Food Insecurity and Cardiovascular-Kidney-Metabolic Syndrome–Related Conditions Among US Adults, National Health and Nutrition Examination Survey, 2015–2020

Abstract

Introduction Cardiovascular-kidney-metabolic (CKM) syndrome includes health disorders that are increasingly prevalent in the US, yet their relationship with food insecurity remains unclear. This study examined CKM syndrome–related conditions among US adults and their associations with food insecurity. Methods This cross-sectional study analyzed data for 13,937 US adult participants from the 2015–2020 National Health and Nutrition Examination Survey. Information about demographic characteristics, food insecurity, and CKM syndrome–related conditions was self-reported on questionnaires. Weighted logistic regression models, adjusting for demographic variables and socioeconomic status, examined associations between food insecurity and CKM syndrome–related health outcomes. Results Mean age of respondents was 47.4 years, and mean body mass index (weight in kg/height in m2) was 29.6. Of total respondents, 28.4% experienced marginal, low, and very low food security. Obesity (40.9%), hyperglycemia (58.9%), and hypertension (29.9%) were the most prevalent cardiometabolic conditions. Lower food security was associated with significantly higher odds of obesity, diabetes, weak or failing kidneys, and cardiovascular diseases (CVDs), with clear dose–response relationships. Compared with full food security, very low food security was associated with higher odds of congestive heart failure (adjusted odds ratio [AOR] = 3.69), coronary heart disease (AOR = 3.43), heart attack (AOR = 3.21), and stroke (AOR = 2.54). Additionally, the likelihood of low or very low food security increased stepwise with number of coexisting CVDs, with the highest odds observed among adults reporting 4 CVDs (AOR = 3.93). Conclusion This study highlights that food insecurity is significantly associated with CKM syndrome–related conditions among US adults. Addressing food insecurity is critical to reducing its substantial health burden and improving population health.