AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
Perceived Food Insecurity and Short-Term BMI Variability in Young Adults
By Heffron S, Hong C, Xia Y et al.
Background: Body weight variability (BWV), or weight cycling—has been linked to incident CVD independent of cumulative body weight and established risk factors. Young adulthood stands out as the life stage with the highest prevalence of BWV. This is of particular concern, as early life exposures have the potential to influence health/disease risk decades into the future. Reasons for unintentional changes in body weight during early adulthood have proven difficult to study and limit our ability to design effective preventive strategies. A prominent hypothesis is high stress levels along with contributing factors such as poverty and food insecurity. These social factors are associated with risk of incident CVD, but the mechanisms linking to disease are unknown. We hypothesize that the association of food insecurity in young adulthood with future CVD risk is partially mediated by greater body weight variability. Methods: As a first step in testing this hypothesis, we identified all patients aged 19 to 39 years with responses to the Hunger Vital Sign - 2 questions concerning frequency of food scarcity and food worry - available within the Epic COSMOS database between 2018 and 2026. 3 responses to the questions are possible: Never, sometimes, or often. From among these patients, we then identified those with at least two longitudinal BMI values separated by ≥6 months surrounding the date of questionnaire response. Kruska-Wallis tests for trend were applied, followed by post-hoc Mann-Whitney U tests for differences between individual responses. Results: 365,736 unique individuals 19 - 39 years had available Hunger Vital Sign responses available and ≥2 BMI corresponding values. Average age was 29±6 years. 68% were female and 57% were White. The proportions of patients reporting that they often (~1.5%) or sometimes (~6%) experienced food worry or scarcity were low. However, either response was associated with larger ranges of BMI over ≥6, ≥12 and ≥18-months (Figure). Conclusions: These findings in a very large sample support that food insecurity among young adults is associated with greater short-term variability in BMI - an independent risk factor for CVD. Better understanding of the relationships between food insecurity, BWV, and future CVD with future research may help guide the development of multilevel interventions and policy initiatives (e.g., targeting food insecurity, neighborhood resources, and stress exposures) designed to reduce harmful BWV and its downstream biological effects.