Household food insecurity is associated with poor dietary intake in the general population, but little is known about persons with diabetes. We examined dietary intake among youth and young adults (YYA) with diabetes in relation to food security (FS) to identify differences in intake quantity and adherence to recommendations. The SEARCH for Diabetes in Youth cross-sectional study includes 1,134 YYA with type 1 diabetes (T1D, mean age: 21 years ± 5) and 274 YYA with type 2 diabetes (T2D, 25 years ± 4.2). Participants (or parents if <18 years) completed the USDA Household FS Survey Module, wherein ≥3 affirmations indicate food insecurity. Diet was assessed via food frequency questionnaire and compared to age- and sex-specific 2020-25 Dietary Guidelines for Americans (DGA) nutritional goals for daily energy, added sugar, saturated fat, calcium, fiber, iron, magnesium, potassium, sodium, vitamins C, D, and E. Associations of FS with daily intake and meeting guidelines were assessed with sex-stratified multivariate linear regression. No intake differences by FS were observed, except females with T1D consumed more sodium (+155 mg, p = .01) and percent of kilocalories from saturated fat (+0.7%, p = .04) when FS was absent. Males with T2D consumed more vitamin E (+1 mg, p = .03) when FS was present. Crude guideline adherence was poor across the board (i.e. below 60%). After multivariate adjustment for demographic, socioeconomic, clinical and diabetes characteristics, females with T1D and T2D, regardless of FS, on average met vitamin C and males met iron guidelines. Males with T2D met percent of kilocalories from saturated fat guidelines in the absence of FS. DGA adherence among YYA with diabetes is of grave concern given that diet is crucial to diabetes management. FS reflects very little enhancement in diet quality. YYA with diabetes consume excessive sodium, added sugars, and inadequate micronutrients except for vitamin C and iron, increasing risk for deficiency, weight gain, heart attack and stroke.


H. D. Bercaw: None. C. Mercado: None. A. D. Liese: None. L. A. Reid: None. J. A. Mendoza: None. E. A. Frongillo: None. K. A. Sauder: None. B. A. Reboussin: None. E. J. Mayer-davis: None. D. Dabelea: None. S. M. Marcovina: None.

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