Details

Autor(en) / Beteiligte

• Jackson, Emahlea

Titel

The Association of Food Insecurity and Disordered Eating Behaviors Among Youth and Young Adults with Diabetes: The SEARCH for Diabetes in Youth Study

Ort / Verlag

ProQuest Dissertations & Theses

Erscheinungsjahr

2021

Quelle

ProQuest Dissertations & Theses A&I

Beschreibungen/Notizen

• Objective: The purpose of this study is to examine the relationship between household food insecurity (HFS; i.e., access to nutritionally adequate and safe food) and disordered eating behaviors (i.e., restriction, bingeing, insulin manipulation, etc.) among a sample of youth and young adults with youth-onset type 1 (T1D) or type 2 diabetes (T2D).Methods: We used cross-sectional data of 2,669 individuals from the SEARCH for Diabetes in Youth Study. Participants ages 18–35 years or parents of participants ages 10–17 years completed the U.S. Household Food Security Survey Module (HFSSM) and the Diabetes Eating Problem Survey-Revised (DEPS-R) between 2016 and 2019. We excluded individuals without completed DEPS-R or HFSSM questions (n = 203) and calculated descriptive statistics of the included study population (n = 2,466). We converted HFS scores to a 10-point standardized scale and dichotomized scores into food secure (HFS ≤ 2.2) vs. food insecure (HFS > 2.2). We used multivariable linear regression to evaluate the association of HFS with continuous DEPS-R score (i.e., 0–80, with a higher score indicating higher levels of disordered eating behaviors), adjusting for potential confounders (i.e., sex, age, race/ethnicity, participant education, parent education, household income, participant health insurance, presence of depressive symptoms, body mass index, and duration of diabetes). We further stratified analyses by diabetes type. We used predictive mean matching multiple imputation to address missing covariate data, including depressive symptoms (as defined by a score of 10 or greater on the Center for Epidemiologic Studies Depression Scale; missingness: 36%), income (missingness: 24%), highest level of parent education (missingness: 3%), and body mass index (missingness: 36%).Results: Participants were on average approximately 22 ± 5 years, 55% female, 69% non-Hispanic White, and had a mean diabetes duration of 11 ± 3 years. The overall mean DEPS-R score was 14.6 ± 10.1 points. Mean unadjusted DEPS-R scores in individuals living in food secure households (n = 2,114) and food insecure households (n = 353) were 13.8 ± 9.6 and 19.6 ± 11.3, respectively. The adjusted DEPS-R scores were 3.8 points (95% confidence interval, CI: 2.8, 4.9; p < 0.001) higher in food insecure compared to food secure households. In the adjusted models stratified by diabetes type, for individuals with T1D (n = 2,185), the DEPS-R scores were 3.7 points (95% CI: 2.6, 4.9; p < 0.001) higher in individuals from food insecure compared to food secure households. However, both the unadjusted and adjusted multivariable regression models for individuals with T2D (n = 360) displayed no significant difference in mean DEB scores (95% CI: –0.3, 4.7; p = 0.086) between food insecure versus food secure households.Conclusions: Household food insecurity among youth and young adults with T1D (p < 0.001), and possibly T2D (p = 0.086), is associated with more disordered eating behaviors. These results suggest that addressing food insecurity among youth and young adults with T1D may decrease risk of disordered eating behaviors and provide another reason to screen individuals with T1D for food insecurity. Additionally, follow-up analyses with a greater number of participants to determine the relationship between food insecurity and disordered eating behaviors in individuals with T2D are warranted.