Food insecurity is associated with prediabetes and dietary differences in U.S. adults aged 20–39

Food insecurity has been linked with lifestyle and metabolic health differences in varying populations. We sought to assess how food insecurity may have been associated with prediabetes and dietary differences in a relatively young subset of U.S. adults. We examined data from the United States National Health and Nutrition Examination Survey (2003–2014) participants aged 20–39 with complete data regarding food insecurity and metabolic laboratory assessment. We also assessed macronutrient intake and Supplemental Nutrition Assistance Program (SNAP) usage. All logistic regression models controlled for age, sex, and household income. Among 3684 included participants, food insecurity had 19.12% (95% confidence interval [95%CI]: 16.16, 22.08) prevalence. Food-insecure participants had prediabetes/diabetes prevalence of 37.36% (95%CI: 30.47, 44.25) and higher odds of having prediabetes/diabetes (adjusted odds ratio [aOR] = 1.36, 95%CI: 1.00, 1.85). Food-insecure adults has significantly different macronutrient intake: higher carbohydrates (p = 0.02), less protein (p = 0.01), and less total fat (p = 0.04) consumption. Food-insecure adults who used SNAP (compared to food-insecure adults who did not use SNAP) had higher odds of having metabolic syndrome (ATP-III MetS) (aOR = 2.56, 95%CI: 1.27, 5.22). We found that food insecurity was relatively prevalent in this subset of younger U.S. adults. We showed that food-insecure participants had increased prevalence and odds of prediabetes. These associations were also correlated with dietary differences. •Food insecurity is associated with higher odds of having prediabetes in U.S. adults aged 20–39.•Food-insecure adults have different macronutrient intake, consuming more carbohydrates, and less protein.•Food-insecure adults who used food assistance programs had higher odds of having metabolic syndrome.