Food Insecurity Linked to High Blood Pressure in Kids

Megan Brooks

September 20, 2018

CHICAGO — Food insecurity is an important contributor to hypertension during childhood, a new analysis of data from the National Health and Nutrition Examination Survey (NHANES) suggests.

Researchers found that children and adolescents who lack good access to nutritional foods are more likely to have high blood pressure than their peers with secure access to food.

"Our study is the first to link food insecurity with high blood pressure in children and adolescents. It is crucial that primary care providers screen for food insecurity in both children and adults as a cardiovascular disease risk factor," Andrew South, MD, director, Hypertension Clinic, Brenner Children's Hospital, and associate professor, pediatric nephrology, Wake Forest School of Medicine, Winston–Salem, North Carolina, told theheart.org | Medscape Cardiology.

He presented the study September 6 during the American Heart Association Joint Hypertension 2018 Scientific Sessions.

South and his colleagues did a cross-sectional analysis of NHANES data on food insecurity and blood pressure from 2007 to 2014 in 7215 children 8 to 17 years of age.

Food insecurity was assessed using the US Department of Agriculture (USDA) food security survey module. Blood pressure was measured three times and averaged. High blood pressure was defined as systolic or diastolic blood pressure in the 90th percentile for children younger than 13 and a measurement of 120/80 mm Hg or higher for children 13 years and older, a reported diagnosis of hypertension, or reported current use of an antihypertensive medication.

More than one-fifth of the children (1460 of 7125; 20.5%) were food insecure and 12.4% (883 of 7125) had high blood pressure, they found.

On bivariate analysis, hypertension was significantly more common in food insecure than food secure children (14.4% vs 11.6%; P = .001). After potentially confounding factors were controlled for, food insecurity remained associated with high blood pressure (odds ratio, 1.25; 95% confidence interval, 1.04 - 1.50).

"We currently do not know the exact reasons for why food insecurity is associated with high blood pressure in children or in adults," South said. "It is likely a multifactorial social and biological risk factor that includes contributions from poor nutrition (for example, higher salt intake) and chronic stress from not having reliable or consistent access to healthy food. We are currently looking into these relationships to better understand how food insecurity contributes to high blood pressure," he told theheart.org | Medscape Cardiology.

South said his center and others have developed programs to intervene in those with food insecurity to provide nutritional and social support, including meeting with nutritionists and social workers, helping with applications to food assistance programs, and providing access to food pantries.

"On a policy level, it is vital that leaders and decision-makers understand the importance of food insecurity to overall health, as well as recognizing that hypertension and cardiovascular disease originate during childhood and are significant healthcare burdens in childhood. Our study supports the idea of increasing access to nutritionally adequate food and educating healthcare providers and families as to the importance of adequate nutrition in order to prevent or attenuate disease," said South.

"Huge" Public Health Issue

Reached for comment, Kevin Fiori, MD, pediatrician and director of the global health delivery program at Children's Hospital at Montefiore, Bronx, New York, said demonstrating a link between food insecurity and high blood pressure in children is " important" but not all that surprising, "particularly if you think about food insecurity not only as not having enough food, but also not having enough of the right kinds of food."

Food insecurity affects an estimated 40 million Americans, including 6 million children and adolescents. "It's a huge public health issue that I don't we are addressing," said Fiori.

Health providers need to look "beyond our normal clinical routine. It's one thing to screen for blood pressure, but are we doing enough to ask about nutrition and are we doing enough to mitigate those risks," said Fiori.

"Of the social needs that we see with families, food insecurity is probably one of the things that we actually can address. It's much harder to address housing than food insecurity."

The study had no commercial funding. South and Fiori have disclosed no relevant financial relationships.

Joint Hypertension 2018 Scientific Sessions (HYP): Poster 230. Presented September 6, 2018.

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