{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T18:34:57Z","timestamp":1785522897684,"version":"3.56.0"},"reference-count":40,"publisher":"BMJ","funder":[{"DOI":"10.13039\/501100000850","name":"National Heart and Lung Institute","doi-asserted-by":"publisher","award":["75N92021D00001"],"award-info":[{"award-number":["75N92021D00001"]}],"id":[{"id":"10.13039\/501100000850","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000850","name":"National Heart and Lung Institute","doi-asserted-by":"publisher","award":["75N92021D00002"],"award-info":[{"award-number":["75N92021D00002"]}],"id":[{"id":"10.13039\/501100000850","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000850","name":"National Heart and Lung Institute","doi-asserted-by":"publisher","award":["75N92021D00003"],"award-info":[{"award-number":["75N92021D00003"]}],"id":[{"id":"10.13039\/501100000850","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000850","name":"National Heart and Lung Institute","doi-asserted-by":"publisher","award":["75N92021D00004"],"award-info":[{"award-number":["75N92021D00004"]}],"id":[{"id":"10.13039\/501100000850","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000850","name":"National Heart and Lung Institute","doi-asserted-by":"publisher","award":["75N92021D00005"],"award-info":[{"award-number":["75N92021D00005"]}],"id":[{"id":"10.13039\/501100000850","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR002014"],"award-info":[{"award-number":["UL1 TR002014"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2 TR002015"],"award-info":[{"award-number":["KL2 TR002015"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2026,7,21]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prior research indicates that food insecurity is negatively associated with cardiometabolic health and plays a role in cardiovascular disease (CVD) risk, which also increases with age. Food insecurity disproportionately affects ageing women in the USA, who face higher poverty and economic insecurity rates than their male counterparts, increasing their risk for hunger, poor nutrition and chronic conditions. We examined the association of food security and assistance with CVD morbidity and mortality risks in postmenopausal women through a target trial emulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted among 41\u2009227 postmenopausal women from the Women\u2019s Health Initiative Observational Study free of CVD at baseline. Approximately 96% reported food security and 3% reported reliance on food assistance at 6 years of follow-up (analytical baseline). Furthermore, 16% of 1861\u2009women reporting food insecurity also reported food assistance. Inverse probability of treatment weighting (IPTW) within Cox regression models was performed using demographic, socioeconomic, lifestyle and health characteristics collected prior to the analytical baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 6037 eligible women experienced CVD outcomes over ~24 years of follow-up. In IPTW Cox regression models, food security (HR=0.65, 95% CI 0.47 to 0.89) and food assistance (HR=0.47, 95%\u2009CI 0.46 to 0.48) were inversely related to CVD risk. Similar results were obtained for all-cause and chronic disease-specific mortality risks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Food security and assistance are generally associated with lower CVD risks after menopause, with implications for food assistance programmes, targeted nutritional counselling, community interventions and holistic care among ageing women in the USA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jech-2026-226762","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T17:20:25Z","timestamp":1785518425000},"page":"jech-2026-226762","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of food security and food assistance with cardiovascular morbidity and mortality among postmenopausal women from the women\u2019s health initiative"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9704-328X","authenticated-orcid":false,"given":"Hind A","family":"Beydoun","sequence":"first","affiliation":[{"name":"Department of Veterans Affairs, VA National Center on Homelessness among Veterans, Washington, Columbia, USA"},{"name":"Department of Management, Policy, and Community Health, University of Texas Health Science Center at Houston, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"May A","family":"Beydoun","sequence":"additional","affiliation":[{"name":"Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley","family":"Tinker","sequence":"additional","affiliation":[{"name":"Cancer Prevention Program, Fred Hutchinson Cancer Center, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert B","family":"Wallace","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew A","family":"Allison","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda G","family":"Snetslaar","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J","family":"Landry","sequence":"additional","affiliation":[{"name":"Department of Population Health and Disease Prevention, University of California Irvine, Irvine, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Nudy","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candice","family":"Price","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0329-648X","authenticated-orcid":false,"given":"Jack","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, VA National Center on Homelessness among Veterans, Washington, Columbia, USA"},{"name":"Department of Management, Policy, and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, 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