Association between food insecurity,cardiorenal syndrome and all-cause mortality among low-income adults

Abstract

Background:

Food insecurity is known to be a major public health issue. There is limited data on food insecurity and chronic disease in the general population.

Aim:

We aimed to assess effect of food insecurity on mortality of individuals with chronic disease like cardiorenal syndrome (CRS).

Methods:

The study was conducted on participants aged 20 years or older in the United States living below the 130% Federal Poverty Level. We assessed food insecurity utilizing the Household Food Security Survey Module in NHANES survey for the years 1999 to 2010 with mortality follow-up. Prospective analysis was performed using complex samples Cox regression with adjustment for known confounders to determine the relationship of food insecurity and CRS.

Results:

Prevalence of food insecurity among the low-income population was 16.1% among males and 21.7% among females. The mean follow-up was 6.5 years. For all-cause mortality, the overall unadjusted hazard ratio (HR) of food insecurity to no food insecurity was 1.28 (95% confidence interval [CI], 1.18–1.37, p < 0.001). Adjusted HR was elevated, 2.81 (CI 1.57–5.05, p < 0.001), among participants who were CRS-positive and food insecure but closer to 1.0 (2.48 CI 1.73–3.55, p < 0.001) among those who were CRS-positive and food secure, after controlling for medical and demographic risk factors.

Conclusions:

Food insecurity is associated with higher mortality than food security. Food insecurity also may modify the effect of CRS on all-cause mortality in a representative general population. Social policy, when addressing food insecurity, should be inclusive among those with specific chronic diseases.