Food insecurity, inflammation, and immune function among older US adults: Findings from the health and Retirement study

Abeer A Aljahdali; Elizabeth Ludwig-Borycz; Cindy W Leung

doi:10.1016/j.bbi.2024.03.034

Food insecurity, inflammation, and immune function among older US adults: Findings from the health and Retirement study

Brain Behav Immun. 2024 Mar 27:119:28-35. doi: 10.1016/j.bbi.2024.03.034. Online ahead of print.

Authors

Abeer A Aljahdali¹, Elizabeth Ludwig-Borycz², Cindy W Leung³

Affiliations

¹ Department of Clinical Nutrition, King Abdulaziz University, Jeddah 21589, Saudi Arabia; Department of Nutritional Sciences, University of Michigan, Ann Arbor MI 48109, USA. Electronic address: aaoaljahdali1@kau.edu.sa.
² School for Environment and Sustainability, University of Michigan, Ann Arbor MI 48109, USA. Electronic address: lizzer@umich.edu.
³ Department of Nutritional Sciences, University of Michigan, Ann Arbor MI 48109, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston MA 02115, USA. Electronic address: cleung@hsph.harvard.edu.

PMID: 38552920
DOI: 10.1016/j.bbi.2024.03.034

Abstract

Background: Food insecurity (FI) is a pressing public health concern among older adults and has been associated with adverse cardiovascular outcomes. Greater systemic inflammation may provide a pathway to explain these associations, but few studies have examined the link between FI and markers of inflammation. Thus, the objective of the present study was to evaluate the associations between FI and multiple inflammatory and immune functioning biomarkers using a nationally representative study of US adults aged > 50 years.

Method: Participants (n = 3,924) were drawn from the longitudinal Health and Retirement Study (HRS). Household FI was assessed using the six-item Short Form Food Security Survey Module from the 2013 HRS Health Care and Nutrition Study. Markers of inflammation (neutrophil-lymphocyte ratio, albumin, hs-CRP, IL6, IL10, IL-1Ra, sTNFR-1, and TGFβ-1) and immune functioning (CMV) were collected during the 2016 HRS Venous Blood Study. Multivariate logistic and linear regression models were used to evaluate associations between household FI and inflammatory and immune functioning biomarkers, adjusting for individual and household sociodemographic characteristics.

Results: The weighted prevalence of FI was 18.8 %. Age and sex-adjusted mean showed that FI was associated with higher levels of inflammation and impaired immune functioning (Ps-value < 0.05). Older adults with FI had higher mean levels of albumin, hs-CRP, IL6, IL10, IL-1Ra, TGFß-1, and CMV seronegative and borderline (Ps-value < 0.05). Multivariate-adjusted regression model showed that FI was associated with high-risk categories of hs-CRP (OR 1.34, 95 % CI 1.06, 1.68), IL-6 (OR 1.66, 95 % CI 1.28, 2.14), IL-1Ra (OR 0.67, 95 % CI 0.48, 0.93), TGFß-1 (OR 1.87, 95 % CI 1.45, 2.42), seronegativity for CMV (OR 0.48, 95 % CI 0.35, 0.64).

Conclusion: In this nationally representative sample of older adults, FI was positively associated with multiple markers of systemic inflammation and impaired immune functioning. Public health efforts that directly work to reduce FI among older adults are warranted and may result in further improvements in their health and well-being.

Keywords: Chronic inflammation; Food insecurity; Health and Retirement Study; Inflammation, immune functioning; Inflammatory cytokines; Older adults.