FRAC’s Senior Nutrition Policy and Research Analyst Heather Hartline-Grafton, Dr.PH., R.D., weighs in on the relationship between health and food insecurity.
Obesity continues to be a major health challenge in the U.S. What does the latest research say about food insecurity and obesity?
The extent of research on food insecurity and obesity has grown considerably over the last 20 years, and much of that research is covered in the obesity section of FRAC’s website. Overall, the strongest and most consistent evidence demonstrates a higher risk of obesity among food-insecure women. The evidence is mixed for children and men, but obesity and food insecurity often coexist in these populations.
There are a number of reasons why food-insecure people are vulnerable to obesity and poor nutrition, including:
- limited resources to obtain adequate or healthy food;
- lack of access to healthy, affordable foods;
- lack of resources to obtain appliances and utensils to preserve, and cook food;
- cycles of food deprivation and overeating;
- high levels of stress, anxiety, and depression; and
- fewer opportunities for physical activity.
What recent research have you seen that demonstrates the connections between food insecurity and diet-related disease?
There is a large body of research on the impact of food insecurity on health outcomes. Many diet-related diseases — diabetes, hypertension, heart disease, and obesity — have been associated with food insecurity.
What I have found particularly interesting over the past few years is the research on food insecurity and diabetes outcomes. There is evidence that adults with diabetes who are food insecure are more likely to have poor glucose control. Explanations for this may include engaging in cost-related medication underuse or nonadherence to prescriptions, e.g., skipping doses, taking less medicine or delaying the filling or refilling of prescriptions; postponing preventive or needed medical care; or forgoing the foods needed for diabetic diets.
Poor glucose control can lead to health complications in the short- and long-term future as well as increased use of the health care system. This is just one example of the ripple effects food insecurity can have on a person’s health and well-being – and on the health system.
Given the connections between food insecurity and diet-related diseases, what can registered dietitians and public health professionals do to address these issues?
Screen and intervene! Screening for food insecurity is critically important in the health care setting, and should be on the radar of all nutrition and health care professionals.
FRAC and the American Academy of Pediatrics recently released Addressing Food Insecurity: A Toolkit for Pediatricians. While this toolkit is geared toward the pediatricians and health care providers that serve children, the overarching message holds true across the lifespan: screen for food insecurity using Hunger Vital Sign™ or a similar screening tool, and connect those who screen positive to the federal nutrition programs and other food resources. These two steps can make a difference in the health and well-being of vulnerable patients.