Food insecurity can lead to heart problems later in life

Many young adults struggle to put food on the table. What may seem like a temporary hardship could have lasting effects on health. A new study from Northwestern Medicine found that those who experienced food insecurity had a 41% higher chance of developing cardiovascular disease later in life.

Even after accounting for demographic and socioeconomic differences, the risk remained significant.

Food insecurity affects one in eight households in the U.S. each year. It refers to the struggle to access enough nutritious food to maintain good health. This study confirms that this insecurity plays a direct role in increasing heart disease risk.

Food insecurity as a preventable risk

“We’ve known that food insecurity and heart disease often go hand in hand, but this study shows, for the first time, that food insecurity comes first,” said Dr. Jenny Jia, an instructor of general internal medicine and preventive medicine at Northwestern University Feinberg School of Medicine and a Northwestern Medicine internist.

“That makes it a clear target for prevention — if we address food insecurity early, we may be able to reduce the burden of heart disease later.”

The research suggests that targeting food insecurity could prevent heart disease before it begins. Early intervention may lower future healthcare burdens and improve long-term health outcomes.

Food access among young adults

The study was focused on data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, which has tracked Black and white U.S. adults since the mid-1980s.

The researchers identified participants who reported food insecurity between 2000 and 2001, then compared their health outcomes over the next 20 years to those with stable food access.

Among the 3,616 participants, those who experienced food insecurity were 41% more likely to develop cardiovascular disease. Over two decades, 11% of food-insecure individuals developed heart disease, compared to only 6% of those who had adequate food access.

“For a long time, there was this chicken-or-the-egg question – does food insecurity cause heart disease, or does heart disease make food insecurity worse because of the high cost of healthcare?” Jia said.

“By following people over two decades, we were able to show that food insecurity, on its own, significantly increases the risk of developing cardiovascular disease.”

The researchers discovered that people with a lack of food security were more likely to be Black and have lower levels of education compared to those with stable food access. This suggests that food insecurity is not just about access to meals but is also linked to broader social and economic inequalities.

Screening for food insecurity

Jia noted that these findings highlight the importance of screening for food insecurity in healthcare settings. Identifying inadequate nutrition early and connecting patients with resources could help reduce future health risks.

Primary care settings offer an ideal space for screening. “Because there tends to be a lot of trust between primary care providers and patients,” Jia explained.

She also suggests extending screenings to emergency rooms and specialties like cardiology. “The more we screen for it, the better,” Jia said.

“We need better strategies to help people once they screen positive. Do we connect them to social workers who can refer them to existing community programs? Should healthcare systems develop their own interventions? These are the next big questions.”

Food insecurity screenings can be conducted by internists, pediatricians, family doctors, nurses, and medical assistants. Even self-reported forms could help identify those at risk.

Long-term effects of food insecurity

Jia and her team plan to continue monitoring this group to understand the long-term consequences of food insecurity.

“It’s surprising to see heart disease in this group, which doesn’t include those 65 or older,” Jia said. “As they near 80, we plan to revisit the study to explore the evolving link to heart disease.”

This study was conducted with support from the U.S. National Heart, Lung, and Blood Institute (NHLBI) in collaboration with institutions such as the University of Alabama at Birmingham, Northwestern University, the University of Minnesota, and the Kaiser Foundation Research Institute.

The study is published in the journal JAMA Cardiology.

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