Abstract 2198: Poverty, food insecurity, and nutritional inflammatory mediators of allostatic load
Authors: Crook Jennifer M. , Lee Eunkyung , Bolajoko Opeyemi , Xie Rui 
Published: March 2024

Background: Though widely recognized in cancer pathogenesis, inflammatory pathways of allostatic load remain vaguely understood. A partial explanation may be found within the realm of food insecurity and micronutrient inadequacies, defined as nutrient intake less than the estimated average requirement. Many micronutrient deficiencies contribute to pro-inflammatory and immunocompromised milieus. Inadequacies, however, which may present without overt symptoms, are not currently well studied. The purpose of this study was to examine relationships between known inflammation-associated nutritional biomarkers of micronutrients and biomarker variables of allostatic load.

Methods: Using NHANES 2017/2018 surveys, adults &gt; 18 years without renal or hepatic disorders, pregnancy, alcohol, or supplement use were included. Plasma levels of vitamins A, B9, C, D, E, calcium (Ca), ferritin (Fe), phosphorus (P), potassium (K) and sodium (Na) were grouped into deficiency, inadequate and adequate groups based on clinically recognized standards. Micronutrient prevalence was assessed and variables of allostatic load [blood pressure, glucose, albumin, creatinine, red cell distribution width (RDW), high density lipoprotein (HDL), low density lipoprotein (LDL), cholesterol and triglycerides] were analyzed for mean differences among micronutrient groups, food security and poverty.

Results: From 3,317 unique participants, inadequacy prevalence percentages were quantified as: vitamins A (0.4%), B9 (12.2%), C (58.3%), D (39.6%), E (21.0%), P (11.4%), K (3.4%), Na (24.2%), Ca (59.5%), and Fe (37.4%) [p &lt; 0.001]. Statistically significant differences were identified in age [C, D, E, Ca, Fe, P, Na (p &lt; 0.004)], race/ethnicity [B9, C, D (p &lt; 0.006)], gender [C, E, Ca, Fe, P, K, Na (p &lt; 0.018)], poverty [A, B9, C, D, E, Fe, K (p &lt; 0.025)], and food security [B9, C, D, E, P (p &lt; 0.032)]. Associations to allostatic load were discovered in: albumin [A, C, D, Ca, Fe, P, Na (p &lt; 0.025)], glucose [C, E, Fe, P, Na (p &lt; 0.009)], HDL [C, D, E, Fe, P, K (p&lt;0.045)], LDL [E, Ca, Fe, Na (p&lt;0.028)], creatinine [C, D, Ca, Fe (p&lt;0.001)], triglycerides [B9, D, E, Fe (p&lt;0.033)], cholesterol [C, D, E, Ca, Fe, Na (p&lt;0.006)], B/P [C, E, Fe, P, Na (p &lt; 0.035)], and RDW [C, D, Ca, Fe (p &lt; 0.001)]. Poverty was significantly associated with all variables of allostatic load (F = 2.85, p = 0.002). Food security was significantly correlated with albumin (p &lt; 0.001), glucose (p = 0.005) and HDL (p &lt; 0.001).

Conclusion: Allostatic load, poverty, and food security were significantly associated with subclinical micronutrient statuses, which may not present with signs of deficiency and are not currently well assessed. Similarly, poverty was significantly associated with all variables of allostatic load, though food security was only identified to be associated with albumin, glucose, and HDL, suggesting that food security may not be currently adequately defined for surveillance.

Citation Format: Jennifer M. Crook, Eunkyung Lee, Opeyemi Bolajoko, Rui Xie. Poverty, food insecurity, and nutritional inflammatory mediators of allostatic load [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2198.