青年期粮食不安全风险与心脏代谢健康的纵向变化：来自青少年到成人健康全国纵向研究的证据。
Risk of Food Insecurity in Young Adulthood and Longitudinal Changes in Cardiometabolic Health: Evidence from the National Longitudinal Study of Adolescent to Adult Health.
作者信息
Nikolaus Cassandra J, Hebert Luciana E, Zamora-Kapoor Anna, Sinclair Ka Imi
机构信息
Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA.
Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA.
出版信息
J Nutr. 2022 Aug 9;152(8):1944-1952. doi: 10.1093/jn/nxac055.
BACKGROUND
Studies have demonstrated relations between food insecurity, the lack of access to enough nutritious food, and greater risk of diet-sensitive chronic diseases. However, most prior evidence relies on cross-sectional studies and self-reported disease.
OBJECTIVES
The objective was to assess the longitudinal relation between risk of food insecurity in young adulthood and changes in diet-sensitive cardiometabolic health outcomes across 10 y among non-Hispanic white, non-Hispanic black, American Indian or Alaska Native, and Hispanic adults.
METHODS
Data from the fourth and fifth waves (n = 3992) of the National Longitudinal Study of Adolescent to Adult Health were used. Measures included risk of food insecurity, body weight, diabetes, and sociodemographic characteristics. Body weight and diabetes were assessed with direct measures. Mixed-effects models assessed the association of risk of food insecurity with BMI, obesity, and diabetes while accounting for sociodemographic characteristics and the complex survey design.
RESULTS
Risk of food insecurity was associated with increases in BMI as well as incidence of obesity and diabetes from young to middle adulthood in unadjusted and adjusted models (all P < 0.01). In models stratified by race and ethnicity, the relations of risk of food insecurity with body weight outcomes and diabetes varied.
CONCLUSIONS
Risk of food insecurity in young adulthood was related to BMI and obesity during young and middle adulthood but not in changes over time. Risk of food insecurity in young adulthood related to an increased incidence of diabetes in middle adulthood. However, the relations among specific racial and ethnic groups were unclear. Estimates of the relation between food insecurity and cardiometabolic health outcomes within racial and ethnic groups experiencing the highest prevalence of these conditions should be refined.
背景
研究表明，粮食不安全（即缺乏获取足够营养食物的途径）与饮食敏感性慢性病的更高风险之间存在关联。然而，大多数先前的证据依赖于横断面研究和自我报告的疾病。
目的
目的是评估年轻成年期粮食不安全风险与非西班牙裔白人、非西班牙裔黑人、美国印第安人或阿拉斯加原住民以及西班牙裔成年人在10年期间饮食敏感性心脏代谢健康结果变化之间的纵向关系。
方法
使用了青少年到成人健康全国纵向研究第四波和第五波（n = 3992）的数据。测量指标包括粮食不安全风险、体重、糖尿病和社会人口统计学特征。体重和糖尿病通过直接测量进行评估。混合效应模型评估了粮食不安全风险与体重指数（BMI）、肥胖症和糖尿病之间的关联，同时考虑了社会人口统计学特征和复杂的调查设计。
结果
在未调整和调整模型中，粮食不安全风险与从年轻到中年期BMI的增加以及肥胖症和糖尿病的发病率相关（所有P < 0.01）。在按种族和民族分层的模型中，粮食不安全风险与体重结果和糖尿病之间的关系各不相同。
结论
年轻成年期的粮食不安全风险与年轻和中年期的BMI及肥胖症有关，但与随时间的变化无关。年轻成年期的粮食不安全风险与中年期糖尿病发病率的增加有关。然而，特定种族和民族群体之间的关系尚不清楚。对于这些疾病患病率最高的种族和民族群体中粮食不安全与心脏代谢健康结果之间的关系估计应进一步完善。
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