Abstract
This study examined associations of home food availabilities with prediabetes and diabetes among 8929 adults (20–70 years) participating in 2007–2010 National Health and Nutrition Examination Surveys. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated by logistic regression. Relative to non-diabetic participants (individuals without diabetes or prediabetes), prediabetes participants were associated with lower availabilities of green vegetables (OR = 0.82; 95% CI = 0.73–0.91; p = 0.0006) and fat-free/low-fat milk (OR = 0.80, 95% CI = 0.65–0.89; p = 0.001) and higher sugary drink availability (OR = 1.24, 95% CI = 1.04–1.48; p = 0.02), adjusting for age, sex, and ethnicity (Model 1). The associations remained significant for vegetables (p = 0.005) and fat-free/low-fat milk (p = 0.02) adjusting for additional confounders (body mass index, education, Model 2). Adjusting for dietary components did not change the above results (in model 2) significantly. Participants with high healthy food availability scores had approximately 31% reduction (p = 0.003) in odds of prediabetes compared to those with low scores in Model 1. No associations were detected for diabetes except for fat-free/low-fat milk availability, for which an inverse association was observed in Model 1 (OR = 0.80, 95% CI = 0.65–0.99; p = 0.04). The results show prediabetes participants had lower availability of healthy foods and higher availability of unhealthy foods, suggesting the need to improve healthy food availability at home for this population.
Highlights
Diabetes is the seventh leading cause of death in the United States
The current results suggest that the availability of healthy foods such as green vegetables or fat-free/low-fat milk was inversely associated with the presence of prediabetes, whereas, a positive association between the availability of unhealthy foods such as sugary drink and prediabetes was detected adjusting for age, sex, and ethnicity
In the current study, we found that the significant associations of green vegetable and fat-free/low-fat milk availabilities and overall healthy food availability scores with the presence of prediabetes were independent of dietary intakes as the associations did not change substantially after further adjusting for dietary variables such as intakes of total energy, carbohydrate, sugar, fat and saturated fat
Summary
Diabetes is the seventh leading cause of death in the United States. 30.3 million (9.4% of the population) Americans had diabetes [1]. Approximately one third of the U.S adults have prediabetes [1], which is characterized by blood glucose levels that are elevated but not high enough to be diagnosed as diabetes [1]. Without proper treatment and prevention efforts, a majority (~70%) of persons with prediabetes will eventually become diabetic [2]. The prevention of type 2 diabetes has mainly focused on behavioral modification and weight management, as causes of the disease are attributed largely to obesity, lack of physical activity, and poor dietary patterns [3,4,5,6]. Home food availability defined as the presence or absence of healthy and unhealthy food items at home is an important avenue to investigate since it may reflect people’s
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