Relationship between food insecurity and high blood pressure in a national sample of children and adolescents.

Abstract

To determine the relationship between food insecurity (FI) and high blood pressure (BP) in a national cohort of children and adolescents. A cross-sectional analysis of children aged 8-17years in the 2007-2014 National Health and Nutrition Examination Survey (NHANES; unweighted N = 7125). FI over the preceding 12months was assessed using the USDA Household Food Security Scale in NHANES. We defined high BP as (i) systolic or diastolic BP ≥ 90% for age < 13years or ≥ 120/80mmHg for age ≥ 13years measured at one visit or (ii) reported hypertension diagnosis or current antihypertensive medication use. We used multivariable logistic regression to determine the association between household and child-specific FI and high BP, controlling for age, sex, race, and household income, accounting for the complex NHANES survey design. The study population was 14.4% black, 21.3% Hispanic, and 49.4% female with a mean age of 12.6years (SD 2.9). 20.3% had FI and 12.8% had high BP. High BP was more common in household FI vs. food-secure subjects (15.3% vs. 12.1%, p = 0.003). Adjusted analysis confirmed that household FI and child FI were associated with high BP (OR 1.26, 95% CI 1.04-1.54; OR 1.42, 95% CI 1.03-1.96, respectively). Household and child FI were associated with an increased likelihood of high BP in a large nationally representative cohort of children and adolescents. FI may have a significant impact on cardiovascular health during childhood. Further research is warranted to better define how FI contributes to health disparities.