Food insecurity is associated with a 41% increased risk of incident cardiovascular disease, even after accounting for demographic and socioeconomic factors, according to a study published March 12 in JAMA Cardiology.

Food insecurity is defined as inconsistent access to enough food for a healthy lifestyle, including limitations in household food variety and/or food quantity. Numerous studies have shown an association between food insecurity and cardiovascular disease; however, studies have been limited to cross-sectional data.

In a prospective cohort study of adults without preexisting cardiovascular disease who were participating in the longitudinal CARDIA study from 2020 through August 31, 2020, Jenny Jia, MD, MSc, et al., examined whether there was a temporal association between food insecurity and cardiovascular disease as well as whether the association varied by sex, race or education. The baseline for this analysis was the 2000-2001 CARDIA examination, which was the first year that it assessed food insecurity.

A total of 3,616 participants were included in the analysis, nearly half (47%) of whom self-reported as Black; the mean age was 40 years and 56% were women. At baseline, 15% reported food insecurity, and they were slightly younger (mean age, 39.6 vs. 40.2 years), and more likely to self-identify as Black (68% vs. 43%) and report lower educational attainment (mean years of education, 13.5 vs. 15.1 years) than those not reporting food insecurity.

The primary outcome of incident cardiovascular disease was defined as fatal and nonfatal coronary heart disease, heart failure, stroke, transient ischemic attack or peripheral arterial disease.

Over the mean 18.8 years of follow-up, results showed there were 255 cardiovascular disease events, of which 11% (57 events) occurred in food-insecure participants and 6% (198 events) in food-secure participants. Food insecurity remained associated with incident cardiovascular disease after adjusting for age, sex and field center (adjusted hazard ratio [aHR], 1.90), as well as for education, marital status and usual source of medical care (aHR, 1.47).

"Food insecurity may be an important social deprivation measure in clinical assessment of individual [cardiovascular disease] risk," write the study authors. Research is needed to assess whether "recognizing and incorporating food insecurity" improves risk prediction models for cardiovascular disease and whether the risk can be modified through food insecurity interventions.