Abstract P093: Food Insecurity and Cardiovascular Risk Among Adults in the United States

Introduction: The relationship between food security status and 10-year projected cardiovascular risk is poorly understood. Hypothesis: The present study sought to examine the associations between food security status and cardiovascular risk factors and projected 10-year cardiovascular risk in a national sample of U. S. adults. Methods: A cross-sectional analysis of 11857 adults aged >=20 years from the National Health and Nutrition Examination Survey (2003–2008) was conducted. Four levels of food security status were defined using 10 standard questions. Cardiovascular risk factors included systolic blood pressure, smoking status, body mass index, urinary albumin-creatinine ratio, and concentrations of HbA1c, total cholesterol, high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, cotinine, and C-reactive protein. Projected 10-year cardiovascular risk was determined from a multivariable risk algorithm derived from Framingham data. Results: Among all participants, 83.6% had full food security, 6.7% had marginally food security, 5.9% had low food security, and 3.7% had very low food security. After adjustment for age, gender, race or ethnicity, educational status, health insurance coverage, alcohol use, cardiovascular disease risk factors, and histories of diabetes, cardiovascular disease, and cancer, mean HbA1c concentration was 0.13% higher (p=0.026) and cotinine concentration was 54.1 ng/ml higher (P <0.001) among participants with very low food security than those with full food security. No significant associations were observed between food security status and, measured as continuous variables, systolic blood pressure, urinary albumin-creatinine ratio, or concentrations of total cholesterol, high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and C-reactive protein. Compared to fully food secure participants, those with very low food security were more likely to have diabetes (adjusted prevalence ratio [aPR]: 1.38, 95%CI: 1.16– 1.64), hypertension (aPR: 1.25, 95% CI: 1.05–1.49), elevated cotinine concentrations (aPR: 1.51, 95% CI: 1.35–1.68), and, in women only, obesity (aPR: 1.22, 95% CI: 1.03–1.45) or be current smokers (aPR: 1.63, 95% CI: 1.46–1.83). Among fasting participants aged 30–74 years (N= 3852), adults aged 30–59 years with very low food security were more likely to have a projected 10-year cardiovascular risk >20% than fully food secure participants (adjusted prevalence ratio: 2.27, 95% CI: 1.39, 3.72). Food security status was not significantly associated with projected cardiovascular risk among participants aged >=60 years. Conclusions: Food insecurity may be associated with impaired cardiovascular health in adults. Additional research into the relationships between food security and cardiovascular health appears warranted.