The following is a summary of “Diet in Food Insecurity: A Mediator of Metabolic Health?” published in the June 2024 issue of Endocrinology by Morselli, et al.

For a study, researchers sought to investigate the role of dietary factors (quantity and quality) as potential mediators in the association between food insecurity (FI) and metabolic health outcomes, including excess weight (body mass index, BMI), central adiposity (waist circumference), and glycemic control (glycohemoglobin, A1C).

Using data from the National Health and Nutrition Examination Survey, a mediation analysis was conducted with FI as the independent variable and BMI, waist circumference, and A1C as metabolic outcome variables. Potential mediators included total energy intake, macronutrient consumption, and diet quality assessed by the Healthy Eating Index-2015 (HEI-2015).

Despite a higher prevalence of obesity among participants experiencing FI, daily energy intake was similar between food-secure and -insecure individuals. Dietary factors did not significantly mediate the associations between FI and metabolic outcomes in adjusted analyses across the entire cohort. However, race-stratified analyses revealed that total sugar consumption partially mediated the relationship between FI and BMI in non-Hispanic Whites. Diet quality measures (HEI-2015 total score and added sugar subscore) were partial mediators of waist circumference and BMI among individuals in the “other” ethnic group.

While dietary factors did not appear to be the primary mediators of the association between FI and metabolic health outcomes in the overall population, they may play a role in specific ethnic groups. Future research should explore other social determinants of health commonly associated with FI to understand this relationship better.

Reference: academic.oup.com/jes/article/8/6/bvae062/7638841