Inconsistent Access to Food and Cardiometabolic Disease: The Effect of Food Insecurity
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Food insecurity is defined as limited or uncertain ability to acquire nutritionally adequate and safe foods in socially acceptable ways. The United States Department of Agriculture (USDA) has divided food insecurity into two categories: low food security and very low food security. Low food security is characterized by irregular access to food, binge eating when food is available, overconsumption of energy-dense foods, obesity, and even type 2 diabetes. This type of food insecurity occurs in impoverished urban areas of high-income countries such as the United States. In contrast, very low food security is distinctly different from low food security and can lead to undernutrition and frank starvation. Very low food security is found in developing countries in both rural areas and urban slums. In these countries, food insecurity is often exacerbated by natural disasters and climate changes that compromise food availability. With a focus on the social, economic, and behavioral factors that promote obesity and cardiometabolic disease in food insecure households in the United States, this review will first define the key terms and concepts associated with food insecurity. Then, the characteristics of food insecure households and the relationship to cardiometabolic disease will be discussed. Finally, the cardiac consequences of food insecurity in developing countries will be briefly described.
KeywordsFood insecurity Obesity Malnutrition Overnutrition Undernutrition Hunger
Darleen C. Castillo, Natalie LM Ramsey, Sophia SK Yu, Madia Ricks, and Anne E. Sumner are supported by the intramural program of NIDDK, NIH. Sophia SK Yu is also supported through the Clinical Research Training Program, a public-private partnership supported jointly by the NIH and Pfizer Inc (via a grant to the Foundation for NIH from Pfizer Inc). Amber B. Courville is supported by the Clinical Center, NIH.
No conflicts of interest relevant to this article were reported.
Papers of particular interest, published recently, have been highlighted as: • Of importance•• Of major importance
- 2.Anderson SA. Core indicators of nutritional state for difficult-to-sample populations. J Nutr. 1990;120 Suppl 11:1559–600.Google Scholar
- 7.•• Ploeg MV, Breneman V, Farrigan T, et al. Access to affordable and nutritious food: measuring and understanding food deserts and their consequences. Washington, DC: US Department of Agriculture, Economic Research Service;2009. Publication No. (AP-036). This is a complete report made by the US Department of Agriculture on food insecurity and its consequences. Google Scholar
- 8.•• Popkin BM. Contemporary nutritional transition: determinants of diet and its impact on body composition. Proc Nutr Soc. 2011;70(1):82–91. This article discusses nutritional transition in global dietary patterns over the past few years and how this energy imbalance affects body composition. Google Scholar
- 10.Nord M, Coleman-Jensen A, Andrews M, Carlson S. Household food security in the United States. Washington D.C.: US Department of Agriculture, Economic Research Service;2010. Report No. (ERR-108)Google Scholar
- 15.Cook J, Jeng K. Child food insecurity: the economic impact on our nation: Feeding America; 2009.Google Scholar
- 16.• Franklin B, Jones A, Love D, Puckett S, Macklin J, White-Means S. Exploring mediators of food insecurity and obesity: a review of recent literature. J Community Health. Feb 2012;37(1):253–264. This article is a review of recent literature on food insecurity and its relationship with obesity. Google Scholar
- 17.Institute of Medicine. Hunger and obesity: understanding a food insecurity paradigm: workshop summary: The National Academies Press; 2011.Google Scholar
- 18.•• Pampel FC, Krueger PM, Denney JT. Socioeconomic disparities in health behaviors. Annu Rev Sociol. 2010;36:349–370. This stellar review article examines factors that influence the inverse relationship of unhealthy lifestyle and socioeconomic status. Google Scholar
- 19.• Lovasi GS, Hutson MA, Guerra M, Neckerman KM. Built environments and obesity in disadvantaged populations. Epidemiol Rev. 2009;31:7–20. This review article discusses the relationship between the built environment and obesity-related health disparities of disadvantaged populations. Google Scholar
- 20.Drewnowski A. Obesity, diets, and social inequalities. Nutr Rev. May 2009;67 Suppl 1(1):S36-39.Google Scholar
- 22.•• Larson NI, Story MT, Nelson MC. Neighborhood environments: disparities in access to healthy foods in the U.S. Am J Prev Med. 2009;36(1):74–81. This superb review summarizes the findings of over 50 research studies that have examined neighborhood differences and their influence in access to food, dietary intake, and obesity. Google Scholar
- 23.Zenk SN, Schulz AJ, Israel BA, James SA, Bao S, Wilson ML. Fruit and vegetable access differs by community racial composition and socioeconomic position in Detroit. Michigan Ethn Dis Winter. 2006;16(1):275–80.Google Scholar
- 26.National Research Council. The public health effects of food deserts: workshop summary: The National Academies Press; 2009: http://www.nap.edu/openbook.php?record_id=12623.
- 29.Bawadi HA, Ammari F, Abu-Jamous D, Khader YS, Bataineh S, Tayyem RF. Food insecurity is related to glycemic control deterioration in patients with type 2 diabetes. Clin Nutr. 2011;25:25.Google Scholar
- 31.•• Seligman HK, Jacobs EA, Lopez A, Tschann J, Fernandez A. Food insecurity and glycemic control among low-income patients with type 2 diabetes. Diabetes Care. 2012;35(2):233–238. This is the first study to evaluate whether food insecurity is associated with poor glycemic control in low-income adults with type 2 diabetes. Google Scholar
- 33.• Kursmark M, Weitzman M. Recent findings concerning childhood food insecurity. Curr Opin Clin Nutr Metab Care. 2009;12(3):310–316. This review article summarizes the recent findings of the effect of food insecurity on the overall health of the child. Google Scholar
- 34.Center for Disease Control and Prevention. Vital signs: current cigarette smoking among adults aged >/=18 years–United States, 2005–2010. MMWR Morb Mortal Wkly Rep. 2011;60(35):1207–12.Google Scholar
- 38.Gooding HC, Walls CE, Richmond TK. Food Insecurity and Increased BMI in Young Adult Women. Obesity (Silver Spring). 2011;21(10):233.Google Scholar
- 50.Center for Disease Control and Prevention. Prevalence of obesity among children and adolescents: United States, trends 1963–1965 through 2007–2008. National Center for Health Statistics, Centers for Disease Control and Prevention. 2010. http://www.cdc.gov/nchs/data/hestat/obesity_child_07_08/obesity_child_07_08.htm.
- 54.Food and Agriculture Organization of the United Nations. The state of food insecurity in the world 2010: Adressing food insecurity in protracted crises.2010: http://www.fao.org/docrep/013/i1683e/i1683e.pdf.