Food insecurity as a risk factor of diabetes mellitus
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Food insecurity occurs whenever access to adequate and safe foods is limited, uncertain, or dependent on altruistic food supplies, scavenging, or stealing. In industrialized countries, it primarily results from financial pauperization. Food insecurity (defined as limited or uncertain access to food resulting from inadequate financial resources) was investigated in order to assess whether it was independently associated with diabetes mellitus. 4423 adults from the National Health and Nutrition Examination Survey (NHANES; 1999-2002) with household incomes ≤300% of the federal poverty level were categorized as food secure, mildly food insecure, or severely food insecure using a well-validated food insecurity scale. Diabetes was either self-reported or determined by fasting serum glucose ≥126 mg/dL. The prevalence of diabetes was 11.7% in the food secure, 10.0% in the mildly food insecure, and 16.1% in the severely food insecure categories. Compared to subjects without food insecurity, subjects with severe food insecurity were more likely to have diabetes after adjusting for socio-demographic data and physical activity, with an adjusted odds ratio of 2.1. This association remained robust after adjustment for body mass index, with an adjusted odds ratio of 2.2. The authors hypothesize that people with low income may resort to cheaper food alternatives, which tend to be nutritionally poor, calorically dense, associated with reduced fruits and vegetables consumption and increased fat intake (including saturated fats) as well as highly-refined carbohydrates, all components related to an increased risk for diabetes mellitus.
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