scholarly journals Race and Sex Differences in the Association between Food Insecurity and Type 2 Diabetes

2016 ◽  
Vol 26 (3) ◽  
pp. 427 ◽  
Author(s):  
Sabrina Strings ◽  
Yamini K. Ranchod ◽  
Barbara Laraia ◽  
Amani Nuru-Jeter
Keyword(s):  
Type 2 Diabetes ◽  
Food Security ◽  
Food Insecurity ◽  
African American Women ◽  
Low Income ◽  
White Women ◽  
California Health Interview Survey ◽  
Latino Men ◽  
The Relationship

<p><strong>Objective: </strong>To examine whether the relationship between food insecurity (FI) and type 2 diabetes (T2D) varies by race/ethnicity and sex. <strong></strong></p><p><strong>Methods: </strong>We analyzed data from low-income adults participating in the 2009 and 2011 waves of the California Health Interview Survey (CHIS) (N=22,596). We used logistic regression models to estimate the sex and race-specific associations between FI and T2D. </p><p><strong>Results</strong><em>: </em>We observed positive associations between low food security and T2D for White men (AOR: 1.9, 95% CI: 1.2, 3.2), and between very low food security and T2D for White women (AOR: 1.6 95% CI: 1.1, 2.5). In Latinas, we observed positive associations between both low food security (AOR: 1.7, 95% CI: 1.3, 2.2) and very low food security (AOR: 1.8, 95% CI: 1.2, 2.6) and T2D. We did not observe any associations between FI and T2D in Latino men, or African American women and men. <strong></strong></p><p><strong>Conclusion</strong><em>: </em>The relationship between FI and T2D may be moderated by race and sex. For African Americans and Latino men, other distal factors may modify the effect of FI on rates of T2D. <em>Ethn Dis. </em>2016;26(3):427-434; doi:10.18865/ ed.26.3.427 </p>

scholarly journals Disparities in the use of a mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes

2015 ◽  
Vol 23 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Lyndsay A Nelson ◽  
Shelagh A Mulvaney ◽  
Tebeb Gebretsadik ◽  
Yun-Xian Ho ◽  
Kevin B Johnson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Depressive Symptoms ◽  
Medication Adherence ◽  
Health Literacy ◽  
Low Income ◽  
Mhealth Intervention ◽  
Lower Health ◽  
The Relationship ◽  
Lower Health Literacy

Abstract Objective Mobile health (mHealth) interventions may improve diabetes outcomes, but require engagement. Little is known about what factors impede engagement, so the authors examined the relationship between patient factors and engagement in an mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes (T2DM). Materials and Methods Eighty patients with T2DM participated in a 3-month mHealth intervention called MEssaging for Diabetes that leveraged a mobile communications platform. Participants received daily text messages addressing and assessing medication adherence, and weekly interactive automated calls with adherence feedback and questions for problem solving. Longitudinal repeated measures analyses assessed the relationship between participants’ baseline characteristics and the probability of engaging with texts and calls. Results On average, participants responded to 84.0% of texts and participated in 57.1% of calls. Compared to Whites, non-Whites had a 63% decreased relative odds (adjusted odds ratio [AOR] = 0.37, 95% confidence interval [CI], 0.19-0.73) of participating in calls. In addition, lower health literacy was associated with a decreased odds of participating in calls (AOR = 0.67, 95% CI, 0.46-0.99, P = .04), whereas older age ( Pnonlinear = .01) and more depressive symptoms (AOR = 0.62, 95% CI, 0.38-1.02, P = .059) trended toward a decreased odds of responding to texts. Conclusions Racial/ethnic minorities, older adults, and persons with lower health literacy or more depressive symptoms appeared to be the least engaged in a mHealth intervention. To facilitate equitable intervention impact, future research should identify and address factors interfering with mHealth engagement.

scholarly journals Accessibility of summer meals and the food insecurity of low-income households with children

2016 ◽  
Vol 19 (11) ◽  
pp. 2079-2089 ◽  
Author(s):  
Daniel P Miller
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
Low Income ◽  
Urban Areas ◽  
California Health Interview Survey ◽  
Lower Probability ◽  
Geographic Accessibility ◽  
Households With Children ◽  
The Impact ◽  
Low Income Households

AbstractObjectiveAlmost no previous research has examined the impact of the US Department of Agriculture’s (USDA) Summer Food Service Program and related Seamless Summer Option, which provide meals and snacks to low-income children over the summer. The present study investigated whether geographic accessibility of summer meals programme sites (a proxy for programme participation) was associated with food insecurity for low-income households.DesignThe study used data from the California Health Interview Survey (CHIS) and administrative data on summer meals sites in California. Geocoding was used to calculate driving time between CHIS households and nearby summer meals sites. Geographic accessibility was measured using a gravity model, which accounted for the spatially distributed supply of and demand for summer meals. Food insecurity and very low food security were measured using a standard six-item measure from the USDA.SubjectsLow-income families with children (n5394).SettingA representative surveillance study of non-institutionalized households in California.ResultsGeographic accessibility was not associated with food insecurity. However, geographic accessibility was associated with a significantly lower probability of very low food security in the full sample and among households with younger children and those living in less urban areas.ConclusionsThe USDA’s summer meals programme may be effective at reducing the most severe form of food insecurity for low-income households with children. Expanding the number of summer meals sites, the number of meals served at sites and sites’ hours of operation may be effective strategies to promote nutritional health over the summer months.

Addressing Food Insecurity and Overweight/Obesity in Hospitalized Low-Income Latino Patients

2019 ◽  
Vol 25 (3) ◽  
pp. 241-248
Author(s):  
Trina Lorraine Gipson-Jones ◽  
Bertha L. Davis ◽  
Ché Matthew Harris
Keyword(s):  
Public Health ◽  
Type 2 Diabetes ◽  
Food Insecurity ◽  
Low Income ◽  
Adverse Outcomes ◽  
Hospital Utilization ◽  
Health Concern ◽  
Public Health Concern ◽  
Disease Risks

Food insecurity (FI), the limited or unreliable availability of safe and nutritious food, is a pressing public health concern affecting millions of U.S. citizens. Unfortunately, FI tends to impact those who are most vulnerable (e.g., low-income minorities) and potentially increases obesity risks, diet-sensitive disease risks (e.g., hypertension and type 2 diabetes), and hospital utilization. Low-income Latino patients may be particularly sensitive to adverse outcomes based on unaddressed socioeconomic needs. Nurses are in a prime position to assess and address FI in these patients. Our article will discuss how nurses can be advocates in combating FI in Latino patients with overweight/obesity.

scholarly journals Inflammation and Stress Biomarkers Mediate the Association between Household Food Insecurity and Insulin Resistance among Latinos with Type 2 Diabetes

2019 ◽  
Vol 149 (6) ◽  
pp. 982-988 ◽  
Author(s):  
Angela Bermúdez-Millán ◽  
Julie A Wagner ◽  
Richard S Feinn ◽  
Sofia Segura-Pérez ◽  
Grace Damio ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Food Security ◽  
Food Insecurity ◽  
Indirect Effect ◽  
Stress Hormones ◽  
Household Food Insecurity ◽  
Mediation Model ◽  
Household Food

ABSTRACT Background Household food insecurity (HFI) is a stressor that is associated with type 2 diabetes (T2D). However, little is known about HFI and the insulin resistance (IR) underlying T2D, and the mechanisms involved. Objective We examined the cross-sectional association between HFI and IR among low-income Latinos with T2D and tested whether inflammation and stress hormones mediated this association. Methods HFI was measured with the 6-item US Household Food Security Survey module. IR was calculated from fasting plasma blood glucose and serum insulin. Inflammation was indicated by high-sensitivity C-reactive protein (hsCRP), and stress hormones included urinary cortisol, metanephrine, and normetanephrine. To test for an indirect effect of HFI on homeostasis model assessment of IR, a parallel multiple mediation model was run with biological markers that significantly differed between food security status—entered as mediators in the model. We used 95% bias-corrected bootstrap CIs, with 10,000 bootstrap samples, to assess the significance of the indirect effects. Results The 121 participants with T2D were primarily Puerto Rican (85.8%), aged mean = 60.7 y, and 74% were female. Eighty-two (68%) were classified as food insecure. Compared with food-secure individuals, food-insecure individuals had a significantly higher IR [mean difference (Δ) = 7.21, P = 0.001], insulin (Δ = 9.7, P = 0.019), glucose (Δ = 41, P < 0.001), hsCRP (Δ = 0.8, P = 0.008), cortisol (Δ = 21, P = 0.045), and total cholesterol (Δ = 29, P = 0.004). Groups did not differ on other lipids, metanephrine, normetanephrine, or A1c. The mediation model showed a significant direct effect of HFI on hsCRP (P = 0.020) and on cortisol (P = 0.011). There was a direct effect of cortisol (P = 0.013), hsCRP (P = 0.044), and HFI on IR (P = 0.015). The total combined indirect effect of HFI through cortisol and hsCRP indicated partial mediation. Conclusions Among Latinos with T2D, HFI is associated with IR partially through inflammation and stress hormones. Interventions to ameliorate HFI and mitigate its effects on inflammation, stress, and IR are warranted. This trial was registered at clinicaltrials.gov as NCT01578096.

798-P: The Prevalence and Impact of Food Insecurity on Glycemic Control in Low-Income Latinos with Type 2 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 798-P
Author(s):  
INA CECILIA FLORES ◽  
DENISSE CRISTINA PORRAS FIMBRES ◽  
J. SONYA HAW ◽  
ALEXANDRA MIGDAL ◽  
BRITT ROTBERG ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Food Insecurity ◽  
Low Income

scholarly journals Food Insecurity is Associated with Autonomic Dysfunction Among Latinos with Type 2 Diabetes

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 162-162
Author(s):  
Angela Bermúdez-Millán ◽  
Kagnica Seng ◽  
Richard Feinn ◽  
Rafael Pérez-Escamilla ◽  
Sofia Segura-Pérez ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Heart Rate ◽  
Food Security ◽  
Food Insecurity ◽  
Health Workers ◽  
Household Food Security ◽  
Management Intervention ◽  
Funding Sources ◽  
Autonomic Index

Abstract Objectives Food insecurity (FI) is higher among Latinos than non-Hispanic Whites and associated with risk for type 2 diabetes (T2D). Autonomic nervous system (ANS) dysfunction increases mortality in diabetes. We examined FI and ANS function among Latinos with T2D. Methods Participants were drawn from the CALMS-D (Community Health Workers Assisting Latinos Manage Stress and Diabetes) stress management intervention trial. Inclusion: age 18 years, Latino or Hispanic, Spanish speaking, ambulatory status, T2D 6 months, A1c &gt; 7.0%. Exclusion: medical or psychiatric instability; pain or dysfunction in hands precluding handgrip testing. Measures: FI was assessed with the 6-item US household food security survey module; affirmative responses to &gt; = 1 questions was coded as FI. Six autonomic measures were scored 0 = normal or 1 = abnormal based on published cutoffs and then summed for a total ANS dysfunction index. ANS measures and their normal cutoffs were: 1) metanephrine &lt;350 ug/day; 2) normetanephrine &lt;600 ug/day; 3) cortisol 50–190 ug/day, all from 24-hour urine specimens; 4) 24-hour heart rate variability as reflected in standard deviation of the normal-to-normal (SDNN) heart rate acquired with 3-channel, 7-lead ambulatory electrocardiogram (holter) monitors, 149 +/–39; 5) difference between the highest diastolic blood pressure (DBP) during sustained handgrip and the average DBP at rest, &gt;15 mmHg; and, 6) difference between baseline supine and the minimal BP after standing up, normal = decline in SBP &lt;=20 mmHg and DBP &lt;=10 mmHg. Results N = 35 participated, n = 23 (65.7%) were women, age M = 61.6 (SD = 11.2) years, A1c M = 8.5% (SD = 1.6) and n = 20 (57.1%) used insulin. N = 22 (62.9%) reported FI and n = 25 (71.4%) had at least one abnormal ANS measure. In t-tests, participants with FI had a higher ANS dysfunction index (M = 1.5, SD = 0.9) than patients who were food secure (M = 0.7, SD = 0.8), P = 0.02). Total autonomic index was not related to A1c or insulin use. Conclusions In this Latino sample with T2D, FI was associated with greater ANS dysfunction. Increasing food security may confer autonomic benefits. Funding Sources Supported by National Institute on Minority Health and Health Disparities grant R01MD005879 and American Diabetes Association grant 7–13-TS-31.

scholarly journals Does the effect of lifestyle intervention for individuals with diabetes vary by food insecurity status? A preplanned subgroup analysis of the REAL HEALTH randomized clinical trial

2020 ◽  
Vol 8 (1) ◽  
pp. e001514
Author(s):  
Seth A Berkowitz ◽  
Yuchiao Chang ◽  
Bianca Porneala ◽  
Sara J Cromer ◽  
Deborah J Wexler ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Weight Loss ◽  
Food Security ◽  
Food Insecurity ◽  
Lifestyle Intervention ◽  
Subgroup Analysis ◽  
Intervention Effect ◽  
Food Security Status

IntroductionWe aimed to test the effectiveness of a lifestyle intervention (LI) for individuals with food insecurity and type 2 diabetes.Research design and methodsAdults with type 2 diabetes, body mass index ≥25 kg/m2 (or ≥23 kg/m2 if Asian), hemoglobin A1c of 6.5%–11.5% (48–97 mmol/mol) and who were willing to lose 5%–7% bodyweight were enrolled in REAL HEALTH-Diabetes. This practice-based randomized clinical trial compared LI (delivered inperson or by telephone) with medical nutrition therapy (MNT) on weight loss at 6 and 12 months. Two or more affirmative responses on the six-item US Department of Agriculture Food Security Survey Module indicated food insecurity. In this prespecified subgroup analysis, we tested using linear mixed effects models whether the intervention effect varied by food security status.ResultsOf 208 participants, 13% were food insecure. Those with food insecurity were more likely to be racial/ethnic minorities (p<0.001) and have lower education (p<0.001). LI, versus MNT, led to greater weight loss at 6 months (5.1% lost vs 1.1% lost; p<0.0001) and 12 months (4.7% lost vs 2.0% lost; p=0.0005). The intervention effect was similar regardless of food security status (5.1% bodyweight lost vs 1.1% in food secure participants and 5.1% bodyweight lost vs 1.3% in food insecure participants at 6 months; 4.7% bodyweight lost vs 2.1% in food secure participants and 4.5% bodyweight lost vs 0.9% in food insecure participants at 12 months; p for interaction=0.99).ConclusionsThe REAL HEALTH-Diabetes lifestyle intervention led to meaningful weight loss for individuals with food insecurity and type 2 diabetes.Trial registration numberNCT02320253.

scholarly journals Food Prescriptions for Management of Prediabetes and Type 2 Diabetes among Food Insecure Youth: A Pilot Protocol

2020 ◽  
Vol 3 ◽  
Author(s):  
Jonathan Oswald ◽  
Lisa Yazel ◽  
Tamara Hannon
Keyword(s):  
Type 2 Diabetes ◽  
Health Outcomes ◽  
Food Insecurity ◽  
Low Income ◽  
Vegetable Consumption ◽  
The Past ◽  
Early Results ◽  
Food And Beverage ◽  
Participant Outcomes

Introduction: Food access and food insecurity represent significant barriers to healthy eating in low-income communities. Food prescription programs have attempted to address these barriers by providing subsidized access to fresh produce through a physician-community collaboration. However, little is known about the health outcomes associated with food prescriptions, especially among youth with diabetes. To address this, we report data from the past two years of the Veggie Box program, a free produce distribution program of Indy Urban Acres. Additionally, we propose a feasibility study to 1) establish a food prescription program for food insecure youth with prediabetes and type 2 diabetes through the Veggie Box program and 2) assess health outcomes of youth who receive a prescription for Veggie Box.   Methods: Through 2018 and 2019, the Veggie Box has been distributed weekly to a low-income community on the eastside of Indianapolis. Participant outcomes have been measured through survey assessment of food and beverage consumption, food insecurity, quality of life indicators, and program satisfaction. The proposed study aims to recruit 70 food insecure families with children aged 10-16 who have prediabetes or type 2 diabetes. Participants will receive a Veggie Box once every two weeks for a total of 12 weeks and will be provided access to a dietitian, health coach, and monthly group diabetes prevention sessions. Participant outcomes will be assessed at baseline and 12 weeks using the same surveys from the past two years with the addition of BMI and HbA1c measurements.  Results: The past two years of Veggie Box distribution led to a statistically significant increase in fruit (p=0.009) and vegetable (p=0.001) consumption among Veggie Box recipients. There was not a significant change in reported food security.  Discussion/Conclusion: Early results from the Veggie Box program showed that it increased fruit and vegetable consumption, indicating its potential use as a food prescription for food insecure youth with prediabetes and type 2 diabetes. This study will begin to fill the gap in knowledge related to health outcomes of food insecure youth with diabetes who are provided a food prescription. 

Self-Management as a Mediator of the Relationship between Social Support Dimensions and Health Outcomes of African American Adults with Type 2 Diabetes

2019 ◽  
Vol 42 (7) ◽  
pp. 485-494
Author(s):  
Tariq N. Al-Dwaikat ◽  
Diane Orr Chlebowy ◽  
Lynne A. Hall ◽  
Timothy N. Crawford ◽  
Pamela A. Yankeelov
Keyword(s):  
Social Support ◽  
Type 2 Diabetes ◽  
African Americans ◽  
Health Outcomes ◽  
Low Income ◽  
Self Management ◽  
Cross Sectional ◽  
The Relationship ◽  
Functional Support

Social support promotes behavior change and self-management that leads to improved health outcomes. The purpose of this study was to evaluate the role of self-management in mediating the relationship between social support dimensions and health outcomes of African Americans with type 2 diabetes (T2D). Cross-sectional data were collected from 102 African Americans with T2D at an outpatient clinic. The majority of the participants were female, single, unemployed, and having low income. Functional support, the quality of the primary intimate relationship, and the number of support persons were negatively correlated with depression. Functional support and satisfaction with support explained a significant small amount of the variance in self-management. However, self-management did not mediate the relationships between social support dimensions and the health outcomes. The results of this study shed the light on the unique relationships of social support dimensions with health outcomes of African Americans with T2D.

scholarly journals Food Insecurity and Psychological Distress Among Former and Current Smokers With Low Income

2018 ◽  
Vol 33 (2) ◽  
pp. 199-207 ◽  
Author(s):  
Jin E. Kim-Mozeleski ◽  
Janice Y. Tsoh
Keyword(s):  
Food Security ◽  
Psychological Distress ◽  
Food Insecurity ◽  
Low Income ◽  
Smoking Status ◽  
Short Form ◽  
Multiple Logistic Regression Analysis ◽  
California Health Interview Survey ◽  
Cross Sectional ◽  
Distress Scale

Purpose: To examine how food insecurity and psychological distress interact in its association with smoking and to explore how food insecurity and psychological distress are associated with quitting smoking using quit ratio estimates. Design: Cross-sectional study. Setting: Data from the 2015 California Health Interview Survey. Participants: A total of 3007 lower income adults who have ever smoked. Measures: Ever smoking was defined as smoking 100+ cigarettes in the entire lifetime, with current smoking defined as smoking “every day” or “some days” and former smoking defined as smoking “not at all.” Psychological distress and food insecurity were measured by the 6-item K6 Psychological Distress Scale and the 6-item Food Security Survey Short Form, respectively. Analysis: Multiple logistic regression analysis was used to examine correlates of smoking status. Quit ratios (percentage of ever smokers who have quit) were calculated across study variables. Results: Reporting food insecurity with psychological distress was independently associated with lower odds of being a former smoker, compared to reporting food security without psychological distress. The quit ratio was lower among ever smokers reporting food insecurity with distress (41%) compared to ever smokers reporting food security without distress (63%). Conclusions: Specific conditions of impoverishment, such as food insecurity, interact with psychological distress in its association with continued smoking. Interventions to reduce socioeconomic disparities in smoking should consider the interacting role of food insecurity and psychological distress.

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