Faculty, Staff and Student Publications

Language

English

Publication Date

6-18-2025

Journal

Nutrients

DOI

10.3390/nu17122031

PMID

40573142

PMCID

PMC12195690

PubMedCentral® Posted Date

6-18-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Food and nutrition security are key social determinants of cardiometabolic health. While food security reflects access to sufficient food, nutrition security incorporates the quality, consistency, and usability of food that supports long-term health. However, few studies have examined how household-level barriers to food utilization shape these relationships. Objective: This study assessed whether tangible (e.g., equipment, storage) and intangible (e.g., time, knowledge) food utilization barriers modify the associations between food and nutrition security and cardiometabolic outcomes in low-income adults.

Methods: A cross-sectional survey was conducted among 486 low-income adults across five U.S. states. Participants reported household food security (USDA 18-item module), nutrition security (four-item scale), and utilization barriers (eight-item scale, categorized into tangible and intangible subscales). Self-reported diagnoses of hypertension, hyperlipidemia, and diabetes were combined into a cardiometabolic outcome. Mixed-effects logistic regression models, adjusted for sociodemographic and program participation factors, were used to assess associations and effect modification.

Results: Higher nutrition security was associated with lower odds of cardiometabolic conditions (AOR = 0.59; 95% CI: 0.41-0.83). Tangible barriers significantly modified the relationship between nutrition security and hypertension (p-interaction = 0.04), with stronger protective effects observed in households without such barriers. No significant moderation effects were found for intangible barriers or for food security.

Conclusions: Tangible household barriers influence the protective association between nutrition security and cardiometabolic outcomes. Public health strategies should address not only food access but also the practical resources required to store, prepare, and consume healthy foods effectively.

Keywords

Humans, Male, Female, Cross-Sectional Studies, Adult, Middle Aged, Food Security, Cardiometabolic Risk Factors, Poverty, United States, Food Insecurity, Food Supply, Cardiovascular Diseases, Nutritional Status, Young Adult, cardiometabolic outcomes, hypertension, utilization barriers, moderation analysis, health disparities, social drivers of health

Published Open-Access

yes

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