Association between food insecurity and healthy ageing: two population-based studies

BACKGROUND: Food insecurity, defined as limited or uncertain access to enough food, has been epidemiologically associated with cardiovascular diseases, mental health and cognitive decline. However, its association with healthy ageing remains obscure. OBJECTIVE: To examine the association between food security and healthy ageing using data from two US population-based surveys: the National Health Interview Survey (NHIS) and the National Health and Nutrition Examination Survey (NHANES). METHODS: In this cross-sectional study, a total of 42,147 and 3,020 participants aged 60 years and older were included from NHIS (2011-2018) and NHANES (2011-2014), respectively. Food security was assessed using the USDA Adult Food Security Survey Module, and healthy ageing was defined with the consideration of chronic diseases, cognitive function, physical limitations, mental and self-perceived health. RESULTS: In both cohorts, food security was significantly associated with each component of healthy ageing, even after controlling for demographic, lifestyles and metabolic comorbidities. Notably, food security was linked to substantially increased likelihoods of healthy ageing (NHIS: OR = 2.24, 95%CI: 1.98 to 2.54; NHANES: OR = 3.32, 95%CI: 1.59 to 6.94). The positive association between food security and healthy ageing was largely consistent across subgroups stratified by gender, race, lifestyle factors and obesity status. CONCLUSION: Food security was associated with higher odds of healthy ageing, highlighting the public health relevance of food security in relation to multidimensional healthy ageing, especially in resource-constrained areas.