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Each year just before Thanksgiving, the US Department of Agriculture (USDA) reports the number of US households that are at risk for going hungry because of an inability to afford food—a condition termed “food insecurity.” After a stable prevalence for the past decade, the rate of food insecurity rose by 32% in 2008, to 14.6% of US households—the highest level since the first food-security survey was conducted in 1995. About 21% of US households with children are affected, as are more than a quarter of black and Hispanic households, and 42% of households with incomes below the federal poverty level (see graph). 1 According to the Life Sciences Research Office, food insecurity exists “whenever the availability of nutritionally adequate and safe foods or the ability to acquire acceptable foods in socially acceptable ways [eg, without resorting to emergency food supplies, scavenging, stealing, or other coping strategies] is limited or uncertain.” The concept of food insecurity thus encompasses both the physical sensation of hunger and compensatory behaviors used to avoid hunger. These compensatory behaviors have enormous implications for the prevention and management of chronic disease. To maintain caloric intake, adults who worry that they will not have adequate money for food reduce the variety in their diet and concentrate their intake on a few low-cost, energy-dense, and (unfortunately) nutritionally poor foods. These are generally refined carbohydrates and foods with added sugars, fats, and sodium. Calorie for calorie, these foods cost less than nutritionally rich fruits, vegetables, and dairy products. For example, $1 can purchase …