Journal article
Measures of Food Inadequacy and Cardiovascular Disease Risk in Black Individuals in the US From the Jackson Heart Study
JAMA network open, v 6(1), pp e2252055-e2252055
03 Jan 2023
PMID: 36689225
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Food insecurity disproportionately affects Black individuals in the US. Its association with coronary heart disease (CHD), heart failure (HF), and stroke is unclear.
To evaluate the associations of economic food insecurity and proximity with unhealthy food options with risk of incident CHD, HF, and stroke and the role of diet quality and stress.
This cohort study was a time-to-event analysis of 3024 Black adult participants in the Jackson Heart Study (JHS) without prevalent cardiovascular disease (CVD) at visit 1 (2000-2004). Data analysis was conducted from September 1, 2020, to November 30, 2021.
Economic food insecurity, defined as receiving food stamps or self-reported not enough money for groceries, and high frequency of unfavorable food stores (>2.5 unfavorable food stores [fast food restaurants, convenience stores] within 1 mile).
The main outcomes were incident CVD including incident CHD, stroke, and HF with preserved ejection fraction and with reduced ejection fraction (HFrEF). During a median follow-up of 13.8 (IQR, 12.8-14.6) years, the associations of measures of food inadequacy with incident CVD (CHD, stroke, and HF) were assessed using multivariable Cox proportional hazards regression models.
Among the 3024 study participants, the mean (SD) age was 54 (12) years, 1987 (66%) were women, 630 (21%) were economically food insecure, and 50% (by definition) had more than 2.5 unfavorable food stores within 1 mile. In analyses adjusted for cardiovascular risk and socioeconomic factors, economic food insecurity was associated with higher risk of incident CHD (hazard ratio [HR], 1.76; 95% CI, 1.06-2.91) and incident HFrEF (HR, 2.07; 95% CI, 1.16-3.70), but not stroke. These associations persisted after further adjustment for diet quality and perceived stress. In addition, economic food insecurity was associated with higher high-sensitivity C-reactive protein and renin concentrations. High frequency of unfavorable food stores was not associated with CHD, HF, or stroke.
The findings of this cohort study suggest that economic food insecurity, but not proximity to unhealthy food options, was associated with risk of incident CHD and HFrEF independent of socioeconomic factors, traditional cardiovascular risk factors, diet quality, perceived stress, and other health behaviors. Economic food insecurity was also associated with markers of inflammation and neurohormonal activation. Economic food insecurity may be a promising potential target for the prevention of CVD.
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Details
- Title
- Measures of Food Inadequacy and Cardiovascular Disease Risk in Black Individuals in the US From the Jackson Heart Study
- Creators
- Rani Zierath - Brigham and Women's HospitalBrian Claggett - Brigham and Women's HospitalMichael E Hall - University of Mississippi Medical CenterAdolfo Correa - University of Mississippi Medical CenterSharrelle Barber - Drexel UniversityYan Gao - University of Mississippi Medical CenterSameera Talegawkar - Milken InstituteEdith I Ezekwe - University of Mississippi Medical CenterKatherine Tucker - University of Massachusetts LowellAna V Diez-Roux - Drexel UniversityMario Sims - University of Mississippi Medical CenterAmil M Shah - Brigham and Women's Hospital
- Publication Details
- JAMA network open, v 6(1), pp e2252055-e2252055
- Publisher
- American Medical Association
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Drexel University
- Web of Science ID
- WOS:001059403300008
- Scopus ID
- 2-s2.0-85147046590
- Other Identifier
- 991020111320504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health