ArticleBMC public health2025
Food insecurity and muscle health: exploring the role of protein, vitamin D, and calcium intake in low muscle mass.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Association Between Food Insecurity and Metabolic Dysfunction-Associated Steatotic Liver Disease: A Cross-Sectional Study in South Korea.Nutrients · 2026Article
- Positive association between LDH to albumin ratio and arthritis: A cross-sectional NHANES study (1999-2010).Medicine · 2026Article
- Association of red cell distribution width-to-albumin ratio with mortality in adults with low muscle mass: A retrospective cohort study.The Journal of international medical research · 2026Article
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Authors and funding
5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundEmpirical evidence concerning the association between household food insecurity and objectively quantified low muscle mass, together with the nutritional mechanisms underlying this link, remains limited. The present study aimed to examine the relation between food insecurity and the odds of low muscle mass in a nationally representative sample of U.S. adults and to determine whether total intakes of protein, vitamin D, and calcium mediate this relation.
methodsA cross-sectional analysis was conducted using data from 6 292 adults (≥ 18 years) enrolled in the 2011-2018 National Health and Nutrition Examination Survey. Household food security was assessed with the 10-item USDA Adult Food Security Survey Module (12-month reference period). Habitual nutrient intakes were estimated from two non-consecutive 24-h dietary recalls obtained with the Automated Multiple-Pass Method and analysed with the Food and Nutrient Database for Dietary Studies, thereby capturing both food- and supplement-derived nutrients. Low muscle mass was defined by dual-energy X-ray absorptiometry as an appendicular lean-mass index < 7.0 kg m
resultsFood insecurity was identified in 22.6 % of participants. After adjustment for socio-demographic and health-related covariates, food insecurity was associated with higher odds of low muscle mass (OR = 1.38; 95 % CI 1.01-1.88). Lower total protein intake accounted for 6.3 % of this association (average causal mediation effect =-0.00093; p = 0.048), whereas intakes of vitamin D and calcium did not exert significant indirect effects. Age, body-mass index, sex and ethnicity were additional independent correlates of low muscle mass.
conclusionsHousehold food insecurity is independently associated with increased odds of low muscle mass in U.S. adults, and inadequate protein intake constitutes a significant-albeit partial-mediating pathway. Prospective and interventional investigations are warranted to establish temporal directionality and to evaluate whether improving dietary protein adequacy can modify this relationship.
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