Written by: Rafael Guimarães, MS & Kristen DiFilippo, PhD, RDN
The intersection of diabetes and food security is a critical issue that affects millions of individuals and families around the world. According to the Centers for Disease Control and Prevention (CDC), “adults who experience food insecurity are 2 to 3 times more likely to have type 2 diabetes,” as nutritious foods can be difficult to access in some communities (CDC, 2024). Therefore, as the prevalence of diabetes continues to rise, ensuring access to healthy, nutritious foods becomes increasingly important for the management and prevention of this chronic disease. In this way, we will explore the connection between diabetes and food security, examine the challenges faced by those living with diabetes, and discuss strategies to improve food security and promote better health outcomes.
Understanding Food Security
Food security is defined by the United Nations as having physical, social, and economic access to sufficient, safe, and nutritious food that meets dietary needs and food preferences for an active and healthy life (FAO, 2008). Food insecurity, on the other hand, occurs when individuals or families lack stable access to adequate food. This can result from various factors, including economic instability, geographic location, and social inequalities.
The Link Between Diabetes and Food Security
Diabetes, particularly Type 2 diabetes, is closely linked to diet and lifestyle (Sami, Ansari, Butt, & Hamid, 2017). Managing diabetes effectively requires consistent access to healthy foods, such as fresh fruits, vegetables, whole grains, and lean proteins (Ley, Hamdy, Mohan, & Hu, 2014). For individuals experiencing food insecurity, maintaining such a diet can be challenging. Studies have shown that food insecurity is associated with poorer glycemic control, higher rates of diabetes-related complications, and increased healthcare costs (Seligman, Laraia, & Kushel, 2010).
According to the Department of Agriculture (USDA), one of the biggest problems with accessing healthy foods is the phenomenon of “food deserts,” where low-income neighborhoods have limited access to affordable, nutritious foods (Ver Ploeg, 2010). In these areas, residents often rely on convenience stores and fast food, which offer calorie-dense but nutrient-poor options. This dietary pattern contributes to obesity and exacerbates the risk of developing Type 2 diabetes (Walker et al., 2010).
Challenges Faced by Individuals with Diabetes
Individuals with diabetes who are also food insecure face multiple challenges. These include:
Economic Constraints: Healthy foods are often more expensive than processed foods. Individuals with limited financial resources may prioritize quantity over quality, opting for cheaper, calorie-dense foods that can negatively impact diabetes management (Gregory & Coleman-Jensen, 2013).
Inconsistent Access: Food insecurity can lead to erratic eating patterns, such as skipping meals or binge eating when food becomes available. These behaviors can cause blood sugar levels to fluctuate, making diabetes management more difficult (Seligman & Schillinger, 2010).
Stress and Mental Health: The stress of food insecurity can negatively impact mental health, leading to conditions like depression and anxiety, which are also linked to poor diabetes outcomes (Lyles et al., 2013).
Strategies to Improve Food Security and Diabetes Management
Addressing food security is crucial for improving diabetes outcomes. Here are some strategies that can help:
Community Programs: Initiatives like community gardens, food pantries, and farmers’ markets can provide fresh produce to low-income families. Programs that offer cooking classes and nutrition education can empower individuals to make healthier food choices (Martin, Wu, Wolff, Colantonio, & Grady, 2016).
Policy Interventions: Government policies can play a significant role in improving food security. Expanding benefits for programs like the Supplemental Nutrition Assistance Program (SNAP) and implementing subsidies for healthy foods can make nutritious options more accessible to those in need (Gundersen, Kreider, & Pepper, 2011).
Healthcare Integration: Healthcare providers can screen for food insecurity during medical visits and refer patients to resources like food banks or nutrition assistance programs. Integrating dietitians and diabetes educators into healthcare teams can provide patients with the support they need to manage their diet and blood sugar levels effectively (Berkowitz, Seligman, & Choudhry, 2017).
Partnerships with Local Businesses: Encouraging partnerships between local governments, nonprofits, and grocery stores can help bring healthy food options into underserved areas. Mobile markets and delivery services can also bridge the gap in food deserts (Raja, Ma, & Yadav, 2008).
Conclusion
The relationship between diabetes and food security is complex and multifaceted. Ensuring that individuals have access to nutritious foods is essential for managing diabetes and preventing its complications. By addressing the economic, social, and environmental factors that contribute to food insecurity, we can support better health outcomes for those living with diabetes. Collaborative efforts from communities, healthcare providers, policymakers, and local businesses are necessary to create a more food-secure future for all.
References
Berkowitz, S. A., Seligman, H. K., & Choudhry, N. K. (2017). Treat or eat: Food insecurity, cost-related medication underuse, and unmet needs. American Journal of Medicine, 127(4), 303–310. doi:10.1016/j.amjmed.2014.12.002
CDC. (2024, June 5). Diabetes and food insecurity. Retrieved July 11, 2024, from Diabetes website: https://www.cdc.gov/diabetes/healthy-eating/diabetes-food-insecurity.html
FAO. (2008). An introduction to the basic concepts of food security. Retrieved July 11, 2024, from http://www.fao.org/3/al936e/al936e.pdf
Gregory, C. A., & Coleman-Jensen, A. (2013). Food insecurity, chronic disease, and health among working-age adults. USDA Economic Research Report. doi:10.2139/ssrn.2349836
Gundersen, C., Kreider, B., & Pepper, J. (2011). The economics of food insecurity in the United States. Applied Economic Perspectives and Policy, 33(3), 281–303. doi:10.1093/aepp/ppr022
Ley, S. H., Hamdy, O., Mohan, V., & Hu, F. B. (2014). Prevention and management of type 2 diabetes: dietary components and nutritional strategies. Lancet, 383(9933), 1999–2007. doi:10.1016/s0140-6736(14)60613-9
Lyles, C. R., Wolf, M. S., Schillinger, D., Davis, T. C., Dewalt, D., Dahlke, A. R., & Seligman, H. K. (2013). Food insecurity in relation to changes in glycemic control among low-income patients with diabetes. Diabetes Care, 36(11), 3128–3133. doi:10.2337/dc13-0553
Martin, K. S., Wu, R., Wolff, M., Colantonio, A. G., & Grady, J. (2016). A novel food pantry program: Food security, self-sufficiency, and diet-quality outcomes. American Journal of Preventive Medicine, 50(5), 569–575. doi:10.1016/j.amepre.2015.09.023
Raja, S., Ma, C., & Yadav, P. (2008). Beyond food deserts: Measuring and mapping racial disparities in neighborhood food environments. Journal of Planning Education and Research, 27(4), 469–482. doi:10.1177/0739456X08317461
Sami, W., Ansari, T., Butt, N. S., & Hamid, M. R. A. (2017). Effect of diet on type 2 diabetes mellitus: A review. International Journal of Health Sciences, 11(2), 65–71. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5426415/
Seligman, H. K., Laraia, B. A., & Kushel, M. B. (2010). Food insecurity is associated with chronic disease among low-income NHANES participants. The Journal of Nutrition, 140(2), 304–310. doi:10.3945/jn.109.112573
Seligman, H. K., & Schillinger, D. (2010). Hunger and socioeconomic disparities in chronic disease. The New England Journal of Medicine, 363(1), 6–9. doi:10.1056/NEJMp1000072
Ver Ploeg, M. (2010). Access to affordable, nutritious food is limited in “food deserts.” Retrieved July 11, 2024, from https://www.ers.usda.gov/amber-waves/2010/march/access-to-affordable-nutritious-food-is-limited-in-food-deserts/
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