Food Insecurity and Adequacy of Dietary Intake in Youth and Young Adults With Youth-Onset Type 1 and Type 2 Diabetes.

Abstract

BACKGROUND:

Household food insecurity is associated with poor dietary intake in the general population, but little is known about this association in persons with diabetes.

OBJECTIVE:

We examined the degree of adherence to the dietary reference intakes and 2020-2025 Dietary Guidelines for Americans overall and according to food security status and diabetes type among youth and young adults (YYA) with youth-onset diabetes.

DESIGN, PARTICIPANTS, AND SETTING:

The SEARCH for Diabetes in Youth study includes 1,197 YYA with type 1 diabetes (mean age = 21 ± 5 years) and 319 YYA with type 2 diabetes (25 ± 4 years). Participants (or parents if younger than age 18 years) completed the US Department of Agriculture Household Food Security Survey Module, wherein ≥3 affirmations indicate food insecurity.

MAIN OUTCOME MEASURES:

Diet was assessed via food frequency questionnaire and compared with age- and sex-specific dietary reference intakes for 10 nutrients and dietary components (calcium; fiber; magnesium; potassium; sodium; vitamins C, D, and E; added sugar; and saturated fat).

STATISTICAL ANALYSES PERFORMED:

Median regression models controlled for sex- and type-specific means for age, diabetes duration, and daily energy intake.

RESULTS:

Prevalence of guideline adherence was overarchingly poor, with <40% of participants meeting recommendations for eight of 10 nutrients and dietary components; however, higher adherence (>47%) was observed for vitamin C and added sugars. YYA with type 1 diabetes who were food insecure were more likely to meet recommendations for calcium, magnesium, and vitamin E (P < 0.05), and less likely for sodium (P < 0.05) than those with food security. In adjusted models, YYA with type 1 diabetes who were food secure had closer median adherence to sodium (P = 0.002) and fiber (P = 0.042) guidelines than those food insecure. No associations were observed in YYA with type 2 diabetes.

CONCLUSIONS:

Food insecurity is associated with lesser adherence to fiber and sodium guidelines in YYA with type 1 diabetes, which may lead to diabetes complications and other chronic diseases.

• Authors: Hope Bercaw, Lauren A Reid, Jason A Mendoza, Edward A Frongillo, Katherine A Sauder, Beth A Reboussin, Elizabeth J Mayer-Davis, Dana Dabelea, Santica M Marcovina, Carla Mercado, Angela D Liese
• Journal: Journal of the Academy of Nutrition and Dietetics (J Acad Nutr Diet) Vol. 123 Issue 8 Pg. 1162-1172.e1 (08 2023) ISSN: 2212-2672 [Print] United States
• PMID: 36990427 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, P.H.S.)
• Copyright: Copyright © 2023 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Chemical References

• Magnesium
• Calcium
• Vitamins
• Ascorbic Acid
• Calcium, Dietary
• Sodium

Topics

• Male
• Female
• Humans
• Adolescent
• Young Adult
• Adult
• Diabetes Mellitus, Type 2 (epidemiology)
• Diabetes Mellitus, Type 1 (epidemiology)
• Magnesium
• Calcium
• Food Supply
• Diet
• Vitamins
• Ascorbic Acid
• Calcium, Dietary
• Eating
• Food Insecurity
• Sodium