Diet in Food Insecurity: A Mediator of Metabolic Health? J Endocr Soc 2024 Apr 06;8(6):bvae062
Date
04/16/2024Pubmed ID
38623381Pubmed Central ID
PMC11017326DOI
10.1210/jendso/bvae062Scopus ID
2-s2.0-85190716270 (requires institutional sign-in at Scopus site)Abstract
OBJECTIVE: Food insecurity (FI) is associated with poor metabolic health. It is assumed that energy intake and diet quality underlie this association. We tested the hypothesis that dietary factors (quantity and quality) mediate the association of FI with excess weight, waist circumference and glycemic control [glycohemoglobin (A1C)].
METHODS: A mediation analysis was performed on data from the National Health And Nutrition Examination Survey using FI as an independent variable; body mass index (BMI), waist circumference, and A1C as metabolic outcome variables and total energy intake, macronutrients, and diet quality measured by the Healthy Eating Index-2015 (HEI-2015) as potential mediators.
RESULTS: Despite a greater prevalence of obesity in participants experiencing FI, daily reported energy intake was similar in food-secure and -insecure subjects. In adjusted analyses of the overall cohort, none of the examined dietary factors mediated associations between FI and metabolic outcomes. In race-stratified analyses, total sugar consumption was a partial mediator of BMI in non-Hispanic Whites, while diet quality measures (HEI-2015 total score and added sugar subscore) were partial mediators of waist circumference and BMI, respectively, for those in the "other" ethnic group.
CONCLUSION: Dietary factors are not the main factors underlying the association of FI with metabolic health. Future studies should investigate whether other social determinants of health commonly present in the context of FI play a role in this association.
Author List
Morselli LL, Amjad R, James R, Kindel TL, Kwitek AE, Williams JS, Grobe JL, Kidambi SAuthors
Justin L. Grobe PhD Professor in the Physiology department at Medical College of WisconsinAnne E. Kwitek PhD Professor in the Physiology department at Medical College of Wisconsin
Joni Williams MD, MPH Associate Professor in the Medicine department at Medical College of Wisconsin
