Julceus Emmanuel F, Liese Angela D, Alfalki Ali M, Brown Andrea D, Pihoker Catherine, Qu Pingping, Malik Faisal S, Jones-Smith Jessica C, Crow Scott, Loots Beth, Reboussin Beth A, Dolan Lawrence M, Igudesman Daria, Sauder Katherine A, Shapiro Allison L B, Turley Christine B, Mendoza Jason A
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
Department of Pediatrics, University of Washington, Seattle, Washington, USA.
Int J Eat Disord. 2025 Mar 12. doi: 10.1002/eat.24411.
To examine the relationship between levels of household food insecurity and disordered eating behaviors (DEB) among youth and young adults with youth-onset type 1 (T1D) and type 2 diabetes (T2D).
We used cross-sectional data from the multicenter SEARCH for Diabetes in Youth Study (2015-2020). The Household Food Security Survey Module and the Diabetes Eating Problem Survey-Revised (DEPS-R) were utilized to measure household food insecurity and continuous scores for DEB. In each stratum of diabetes type, we evaluated the association of household food insecurity levels with DEB through linear regression adjusting for potential confounders.
Participants (n = 2669) were on average 21.5 ± 5.1 years old and had a mean diabetes duration of 11.2 ± 3.3 years; 54.2% were female, 64.0% non-Hispanic white, and respectively 12.9%, 11.1%, and 8.43% experienced marginal, low, and very low food security. The overall unadjusted mean DEPS-R score was 13.5 ± 9.5, with scores of 18.6 ± 11.8 and 21.1 ± 11.7 among T1D and T2D participants with very low food security, and scores of 11.5 ± 8.9 and 15.2 ± 8.8 among T1D and T2D participants with high food security. Compared to participants who reported high food security, adjusted DEPS-R scores among those with very low food security were 5.8 points (95% CI: 4.3, 7.4) and 6.6 points (95% CI: 3.3, 9.2) higher, respectively, in those with T1D (n = 2274) and T2D (n = 395). Less severe levels of household food insecurity showed similar associations with smaller effect sizes.
Addressing household food insecurity may decrease DEB and future adverse health outcomes for youth and young adults with diabetes.
研究青少年及青年期发病的1型糖尿病（T1D）和2型糖尿病（T2D）患者家庭粮食不安全水平与饮食失调行为（DEB）之间的关系。
我们使用了多中心青少年糖尿病SEARCH研究（2015 - 2020年）的横断面数据。采用家庭粮食安全调查模块和修订后的糖尿病饮食问题调查（DEPS - R）来衡量家庭粮食不安全状况和DEB的连续得分。在每种糖尿病类型的分层中，我们通过线性回归并对潜在混杂因素进行调整，评估家庭粮食不安全水平与DEB之间的关联。
参与者（n = 2669）平均年龄为21.5±5.1岁，糖尿病病程平均为11.2±3.3年；54.2%为女性，64.0%为非西班牙裔白人，分别有12.9%、11.1%和8.43%经历了边缘、低和极低粮食安全状况。总体未调整的DEPS - R平均得分为13.5±9.5，在粮食安全状况极低的T1D和T2D参与者中得分分别为18.6±11.8和21.1±11.7，在粮食安全状况高的T1D和T2D参与者中得分分别为11.5±8.9和15.2±8.8。与报告粮食安全状况高的参与者相比，在T1D（n = 2274）和T2D（n = 395）患者中，粮食安全状况极低的参与者调整后的DEPS - R得分分别高出5.8分（95%CI：4.3，7.4）和6.6分（95%CI：3.3，9.2）。不太严重的家庭粮食不安全水平显示出类似的关联，但效应量较小。
解决家庭粮食不安全问题可能会降低糖尿病青少年及青年患者的饮食失调行为和未来不良健康结局。
