Food insecurity risk related to diabetes later in life

While previous research has associated food insecurity with a range of health issues including diabetes, obesity and hypertension, this study showed a connection over time, suggesting a causal relationship.

In the study, published in the Journal of Nutrition, researchers analyzed data on nearly 4,000 people from the National Longitudinal Study of Adolescent to Adult Health. They found that adults ages 24-32 who said they'd been worried about food running out in the last year showed greater incidence of diabetes, either through blood glucose tests or self-reports, at ages 32-42, compared to those who did not report food insecurity risk.

"When we look at the data 10 years later, we do see this separation in prevalence of diabetes: those that experienced risk of food insecurity at young adulthood are more likely to have diabetes in middle adulthood," said Cassandra Nguyen, the study's lead author and an assistant professor with WSU's Institute for Research and Education to Advance Community Health or IREACH.

While the study could not identify the exact reason for this connection, previous research has shown that food-insecure households often have diets with lower nutritional values.

"Eating according to the dietary guidelines tends to cost more money, and it may cost more time," said Nguyen. "It's not always accessible to households that have limitations such as transportation to sources of lower cost, nutritionally dense food."

Nguyen added that people experiencing food insecurity can also get caught in a negative reinforcing cycle: when food insecurity is associated with a diet that contributes to disease risk, which then creates additional health care expenses, stressing a household's economic resources and deepening food insecurity.

The study did not reveal differences among race or ethnicity, but the authors noted that the numbers of minorities in the sample may be too low to show a pattern.

For future work, the research team plans to investigate food insecurity risk and health issues within American Indian and Alaska Native populations. These communities are often left out of annual reports on food insecurity, which means they may be overlooked when reforms are made to food assistance programs and policies. Nguyen recently led a review of 30 studies that found food insecurity estimates in Native populations varied widely, but even the lowest estimate far exceeds the prevalence among non-Hispanic white adults.

Interventions -- such as SNAP, the Supplemental Nutrition Assistance Program, it's educational component SNAP-Ed and EFNEP, the Expanded Food and Nutrition Education Program -- have been shown to be effective in improving diet and health, Nguyen said. But to benefit from them, people have to be counted first.

"It's really important to ensure that individuals who are experiencing food insecurity are able to be identified and that they have resources made available to them to be able to break the cycle," she said.

The study was conducted by an interdisciplinary team all affiliated with IREACH: Nguyen, who published the work under her maiden name Nikolaus, and Luciana Herbert are both from WSU Elson S. Floyd College of Medicine; Anna Zamora-Kapoor from the WSU Department of Sociology and Ka'imi Sinclair from the WSU College of Nursing.

This research is supported by the National Institute of Diabetes and Digestive and Kidney Diseases through a grant to the Center for American Indian and Alaska Native Diabetes Translation Research.