Abstract

Food insecurity, defined as insufficient access to nutritious foods, poses a significant public health problem in the U.S. In the general population, food insecurity is related to poor cardiometabolic health. American Indians (AIs) have some of the greatest burdens of food insecurity and cardiometabolic disease in comparison to other racial/ethnic groups. However, few studies have established how food insecurity is related to cardiometabolic health with data disaggregated for AIs. The objective of this study was to assess the cross-sectional association of food insecurity and cardiometabolic risk factors among AI adults during young adulthood in comparison with non-Hispanic white, non-Hispanic Black, and Hispanic respondents. Data from the fourth wave of the National Longitudinal Study of Adolescent to Adult Health (Add Health) was used. Measures included one survey item on risk of food insecurity, objective measures of cardiometabolic health (body mass index, hemoglobin A1c, fasting blood glucose), and sociodemographic items. Multivariable regression models were used to assess the association of food insecurity with cardiometabolic health, while controlling for sociodemographic variables. All analyses were weighted and accounted for complex sampling survey design. In models inclusive of all adults, AI and non-Hispanic Black adults had significantly higher odds of reporting risk of food insecurity than non-Hispanic white adults. In models stratified by race, measures of cardiometabolic health were not significantly associated with risk of food insecurity among AI adults. Results suggest that AIs’ elevated risk of food insecurity is present in young adulthood, but its relationship with cardiometabolic health is unclear. Study implications are limited by the cross-sectional design, age of respondents, and reliance on a single-item measure of food insecurity. Future work should capitalize on longitudinal data and the USDA food security surveys. Disclosure C. J. Nikolaus: None. L. E. Hebert: None. A. Zamora-kapoor: None. K. Sinclair: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (P30DK092923)

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