Food Insecurity in Young Adulthood Linked to Obesity, Diabetes Risk Later in Life


An analysis of data from more than 3500 individuals followed for more than 20 years provides insight into the impact of food insecurity on risk of cardiometabolic conditions, including obesity and type 2 diabetes.

A man in the supermarket

A recent analysis of data from nearly 4000 patients in the US provides insight into the association of food insecurity in young adulthood with risk of diabetes later in life.

Conducted by investigators from Washington State University (WSU), data from the study suggest food insecurity was associated with increases in BMI as well as increased incidence of obesity and diabetes from young to middle adulthood in unadjusted and adjusted models.

“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, PhD, the study’s lead author and an assistant professor with WSU’s Institute for Research and Education to Advance Community Health, in a statement from WSU.

Citing reliance on cross-sectional studies and self-reported data among previous studies, Nguyen and a team of colleagues designed the current study as an analysis of data from the 4th and 5th waves of the National Longitudinal Study of Adolescent to Adult Health, with the intent of assessing the association of risk of food insecurity with BMI, obesity, and diabetes, with adjustment for sociodemographic features. A nationally representative cohort study conducted by the Carolina Population Center at the University of North Carolina–Chapel Hill, the study provided investigators with data related to more than 20,000 adolescent patients enrolled during the 1994-1995 academic school year.

Limiting their study to those with data from waves 4 and 5 of the study, which occurred in 2008-2009 and 2016-2018 when cohort members were 24–32 and 32–42 years old, respectively, investigators identified a cohort of 3992 individuals with no missing data related to risk of food insecurity, body weight, diabetes, and sociodemographic characteristics for inclusion in their study. Overall, 4655 patients had participated in both wave 4 and wave 5, but 663 patients were considered ineligible for inclusion based on missing data.

Results of the investigators’ analyses suggested risk of food insecurity at wave 4 was significantly associated with respondents’ sex (P=.05), race/ethnicity (P <.001), formal education (P <.001), current employment (P <.001), household income (P <.001), smoking cigarettes (P <.001), and drinking alcohol (P=.02). Initial analysis indicated the prevalence of obesity at both wave 4 (P <.001) and wave 5 (P=.004) was higher among participants who were at risk of food insecurity at wave 4 in comparison to those not at risk of food insecurity. Additionally, the prevalence of diabetes at wave 4 was not significantly altered by risk of food insecurity at wave 4 (P=.21) but was more prevalent among participants during wave 5 who had reported risk of food insecurity at wave 4 (P=.002).

In models adjusting for Further analysis revealed risk of food insecurity was no longer significantly associated with obesity among non-Hispanic White respondents (P >.05), and interaction terms between risk of food insecurity and assessment wave were not significant in any models (P >.05) in models adjusting for sociodemographic characteristics.

“In the current study, risk of food insecurity assessed at 1 time point in young adulthood was associated with BMI and obesity at young adulthood and middle adulthood but did not relate to change over time. This aligns with prior research that reports food insecurity is associated with higher BMI,” investigators wrote.

This study, “Risk of Food Insecurity in Young Adulthood and Longitudinal Changes in Cardiometabolic Health: Evidence from the National Longitudinal Study of Adolescent to Adult Health,” was published in the Journal of Nutrition.

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