1. Pathways by Which Food Insecurity Is Associated With Atherosclerotic Cardiovascular Disease Risk
- Author
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Alain G. Bertoni, Edward H. Ip, Deepak Palakshappa, David P. Miller, Gary E. Rosenthal, Seth A. Berkowitz, Kristie L. Foley, and Mara Z. Vitolins
- Subjects
Adult ,Epidemiology ,Cardiovascular health ,Food Supply ,Risk Factors ,Environmental health ,Cardiovascular Disease ,Medicine ,Diseases of the circulatory (Cardiovascular) system ,Humans ,Social determinants of health ,Aged ,Original Research ,Diet and Nutrition ,Atherosclerotic cardiovascular disease ,business.industry ,atherosclerotic cardiovascular disease ,Middle Aged ,Atherosclerosis ,Nutrition Surveys ,Food insecurity ,Food Insecurity ,Cross-Sectional Studies ,Mental Health ,Cardiovascular Diseases ,RC666-701 ,social determinants of health ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Food insecurity (FI) has been associated with an increased atherosclerotic cardiovascular disease (ASCVD) risk; however, the pathways by which FI leads to worse cardiovascular health are unknown. We tested the hypothesis that FI is associated with ASCVD risk through nutritional/anthropometric (eg, worse diet quality and increased weight), psychological/mental health (eg, increased depressive symptoms and risk of substance abuse), and access to care pathways. Methods and Results We conducted a cross‐sectional study of adults (aged 40–79 years) using the 2007 to 2016 National Health and Nutrition Examination Survey. Our primary exposure was household FI, and our outcome was 10‐year ASCVD risk categorized as low (P P P =0.002) pathways. We did not find a significant direct effect of FI on ASCVD risk, and the nutrition, psychological, and access to care pathways accounted for 31.6%, 43.9%, and 15.8% of the association, respectively. Conclusions We found that the association between FI and ASCVD risk category was mediated through the nutrition/anthropometric, psychological/mental health, and access to care pathways. Interventions that address all 3 pathways may be needed to mitigate the negative impact of FI on cardiovascular disease.
- Published
- 2021