Food Insecurity and Blood Pressure in a Multiethnic Population

Author:

Ing Claire Townsend1ORCID,Clemens Brettany2,Ahn Hyeong Jun3,Kaholokula Joseph Keawe‘aimoku1,Hovmand Peter S.4,Seto Todd B.5,Novotny Rachel6

Affiliation:

1. Department of Native Hawaiian Health, University of Hawaii at Mānoa, 677 Ala Moana Boulevard, Honolulu, HI 96813, USA

2. Nancy Atmospera-Walch School of Nursing, University of Hawaii at Mānoa, 2528 McCarthy Mall, Honolulu, HI 96822, USA

3. Department of Complementary & Integrative Medicine, University of Hawaii at Mānoa, 651 Ilalo Street, Honolulu, HI 96813, USA

4. Center for Community Health Integration, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA

5. Cardiovascular Diseases, Queen’s Medical Center, 550 S Beretania Street, Honolulu, HI 96813, USA

6. Human Nutrition, Food and Animal Sciences, University of Hawaii at Mānoa, 1955 East-West Road, Honolulu, HI 96822, USA

Abstract

Food insecurity is a social determinant of health and is increasingly recognized as a risk factor for hypertension. Native Hawaiians bear a disproportionate burden of hypertension and known risk factors. Despite this, the relative effects of food insecurity and financial instability on blood pressure have yet to be investigated in this population. This study examines the relative effects of food insecurity and financial instability on blood pressure, controlling for potential confounders in a multiethnic sample. Participants (n = 124) were recruited from a U.S. Department of Agriculture-funded study called the Children’s Healthy Living Center of Excellence. Biometrics (i.e., blood pressure, weight, and height) were measured. Demographics, physical activity, diet, psychosocial variables, food insecurity, and financial instability were assessed via self-report questionnaires. Hierarchical linear regression models were conducted. Model 1, which included sociodemographic variables and known biological risk factors, explained a small but significant amount of variance in systolic blood pressure. Model 2 added physical activity and daily intake of fruit, fiber, and whole grains, significantly improving the model. Model 3 added financial instability and food insecurity, further improving the model (R2 = 0.37, F = 2.67, p = 0.031). Food insecurity, female sex, and BMI were significantly and independently associated with increased systolic blood pressure. These results suggest a direct relationship between food insecurity and systolic blood pressure, which persisted after controlling for physical activity, consumption of fruits, fiber, and whole grains, and BMI. Efforts to reduce food insecurity, particularly among Native Hawaiians, may help reduce hypertension in this high-risk population.

Funder

National Heart, Lung, and Blood Institute

National Institute of General Medical Sciences

USDA National Institute of Food and Agriculture

Publisher

MDPI AG

Subject

Health, Toxicology and Mutagenesis,Public Health, Environmental and Occupational Health

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