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
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