Food Insecurity and Cardiovascular-Kidney-Metabolic Syndrome–Related Conditions Among US Adults, National Health and Nutrition Examination Survey, 2015–2020

Introduction: Cardiovascular-kidney-metabolic (CKM) syndrome includes health disorders that are increasingly prevalent in the US, yet their relationship with food insecurity remains unclear. This study examined CKM syndrome-related conditions among US adults and their associations with food insecurity. Methods: This cross-sectional study analyzed data for 13,937 US adult participants from the 2015-2020 National Health and Nutrition Examination Survey. Information about demographic characteristics, food insecurity, and CKM syndrome-related conditions was self-reported on questionnaires. Weighted logistic regression models, adjusting for demographic variables and socioeconomic status, examined associations between food insecurity and CKM syndrome-related health outcomes. Results: ) was 29.6. Of total respondents, 28.4% experienced marginal, low, and very low food security. Obesity (40.9%), hyperglycemia (58.9%), and hypertension (29.9%) were the most prevalent cardiometabolic conditions. Lower food security was associated with significantly higher odds of obesity, diabetes, weak or failing kidneys, and cardiovascular diseases (CVDs), with clear dose-response relationships. Compared with full food security, very low food security was associated with higher odds of congestive heart failure (adjusted odds ratio [AOR] = 3.69), coronary heart disease (AOR = 3.43), heart attack (AOR = 3.21), and stroke (AOR = 2.54). Additionally, the likelihood of low or very low food security increased stepwise with number of coexisting CVDs, with the highest odds observed among adults reporting 4 CVDs (AOR = 3.93). Conclusion: This study highlights that food insecurity is significantly associated with CKM syndrome-related conditions among US adults. Addressing food insecurity is critical to reducing its substantial health burden and improving population health.