Abstract 17568: Myocardial Infarction Modifies the Effect of Food Insecurity on Diabetes-Related Mortality

Abstract

Introduction: Food Insecurity continues to be a public health problem that requires attention. A quarter of households have experienced food insecurity in their lifetime. Hypothesis: In this study, we will determine how myocardial infarction increases the effect of food insecurity among diabetes-related mortality. Methods: The National Health and Nutrition Examination Survey (NHANES) is a survey completed by non-institutionalized population of the U.S. All respondents from the NHANES survey, who were 20 years or older between the years 1999-2010 were included in the analysis with follow-up through 2019. Self-reported information was used for USDA Food Security Survey. Analysis was performed using complex samples Cox regression to determine the relationship of food insecurity on diabetes-related mortality and how myocardial infarction influences this. Results: Percent mortality among individuals with diabetes was 6.11% among males and 5.67% among females with mean follow-up of 13.7 years. For diabetes-related mortality, the crude hazard ratio (HR) for food insecurity was 1.42 (95% confidence interval [CI], 1.03-1.95 p = 0.03). The adjusted HR was elevated, 2.66 (CI 1.05-6.78, p = 0.04), among food insecure individuals who had myocardial infarction (MI) but close to 1.0 (1.33 CI 0.99-1.79, p = 0.06) among food insecure individuals who had no MI infarction, after adjusting for medical (tobacco use) and demographic risk factors (poverty-income-ratio, age, gender, ethnicity). Conclusions: We found that not only food insecurity leads to higher diabetes-related mortality, but also MI occurrence affects this relationship. Prevention programs for food insecurity are especially important with comorbidities to implement social change.