Saiz Augustine M, Aul Allison M, Malecki Kristen M, Bersch Andrew J, Bergmans Rachel S, LeCaire Tamara J, Nieto F Javier
University of Wisconsin School of Medicine and Public Health, United States.
Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, United States.
Prev Med. 2016 Dec;93:1-6. doi: 10.1016/j.ypmed.2016.09.002. Epub 2016 Sep 6.
The social and economic environment has become a major area of interest regarding the determinants of cardiovascular health. Among markers of economic distress, food insecurity has been found associated with metabolic disorders, dyslipidemia, and obesity, but no previous studies have examined its association with overall cardiovascular health.
We conducted a cross-sectional analysis among 2935 participants in the Survey of the Health of Wisconsin (SHOW), a statewide population-based representative sample. The presence of food insecurity was determined by an affirmative answer to the question "In the last 12months, have you been concerned about having enough food for you or your family?" Cardiovascular health (CVH) was defined based on the American Heart Association Life's Simple 7 criteria and classified as "poor," "intermediate," or "ideal" using previously published criteria. "Good" CVH was defined as having no poor in any of the seven criteria (any amount of intermediate or ideal). Crude and adjusted odds ratios (OR) of good CVH according to presence of food insecurity were calculated using logistic regression models. Overall, food insecurity was associated with a decreased likelihood of good CVH (OR 0.53; 95% Confidence Interval 0.31 to 0.92; p=0.02). This association persisted in models controlling for age, gender, race, and urbanization.
Participants who were food insecure were significantly less likely to have good CVH compared to participants who were food secure. Even though this study cannot confirm causality, these results suggest that food insecurity might be one of several socio-economic barriers contributing to poor CVH.
社会经济环境已成为心血管健康决定因素的一个主要关注领域。在经济困境的指标中，粮食不安全已被发现与代谢紊乱、血脂异常和肥胖有关，但此前尚无研究探讨其与整体心血管健康的关联。
我们对威斯康星州健康调查（SHOW）的2935名参与者进行了横断面分析，该调查是一个基于全州人口的代表性样本。粮食不安全的存在通过对“在过去12个月里，你是否担心自己或家人没有足够的食物？”这个问题的肯定回答来确定。心血管健康（CVH）根据美国心脏协会的“生命简单七项”标准进行定义，并使用先前公布的标准分为“差”、“中等”或“理想”。“良好”的CVH定义为在七项标准中任何一项都不差（有任何数量的中等或理想情况）。使用逻辑回归模型计算根据粮食不安全情况得出的良好CVH的粗比值比（OR）和调整后比值比。总体而言，粮食不安全与良好CVH的可能性降低相关（OR 0.53；95%置信区间0.31至0.92；p = 0.02）。在控制年龄、性别、种族和城市化的模型中，这种关联仍然存在。
与粮食安全的参与者相比，粮食不安全的参与者拥有良好CVH的可能性显著降低。尽管这项研究不能证实因果关系，但这些结果表明，粮食不安全可能是导致不良CVH的若干社会经济障碍之一。
