Institute for Research and Education to Advance Community Health, Washington State University-Spokane, Seattle, Washington, USA
Sociology, Washington State University, Pullman, Washington, USA.
BMJ Open. 2022 Jun 9;12(6):e054162. doi: 10.1136/bmjopen-2021-054162.
Our aim was to assess the cross-sectional associations between food insecurity and cardiometabolic health indicators in American Indian young adults compared with non-Hispanic white, black, Asian or Pacific Islander and Hispanic young adults.
Data from the fourth wave of the National Longitudinal Study of Adolescent to Adult Health (Add Health) were used. Variables included a self-assessed measure of risk of food insecurity, indicators of cardiometabolic health (body mass index, haemoglobin A1c, blood pressure) and sociodemographic characteristics. Multivariable regression models were used to assess the association of risk of food insecurity with cardiometabolic health, while controlling for sociodemographic variables. All analyses were weighted and accounted for the complex survey design.
The analytical sample of n=12 799 included mostly non-Hispanic white respondents (n=7900), followed by n=2666 black, n=442 American Indian, n=848 Asian or Pacific Islander and n=943 Hispanic.
Risk of food insecurity was more common among respondents who were female, Black, American Indian, had lower educational attainment, and were classified as having obesity or diabetes. In unadjusted models, risk of food insecurity was significantly associated with greater odds of obesity (OR=1.39; 95% CI 1.20 to 1.60) and diabetes (OR=1.61; 95% CI 1.23 to 2.11). After adjusting for sociodemographic factors (age, sex, education, income, household size, tobacco smoking, alcohol intake and race/ethnicity), only the association between risk of food insecurity and obesity remained (OR=1.19; 95% CI 1.03 to 1.38). Relationships among risk of food insecurity, sociodemographic characteristics and diabetes varied across models stratified by race and ethnicity.
Results suggest that elevated risk of food insecurity is present in young American Indian adults, but its relationship with cardiometabolic health is unclear. Future work should capitalise on longitudinal data and the US Department of Agriculture's Food Security Survey Modules.
我们旨在评估与非西班牙裔白人、黑种人、亚洲或太平洋岛民以及西班牙裔相比，食物不安全与美国印第安青年成年人的心血管代谢健康指标之间的横断面关联。
使用了青少年至成年健康纵向研究（Add Health）第四波的数据。变量包括食物不安全风险的自我评估测量、心血管代谢健康指标（体重指数、血红蛋白 A1c、血压）和社会人口统计学特征。使用多变量回归模型评估食物不安全风险与心血管代谢健康之间的关联，同时控制社会人口统计学变量。所有分析均经过加权处理，并考虑了复杂的调查设计。
分析样本包括 n=12799 名参与者，其中大多数为非西班牙裔白人（n=7900），其次是 n=2666 名黑种人、n=442 名美国印第安人、n=848 名亚洲或太平洋岛民和 n=943 名西班牙裔。
在女性、黑种人、美国印第安人、教育程度较低以及被归类为肥胖或糖尿病的受访者中，食物不安全风险更为常见。在未调整的模型中，食物不安全风险与肥胖的几率显著增加相关（OR=1.39；95%CI 1.20 至 1.60）和糖尿病（OR=1.61；95%CI 1.23 至 2.11）。在调整了社会人口统计学因素（年龄、性别、教育程度、收入、家庭规模、吸烟、饮酒和种族/族裔）后，仅食物不安全风险与肥胖之间的关联仍然存在（OR=1.19；95%CI 1.03 至 1.38）。在按种族和族裔分层的模型中，食物不安全风险与社会人口统计学特征和糖尿病之间的关系存在差异。
结果表明，美国印第安青年成年人中存在较高的食物不安全风险，但与心血管代谢健康的关系尚不清楚。未来的工作应该利用纵向数据和美国农业部的粮食安全调查模块。
