Association Between Food Insecurity and Poor Cardiovascular Health Assessed by the Life's Essential 8 Metric: A Population-Based Study of Korean Adults.

Background/objectives: Access to nutritious and well-balanced food is essential for well-being. We investigated the relationship between food insecurity (FI) and cardiovascular health (CVH).

Methods: This cross-sectional analysis included a nationwide sample consisting of 12,369 Korean adults. The 18-item Household Food Security Survey Module was employed to evaluate FI, with categories ranging from none, to mild, to moderate-to-severe. CVH was assessed through the "Life's Essential 8" (LE8) framework established by the American Heart Association. This framework includes four health behaviors (diet quality, exercise, tobacco use, and sleep) and four biometric factors (body mass index, blood lipids, blood glucose, and blood pressure). Overall, CVH was scored on a scale from 0 to 100 and categorized into ideal (LE8 score: 80-100), intermediate (LE8 score: 50-79), and poor CVH (LE8 score: 0-49). Multivariate linear and logistic regression models were used to determine the association of FI with CVH status.

Results: Within the sample, 3.7% and 0.8% experienced mild and moderate-to-severe FI, respectively. Compared with those without FI, individuals with mild (β: -2.92; 95% CI [confidence interval]: -4.37, -1.48) or moderate-to-severe (β: -7.71; 95% CI: -11.22, -4.20) FI had lower LE8 scores. Additionally, those with mild or moderate-to-severe FI were more likely to have poor CVH status (OR [odds ratio]: 2.14; 95% CI: 1.33, 3.66 for mild FI and OR: 4.83; 95% CI: 1.64, 14.17 for moderate-to-severe FI).

Conclusions: FI is negatively associated with CVH in Korean adults. These findings underscore the need for comprehensive policy interventions to enhance food access and promote CVH in this at-risk population.