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Food insecurity among Puerto Ricans linked with low glycemic control
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Where limits or uncertainties exist in the availability of nutritionally adequate food, or the ability to acquire it, people are likely to consume less fruits and vegetables, according to findings published in Diabetes Care.
This food insecurity was associated with poor longitudinal glycemic control in a prospective, population-based investigation conducted in Massachusetts using information gathered from the Boston Puerto Rican Health Study.
“The association between food insecurity and poor dietary quality, especially with regard to vegetable consumption, may be an important consideration for both clinicians and those working with nutrition policy,” the researchers wrote.
Seth A. Berkowitz, MD, of the department of medicine at Massachusetts General Hospital, and colleagues, evaluated 516 adults aged 45 to 75 years with diabetes. Participants had Food Security Survey Module records, dietary pattern data based on Healthy Eating Index 2005 (HEI 2005) and HbA1c measurements from the study’s baseline and follow-up at 2 years.
Using multivariable-adjusted repeated mixed-effects models, the researchers determined the relationships between food security and dietary patterns, then assessed the impact of patterns on HbA1c concentrations over time.
People with food insecurity reported lower dietary quality and lower fruit and vegetable intake overall. Based on interactions between food insecurity and HEI 2005 (P<.001), a higher-quality diet was found to be more strongly associated with decreased HbA1c levels with food insecurity compared with food security.
In adjusted models, decreased HbA1c levels at follow-up were associated with increased HEI 2005 scores (beta = –0.01 HbA1c % per HEI 2005 point per year, P=.003). The same models showed associations between decreased HbA1c and intake of total vegetables (b = –0.09, P=.04) and dark green and orange vegetables and legumes (b = –0.06, P=.048)
People with the maximum total vegetable score showed HbA1c improvements of 0.5% per year, compared with the minimum.
“Future research should test whether interventions that materially support reductions in food insecurity and increases in vegetable consumption improve health in vulnerable patients with diabetes,” the researchers wrote.
Disclosures: One researcher was supported by an Institutional National Research Service Award, the Ryoichi Sasakawa Fellowship Fund and the General Medicine Division at Massachusetts General Hospital. The Boston Puerto Rican Health Study was supported by the National Institute on Aging and the National Heart, Lung and Blood Institute.
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