Introduction: Disparities in cardiovascular diseases are one of today’s most important public health challenges. Pathological processes related to modifiable cardiovascular risk factors have shown to begin in childhood and disparities in these risk factors have been reported in adolescence. Food insecurity is significantly associated with cardiovascular risk factors in adults; however, little is known about cardiovascular risk in food insecure adolescents.

Objective: The objective of this study was to examine the relationship between food insecurity and cardiovascular risk factors in U.S. adolescents aged 12-17 years.

Methods: Using cross-sectional data on 1,853 adolescents aged 12-17 years from the National Health and Nutrition Examination Survey 2007-2012, we examined the association between food insecurity and cardiovascular risk factors. Food security status was measured using the validated 18-item Household Food Security Survey Module. Cardiovascular risk was measured based on American Heart Association’s Life’s Simple 7 factors (LS7; tobacco smoke exposure, diet quality, physical activity, body mass index, blood pressure, total cholesterol, blood glucose levels).

Results: Nearly 10.0% of U.S. adolescents were food insecure. A total of 26.1% of adolescents failed to attain ideal scores on more than 5 LS7 components. In bivariate analyses, food secure, in comparison to food insecure adolescents, were more likely to have ideal scores on 5-7 LS7 components (75.1% vs. 63.0%, p = 0.0089). In multivariate models adjusted for demographic, socioeconomic, health, and health care access factors, food insecurity was not significantly associated with cardiovascular risk in adolescents. However, food insecure adolescents had significantly lower odds of attaining ideal levels of tobacco smoke exposure ([OR] = 0.54 [95% CI 0.31, 0. 94]) than food secure adolescents. Adolescents living in families with incomes below the Federal Poverty Level (Odds Ratio [OR] = 0.59 [95% CI 0.40,0.86]) had significantly lower odds of having ideal LS7 scores and lower odds of attaining ideal scores on tobacco smoke exposure ([OR] = 0.25 [95% CI 0.13, 0.49]) and physical activity ([OR] = 0.60 [95% CI 0.38, 0.95]).

Conclusion: Although cardiovascular risk is not more pronounced in food insecure adolescents than their counterparts, adolescents from low SES households may be at particular risk of developing cardiovascular diseases. Multifaceted and tailored strategies inclusive of nutrition assistance are needed to facilitate effective cardiovascular risk prevention as these vulnerable populations transition into early adulthood.

Key Take Away Points

  1. Food insecurity among adolescents was not significantly associated with cardiovascular risk after accounting for differences in demographic characteristics, socioeconomic status, self-reported health status, and health care access factors.
  2. Food insecure adolescents were significantly more likely to be exposed to tobacco smoke in comparison to their counterparts.
  3. Adolescents from households of low SES had greater cardiovascular risk, particularly due to tobacco exposure and low levels of physical activity.
  4. Early cardiovascular risk prevention efforts should emphasize adequate access to nutrition assistance programs as means to alleviating potential coping mechanisms in food insecure adolescents, including tobacco product use.

Author Biography

Elisabeth Lilian Pia Sattler, Ph.D., B.S. Pharm, is an Interdisciplinary Assistant Professor in the Department of Foods and Nutrition, College of Family and Consumer Sciences, and the Department of Clinical and Administrative Pharmacy, College of Pharmacy, at the University of Georgia. Her interdisciplinary research focuses on understanding how health systems and services can be improved to address socioeconomic disparities in prevention and management of chronic diseases. Vibha Bhargava, Ph.D., is an Adjunct Assistant Professor in the Department of Financial Planning, Housing and Consumer Economics at the University of Georgia. Her research focuses on understanding how various social, economic, and public policy factors influence health and health care decisions of individuals and families and ultimately their health and well-being across lifespan.