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Severe food insecurity among low-income adults is linked to an increased rate of diabetes

About 12 percent of the U.S. population experiences food insecurity (i.e., difficulty getting enough food to eat). Food insecurity occurs in homes that suffer a lack of financial resources and has been linked to weight gain and obesity among women. A new study goes a step further to link food insecurity to diabetes risk, independent of obesity.

Researchers found that adults who were severely insecure about food availability were twice as likely to have diabetes as those who had food security. This finding held, even after adjusting for body mass index, level of physical activity, history of diabetes, and sociodemographic factors (such as age, income, and race). There was a definite link between food insecurity and obesity among women, but not men; however, increased obesity rates accounted for only 20 percent of the increased odds of diabetes among these women.

Families in low-income households trying to plan meals often look for cheaper food alternatives, such as refined grains, added sugars, and added fats. These alternatives tend to be calorically dense, but nonnutritious. These poor food choices may play a role in the relationship between food insecurity and diabetes, suggest the researchers. They analyzed 1991 and 2002 data on 4,423 adults from the National Health and Nutrition Examination Survey, a nationally representative survey of U.S. households.

Women in the severe food insecurity category had a mean daily caloric intake of 1,876 kcal/day and carbohydrate intake of 242 g/day compared to 1,822 kcal/day and 237 g/day, respectively, in the mild food insecurity group, and 1,780 kcal/day and 233 g/day, respectively, in the food secure group. There was no similar trend in men. Stress and irregular eating patterns may also mediate the relationship between food insecurity and diabetes.

The study was supported in part by the Agency for Healthcare Research and Quality (HS11415).

See "Food insecurity is associated with diabetes mellitus: Results from the National Health Examination and Nutrition Examination Survey (NHANES) 1999-2002," by Hilary K. Seligman, M.D., M.A.S., Andrew B. Bindman, M.D., Eric Vittinghoff, Ph.D., and others, in the April 2007 Journal of General Internal Medicine 22, pp. 1018-1023.

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