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Monday, November 18, 2019
Home Specialties Diabetes 40 Million Americans in Food-Insecure Households are at Risk of Type 2...

40 Million Americans in Food-Insecure Households are at Risk of Type 2 Diabetes

A shocking 40 million Americans — including 6.5 million children — are living in food-insecure households, which means they do not have access to nutritionally adequate food, or that their ability to regularly consume safe food is uncertain or unstable. And all 40 million of these individuals are at a higher risk for insulin resistance, the leading cause of type 2 diabetes.

According to a recent study published in the Journal of Nutrition, completed through the UConn School of Medicine, UConn School of Dental Medicine, Yale School of Public Health, Quinnipiac University, Hartford Hospital, and the Hispanic Health Council, suggests that for the Latino population in particular, type 2 diabetes is linked to food insecurity. 

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Why? Latinos are both disproportionately affected by metabolic disorders and food-insecure households. According to the study, the rate of type 2 diabetes is 12.1 percent in Hispanics, as compared to only 7.4 percent in non-Hispanic white individuals. In this particular study alone, out of 121 Latinos with type 2 diabetes, 68 percent were found to be food insecure.

The Health Effects of Food Insecurity

Sadly, the association between insulin resistance and food insecurity is placing even young children at risk for type 2 diabetes. And the health problems associated with food insecurity in children may lead to a lifelong battle. To further complicate the issue, food insecurity—and the resulting health problems it leads to—can be, at first glance, difficult to diagnose. 

Researchers revealed that food insecurity may increase inflammation in the body, as a result of several factors, including diet-related obesity, excess abdominal fat, and the effects of stress on the body. When food-insecure adults and children aren’t sure where their next meal is coming from or don’t know what it will be, their bodies enter a state of mental distress, which triggers the release of cortisol and other hormones. Those stress hormones then contribute further to insulin resistance and can cause excess abdominal fat and weight gain, trapping the individual in a vicious cycle that only increases their risk of diabetes.

To demonstrate the startling health effects of food insecurity, the researchers tested several health markers, including fasting blood glucose, insulin levels and resistance, stress hormones, and inflammation markers, and their relationship with household food insecurity using baseline data from the Community Health Workers Assisting Latinos Manage Stress and Diabetes (CALMS-D) randomized controlled trial. The results showed that food insecure individuals had “significantly higher” levels of insulin resistance, insulin levels in general, glucose, stress hormones, inflammation, and total cholesterol. 

Overall, Angela Bermúdez-Millán, PhD, MPH, an assistant professor in the Department of Community Medicine and Health Care at UConn School of Medicine calls food insecurity “a powerful social determinant of health.”

What Can Healthcare Practitioners Do?

The first step in helping to decrease the overall rate of type 2 diabetes in food-insecure populations begins with healthcare practitioners implementing appropriate screening protocols to identify those at risk. It’s especially important for healthcare practitioners to recognize that Latino populations are at high risk, and that high BMI patients and children of high BMI patients or patients who already have a type 2 diabetes diagnosis may be part of families and communities that are food insecure.

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Dr. Bermúdez-Millán adds clinicians should connect patients to local facilities that address insecurity and communities should allocate more resources to ending food insecurity. 

Healthcare practitioners can also appeal to legislators to step up policy efforts that will address food insecurity in the United States. For example, Dr. Bermúdez-Millán supports legislature efforts such as modifying disbursement of SNAP benefits to help decrease diabetes and increasing access to more fresh food in lieu of processed options. 

References:
Inflammation and Stress Biomarkers Mediate the Association between Household Food Insecurity and Insulin Resistance among Latinos with Type 2 Diabetes, Journal of Nutrition.

Last updated on 10/8/19.

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