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Diet quality trends among adults with diabetes by socioeconomic status in the U.S.: 1999–2014
BACKGROUND: The diet quality of adults living in the United States has improved overtime. We aim to determine whether diet quality among adults with diabetes mellitus has changed over time, and to examine trends in socioeconomic disparities in diet quality. METHODS: Repeated cross-sectional analysis...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544994/ https://www.ncbi.nlm.nih.gov/pubmed/31151439 http://dx.doi.org/10.1186/s12902-019-0382-3 |
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author | Orr, Colin J. Keyserling, Thomas C. Ammerman, Alice S. Berkowitz, Seth A. |
author_facet | Orr, Colin J. Keyserling, Thomas C. Ammerman, Alice S. Berkowitz, Seth A. |
author_sort | Orr, Colin J. |
collection | PubMed |
description | BACKGROUND: The diet quality of adults living in the United States has improved overtime. We aim to determine whether diet quality among adults with diabetes mellitus has changed over time, and to examine trends in socioeconomic disparities in diet quality. METHODS: Repeated cross-sectional analysis of eight National Health and Nutrition Examination Survey (NHANES) cycles (1999–2000 through 2013–2014). We included 5882 adult participants (age 20 or older) with diabetes mellitus (type 1 or 2) who completed 24-h dietary recalls. Diet quality was measured by the Healthy Eating Index 2010 (HEI) score (range 0–100, higher scores indicate better diet quality). We tested whether there were differences in diet quality across education, income, and food security categories, and whether any differences changed over time, using weighted linear regression models accounting for the complex survey design and adjusted for age, gender, and race/ethnicity. RESULTS: Twenty nine percent of US adults with diabetes had less than a high school diploma, 17% had income < 100% of federal poverty level, and 15% reported food insecurity. Average adjusted HEI score increased from 49.4 to 52.4 over the study period (p for trend = 0.003). We observed differences in HEI between high and low education (4.1, 95% CI 3.0–5.3), high and low income (3.7, 95%CI 2.4–5.0) and food secure relative to food insecure (2.1, 95% CI 0.8–3.3). These differences did not improve over time for education (p = 0.56), income (p = 0.65) or food security (p = 0.39) categories. CONCLUSIONS: Diet quality for adults with diabetes in the U.S. has improved overall; however, substantial disparities exist and have not improved. A concerted effort to improve diet quality in vulnerable groups may be needed. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12902-019-0382-3) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6544994 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-65449942019-06-04 Diet quality trends among adults with diabetes by socioeconomic status in the U.S.: 1999–2014 Orr, Colin J. Keyserling, Thomas C. Ammerman, Alice S. Berkowitz, Seth A. BMC Endocr Disord Research Article BACKGROUND: The diet quality of adults living in the United States has improved overtime. We aim to determine whether diet quality among adults with diabetes mellitus has changed over time, and to examine trends in socioeconomic disparities in diet quality. METHODS: Repeated cross-sectional analysis of eight National Health and Nutrition Examination Survey (NHANES) cycles (1999–2000 through 2013–2014). We included 5882 adult participants (age 20 or older) with diabetes mellitus (type 1 or 2) who completed 24-h dietary recalls. Diet quality was measured by the Healthy Eating Index 2010 (HEI) score (range 0–100, higher scores indicate better diet quality). We tested whether there were differences in diet quality across education, income, and food security categories, and whether any differences changed over time, using weighted linear regression models accounting for the complex survey design and adjusted for age, gender, and race/ethnicity. RESULTS: Twenty nine percent of US adults with diabetes had less than a high school diploma, 17% had income < 100% of federal poverty level, and 15% reported food insecurity. Average adjusted HEI score increased from 49.4 to 52.4 over the study period (p for trend = 0.003). We observed differences in HEI between high and low education (4.1, 95% CI 3.0–5.3), high and low income (3.7, 95%CI 2.4–5.0) and food secure relative to food insecure (2.1, 95% CI 0.8–3.3). These differences did not improve over time for education (p = 0.56), income (p = 0.65) or food security (p = 0.39) categories. CONCLUSIONS: Diet quality for adults with diabetes in the U.S. has improved overall; however, substantial disparities exist and have not improved. A concerted effort to improve diet quality in vulnerable groups may be needed. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12902-019-0382-3) contains supplementary material, which is available to authorized users. BioMed Central 2019-05-31 /pmc/articles/PMC6544994/ /pubmed/31151439 http://dx.doi.org/10.1186/s12902-019-0382-3 Text en © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Orr, Colin J. Keyserling, Thomas C. Ammerman, Alice S. Berkowitz, Seth A. Diet quality trends among adults with diabetes by socioeconomic status in the U.S.: 1999–2014 |
title | Diet quality trends among adults with diabetes by socioeconomic status in the U.S.: 1999–2014 |
title_full | Diet quality trends among adults with diabetes by socioeconomic status in the U.S.: 1999–2014 |
title_fullStr | Diet quality trends among adults with diabetes by socioeconomic status in the U.S.: 1999–2014 |
title_full_unstemmed | Diet quality trends among adults with diabetes by socioeconomic status in the U.S.: 1999–2014 |
title_short | Diet quality trends among adults with diabetes by socioeconomic status in the U.S.: 1999–2014 |
title_sort | diet quality trends among adults with diabetes by socioeconomic status in the u.s.: 1999–2014 |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544994/ https://www.ncbi.nlm.nih.gov/pubmed/31151439 http://dx.doi.org/10.1186/s12902-019-0382-3 |
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