Curr Atheroscler Rep. 2026 Oct 31;28(1):107. doi: 10.1007/s11883-026-01473-5.
ABSTRACT
PURPOSE OF REVIEW: Food insecurity affects 18.4% of US households with children and disproportionately impacts racial and ethnic minority and single-parent households. This review examines the association between childhood food insecurity and the development of atherosclerotic cardiovascular disease (ASCVD), the pathways through which food insecurity may accelerate cardiovascular risk, and the role of nutrition assistance programs and interdisciplinary teams in mitigating that risk.
RECENT FINDINGS: Children with food insecurity demonstrate lower Life's Essential 8 cardiovascular health scores, primarily driven by higher body mass index, compared to food-secure peers. Food insecurity is cross-sectionally associated with cardiovascular-kidney-metabolic (CKM) syndrome stages 1 and 2 among adolescents, with food-secure adolescents having 40% lower odds of CKM stages 1 to 2 in fully adjusted models (OR, 0.60; 95% CI, 0.44 to 0.82). Food insecurity is associated with adverse cardiometabolic markers including lower HDL cholesterol, higher triglycerides, and elevated fasting glucose. Non-dietary mechanisms, including chronic psychosocial stress, hypothalamic-pituitary-adrenal axis dysregulation, gut dysbiosis, and epigenetic modifications, further contribute to cardiovascular risk. Participation in federally funded nutrition assistance programs is associated with improved cardiovascular health metrics and cardiometabolic profiles. Childhood food insecurity is associated with the accelerated development of ASCVD risk factors through dietary, metabolic, and psychosocial pathways. Early identification of food insecurity and coordinated interdisciplinary intervention represent critical strategies for cardiovascular risk reduction in vulnerable pediatric populations.
KEY POINTS: • Food insecurity affects 18.4% of US households with children and is cross-sectionally associated with CKM syndrome stages 1 and 2 among adolescents. • Non-dietary pathways including chronic stress, gut dysbiosis, and epigenetic changes contribute to ASCVD risk. • Nutrition assistance programs improve cardiovascular health metrics. • Evidence supporting food insecurity screening tools for improving health outcomes remains insufficient.
PMID:42965738 | DOI:10.1007/s11883-026-01473-5