continue to deal with the consequences of cardiovascular disease instead of preventing it.”
Coverage of chronic health problems by stat is supported by a subsidy of Bloomberg philanthropies. OUR financial supporters are not involved in any decision concerning our journalism.