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Direct and Indirect Pathways Between Food Insecurity and Glycemic Control in Adults with Diabetes
Rebekah J Walker1, Rabia Amjad2, Jennifer A Campbell1
1Division of Population Health, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA.
Food insecurity worsens glycemic control in adults with diabetes, directly and indirectly through increased waist circumference and poorer healthy eating. Body composition was not a significant factor.
Area of Science:
- Nutrition Science
- Public Health
- Endocrinology
Background:
- Food insecurity is a known contributor to poor glycemic control in adults with diabetes.
- Understanding the pathways linking food insecurity to glycemic control is crucial for targeted interventions.
Purpose of the Study:
- To investigate the direct and indirect relationships between food insecurity and glycemic control in adults with diabetes.
- To examine the mediating roles of body composition, anthropometrics (waist circumference), and healthy eating.
Main Methods:
- Utilized National Health and Nutrition Examination Survey (NHANES) data (2011-2018) from adults with diabetes.
- Employed structural equation modeling to analyze associations between food insecurity, glycemic control (HbA1c), and potential mediators.
- Measured body composition, anthropometrics, healthy eating index (HEI), and food insecurity using established scales.
Main Results:
- Higher food insecurity was directly associated with higher HbA1c.
- Food insecurity indirectly impacted HbA1c through increased waist circumference and lower HEI scores.
- Waist circumference and HEI were significant mediators, while body composition was not.
Conclusions:
- Waist circumference and overall healthy eating index are significant pathways linking food insecurity to worse glycemic control in adults with diabetes.
- Interventions addressing healthy eating and weight management may mitigate the negative effects of food insecurity on diabetes outcomes.
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