Struggling to afford food today could lead to heart problems in the future, according to a study by Northwestern Medicine. The research found that young adults facing food insecurity have a 41% higher risk of developing heart disease in midlife, even when demographic and socioeconomic factors are considered. Food insecurity affects one in eight U.S. households annually.
Dr. Jenny Jia, an instructor at Northwestern University Feinberg School of Medicine, stated, “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.” She emphasized that addressing food insecurity early might reduce the burden of heart disease later.
Published on March 12 in JAMA Cardiology, the study analyzed data from the Coronary Artery Risk Development in Young Adults (CARDIA) study. This long-term cohort study has tracked Black and white U.S. adults since the mid-1980s. Researchers identified participants who reported food insecurity in 2000-2001 and compared their health outcomes over 20 years with those who were food secure.
The study involved 3,616 participants and revealed that those experiencing food insecurity were 41% more likely to develop cardiovascular disease than their counterparts with adequate food access. Over the study period, 11% of food-insecure individuals developed heart disease compared to 6% of those with sufficient food access.
Jia noted that previously there was uncertainty about whether food insecurity caused heart disease or if heart disease exacerbated food insecurity due to healthcare costs. “By following people over two decades,” she said, “we were able to show that food insecurity, on its own, significantly increases the risk of developing cardiovascular disease.”
At baseline, participants with food insecurity were more likely to identify as Black and had lower educational attainment than those who were not experiencing such issues.
Jia suggests healthcare providers need effective strategies for screening patients for food insecurity and connecting them with community resources. Primary care settings are deemed ideal for these screenings due to established trust between providers and patients. Screenings could also extend to emergency rooms and specialties like cardiology.
“The more we screen for it, the better,” Jia remarked. She stressed the need for strategies post-screening: “Do we connect them to social workers who can refer them to existing community programs? Should healthcare systems develop their own interventions? These are the next big questions.”
Looking ahead, Jia's team plans further tracking of this group to understand long-term effects as they age toward 80 years old.
The CARDIA study received support from several institutions including the U.S. National Heart, Lung, and Blood Institute (NHLBI), University of Alabama at Birmingham, Northwestern University, University of Minnesota, and Kaiser Foundation Research Institute. Dr. Jia is supported by grant K23HL173655 from NHLBI while Dr. Kandula is supported by grant K24HL155897 from NHLBI.