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. 2007 Jul;22(7):1018-23.
doi: 10.1007/s11606-007-0192-6. Epub 2007 Apr 11.

Food insecurity is associated with diabetes mellitus: results from the National Health Examination and Nutrition Examination Survey (NHANES) 1999-2002

Hilary K Seligman  1 , Andrew B Bindman, Eric Vittinghoff, Alka M Kanaya, Margot B Kushel
Affiliations

Food insecurity is associated with diabetes mellitus: results from the National Health Examination and Nutrition Examination Survey (NHANES) 1999-2002

Hilary K Seligman et al. J Gen Intern Med. 2007 Jul.

Abstract

Background: Food insecurity refers to limited or uncertain access to food resulting from inadequate financial resources. There is a clear association between food insecurity and obesity among women, but little is known about the relationship between food insecurity and type 2 diabetes.

Objective: To evaluate whether there is an independent association between food insecurity and diabetes.

Design: Cross-sectional analysis of the nationally representative, population-based National Health and Nutrition Examination Survey (1999-2002 waves).

Participants: Four thousand four hundred twenty-three adults > 20 years of age with household incomes < or = 300% of the federal poverty level.

Measurements: We categorized respondents as food secure, mildly food insecure, or severely food insecure using a well-validated food insecurity scale. Diabetes was determined by self-report or a fasting serum glucose > or = 126 mg/dl.

Results: Diabetes prevalence in the food secure, mildly food insecure, and severely food insecure categories was 11.7%, 10.0%, and 16.1%. After adjusting for sociodemographic factors and physical activity level, participants with severe food insecurity were more likely to have diabetes than those without food insecurity (adjusted odds ratio [AOR] 2.1, 95% CI 1.1-4.0, p = .02). This association persisted after further adjusting for body mass index (AOR 2.2, 95% CI 1.2-3.9, p = .01).

Conclusions: Food insecurity may act as a risk factor for diabetes. Among adults with food insecurity, increased consumption of inexpensive food alternatives, which are often calorically dense and nutritionally poor, may play a role in this relationship. Future work should address how primary care clinicians can most effectively assist patients with food insecurity to make healthy dietary changes.

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References

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