Household food insecurity (HFI) (or unavailability of nutritionally adequate and safe foods) is associated with unhealthy diet and increased risk of obesity and chronic diseases. Additionally, people with diabetes are at increased risk for depression. Although access to a regular and healthy diet is important to proper nutrition and to diabetes management, no studies have assessed how HFI is related to depression among youth and young adults (YYA) with type 1 diabetes (T1D) or type 2 diabetes (T2D).
This study used cross-sectional data from the SEARCH for Diabetes in Youth study collected in 2015-2019 to evaluate associations between HFI and depression among YYA with T1D and T2D. HFI was categorized as a binary variable (food secure vs. food insecure) using the 18-item U.S. Department of Agriculture food security survey, where ≥3 affirmations indicated being food insecure. The 20-item Center for Epidemiologic Studies Depression (CES-D) scale was used to quantify depression symptoms as a continuous outcome (scores 0-60). Linear regression models were adjusted for age, sex, race/ethnicity, site, and diabetes duration. Models were analyzed separately for youth with T1D, young adults with T1D, and young adults with T2D.
HFI and CES-D data were available for 335 T1D youth (10-17 years), 731 T1D young adults (18-35 years), and 272 T2D young adults (18-34 years). Of these, 18.8%, 17.5%, and 30.1%, respectively, reported being food insecure. Adjusted models showed that food insecure young adults with T1D had 7.4 higher scores on symptoms of depression (p<.0001) and those with T2D had 4.8 higher scores on symptoms of depression (p=0.0002), when compared to those that were food secure. Food insecure youth with T1D had 3.2 higher scores on symptoms of depression compared to food secure youth with T1D after adjustment for covariates (p=0.0031).
Findings from this study suggest that living in a food insecure household is associated with increased depression symptomology among YYA with T1D or T2D.
A.D. Brown: None. J.A. Mendoza: None. K. Flory: None. B.A. Reboussin: None. C. Mercado: None. E.T. Jensen: None. L.M. Dolan: None. D. Dabelea: None. J.M. Lawrence: None. A.D. Liese: None.
SEARCH for Diabetes in Youth Cohort Study (1UC4DK108173); SEARCH Food Security Cohort Study (1R01DK117461-01); National Institute of General Medical Sciences (T32GM081740)