(P14-020-23) Association Between Food Insecurity, Dietary Quality, and Metabolic Syndrome Among Puerto Rican Adults

Objectives: To examine cross-sectional associations between food security status and dietary quality and metabolic syndrome (MetS) among Puerto Rican adults living on the U.S. mainland.

Methods: Participants with complete baseline and dietary data from the Boston Puerto Rican Health Study were included in this analysis (n=1249; 57.1±7.6 y; 71.8% female). MetS was defined as three or more of the following: fasting triglycerides (≥150 mg/dL), HDL cholesterol (≤40 mg/dL for males, ≤50 mg/dL for females), systolic (≥130 mmHg) and diastolic (≥85 mmHg) blood pressure, plasma glucose (≥100 mg/dL), and waist circumference ( >102 cm for males, >88 cm for females). Food insecurity (FI) was assessed via the 6-item USDA Food Security Scale and diet from an FFQ. Three dietary quality indices (Healthy Eating Index (HEI), Mediterranean Diet Score (MedS), and DASH Diet Score (DASH)) were derived from average daily food and nutrient intake. FI was categorized as food security, mild FI, or severe FI. Analysis of variance and logistic regression models were used to assess associations between FI and dietary quality and MetS adjusting for potential confounders.

Results: The prevalence of MetS was 76.8%. Greater adherence to all dietary quality indices was significantly higher among those who were food secure (FS) compared with those who had severe FI (HEI: 72.1±0.3, 95%CI: 71.5-72.7 vs 68.9±0.88, 95%CI: 67.2-70.7, P < 0.001; MedS: 4.99±0.05, 95%CI: 4.9-5.1 vs 4.7±0.14, 95%CI: 4.4-5.0, P=0.05; DASH: 24.3±0.15, 95%CI: 24.0-24.6 vs 22.8±0.45, 95%CI: 21.9-23.7, P=0.002). Mild FI was associated with lower adherence to HEI and DASH than FS individuals. Further, severe FI was associated with higher odds of MetS compared with those who were FS (OR: 1.67, 95%CI: 1.06-2.64).

Conclusions: Those who experience severe FI had poorer dietary quality and higher likelihood of MetS compared with those who were food secure. Thus, severe FI may be a risk factor for MetS, which may be due, in part, to the impact on dietary quality in this high-risk population. Improving FI may be an important strategy for cardiometabolic interventions in this population.

Funding Sources: NIH