Early Childhood Food Insecurity and Cardiovascular Health in Young Adulthood
Emily L Lam1, Abigail M Gauen2, Namratha R Kandula1,2
1Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Insights
Early childhood food insecurity is linked to poorer cardiovascular health in young adults, particularly if families don't receive nutrition assistance. Promoting food security may improve long-term health outcomes.
Area of Science:
- Public Health
- Cardiovascular Health
- Nutritional Epidemiology
Background:
- Food insecurity is a significant social determinant of health.
- Early life experiences can have lasting impacts on cardiovascular health (CVH).
- The role of nutritional assistance programs in mitigating these effects needs further investigation.
Purpose of the Study:
- To examine the association between early childhood food insecurity and CVH in young adulthood.
- To determine if participation in the Supplemental Nutrition Assistance Program (SNAP) modifies this association.
Main Methods:
- A prospective cohort study followed 1071 individuals from birth to young adulthood (mean age 22.3 years).
- Food insecurity and SNAP participation were assessed in early childhood (ages 3-5 years).
- Cardiovascular health was evaluated using the American Heart Association Life's Essential 8 (LE8) score and clinical risk factors.
Main Results:
- Early childhood food insecurity was associated with a lower LE8 score in young adulthood.
- Food insecurity was linked to higher body mass index (BMI) and increased odds of obesity.
- The negative association between food insecurity and CVH was stronger in participants whose households did not receive SNAP benefits.
Conclusions:
- Early childhood food insecurity is a risk factor for adverse cardiovascular health, specifically higher BMI, in young adulthood.
- SNAP participation may buffer some of the negative impacts of food insecurity on CVH.
- Policies aimed at improving food security in early childhood could promote better long-term cardiovascular health.
Importance:
Food insecurity is a social risk factor that may be associated with cardiovascular health across the life course.
Objective:
To evaluate the association of food insecurity in early childhood with cardiovascular health (CVH) in young adulthood and whether associations are modified by participation during childhood in the Supplemental Nutrition Assistance Program (SNAP).
Design, Setting, And Participants:
The Future of Families-Cardiovascular Health Among Young Adults cohort study was conducted in 20 US cities among 1071 individuals enrolled at birth (February 1998 to September 2000), evaluated in childhood (age, 3-5 years), and followed up to young adulthood (September 2021 to September 2023; mean [SD] participant age, 22.3 [0.7] years).
Main Outcomes And Measures:
Household food insecurity (assessed by the US Department of Agriculture Food Insecurity survey) and SNAP participation at ages 3 to 5 years and CVH (assessed by the American Heart Association Life's Essential 8 [LE8] score, component LE8 scores, and clinical CVH risk factors).
Results:
Of the 1071 participants, 570 were female (53%), 422 (39%) lived in households with food insecurity, and 475 (44%) participated in SNAP. Early childhood food insecurity was associated with having a lower LE8 score in young adulthood (β, -2.2 [95% CI, -4.0 to -0.4]). Among component LE8 scores and clinical CVH risk factors, food insecurity was associated with a lower LE8 score for body mass index (BMI; β, -4.9 [95% CI, -9.6 to -0.3]) and higher odds of having a BMI of 30 or more (adjusted odds ratio, 1.40 [95% CI, 1.07-1.84]). Food insecurity was more strongly associated with a lower LE8 score among those whose households did not participate in SNAP (β, -4.9 [95% CI, -7.6 to -2.3]) compared with those whose households participated in SNAP (β, 1.0 [95% CI, -1.6 to 3.7]).
Conclusions And Significance:
This study suggests that early childhood food insecurity is associated with a higher BMI in young adulthood, which is associated with a worse overall LE8 score, especially among children whose families did not participate in SNAP. Policies to promote food security among children may promote healthy BMIs and better CVH across the life course.
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