E-News Exclusive

Study Suggests Link Between Food Insecurity, CVD

Food insecurity is one of the nation’s leading health and nutrition issues—about 13.7 million (10.5%) households in the United States were food insecure at some time during 2019, a trend that has increased exponentially during the COVID-19 pandemic. According to preliminary research conducted by researchers at Penn Medicine at the University of Pennsylvania, growing rates of food insecurity in counties across the United States are independently associated with an increase in cardiovascular death rates among adults between the ages of 20 and 64.

The large-scale, national study, presented at the American Heart Association’s Scientific Sessions 2020, provides evidence of the link between food insecurity and increased risk of cardiovascular death. This is one of the first national analyses to evaluate changes in both food security and cardiovascular mortality over time, and to see whether changes in food insecurity impact cardiovascular health. The findings are published in Circulation: Cardiovascular Quality and Outcomes.

“This research gives us a better understanding of the connection between economic distress and cardiovascular disease,” says Sameed Khatana, MD, MPH, senior author of the study and instructor of cardiovascular medicine in the Perelman School of Medicine at the University of Pennsylvania. “What’s going on outside the clinic has significant impact on patients’ health. There are many factors beyond the medications we may be prescribing that can influence their well-being, food insecurity being one of them.”

Researchers analyzed data from the National Center for Health Statistics and the Map the Meal Gap study to examine county-level cardiovascular death rates and food insecurity rates from 2011 to 2017 among adults aged 20 to 64 and those aged 65 and older.

The researchers found that while the overall food insecurity rates for the entire country declined between 2011 and 2017, the counties that had the most increase in food insecurity levels had cardiovascular death rates that increased from 82 to 87 per 100,000 individuals. In addition, for every 1% increase in food insecurity, there was a similar increase in cardiovascular mortality among nonelderly adults (0.83%).

“There has been a growing disparity when it comes to food insecurity, and this data demonstrates that parts of the country are being left behind. Unfortunately, this may only get worse as the country grapples with the ramifications of the COVID-19 pandemic,” Khatana says. “However, interventions that improve a community’s economic well-being could potentially lead to improved community cardiovascular health.”

— Source: Perelman School of Medicine at the University of Pennsylvania

 

Bacterial Metabolism of Soy May Lower Dementia Risk

A metabolite produced following dietary soy consumption may decrease a key risk factor for dementia—with the help of the right bacteria, according to a new discovery led by researchers at the University of Pittsburgh Graduate School of Public Health.

Their study, published in the journal Alzheimer’s & Dementia: Translational Research & Clinical Interventions, reports that elderly Japanese men and women who produce equol—a metabolite of dietary soy created by certain types of gut bacteria—display lower levels of white matter lesions within the brain.

“White matter lesions are significant risk factors for cognitive decline, dementia, and all-cause mortality,” says lead author Akira Sekikawa, MD, PhD, an associate professor of epidemiology at Pitt Public Health. “We found 50% more white matter lesions in people who cannot produce equol compared to people who can produce it, which is a surprisingly huge effect.”

To obtain this result, Sekikawa’s research team measured equol levels within the blood of 91 Japanese older adult participants with normal cognition. Participants were sorted by their equol production status, and then six to nine years later underwent brain imaging to detect levels of white matter lesions and deposits of amyloid-beta, which is the suspected molecular cause of Alzheimer’s disease.

The researchers found that while equol production didn’t appear to impact levels of amyloid-beta deposited within the brain, it was associated with reduced white matter lesion volumes. Sekikawa’s team also discovered that high levels of isoflavones—soy nutrients that are metabolized into equol—had no effect on levels of white matter lesions or amyloid-beta when equol wasn’t produced.

According to Sekikawa, the ability to produce equol from soy isoflavones may be the key to unlocking protective health benefits from a soy-rich diet, and his team previously has shown that equol production is associated with a lower heart disease risk. As heart disease is strongly associated with cognitive decline and dementia, equol production could help protect the aging brain as well as the heart.

Epidemiologic studies in Japan, where soy is consumed regularly, have shown that dietary intake of soy isoflavones has been linked to a lower risk of heart disease and dementia. However, most clinical trials in America have failed to show this.

Sekikawa believes this discrepancy may be due to the microbiome—40% to 70% of Japanese harbor gut bacteria that can convert dietary isoflavones into equol compared with only 20% to 30% of Americans.

Sekikawa says equol supplements could one day be combined with existing diet-based prevention strategies that appear to lower dementia risk, particularly the DASH and Mediterranean diets.

Though Sekikawa hopes to evaluate the neuroprotective effects of equol supplements in a future randomized clinical trial, in the meantime, he urges caution to anyone who might be tempted to purchase equol supplements to stave off dementia.

“This type of study always catches people’s attention, but we cannot prove that equol protects against dementia until we get a randomized clinical trial with sufficient evidence,” he says.

— Source: Health Sciences at the University of Pittsburgh