Measures of Food Inadequacy and Cardiovascular Disease Risk in Black Individuals in the US From the Jackson Heart Study.
Measures of Food Inadequacy and Cardiovascular Disease Risk in Black Individuals in the US From the Jackson Heart Study.
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DOI：
10.1001/jamanetworkopen.2022.52055
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发表时间：
2023-01-03
影响因子：
13.8
通讯作者：
Shah, Amil M.
中科院分区：
文献类型：
--
作者：
Zierath, Rani;Claggett, Brian;Hall, Michael E.;Correa, Adolfo;Barber, Sharrelle;Gao, Yan;Talegawkar, Sameera;Ezekwe, Edith I.;Tucker, Katherine;Diez-Roux, Ana V.;Sims, Mario;Shah, Amil M.
这项队列研究探讨了经济粮食不安全的黑人个体的心血管疾病事件。食物不足与心血管疾病风险的关系如何？在这项对3024名黑人成年研究参与者的队列研究中，经济粮食不安全，但不是接近不健康的食物选择，与冠心病和心力衰竭事件有关。多变量调整后，射血分数降低。这项研究的结果表明，经济粮食不安全与射血分数降低的心力衰竭和冠心病有关，是预防心血管疾病的一个有希望的潜在目标。粮食不安全对美国黑人的影响不成比例。其与冠心病（CHD）、心力衰竭（HF）和中风的关系尚不清楚。评估经济粮食不安全和接近不健康食品选择与冠心病、心力衰竭和中风风险的关系，以及饮食质量和压力的作用。该队列研究是对杰克逊心脏研究（JHS）中3024例访视1（2000-2004）时无心血管疾病（CVD）的黑人成人受试者进行的事件发生时间分析。数据分析于2020年9月1日至2021年11月30日进行。经济粮食不安全，定义为领取食品券或自我报告没有足够的钱购买食品杂货，以及频繁的不良食品商店（1英里内>2.5家不良食品商店[快餐店，便利店]）。主要结局为CVD事件，包括CHD事件、卒中和射血分数保留和射血分数降低（HFrEF）的HF。在13.8年（IQR，12.8-14.6）的中位随访期间，采用多变量考克斯比例风险回归模型评估食物不足指标与CVD事件（CHD、卒中和HF）的相关性。在3024名研究参与者中，平均（SD）年龄为54（12）岁，1987（66%）人为女性，630（21%）人经济上粮食不安全，50%（根据定义）在1英里内有超过2.5个不利的食品商店。在调整心血管风险和社会经济因素的分析中，经济粮食不安全与CHD事件（风险比[HR]，1.76; 95%CI，1.06-2.91）和HFrEF事件（HR，2.07; 95%CI，1.16-3.70）的风险较高相关，但与卒中无关。在进一步调整饮食质量和感知压力后，这些关联仍然存在。此外，经济粮食不安全与较高的高敏C反应蛋白和肾素浓度有关。高频率的不良食物储存与CHD、HF或中风无关。这项队列研究的结果表明，经济粮食不安全，而不是接近不健康的食物选择，与冠心病和HFrEF事件的风险相关，独立于社会经济因素，传统的心血管危险因素，饮食质量，感知压力和其他健康行为。经济粮食不安全也与炎症和神经激素激活的标志物有关。经济粮食不安全可能是预防CVD的一个有希望的潜在目标。
This cohort study examines incident cardiovascular disease in Black individuals with economic food insecurity. How are measures of food inadequacy associated with risk of incident cardiovascular disease? In this cohort study of 3024 Black adult study participants, economic food insecurity, but not proximity to unhealthy food options, was associated with incident coronary heart disease and incident heart failure. Reduced ejection fraction was noted after multivariable adjustment. The findings of this study suggest that economic food insecurity is associated with heart failure with reduced ejection fraction and coronary heart disease and is a promising potential target for the prevention of cardiovascular disease. Food insecurity disproportionately affects Black individuals in the US. Its association with coronary heart disease (CHD), heart failure (HF), and stroke is unclear. To evaluate the associations of economic food insecurity and proximity with unhealthy food options with risk of incident CHD, HF, and stroke and the role of diet quality and stress. This cohort study was a time-to-event analysis of 3024 Black adult participants in the Jackson Heart Study (JHS) without prevalent cardiovascular disease (CVD) at visit 1 (2000-2004). Data analysis was conducted from September 1, 2020, to November 30, 2021. Economic food insecurity, defined as receiving food stamps or self-reported not enough money for groceries, and high frequency of unfavorable food stores (>2.5 unfavorable food stores [fast food restaurants, convenience stores] within 1 mile). The main outcomes were incident CVD including incident CHD, stroke, and HF with preserved ejection fraction and with reduced ejection fraction (HFrEF). During a median follow-up of 13.8 (IQR, 12.8-14.6) years, the associations of measures of food inadequacy with incident CVD (CHD, stroke, and HF) were assessed using multivariable Cox proportional hazards regression models. Among the 3024 study participants, the mean (SD) age was 54 (12) years, 1987 (66%) were women, 630 (21%) were economically food insecure, and 50% (by definition) had more than 2.5 unfavorable food stores within 1 mile. In analyses adjusted for cardiovascular risk and socioeconomic factors, economic food insecurity was associated with higher risk of incident CHD (hazard ratio [HR], 1.76; 95% CI, 1.06-2.91) and incident HFrEF (HR, 2.07; 95% CI, 1.16-3.70), but not stroke. These associations persisted after further adjustment for diet quality and perceived stress. In addition, economic food insecurity was associated with higher high-sensitivity C-reactive protein and renin concentrations. High frequency of unfavorable food stores was not associated with CHD, HF, or stroke. The findings of this cohort study suggest that economic food insecurity, but not proximity to unhealthy food options, was associated with risk of incident CHD and HFrEF independent of socioeconomic factors, traditional cardiovascular risk factors, diet quality, perceived stress, and other health behaviors. Economic food insecurity was also associated with markers of inflammation and neurohormonal activation. Economic food insecurity may be a promising potential target for the prevention of CVD.
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影响因子：
37.8
作者：
Kamimura D;Cain LR;Mentz RJ;White WB;Blaha MJ;DeFilippis AP;Fox ER;Rodriguez CJ;Keith RJ;Benjamin EJ;Butler J;Bhatnagar A;Robertson RM;Winniford MD;Correa A;Hall ME
通讯作者：
Hall ME
影响因子：
5.5
作者：
Gaglioti, Anne H.;Xu, Junjun;Akintobi, Tabia Henry
通讯作者：
Akintobi, Tabia Henry
影响因子：
24
作者：
Fox, Ervin R.;Samdarshi, Tandaw E.;Taylor, Herman A.
通讯作者：
Taylor, Herman A.
影响因子：
3.7
作者：
Berkowitz, Seth A.;Berkowitz, Theodore S. Z.;Wexler, Deborah J.
通讯作者：
Wexler, Deborah J.
影响因子：
4.8
作者：
Krebs-Smith SM;Pannucci TE;Subar AF;Kirkpatrick SI;Lerman JL;Tooze JA;Wilson MM;Reedy J
通讯作者：
Reedy J