Food Security and Cardiovascular and Metabolic Health

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ABSTRACT Food insecurity among U.S. college students is alarmingly high. More than 30% of U.S. college students (over 6 million) experience food insecurity, and over 40% of California college students do so (~870,000). Current U.S. college students are unlike those of previous generations. Contemporary students are nontraditional—from low- income backgrounds, financially independent, and/or first in their families to attend college (first generation). These characteristics put students at risk for food insecurity, with disparities in Black and Latino students. Food insecurity in college students is associated with factors known to contribute to poor cardiovascular and metabolic health (CVMH). Heart disease is also the 5th leading cause of death among 12 to 24 year olds, calling attention to emerging adulthood (ages 18-26) as a critical period for modifying future risk of poor CVMH. The American Heart Association (AHA) recently defined that ideal CVMH is based on Life’s Essential 8, which includes CVMH behaviors (diet, physical activity, sleep, nicotine exposure) and factors (body mass index, blood glucose, blood pressure, blood lipids). It is biologically plausible that food insecurity influences CVMH among college students via several mechanisms, but there is limited knowledge in this area. Critical gaps include limited information regarding: 1) the chronicity of food insecurity in college students, 2) emerging adulthood in the context of food insecurity and CVMH, and 3) lack of objective assessment of CVMH. Longitudinal and objective information about this relationship would provide a more comprehensive understanding of food insecurity as a modifiable risk factor for CVMH in a vulnerable student population of emerging adults . The overall objective of the proposed work is to improve our understanding of the impact of food insecurity on risk for poor CVMH in emerging adults. We propose to recruit a randomly selected cohort of students (N = 563) from UC Santa Cruz, a campus that reflects the diversity of U.S. college students. We will assess food insecurity status monthly in Year 1 and CVMH annually over a 2-year period. CVMH will be determined by CVMH behaviors and factors, as described by the AHA. Factors that are salient during emerging adulthood (family obligation, parental and social support, stress) will also be assessed. We expect that more chronic food insecurity will predict poor CVMH among students over time (Aim 1); poorer CVMH behaviors will mediate the relationship between more chronic food insecurity and poorer CVMH factors (Aim 2); and the relation of SES and food insecurity will be moderated by family obligation and supports, and the relation of food insecurity and CVMH behaviors with CVMH factors will be mediated by stress (Aim 3). This project will address many concerns regarding food insecurity and the potential CVMH disparities that exist among young adults in higher education. Food insecurity as a modifiable target for CVMH prevention is biologically plausible and potentially high impact through new and existing policy interventions.