Background

Hispanics are disproportionately affected by both type 2 diabetes and food insecurity (FI); however, the relationship between prediabetes in children and bio-behavioral influences such as FI is largely unclear. The purpose of this study was to examine associations between FI and prediabetes in children utilizing a child’s own report of their food security experiences.

Methods

This analysis used cross-sectional baseline data from TX Sprouts, a 1-year school-based gardening, cooking, and nutrition intervention. The study targeted primarily Hispanic 3rd-5th grade students and their families from 16 elementary schools in the Austin, Texas area. Height, weight, Body Mass Index percentile (BMI-P) via bioelectrical impedance, and fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) via fasting blood draw were collected. Food security status was collected via the validated 5-item Child Food Security Assessment. Linear and binary mixed effect regression models were used to estimate the associations between food insecurity and FPG, HbA1c, and prediabetes with random effects at the school level to account for clustering by schools. Models were adjusted for child’s age, sex, ethnicity, BMI-P, and participation in the Supplemental Nutrition Assistance Program.

Results

The analytic sample consisted of 972 children who were primarily Hispanic (69%) and female (53%) and had an average age of nine. FI was reported by 68% of the sample. Average FPG was 92.6mg/dL, average HbA1c was 5.2%, and 25% of children were prediabetic (FPG >99 and <126). FI was associated with a 0.1-unit increase in HbA1c (p=0.001). FI was not associated with FPG; however, FI was associated with a 1.5 times greater odds of having prediabetes (95% CI 1.10-2.18; p=0.04).

Conclusions

Food insecurity among children was associated with higher HbA1c and increased risk for prediabetes.Further studies should examine the longitudinal and intervention effects of food insecurity on glycemic control during child development.