Working at the intersection of nutrition and health equity

Cindy Leung
The Big 3: Three questions, three answers

December 5, 2022—In this Big 3 Q&A, Cindy Leung, assistant professor of public health nutrition at Harvard T.H. Chan School of Public Health, discusses a recent paper she co-authored linking food insecurity and food addiction, as well as her other research efforts. 

Q: Tell us about your recent study and the interesting findings around food insecurity.

A: Food insecurity is a socioeconomic condition of limited access to affordable and healthy food. In my prior research, I found that people experiencing food insecurity are more likely to have poorer quality diets and are at higher risk for chronic conditions. Food addiction is a newer paradigm where we’re seeing experiences of withdrawal and other symptoms similar to those, for example, of alcohol abuse, as a result of eating highly processed foods. Knowing that highly processed foods are abundant in low-income neighborhoods, we wondered if people who are food insecure might be more vulnerable to food addiction.

In two different samples—one of low-income pregnant women in the San Francisco Bay area, and another of mothers of preadolescent children in southeast Michigan—we found a consistent and significant positive association between food insecurity and food addiction, even after adjusting for sociodemographic factors like education, race/ethnicity, and income level.

In our study, we couldn’t tease apart the mechanisms behind this link, but I believe that stress and ubiquitous access to highly processed foods are big components. Food insecurity is a source of chronic stress—a constant cognitive process to manage one’s food resources in relation to the family’s food needs. This chronic stress may alter the reward system to overconsume highly processed foods, increasing the risk of food addiction over time. The combination of high stress and easy access to highly palatable foods may also explain the higher risks of other chronic diseases that we’ve seen in relation to food insecurity.

Q: What other research questions are you looking at?

A: When we talk about interventions for food insecurity, we automatically go to our federal food programs. During the COVID-19 pandemic, we’ve seen swift expansions of our biggest nutrition programs, showing that they are important levers to reduce food insecurity during national emergencies. My colleagues and I are evaluating some of these recent policies. I am also really interested in seeing how poverty alleviation programs might reduce food insecurity. Programs and policies that address the minimum wage or reduce unemployment could have secondary impacts on preventing food insecurity, which is so intimately tied to poverty.

Separate from this, I am interested in testing and evaluating environmental interventions to improve dietary intake. I have been involved in some large-scale interventions to reduce sugar-sweetened beverage consumption. Currently, I am working with a team at the University of Michigan to test various dining hall changes to reduce red meat consumption, which is an important goal for both health and sustainability reasons.

Q: What does it mean to you as an alumna to be back at the School as a faculty member?

I am excited and humbled to be back at Harvard Chan School, where I got my foundational training and launched my career. Now, ten years later, I think I have a more holistic perspective of how I can take my work to the next stage. I also feel very privileged to work alongside my former mentors and colleagues, and the increasingly talented pool of students that we have.

Overall, I am really optimistic about growing my research program at the School, focusing on the intersection of nutrition and health equity. I am deeply committed to serving the public health community in that space.

Amy Roeder