Abstract 4359272: Associations Between Food Insecurity and Life’s Essential 8 Metrics Among Women of Reproductive Age in the SAFE HEART Study

Introduction: Food insecurity, a critical social determinant of health, that affects many women of reproductive age, particularly those living in communities at high risk for cardiovascular disease and adverse pregnancy outcomes. While food insecurity is linked to poor cardiometabolic health, few studies have examined its impact among a diverse population of reproductive-age women using cardiovascular health metrics like Life’s Essential 8 (LE8). Methods: We conducted a cross-sectional analysis of women aged 18–50 enrolled in the SAFE HEART Study, which includes participants recruited through community outreach and the American Heart Association’s Research Goes Red registry. Food insecurity was assessed using a validated two-item screener. Key Cardiovascular health measures including sleep, BMI, cholesterol, blood glucose, and blood pressure. Multivariable logistic regressions estimated odds ratios (ORs) and 95% confidence intervals (CIs) for adverse LE8 outcomes associated with food insecurity across three models: unadjusted, sociodemographic-adjusted, and fully adjusted for cardiovascular risk factors. Results: Among 430 participants (mean age: 30.7 ± 6.8), 44.7% were Non-Hispanic Black, 28.1% Hispanic/Other, and 23.0% Non-Hispanic White. Food insecurity was significantly associated with adverse LE8 risk factors. In fully adjusted models, women who reported being worried food would run out (Question 1) had higher odds of high cholesterol (OR = 2.83; 95% CI: 1.45–5.54), diabetes (OR = 1.98; 95% CI: 1.01–3.88), and poor sleep (OR = 1.61; 95% CI: 1.01–2.57). Women who reported food did not last (Question 2) also had increased odds of high cholesterol (OR = 2.04; 95% CI: 1.06–3.91) and diabetes (OR = 1.99; 95% CI: 1.03–3.84). Other LE8 risk factors were not significantly associated with food insecurity in fully adjusted models. Conclusion: Food insecurity was independently associated with adverse LE8 cardiovascular health risk factors, specifically high cholesterol, diabetes, and poor sleep, among women of reproductive age. These findings highlight food insecurity as a modifiable risk factor and reinforce the importance of integrating social risk screening and intervention into CVD prevention efforts targeting diverse populations.