A Hunger

Obesity Growing with Food Insecurity

Food insecurity may well be the next pandemic that results from COVID-19. But new research in JAMA Network Open tells us that the problem is already here. Candice Myers, Emily Mire, and Peter Katzmarzyk tell us food insecurity doubled between 2000 and 2016 in the U.S. Moreover, with this doubling, obesity rose in close correlation.

Huge Disparities

These data come from 46,145 adults in the NHANES Survey. They reveal daunting racial and ethnic disparities. In fact for 2016, Hispanic persons were nearly three times more likely to have food insecurity than Whites. The likelihood for Black adults was more than doubled.

These disparities mirror the disparity in obesity rates, as well as disparity in the access to care that results from obesity.

Implication for Premature Death

Thus, it’s not surprising that yet another new study finds food insecurity brings a 46 percent increase in the risk of death over a 10-year follow-up. In their study, Srikanta Banerjee and colleagues found cardiovascular deaths were 75% higher for persons with food insecurity. Banerjee et al concluded food insecurity is an important independent risk factor for heart disease. So Banerjee says it should be an important part of assessing every patient’s risk for heart disease.

An Important Piece of a Larger Puzzle

With these and other data, it’s increasingly clear that food security is essential for good health. Writing in 2017, Emily Dhurandhar proposed that obesity is a physiological response to a threatened food supply in low social individuals. Thus, she writes, it’s no surprise that simply “educating” the affected people to change their behaviors tends to have minimal effects. It may be that social status has more effect on obesity than behavioral interventions.

In a similar vein, Daniel Nettle and colleagues offer an insurance hypothesis to explain the relationship between food security and obesity. Fat reserves increase when food supplies are uncertain. They allow that food security is not enough to explain who gets obesity and who does not. It explains the most for adult women in high-income countries. But they say it may be an important piece of a larger puzzle.

Disparities in health, wealth, social status, and food security seem to travel together. Without addressing social and economic disparities, it may prove to be quite difficult to reduce health disparities.

Click here for the study by Myers et al, here for Banerjee et al, here for Dhurandhar’s paper, and here for Nettle et al.

A Hunger, photograph © Sippanont Samchai / flickr

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August 11, 2020