A generation ago, the difficulties of getting enough food on the table made malnutrition the public health problem of the impoverished, the sunken cheeks and protruding bones of the underfed the enduring image of poverty.
In recent years, concerns have flipped; living below the poverty line is to be both stuffed and starved. Meals planned around the cheapest available calories lead to high consumption of food lacking in any real nutritional value, causing weight gain or other obesity-related health problems.
As researchers look more closely at the health problems associated with poverty, a more complicated picture of what low food security means for well-being is emerging. Obesity is associated with food insecurity in women, for example, but researchers don't see the same link in men.
As for cardiovascular disease, a health problem strongly linked with diet, studies have shown that Americans living in poverty are more likely to have certain individual factors that could signal heart disease, but little research has been conducted on food security as it relates to predicted cardiovascular disease risk.
Earlier this month, the Centers for Disease Control and Prevention published a study by Dr. Earl S. Ford in its Preventing Chronic Disease journal that looks at that harder, more definite metric for heart disease risk—the one that considers the potential for the disease occurring over a 10-year period—rather than just the individual risk factors. And the numbers aren't promising for those with very low food security: “Participants aged 30 to 59 years…were more likely to have a predicted 10-year cardiovascular disease risk greater than 20% than fully food secure participants,” the study reads.
The study, which looked at data collected between 2003 and 2008 from 10,455 adults as part of the National Health and Nutrition Examination Survey, also looked at some of the risk factors associated with heart disease. The findings show that participants with low food security had 0.15 percent higher mean hemoglobin A1C, suggesting a greater risk of diabetes, 0.8 mg/L higher concentration of c-reactive protein, a measure of overall inflammation, and nearly twice as much cotinine, an alkaloid found in tobacco.
“The clinical relevance of a difference in concentrations of HbA1c of 0.15% between adults with full food security and adults with very low food security is uncertain,” the study reads. As for the 20 percent difference in predicted 10-year cardiovascular-disease risk between participants with high food security and those with low food security? Ford, the study’s author, provides no caveats.