Bridging science and action: three scholars tackle heart health challenges

“Heart health is a function of so much more than diet and exercise. We have to look at the broader factors—like financial stress, food insecurity, and accessibility—to truly make an impact,” said Amber W. Kinsey, Ph.D., during a recent Forge AHEAD seminar.

The March event featured three Forge AHEAD scholars who shared their research on addressing cardiovascular health through behavioral interventions. Their work, spanning financial wellness, food insecurity, and maternal health, highlights the need for integrated solutions that go beyond traditional public health approaches.

The seminar provided a platform for Kinsey, Candice A. Myers, Ph.D., and Camille Schneider-Worthington, Ph.D., to discuss their Forge AHEAD pilot projects and the real-world applications of their research.

Rethinking heart health: the role of financial wellness

Kinsey, an assistant professor at the University of Alabama at Birmingham, studies the intersection of financial well-being and physical activity in relation to cardiovascular health.

Her research underscores a crucial but often overlooked connection: financial stress is more than a burden; it’s a physiological risk factor for heart disease.

“Financial insecurity isn’t just about money. It’s a stressor that changes behavior and impacts physical health in ways we don’t always consider,” she said.

Kinsey’s study, “An integrated cardiometabolic intervention targeting physical and financial health: A pilot study”, integrates resistance training and financial coaching for participants facing economic hardships. The pilot program examines whether improving financial literacy can lead to better health choices and reduced stress, ultimately lowering cardiovascular risk.

Did you know? Chronic financial stress isn’t just a mental burden—it affects your body, too.

Increased Cortisol Levels – Prolonged stress triggers excess cortisol, which contributes to inflammation, insulin resistance, and high blood pressure—all key risk factors for heart disease (American Psychological Association, 2022).

Higher Blood Pressure & Heart Rate – Financial strain has been linked to hypertension, even after adjusting for lifestyle factors (Gallo et al., Psychosomatic Medicine, 2021).

Behavioral Impact – People experiencing financial hardship may be more likely to reduce physical activity, skip medical appointments, or make diet choices based on affordability rather than health (Kinsey, Forge AHEAD Seminar, 2024).

➡️ Dr. Amber Kinsey’s research explores whether financial coaching, combined with resistance training, can break this cycle and improve overall heart health.

Food insecurity: a hidden cardiovascular risk

Myers, assistant professor in the Division of Population and Public Health Science at Pennington Biomedical Research Center, focuses on food insecurity as a driver of poor heart health in her project “TARGETing Healthy Weight Loss in the Context of Food Insecurity Pilot and Feasibility Trial“.

Using data from the PROPEL trial—an obesity treatment study—Myers explored whether individuals with food insecurity had worse cardiovascular outcomes than those with consistent access to food. Surprisingly, her baseline analysis found no significant difference between the two groups.

But that doesn’t mean food insecurity isn’t a critical factor. Instead, it suggests that broader health challenges overshadow the differences in food access alone.

“Food insecurity is linked to chronic disease in ways we don’t fully understand yet. It’s not just about nutrition—it’s about the stress, the trade-offs, and the long-term effects on health behavior,” Myers explained.

Her next steps involve using the updated Life’s Essential 8 cardiovascular health model to see if new insights emerge.

Maternal health and the power of food as medicine

Worthington’s work bridges pregnancy, nutrition, and cardiovascular health. She studies how food access during pregnancy influences both maternal and infant health outcomes.

Her pilot study, “Use of home-delivered meals to manage cardiometabolic health during pregnancy among predominantly Black, low-income women in Alabama“, tested a meal delivery intervention for pregnant individuals facing food insecurity. Participants received nutritionally balanced meals, with the goal of reducing stress, improving diet quality, and preventing excessive gestational weight gain—a major risk factor for cardiovascular disease.

But recruitment proved more challenging than anticipated. Despite offering free, healthy meals, many potential participants declined.

“We assume that free food is an easy sell, but there are barriers we don’t always think about—time, trust, preferences, and the reality of everyday life,” Worthington said.

The qualitative exit interviews, however, revealed a clear impact: Participants reported reduced stress, improved food security, and the discovery of new, healthy foods they previously wouldn’t have tried.

What if your doctor could prescribe healthy meals?

That’s the idea behind Food is Medicine (FIM).

What is it?

A growing movement in healthcare that integrates nutrition into medical treatment by providing medically tailored meals, produce prescriptions, or grocery deliveries to improve health outcomes.

Why does it matter?

Studies show that medically tailored meals reduce hospitalizations by 49% and overall healthcare costs by 16% (JAMA Network Open, 2019).

For pregnant individuals, better nutrition can lower risks of gestational diabetes, preeclampsia, and excessive weight gain—which all affect long-term cardiovascular health (Worthington, Forge AHEAD Seminar, 2024).

➡️ Dr. Camille Worthington’s pilot study tested a meal delivery intervention for pregnant women, exploring whether better nutrition access could improve maternal and infant health outcomes.

Amber W. Kinsey, Ph.D.

Assistant Professor, Division of General Internal Medicine & Population Science at UAB Heersink School of Medicine

Learn more about Kinsey.

Candice A. Myers, Ph.D.

Assistant Professor, Pennington Biomedical Research Center

Learn more about Myers.

Life's Essential 8™

The American Heart Association’s Life’s Essential 8™ is a comprehensive guide outlining eight key measures to maintain and improve cardiovascular health:

Eat Better, Be More Active, Quit Tobacco, Get Healthy Sleep, Manage Weight, Control Cholesterol, Manage Blood Sugar, Manage Blood Pressure

These measures collectively aim to enhance cardiovascular health and reduce the risk of heart disease and stroke.

➡️ Dr. Candice Myers is applying this updated model to reassess the relationship between food insecurity and cardiovascular health—hoping to uncover new insights missed by the older metric.

Learn more about Life’s Essential 8™

Camille Schneider-Worthington, Ph.D.

Assistant Professor, Division of General Internal Medicine & Population Science at UAB Heersink School of Medicine

Learn more about Worthington.

A shared vision: addressing the root causes of health challenges

Despite the distinct focuses of their projects, all three scholars emphasized a shared reality: improving cardiovascular health requires tackling the social and economic barriers that shape behavior.

“We can’t talk about heart health in isolation. If we want to make a difference, we have to address the structural and social factors that limit people’s ability to make healthy choices,” Kinsey said.

Looking ahead: turning research into action

Each scholar’s research reflects a critical shift in public health: moving beyond individual behavior change to structural solutions that improve health outcomes at a community level.

As these projects progress, they will continue to inform policy, interventions, and best practices for addressing cardiovascular health—ensuring that heart health research doesn’t stay in the lab, but makes a real-world impact.

For updates on upcoming Forge AHEAD events and resources, visit our website.

You can watch the seminar presentation video here.

Follow-up: how nutrition is transforming maternal health in Alabama

Last year, Forge AHEAD featured the work of Camille Worthington, Ph.D., RDN, an assistant professor at the University of Alabama at Birmingham, who is studying how home-delivered meals could improve pregnancy outcomes for Medicaid-eligible women in Alabama. Since then, her pilot study has progressed, providing insights into how food access, stress, and nutrition interventions shape maternal health.

During National Nutrition Month, it’s an opportunity to look at what’s changed, what’s been learned, and how these findings could influence maternal health policies.

New Findings from the Home-Delivered Meal Study

Worthington’s study provides ten free, healthy meals per week to participants, aiming to improve diet quality, support healthy weight gain, and reduce stress.

“We are still analyzing the full results, but one of the biggest takeaways so far is that these meals aren’t just about nutrition. They provide peace of mind. Participants tell us they feel relieved knowing they have healthy meals ready to go, especially after a long day,” Worthington said.

Women also reported that the convenience of having meals already prepared reduced stress and saved time. Many used the meals for work lunches or relied on them when they didn’t have the energy to cook. Some even discovered new foods they had never tried before.

“One mom told us she had never had bok choy before and now she loves it. That’s a small but important shift, because when people are exposed to new, healthy foods in a convenient way, they’re more likely to integrate them into their daily lives,” Worthington explained.

Another unanticipated benefit was that participants started recreating meals on their own. Having access to prepared, balanced meals helped reinforce healthier eating habits beyond pregnancy.

“We saw that some women wanted to make their own versions of the meals they loved, which is an exciting sign that these interventions could have a lasting impact,” she said.

Camille Schneider-Worthington, Ph.D.

Assistant Professor, Division of General Internal Medicine & Population Science, UAB Heersink School of Medicine

Learn more about Worthington.

Maternal Health in Alabama

Alabama has one of the highest maternal mortality rates in the U.S.

36.4 maternal deaths per 100,000 live births – 3rd highest in the nation.
Black women are twice as likely to die from pregnancy-related causes compared to white women.
Food insecurity and poor nutrition access are key contributors to pregnancy complications.

For more information, refer to the ADPH “2020 Maternal Mortality Review“.

How Home-Delivered Meals Fit into Maternal Health Care

A year ago, Worthington described her long-term vision for making nutrition a standard part of prenatal care. That goal remains the same, but now, the study is providing evidence to support that vision.

“Pregnancy complications shouldn’t be inevitable. If we can remove barriers to nutrition—cost, transportation, time—we can help prevent conditions like gestational diabetes, preeclampsia, and excessive weight gain before they start.”

🍽️ How Home-Delivered Meals Support Pregnancy

✅ Eliminates the Stress of Finding Healthy Food – Pregnant women in food-insecure households are more likely to have preterm births. (Journal of the Academy of Nutrition and Dietetics, 2022)

✅ Provides Essential Nutrients – Home-delivered meals ensure intake of critical pregnancy nutrients, including folate, iron, and protein. (National Institute on Minority Health and Health Disparities, 2023)

✅ Supports Weight Management & Reduces Health Risks – Women with better dietary intake during pregnancy have a 20% lower risk of gestational diabetes. (American Journal of Clinical Nutrition, 2023)

✅ Encourages Long-Term Healthy Eating Habits – Women in structured meal programs are more likely to continue healthy eating postpartum. (Centers for Disease Control and Prevention, 2023)

She hopes these findings can be used to make the case for meal delivery as a covered healthcare service for pregnant women.

“My goal is to take this research beyond a pilot study and work toward integrating nutrition support into prenatal care on a larger scale. I plan to present our findings to Alabama Medicaid and other insurance providers to advocate for meal delivery as a covered healthcare service. If we can show that providing healthy meals improves pregnancy outcomes while reducing medical costs, we can make a strong case for long-term policy change.”

Expanding Nutrition Education Beyond Delivery

One of the next steps in the study is to incorporate nutrition education alongside meal delivery.

“We’re exploring ways to not only provide meals but also give participants the knowledge and confidence to cook these meals for themselves and their families. In our future studies, we’re considering including recipe cards with meals to support long-term healthy eating habits.”

This shift aligns with the National Nutrition Month theme, “Food That Connects Us.”

“Food isn’t just about physical health. It’s deeply tied to culture, family, and connection. If we can provide meals that introduce women to healthier versions of culturally familiar foods, we’re not just improving nutrition. We’re strengthening community ties and giving women tools they can carry with them long after pregnancy.”

How to Get Involved

One year later, Worthington’s research continues to evolve, but the need for better maternal nutrition support remains urgent. Here’s how you can help:

✔ Stay Informed – Follow Forge AHEAD and Worthington’s research to stay updated on nutrition and maternal health advancements.

✔ Support Local Food Initiatives – Donate or volunteer with food security programs helping pregnant women access healthy meals.

“We know that food connects us in so many ways. By making healthy food more accessible, we’re going beyond improving individual pregnancies. We’re also strengthening entire communities.”

-Camille Schneider-Worthington, Ph.D.

“Healthy Eating for Women Who Are Pregnant or Breastfeeding”
USDA: MyPlate.gov

“Build a Healthy Eating Routine When You’re Pregnant or Breastfeeding”
DietaryGuidelines.gov

“Advice About Eating Fish”
FDA.gov

“Food Safety for Baby and Me”
FoodSafety.gov

Here are some nutrition resources that may be helpful, especially for women who are pregnant or breastfeeding

Our Scholars’ stories: Worthington revolutionizes maternal health through innovative nutrition programs

Our Scholars’ stories: Worthington revolutionizes maternal health through innovative nutrition programs

Camille Worthington, Ph.D., assistant professor in the Department of Medicine at the University of Alabama at Birmingham (UAB), is spearheading a groundbreaking initiative to transform maternal health through innovative nutritional interventions.

Her project, “Use of Home-Delivered Meals to Manage Cardiometabolic Health during Pregnancy among Predominantly Black, Low-Income Women in Alabama,” focuses on the critical juncture of pregnancy, diet, maternal well-being, and birth outcomes among Medicaid-eligible pregnant individuals.

Worthington’s “Why”

At the heart of Worthington’s initiative lies a profound purpose—to resolve the disparities prevalent in healthy eating and appropriate pregnancy weight gain that contribute to unequal risk of poor pregnancy outcomes, such as high blood pressure, particularly among marginalized communities.

“The U.S. and Alabama have some of the highest rates of pregnancy complications, poor pregnancy outcomes, and mom and baby death related to pregnancy,” Worthington explains. “Good nutrition is an important part of a healthy pregnancy, but not everyone has the ability to afford or access a healthy diet.”

Worthington explains that neighborhoods with more Black/African American residents and more low-income households have more fast-food restaurants, less grocery stores, and fewer healthy food options. These circumstances contribute to poor outcomes during pregnancy.

A staggering 70% of pregnant women exceed recommended intakes of added sugars, sodium, and saturated fats. Additionally, more than half gain excess weight during pregnancy, risking their and their babies’ health.

Transforming outcomes through food delivery

“The purpose of my project is to see if providing pregnant moms who are Medicaid-eligible with ten free healthy meals delivered right to their homes each week during their pregnancy helps them eat healthier, gain the right amount of pregnancy weight, have less stress, and if it is a service that they like,” says Worthington.

She envisions a transformative impact on the community by providing access to healthy meals.

“Healthy meal delivery can support healthier pregnancies, which supports healthier babies, and ultimately healthier communities,” she says.

“Long-term, we hope to show that providing pregnant people with healthy meals improves pregnancy outcomes and saves insurance companies money by preventing moms and babies from having pregnancy complications and having to stay in the hospital.”

Worthington explains that pregnant individuals eligible for Medicaid are participants in the program. Health care providers, community organizations supporting expectant mothers, and insurance providers are stakeholders in broader implementation.

Moving towards change

“We want healthy meal delivery to become a covered health care service to support all moms’ ability to eat healthy and have a healthy pregnancy.”

Worthington passionately emphasizes the intrinsic link between a balanced diet, stress reduction, and improved health outcomes for both mother and baby, paving the way to address the prevailing disparities in maternal healthcare across the U.S.

“Overall, a better diet, healthier pregnancy weight gain, and lower stress can improve health outcomes for mom and baby and could help to overcome the unequal rates of pregnancy complications that we see in the U.S.,” she says.

Worthington’s visionary initiative serves as a beacon of hope, steering academia, health care providers, and policymakers toward a paradigm shift in maternal health, advocating for a future where access to nutritious meals becomes an inalienable right for every expectant mother.