Food insecurity and the risk of mortality among Hispanics with hypertension.

BACKGROUND AND AIMS: Hypertension continues to be a major public health problem affecting almost half of the adults in the US. The intersection of hypertension with food insecurity has not been well-examined specifically among minority populations. We aimed to examine the influence of food insecurity on mortality among adult Hispanics. METHODS AND RESULTS: Data on adult Hispanic (age≥ 20 years) respondents of the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010 were analyzed. Mortality was assessed by linking these data with the National Death Index through December 31, 2019. Using complex samples Cox regression analysis, the relationship between hypertension, food insecurity, and mortality was assessed. Sociodemographic (age, gender, poverty-income-ratio, marital status, and citizenship status) and health-related characteristics (COPD, diabetes, cardiovascular disease, chronic kidney disease) of the population were included as covariates in the regression analysis to assess mortality risk. The crude hazard ratio (HR) for overall mortality related to hypertension was 4.95 (95% confidence interval [CI] = 4.22-5.82, p < .001). The adjusted HR was elevated, 2.01 (95%CI = 1.50-2.70, p < .001), among individuals with both hypertension and food insecurity. However, among individuals with hypertension and no food insecurity, there was no statistically significant increase in the risk of mortality (HR = 1.09, 95%CI = 0.89-1.34, p > 0.05). CONCLUSIONS: In adult Hispanics, food insecurity significantly increases the risk of mortality among those with hypertension compared to food-secure individuals. Clinicians should be sensitized to the need for food security among Hispanics with hypertension to effectively manage hypertension and reduce premature mortality.

Food Insecurity and Mortality in American Adults: Results From the NHANES-Linked Mortality Study.

Food insecurity is a significant public health problem in the United States leading to substantial social, economic, and health care-related burdens. While studies continue to estimate the prevalence of food insecurity, the long-term outcomes are not extensively explored. The purpose of this study was to assess the impact of food insecurity on mortality. We analyzed data on adults (≥ 20 years) from the 1999-2010 National Health and Nutrition Examination Survey, with mortality data obtained through 2015. Among the total study participants (n = 25,247), 17.6% reported food insecurity. Food-insecure individuals were more likely to be younger in age, minorities, poorer, with lesser education, obese, smokers, and with diabetes compared to food-secure counterparts. During a 10.2-year follow-up, among the food insecure, 821 individuals died (11%). The hazard ratio (HR) for mortality among the food insecure compared with the food secure, with adjustment for age and gender only, was 1.58; 95% confidence interval [CI: 1.25, 2.01]. The adjusted HRs for all-cause mortality, HR = 1.46, CI [1.23, 1.72], p < .001, and cardiovascular mortality, HR = 1.75, CI [1.19, 2.57], p < .01, were statistically significantly higher among food-insecure individuals, after adjustment for multiple demographic and health risk factors. Individuals who are food-insecure have a significantly higher probability of death from any cause or cardiovascular disease in long-term follow-up. Comprehensive and interdisciplinary approaches to reducing food insecurity-related disparities and health risks should be implemented. Including food insecurity in health risk assessments and addressing food insecurity as a determinant of long-term outcomes may contribute to lower premature death rates.

A new Japanese vegetarian food guide.

Vegetarianism continues to gain popularity in Japan and the Westernized world, in part from decades of science supporting the health advantages of properly planned vegetarian-based diets. Although there are Asian nutritional tools, one specific to a Japanese vegetarian diet is lacking. Thus, the Japanese vegetarian food guide (JVFG) was developed and based in part on the American Dietetic Association position paper for vegetarian diets and the Japanese Food Guide Spinning Top. The JVFG was developed by collecting dietary information from 3 different institutes in Japan that specialize in regularly offering vegetarian meals. The JVFG was divided into 6 groups with respective recommended servings: vegetables (7.5), grains (4.5), protein foods (4), milk (3), fruits (2), and fats, sugar, and seasonings (<3). The JVFG was developed so that it would adequately provide for all nutrients and be structured for practical use by the general public as well as health professionals.

Caloric restriction and calcium's effect on bone metabolism and body composition in overweight and obese premenopausal women.

Obesity results in numerous preventable deaths and comorbidities. Unfortunately, a reduction of body weight has been correlated with a reduction in bone mass, the reasons for which have not been fully elucidated. The importance of maximizing peak bone mass during premenopausal years is well known. Most studies demonstrate a positive relationship between calcium intake and bone mass. However, during caloric restriction, which is commonly used for weight loss, calcium intake has shown mixed results. Calcium from dairy sources has received additional attention, beyond its importance to bone, for its role in regulating body weight and composition. Dairy foods are perceived as high fat, and therefore, are generally minimized or avoided during caloric restriction. The current calcium intake for premenopausal women is significantly below recommendations, and even if met during caloric restriction, may not be adequate. This review underscores the need for maintaining at least adequate intake levels of calcium, if not more, during weight loss regimens to minimize potential long-term detrimental effects on bone metabolism.