Gender differences in the association between food insecurity and insulin resistance among US adults: National Health and Nutrition Examination Survey, 2005-2010

Purpose: To examine gender-specific associations between food insecurity and insulin resistance in a representative U.S. population. Methods: Data on 5533 adults of 20 years of age or more (2742 men and 2791 women) without diabetes from the 2005-2010 National Health and Nutrition Examination Survey were analyzed. Respondents were categorized as having full, marginal, low, or very low food security using a validated scale. Insulin-resistant individuals were defined as those with a homeostasis model assessment of insulin resistance value 2.5 or more. Results: Insulin resistance was higher in both normal-weight (P =.001) and overweight or obese (P <.001) women with lower food security, but no linear trend was found in men. In multiple logistic regression analyses, however, very low food security compared with full food security was associated with insulin resistance in normal-weight men (odds ratio, 3.99; 95% confidence interval, 1.71-9.33), and marginal food insecurity was associated with insulin resistance in overweight or obese men (odds ratio, 2.07; 95% confidence interval, 1.18-3.64) after adjusting for potential confounders. In women, the association between food insecurity and insulin resistance was no longer significant after adjustment. Conclusions: Food insecurity is associated with insulin resistance in adults without diabetes, and this effect varies by gender in normal-weight and overweight or obese populations. Improving food security status may help reduce insulin resistance, an underlying risk factor for diabetes and cardiovascular disease. (C) 2015 Elsevier Inc. All rights reserved.