Higher Consumption of Subsidized Foods and Adverse Cardiometabolic Risk

Study Questions:

Is higher consumption of foods derived from subsidized food commodities associated with adverse cardiometabolic risk among US adults?

Methods:

The study was a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) data from 2001 to 2006 and performed in January 2016. Participants were 10,308 nonpregnant adults 18-64 years old in the general community. From a single day of 24-hour dietary recall in NHANES, an individual-level subsidy score was calculated that estimated an individual’s consumption of subsidized food commodities as a percentage of total caloric intake. The main outcomes were body mass index, abdominal adiposity (waist/height), C-reactive protein, blood pressure, non–high-density lipoprotein cholesterol level (non-HDL-C), and dysglycemia (hemoglobin A1c ≥5.7%).

Results:

Among 10,308 participants, the mean [standard deviation (SD)] age was 40.2 (0.3) years, and a mean (SD) of 50.5% (0.5%) were male. Overall, 56.2% of calories consumed were from the major subsidized food commodities. US adults in the highest quartile of the subsidy score (compared with the lowest) had increased probabilities of having a body mass index of ≥30 kg/m2 (prevalence ratio, 1.37; 95% confidence interval [CI], 1.23-1.52), waist/height ≥0.60 (prevalence ratio, 1.41; 95% CI, 1.25-1.59), a C-reactive protein ≥0.32 mg/dl (prevalence ratio, 1.34; 95% CI, 1.19-1.51), an elevated non-HDL-C (prevalence ratio, 1.14; 95% CI, 1.05-1.25), and dysglycemia (prevalence ratio, 1.21; 95% CI, 1.04-1.40). There was no statistically significant association between the subsidy score and blood pressure.

Conclusions:

Among US adults, higher consumption of calories from subsidized food commodities was associated with a greater probability of some cardiometabolic risks. Better alignment of agricultural and nutritional policies may potentially improve population health.

Perspective:

The US Department of Agriculture provides supplemental food via mobile pantries to persons below the poverty level to fight food insecurity and malnutrition as well as food purchase assistance. But those foods for which the US subsidizes the production and that are available for shoppers in indigent areas are associated with obesity and often limited in healthy fresh fruits/vegetables/fiber and protein. Of course this increases health care costs for obesity and related metabolic disorders.

Clinical Topics: Diabetes and Cardiometabolic Disease, Clinical Topic Collection: Dyslipidemia, Prevention, Lipid Metabolism, Nonstatins, Diet

Keywords: Adiposity, Blood Pressure, Body Mass Index, C-Reactive Protein, Cholesterol, Diet, Food Supply, Hemoglobins, Lipoproteins, HDL, Metabolic Syndrome X, Obesity, Primary Prevention, Risk Factors


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