Association Of Household Food Security And Physical Activity Among Youth And Young Adults With Diabetes

Abstract

Physical activity (PA) is so essential in diabetes management that it is usually prescribed as a lifestyle change in addition to medications. Food insecurity may cause youth and young adults (YYAs) with diabetes to be more fatigued, thereby negatively impacting their PA. PURPOSE: The purpose of this study is to examine the association between household food security and PA in YYAs with diabetes. METHODS: Data from 2,195 YYAs with diabetes (1,855 type 1, 340 type 2, mean age: 21.4 years) were analyzed from the SEARCH for Diabetes in Youth Study. Household food security status was measured with the 18-item U.S. Household Food Security Survey Module by adult participants or parents of minors. Households that affirmed ≥3 food insecure conditions or behaviors were considered food insecure. PA was measured with the International Physical Activity Questionnaire Short Form. Walking, moderate (excluding walking) intensity physical activity (MPA), and vigorous intensity physical activity (VPA) minutes/week were multiplied by 3.3, 4.0, and 8.0, respectively, to obtain metabolic equivalent minutes (MET min/wk), and summed to calculate total PA MET min/wk. We conducted median regression analyses, adjusting for socioeconomic, demographic and clinical covariates, for both the full sample and by diabetes type. RESULTS: 20% of the sample (15% type 1, 5% type 2) was food insecure. The median amount of walking, MPA, VPA, and total PA were 991, 481, 955, and 2,967 MET min/wk, respectively. In the unadjusted analysis, food insecurity was significantly associated with less VPA (β: -480; p=0.0067) and more walking (β: 399; p-value=0.0006) MET min/wk. The effect for walking persisted after covariate adjustment (β: 242; p=0.0238). There was no significant difference observed by diabetes type. CONCLUSION: Household food security was not associated with MPA, VPA, or total PA MET min/wk in adjusted analyses. Food insecurity was associated with more walking MET min/wk. Future research should consider walking for travel vs. walking for leisure among food insecure YYAs with diabetes. Future research should also consider use of an objective measure of PA in contrast to the present study which relied on subjective recall. Supported by NIH Grant R01DK117461.