Expand SNAP to Reduce Nonalcoholic Fatty Liver Disease in the United States
2020
Gundersen, Craig
Food insecurity is one of the most serious health issues in the United States today for 2 central reasons. First, the magnitude of the problem is enormous. In 2017, almost 40 million Americans lived in food-insecure households (1), slightly down from a peak of over 50 million in 2011. Second, there are numerous health and other consequences associated with being food insecure (2), including, for example, poorer general health, lower nutrient intakes, worse oral health, and complications associated with diabetes. These worse health outcomes result in higher healthcare costs, about $1834 per year for food-insecure adults (3). In this issue of the Journal, Golovaty et al. (4) make a nice contribution to this literature on the association of food insecurity with negative outcomes in “Food insecurity may be an independent risk factor associated with nonalcoholic fatty liver disease among low-income adults in the United States.” Their work examines an especially important issue insofar as nonalcoholic fatty liver disease (NAFLD) affects 1 in 3 adults (5), and will likely be the leading cause of liver transplantation in the United States by 2020 (6). Using data from the 2005 to 2014 NHANES, the authors find that, after controlling for relevant other factors, food-insecure adults are substantially more likely to suffer from NAFLD. In addition, food insecure adults are more likely than food-secure adults to develop advanced fibrosis, a predictor of adverse outcomes for those with NAFLD (7).
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