Why Staying Active Is Tough When You Don’t Know Where Your Next Meal Is Coming From

When people don’t have steady access to healthy food, staying physically active becomes a real challenge. Research has long shown that food insecurity is tied to lower activity levels and a higher risk of heart and metabolic problems. A growing number of programs, often called "Food Is Medicine" (FIM) initiatives, are designed to help by giving people better food options. But what about movement and exercise? A recent study dug into how adults dealing with food insecurity think about physical activity while taking part in one of these programs.

The research was part of a larger clinical trial called Healthy Food First, which focused on adults with high blood pressure who also struggled to get enough food. Participants were split into groups. Some received fresh produce delivered to their homes, while others got a grocery subsidy. A portion of the group also worked with a community health worker, or CHW, who offered coaching on lifestyle habits. Researchers interviewed 38 people, most of them women and Black, at either 12 or 18 months into the program, depending on how long their group ran. The conversations explored what made being active easier or harder.

Three big themes emerged from the interviews. First, people genuinely cared about physical activity and saw it as important for feeling good and staying healthy. Many said they wanted to move more. But actually doing it on a regular basis was another story. Barriers popped up everywhere. Lack of time, feeling exhausted after long workdays, jobs that were physically grueling, unsafe neighborhoods, bad weather, ongoing health problems, and tight budgets all got in the way. Some participants had jobs that kept them on their feet all day, which left little energy for exercise during their free time.

On the flip side, certain things made activity more doable. Social support mattered a lot. Having friends, family, or neighbors to walk with or talk to helped people stay motivated. Access to safe outdoor spaces, like parks or walking paths, was another big plus. The community health workers were seen as helpful and encouraging, but their coaching leaned heavily toward nutrition advice. Physical activity didn’t get as much attention, which limited how much impact they could have on exercise habits. Participants also noticed an interesting link: better food quality gave them more energy, and that energy made it easier to be active. Likewise, being active helped them feel better about eating well. It was a two-way street.

The takeaway from this study is clear. People facing food insecurity really do want to be active, but life keeps getting in the way. Food is Medicine programs that focus only on food miss a big part of the picture. Adding simple, low-effort ways to support physical activity right alongside nutrition help could make these programs work even better. Future interventions should think about how to fold movement support into the mix without piling extra stress onto people who are already juggling a lot.