Objectives: To examine the independent association of food insecurity with type 2 diabetes (T2D), and to identify the T2D risk factors related to food insecurity among Latinas.
Methods: Case-control study in a convenience sample of 201 Latinas (100 cases with T2D, 101 controls) aged 35-60 years and living in an urban setting. Self-reported data, including food insecurity, T2D status, depression symptoms, and socioeconomic, demographic, and lifestyle characteristics (food and alcohol intake, cigarette smoking, physical activity) were collected, and height, weight and waist circumference were measured. Separate multivariate logistic regression models were specified for T2D and food insecurity.
Results: Participants with very low food security were 3.3 times more likely to have T2D (OR 3.33, 95% CI 1.34-8.23) independently of employment status, acculturation, waist circumference, and lifestyle characteristics. High waist circumference (>88cm) (OR 2.46, 95% CI 1.13-5.38) and being in the lowest quartile of physical activity level (OR 3.75, 95% CI 1.21-11.62) were also risk factors for T2D. Elevated depression symptoms and participation in the Supplemental Nutrition Assistance Program (SNAP) were positively related to low and very low food security after adjusting for waist circumference (P<.01); cigarette smoking was positively associated with very low food security, and nutrition knowledge was negatively related to low food security (P<.01).
Conclusions: These results highlight the need for interventions focusing on prevention of depression and food insecurity among Latinas with T2D.