The Monthly Cycling of Food Insecurity and Diabetes Risk

粮食不安全和糖尿病风险的每月循环

• 批准号: 10447132
• 负责人: Angela bermudez-millan
• 金额: $ 19.23万
• 依托单位: UNIVERSITY OF CONNECTICUT SCH OF MED/DNT
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-04 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10447132
• 关键词: Address; Affect; Age; American; Anxiety; Attention; Behavior Therapy; Binge Eating; Biological Markers; Blood Glucose; Body mass index; Budgets; Cardiovascular Diseases; Child; Chronic; Communities; Community Healthcare; Connecticut; Data; Dependence; Development; Diabetes Mellitus; Diet; Dietary intake; Distress; Eating; Education; Emotions; Equipment and supply inventories; Exploratory/Developmental Grant for Diagnostic Cancer Imaging; Faculty; Family; Fatty acid glycerol esters; Food; Food Energy; Frequencies; Fructosamine; Glycosylated hemoglobin A; Health; Healthcare; High Risk Woman; Home visitation; Household; Hyperphagia; Insulin Resistance; Intake; Intervention; Intervention Studies; Interview; Latina Population; Latino; Latino Population; Left; Link; Literature; Measures; Mediating; Mediation; Mental Depression; Metabolic; Modeling; Mothers; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Nutritionist; Nutritive Value; Obesity; Overweight; Palate; Participant; Persons; Pilot Projects; Policies; Prediabetes syndrome; Preparation; Prevention; Process; Psyche structure; Public Health; Reduce health disparities; Research; Risk; Risk Factors; Risk Marker; Role; Secure; Testing; Unhealthy Diet; Universities; Weight Gain; Woman; Women' s Health; Work; anxiety symptoms; child bearing; depressive symptoms; design; diabetes risk; dietary; emotional distress; emotional eating; experience; fasting glucose; food insecurity; food resource; food security; fruits and vegetables; glycemic control; glycosylated serum albumin; health disparity; high risk; improved; longitudinal design; medical schools; mobile application; mortality; novel; nutrition; policy implication; programs; psychological distress; response; smartphone Application; social; sugar; therapy design; waist circumference

PROJECT SUMMARY/ABSTRACT This is an application for an R21 award for Dr. Bermúdez-Millán, a Public Health Nutritionist and junior faculty at the Department of Community Health and Health Care, School of Medicine at the University of Connecticut Health Center. As compared with non-Latino White women, Latino women are at higher risk of developing type 2 diabetes mellitus. A novel putative risk factor for the development of diabetes that disproportionately affects Latinas is food insecurity, and more specifically, the monthly cycling of food insecurity. Food insecurity has been linked to obesity, diabetes, and cardiovascular disease although the mechanisms are not well elucidated. The proposed research narrows in, specifically, the monthly cycling of food insecurity and its associations with dietary intake/quality, eating disturbance, mental distress and diabetes risk markers. The research plan involves conducting a formative pilot study among 100 food insecure Latinas of childbearing age, to investigate the influence of food insecurity on diabetes risk. Since food insecurity is a long term and episodic experience, our overall hypothesis is that, compared to weeks of food adequacy (food security), weeks of food inadequacy (food insecurity) will be characterized by worsened near-term diabetes risk markers, i.e., fasting glucose, insulin resistance, fructosamine, and glycated albumin and higher long-term metabolic risk markers, i.e. HbA1c, waist circumference, and body mass index. We are also planning to determine if diet, eating disturbance, and psychological distress mediate the relationship between food insecurity and diabetes risk. We hypothesize that, compared to weeks of food adequacy (food security), weeks of food inadequacy (food insecurity) (1) will be characterized by eating disturbance (emotional eating and binge-eating); poorer diet quality (Fat/Sugar/Fruit/Vegetable Screener); and increased psychological distress (depression and anxiety symptoms). Using a repeated measure design, we will collect data at timepoints that will allow us to model mediation effects. Finally, we will develop and collect household food inventory data using an app for smart phones, where subjects can enter foods left in their pantry and refrigerator weekly, as well as uploading photographs. Following completion of the quantitative study, we will conduct 15 in-depth interviews with women having the worse glycemic control, to identify barriers and facilitators to improve Fat/Sugar/Fruit/Vegetable intake among food insecure Latinas using the Health Action Process Approach (HAPA) framework, and inform the design of a larger study for an intervention application. Eventually this line of research will lead to novel interventions and inform policy to decrease the deleterious effects of food insecurity on risk for type 2 diabetes. My established relationships with community agencies in the Latino community make this project highly feasible. 1

项目总结/摘要 这是一个R21奖的申请Bermústan-Millán博士，公共卫生营养学家和初级教师 康涅狄格大学医学院社区卫生和医疗保健系 健康中心。与非拉丁裔白色妇女相比，拉丁裔妇女患上 2型糖尿病。糖尿病发展的一种新的假定风险因素， 拉丁美洲是粮食不安全，更具体地说，是粮食不安全的每月循环。粮食无保障 与肥胖、糖尿病和心血管疾病有关，尽管其机制尚未得到很好的阐明。 拟议的研究缩小了范围，特别是粮食不安全及其关联的每月周期 饮食摄入/质量、进食障碍、精神困扰和糖尿病风险标志物。研究计划 包括在100名育龄期食物不安全的拉丁美洲人中进行一项初步研究， 粮食不安全对糖尿病风险的影响。由于粮食不安全是一个长期和偶发的经历， 我们的总体假设是，与数周的食物充足（食物安全）相比，数周的食物不足 (food不安全感）的特征在于恶化的近期糖尿病风险标志物，即，空腹血糖， 胰岛素抵抗、果糖胺和糖化白蛋白以及更高的长期代谢风险标志物，即 HbA 1c、腰围和体重指数。我们还计划确定饮食，饮食 精神障碍和心理困扰介导了粮食不安全与糖尿病风险之间的关系。我们 假设，与食物充足（食物安全）周相比，食物不足（食物安全）周 不安全感）（1）将以饮食失调（情绪化饮食和暴饮暴食）为特征;饮食较差 质量（脂肪/糖/水果/蔬菜筛选器）;心理困扰（抑郁和焦虑）增加 症状）。使用重复测量设计，我们将在各个时间点收集数据，以便我们能够建模 中介效应。最后，我们将使用智能应用程序开发和收集家庭食品库存数据， 手机，受试者可以输入每周留在食品储藏室和冰箱里的食物， 照片在完成定量研究后，我们将进行15次深入访谈， 血糖控制较差的女性，以确定改善的障碍和促进因素 使用健康行动过程方法的食品不安全拉丁美洲人的脂肪/糖/水果/蔬菜摄入量 （HAPA）框架，并为干预应用的更大研究的设计提供信息。最终这条线 研究将导致新的干预措施，并为政策提供信息，以减少食物的有害影响。 2型糖尿病的危险因素。我和拉丁美洲的社区机构建立了关系 社区使这个项目具有很高的可行性。 1