The Association of Levels of Food Insecurity and Disordered Eating Behaviors Among Youth and Young Adults With Diabetes: The SEARCH for Diabetes in Youth Study.

Objective: To examine the relationship between levels of household food insecurity and disordered eating behaviors (DEB) among youth and young adults with youth-onset type 1 (T1D) and type 2 diabetes (T2D).

Method: We used cross-sectional data from the multicenter SEARCH for Diabetes in Youth Study (2015-2020). The Household Food Security Survey Module and the Diabetes Eating Problem Survey-Revised (DEPS-R) were utilized to measure household food insecurity and continuous scores for DEB. In each stratum of diabetes type, we evaluated the association of household food insecurity levels with DEB through linear regression adjusting for potential confounders.

Results: Participants (n = 2669) were on average 21.5 ± 5.1 years old and had a mean diabetes duration of 11.2 ± 3.3 years; 54.2% were female, 64.0% non-Hispanic white, and respectively 12.9%, 11.1%, and 8.43% experienced marginal, low, and very low food security. The overall unadjusted mean DEPS-R score was 13.5 ± 9.5, with scores of 18.6 ± 11.8 and 21.1 ± 11.7 among T1D and T2D participants with very low food security, and scores of 11.5 ± 8.9 and 15.2 ± 8.8 among T1D and T2D participants with high food security. Compared to participants who reported high food security, adjusted DEPS-R scores among those with very low food security were 5.8 points (95% CI: 4.3, 7.4) and 6.6 points (95% CI: 3.3, 9.2) higher, respectively, in those with T1D (n = 2274) and T2D (n = 395). Less severe levels of household food insecurity showed similar associations with smaller effect sizes.

Discussion: Addressing household food insecurity may decrease DEB and future adverse health outcomes for youth and young adults with diabetes.