Food insecurity rises among people with heart disease, study says

Sept. 28 (UPI) -- Nearly 4 in 10 people with heart disease in the United States faced hunger -- with limited or uncertain access to adequate food -- in 2017-2018, which is more than double what it was two decades earlier, a national study says.

Cardiovascular disease remains the leading cause of death in the United States, and diet is the greatest contributor to death from that disease, researchers from the University of Michigan said.

They found that all cardiovascular disease and cardiometabolic diseases, except coronary artery disease, were more prevalent among people with food insecurity.

Based on their findings, the researchers described "a two-way relationship," saying that people who are food insecure may have increased risk for cardiovascular disease, and vice versa.

The study was published Wednesday in JAMA Cardiology, coincidentally on the day of the first White House Conference on Hunger, Nutrition and Health to be held in 50-plus years.

Similar to the Biden administration's call for national action, the researchers urged healthcare providers to improve their patients' health and well-being by addressing food insecurity.

The newly unveiled national strategy calls in part for an expansion of the Supplemental Nutrition Assistance Program, or SNAP, to access more underserved communities.

For those who had food insecurity, the University of Michigan study found that SNAP participation was higher among people with cardiovascular disease than in those without it: at 54.2% vs. 44.3%, respectively.

For the study, a Michigan Medicine team analyzed data from the National Health and Nutrition Examination Survey, representing 312 million American adults between 1999 and 2018. They found that 38.1% of those with cardiovascular disease faced hunger in 2017-2018, up from 16.3% in 1999-2000.

"Food insecurity is a common problem among people with cardiovascular disease, and we are seeing that issue become even more prevalent in recent years," Dr. Eric J. Brandt, the study's lead author and a cardiologist at the University of Michigan Health Frankel Cardiovascular Center, said in a news release.

Brandt said getting heart disease increases a person's risk of "developing socioeconomic problems that could reduce access to adequate and quality food."

And, he said, food insecurity "can often occur with other social determinants of health, such as poor transportation access or access to healthcare, which further compounds this relationship."

Overall, Black and Hispanic adults were more likely to report food insecurity, the researchers found. Since 2011, they said, 24% of Hispanic adults and 18% of Black adults were food insecure, compared to 8% of Asian adults and 13% of White adults.

The investigators concluded that cardiovascular disease is associated with a higher risk of food insecurity: Those adults with heart disease were more than two times likely to be food insecure than those without it.

According to Brandt, food insecurity may worsen existing racial and ethnic health disparities. However, differences in cardiovascular outcomes aren't related to a person's racial or ethnic origin, but rather more to their social experience.

Taking this broader view, a cardiovascular event could have a major impact on an individual's social circumstances "that places them at risk for food insecurity and other socioeconomic difficulties," he said.

Brandt said people experiencing food insecurity are "more likely to shoulder a greater burden" from diet-related cardiovascular disease. And, he said, they are more likely to be stressed and not take prescription medication to treat risk factors such as diabetes and high blood pressure.

"More patients than you may think are impacted by food insecurity," Dr. Tammy Chang, the study's co-author, said in the release.

Chang, a family physician at U-M Health and co-director of the National Clinician Scholars Program at the U-M Institute for Healthcare Policy and Innovation, urged a team-based approach, including social workers, case managers and social service departments, to help patients get connected with local resources.

"If we are serious about promoting health, healthcare providers need to ensure people have access to healthy foods and don't go hungry," she said.