Food insecurity and development of type 2 diabetes linked

A collaborative study by a team of US researchers from various institutions, including the Yale School of Public Health, shows a strong connection between food insecurity and insulin resistance, the underlying problem in type 2 diabetes. Published in the June issue of Journal of Nutrition, the research suggests that Latinos with type 2 diabetes who live in food-insecure households are at greater risk to developing type 2 diabetes.

In the United States, the rate of food-insecurity is higher for Latinos, who are also disproportionately affected by type 2 diabetes. Rates of type 2 diabetes are 12.1% among Hispanics compared with 7.4% for non-Hispanic whites.

According to the researchers, food insecurity may increase inflammation in the body which can be caused by diet-related obesity and excess abdominal fat. Food insecurity is stressful, often accompanied by mental distress, which triggers the release of cortisol and other stress hormones. These hormones may lead to the progression of insulin resistance.

Compared with food secure individuals, food insecure individuals had significantly higher insulin resistance, insulin, glucose, stress hormones, inflammation*, and total cholesterol. Food insecure individuals had higher insulin resistance than those who were food secure. Inflammation and stress hormones were the mechanisms through which food insecurity and insulin resistance were linked.

“Our findings support the plausibility of links between food insecurity and poor health,” says Dr. Angela Bermúdez-Millán, “Resources should be redirected toward ending or decreasing food insecurity, a powerful social determinant of health.”

The study included 121 study Latinos with type 2 diabetes. Sixty-eight percent of the participants were classified as food insecure.

According to Bermúdez-Millán, the findings highlight the importance of implementing interventions that address food insecurity in order to mitigate its effects on inflammation, stress, and insulin resistance.

“Food insecurity is prevalent, widespread, and detrimental to health,” she says. “Health care facilities can also help address the issue by screening for food insecurity and connecting patients to available resources and interventions.”

What is insulin resistance?

Insulin resistance happens when cells do not respond normally to the body’s insulin. Insulin is necessary for cells taking in glucose which is used as fuel or stored as body fat. When the body becomes resistant to insulin, it tries to cope by producing more insulin. People with insulin resistance are often producing much more insulin than healthy people but also have excess glucose in the blood.  Insulin resistance is also associated not only with type 2 diabetes but also with heart disease.

What is food insecurity?

Food insecurity is defined as a state in which “consistent access to adequate food is limited by a lack of money and other resources at times during the year.” (US Department of Agriculture).

In the US,  food deserts largely contribute to food insecurity and are a principle cause of hunger. Food deserts are areas where inhabitants cannot access affordable and nutritious food. For example, in certain low-income urban or rural areas, a convenience store primarily selling candy, sodas, snacks and other processed food may be all that is available for families to eat for miles. Food deserts are a very real documented problem.  Essentially, food insecurity is inherently connected to low income.

For more information, please see the original study here: Inflammation and Stress Biomarkers Mediate the Association between Household Food Insecurity and Insulin Resistance among Latinos with Type 2 Diabetes.

*In people with type 2 diabetes, cytokine levels are elevated inside fat tissue. Abdominal fat can cause continuous (chronic), low levels of abnormal inflammation that alter insulin’s action and contribute to type 2 diabetes.  As type 2 diabetes progresses, the body becomes less sensitive to insulin and the resulting insulin resistance also leads to inflammation. A vicious cycle ensues.