Journal article
Associations of food security and food assistance with cardiovascular morbidity and mortality among postmenopausal women from the women's health initiative
Journal of epidemiology and community health (1979)
07/31/2026
DOI: 10.1136/jech-2026-226762
PMID: 42538154
Abstract
Prior research indicates that food insecurity is negatively associated with cardiometabolic health and plays a role in cardiovascular disease (CVD) risk, which also increases with age. Food insecurity disproportionately affects ageing women in the USA, who face higher poverty and economic insecurity rates than their male counterparts, increasing their risk for hunger, poor nutrition and chronic conditions. We examined the association of food security and assistance with CVD morbidity and mortality risks in postmenopausal women through a target trial emulation.
A retrospective cohort study was conducted among 41 227 postmenopausal women from the Women's Health Initiative Observational Study free of CVD at baseline. Approximately 96% reported food security and 3% reported reliance on food assistance at 6 years of follow-up (analytical baseline). Furthermore, 16% of 1861 women reporting food insecurity also reported food assistance. Inverse probability of treatment weighting (IPTW) within Cox regression models was performed using demographic, socioeconomic, lifestyle and health characteristics collected prior to the analytical baseline.
Overall, 6037 eligible women experienced CVD outcomes over ~24 years of follow-up. In IPTW Cox regression models, food security (HR=0.65, 95% CI 0.47 to 0.89) and food assistance (HR=0.47, 95% CI 0.46 to 0.48) were inversely related to CVD risk. Similar results were obtained for all-cause and chronic disease-specific mortality risks.
Food security and assistance are generally associated with lower CVD risks after menopause, with implications for food assistance programmes, targeted nutritional counselling, community interventions and holistic care among ageing women in the USA.
Details
- Title: Subtitle
- Associations of food security and food assistance with cardiovascular morbidity and mortality among postmenopausal women from the women's health initiative
- Creators
- Hind A Beydoun - The University of Texas Health Science Center at HoustonMay A Beydoun - National Institute on AgingLesley Tinker - Fred Hutch Cancer CenterRobert B Wallace - University of IowaMatthew A Allison - University of California San DiegoLinda G Snetslaar - University of IowaMatthew J Landry - University of California, IrvineMatthew Nudy - Penn State Milton S. Hershey Medical CenterCandice Price - National Heart Lung and Blood InstituteJack Tsai - The University of Texas Health Science Center at Houston
- Resource Type
- Journal article
- Publication Details
- Journal of epidemiology and community health (1979)
- DOI
- 10.1136/jech-2026-226762
- PMID
- 42538154
- ISSN
- 1470-2738
- eISSN
- 1470-2738
- Publisher
- BMJ Group
- Grant note
- National Center for Advancing Translational Sciences: UL1 TR002014, KL2 TR002015 National Heart and Lung Institute: 75N92021D00001, 75N92021D00002, 75N92021D00003, 75N92021D00004, 75N92021D00005
The WHI programme is funded by the National Heart, Lung and Blood Institute, National Institutes of Health, US Department of Health and Human Services, through 75N92021D00001, 75N92021D00002, 75N92021D00003, 75N92021D00004, 75N92021D00005. MN is supported by the National Center for Advancing Translational Sciences, Grant KL2 TR002015 and Grant UL1 TR002014. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The sponsors did not play a role in the study design, collection, analysis and interpretation of data, in the writing of the report or in the decision to submit the article for publication.
- Language
- English
- Electronic publication date
- 07/31/2026
- Academic Unit
- Epidemiology; Injury Prevention Research Center
- Record Identifier
- 9985214914002771
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