DEI/CRT
Food insecurity and incident cardiovascular disease among Black and White US individuals
JAMA Cardiology
About The Study:
In this prospective cohort study among participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study, food insecurity was associated with incident cardiovascular disease (CVD) even after adjustment for socioeconomic factors, suggesting that food insecurity may be an important social deprivation measure in clinical assessment of CVD risk. Whether interventions to reduce food insecurity programs can potentially alleviate CVD should be further studied.
Corresponding Author: To contact the corresponding author, Jenny Jia, MD, MSc, email jenny.jia@northwestern.edu.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamacardio.2025.0109)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflicts of interest and financial disclosures, and funding and support.
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Journal
JAMA Cardiology
Food insecurity today, heart disease tomorrow?
Study is the first to show food insecurity raises risk of heart disease over time
Peer-Reviewed Publication- Study compares those with food insecurity to food-secure individuals over 20 year
- Food insecurity is associated with a 41% increased risk of heart disease over time
- Findings suggest food security screening as a key tool to prevent heart disease
CHICAGO --- Struggling to afford food today could mean heart problems tomorrow. Young adults experiencing food insecurity have a 41% greater risk of developing heart disease in midlife, even after accounting for demographic and socioeconomic factors, according to a new Northwestern Medicine study. Food insecurity — struggling to get enough nutritious food to stay healthy — affects one in eight households in the U.S. each year.
“We’ve known that food insecurity and heart disease often go hand in hand, but this study shows, for the first time, that food insecurity comes first,” said Dr. Jenny Jia, an instructor of general internal medicine and preventive medicine at Northwestern University Feinberg School of Medicine and a Northwestern Medicine internist. “That makes it a clear target for prevention — if we address food insecurity early, we may be able to reduce the burden of heart disease later.”
The study will be published on Wednesday (March 12) in JAMA Cardiology.
How the study was conducted
Jia and her colleagues analyzed data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a long-term cohort study that has followed Black and white U.S. adults since the mid-1980s. The scientists identified participants who reported food insecurity in 2000-2001, when they were in their early 30s to mid-40s, and compared their health outcomes over the next 20 years to those who were food secure.
Among the 3,616 study participants, those experiencing food insecurity were 41% more likely to develop cardiovascular disease than their food-secure counterparts. Over the study period, 11% of food-insecure individuals developed heart disease, compared to 6% of those with adequate food access.
“For a long time, there was this chicken-or-the-egg question — does food insecurity cause heart disease, or does heart disease make food insecurity worse because of the high cost of healthcare?” Jia said. “By following people over two decades, we were able to show that food insecurity, on its own, significantly increases the risk of developing cardiovascular disease.”
At baseline, participants with food insecurity were more likely to identify as Black and had lower educational attainment than those who were food secure.
Screening for food insecurity
Jia says the findings highlight the need for healthcare providers to be savvy in how to best screen for food insecurity and connect patients with community resources.
She says primary care settings, such as with internists, pediatricians and family doctors, are ideal for screening for food insecurity, “because there tends to be a lot of trust between primary care providers and patients.”
Jia also stresses that food security screenings could extend to emergency rooms and specialties like cardiology, and can be done by nurses, medical assistants or even patients themselves filling out forms.
“The more we screen for it, the better,” Jia said, adding that “we need better strategies to help people once they screen positive. Do we connect them to social workers who can refer them to existing community programs? Should healthcare systems develop their own interventions? These are the next big questions.”
Next steps
Jia and her team plan to continue tracking this group to understand the long-term effects of food insecurity. “It’s surprising to see heart disease in this group, which doesn’t include those 65 or older,” Jia said. “As they near 80, we plan to revisit the study to explore the evolving link to heart disease.”
The CARDIA study was conducted and supported by the U.S. National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (75N92023D00002 and 75N92023D00005), Northwestern University (75N92023D00004), the University of Minnesota (75N92023D00006) and the Kaiser Foundation Research Institute (75N92023D00003). Dr. Jia is supported by grant K23HL173655 from the NHLBI. Dr. Kandula (another study author) is supported by grant K24HL155897 from the NHLBI.
Journal
JAMA Cardiology
Article Title
Food Insecurity and Incident Cardiovascular Disease Among Black and White US Individuals, 2000-2020
Article Publication Date
12-Mar-2025
Researchers identify molecular differences in pancreatic cancer of Black and white patients
Findings reinforce the need for diverse racial makeup in clinical trials
image:
Ling Huang, Ph.D. performs research work at the Henry Ford Health Pancreatic Cancer Center in Detroit.
view moreCredit: Photo courtesy of Henry Ford Health
DETROIT – Researchers have discovered race-associated molecular differences in tumors that may impact the way patients with pancreatic cancer respond to immunotherapies. The findings, which were recently published in the American Association for Cancer Research (AACR) Journal, reinforce the need to include racially diverse participants in clinical studies.
Immunotherapies are a type of cancer treatment that uses the body’s own immune system to fight cancer. Black or African American patients have a higher incidence of pancreatic cancer, the third leading cause of cancer-related death in the United States, compared with other racial groups.
In the article appearing in the AACR Journal, researchers at the Henry Ford Health Pancreatic Cancer Center, found that Black patients showed a higher prevalence of PD-L1 overexpression, a marker often linked with aggressive cancer behavior and a key target for immunotherapy treatments. Additionally, Black patients showed higher frequencies of TP53 mutations and KRASG12R mutations compared to White patients. Those genes affect how quickly cancer grows and the body’s ability to fight cancer.
“This finding strongly supports that in clinical trials across the country, we need to enroll patients from different racial groups to reflect the racial makeup in the U.S. and to more accurately represent tumor molecular changes,” said lead researcher Ling Huang, Ph.D.
In a separate analysis of recent clinical trials testing immunotherapies for pancreatic cancer, the researchers found that Black patients and other minorities were underrepresented in most clinical trials.
“It is also important to ensure people of different racial background have equal access to cancer care, especially precision medicine,” Dr. Huang said.
PD-L1 is like a shield that some cells wear. Normally, it tells the immune system’s T cells (which kill harmful cells) not to attack. Cancer cells can hijack this signal, wearing PD-L1 as armor to protect themselves from being destroyed by the immune system. When cancer cells have a lot of this PD-L1 shield, it’s harder for the body to fight the cancer, leading to a worse outlook for the patient.
Think of TP53 like a brake pedal in a car that helps stop cancer growth. If something goes wrong with this gene (like mutations), it’s like the brakes are broken, and the car (or cancer) can keep going without control.
The KRAS gene is often faulty in pancreatic cancer. The KRASG12R is a specific error in this gene. This error makes the KRAS gene stuck in the “on” position, constantly telling cells to grow and divide, which can lead to cancer. This is like flooring the gas pedal of a car, making it accelerate to full speed.
This study shows that, in pancreatic cancer, Black patients tend to have higher levels of the PD-L1 shield on their cancer cells compared to white patients. This could affect how their cancer progresses and responds to treatment.
The research team emphasizes that these molecular features are not necessarily the determinants, but associations, that help understand the complex nature of cancer disparities.
“We hope that these insights will guide future studies and lead to improved outcomes for all patients, regardless of race,” Dr. Huang said.
Molecular profiles of patient tumors were determined from the Tempus multimodal database, through collaboration between Dr. Huang’s team, Tempus AI, and Henry Ford scientists, Howard Crawford and Albert Levin. Members from Dr. Huang’s team, Saurabh Mandal and Swathi Sridhar also contributed significantly to this project.
Based in Detroit, where 77% of the population identifies as Black or African American, Henry Ford Health is nationally recognized for its commitment to inclusive research endeavors that address healthcare disparities, develop new treatments, and identify ways to prevent and understand disease.
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MEDIA CONTACT: mediarelations@hfhs.org
Journal
Cancer Research Communications
Method of Research
Data/statistical analysis
Subject of Research
People
Article Title
Molecular Differences in Pancreatic Ductal Adenocarcinomas from Black versus White Patients
COI Statement
E.A. Teslow reports personal fees and other support from Tempus AI during the conduct of the study, as well as personal fees and other support from Tempus AI outside the submitted work. M. Huang reports other support from Tempus AI during the conduct of the study. Y. Yu reports receiving a salary from Tempus and stock ownership in Tempus. A.J. Hockenberry reports other support from Tempus AI, Inc. outside the submitted work. M.C. Stoppler reports other support from Tempus AI, Inc. during the conduct of the study. No disclosures were reported by the other authors.
