title: Gender differences in the association between food insecurity and insulin resistance among U.S. adults: National Health and Nutrition Examination Survey, 2005-2010.
abstract: OBJECTIVE
  To examine gender-specific associations between food insecurity and insulin resistance in a representative U.S.
  
  
  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.
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC. Electronic address: Junxiuliu99@gmail.com.
authors.forename: Junxiu
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.
authors.forename: Yong-Moon Mark
authors.initials: YM
authors.lastname: Park
authors.affiliation: Division of General Internal Medicine, Massachusetts General Hospital, Boston; Harvard Medical School, Boston, MA.
authors.forename: Seth A
authors.initials: SA
authors.lastname: Berkowitz
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.
authors.forename: Qingwei
authors.initials: Q
authors.lastname: Hu
authors.affiliation: Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Kyungdo
authors.initials: K
authors.lastname: Han
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.
authors.forename: Andrew
authors.initials: A
authors.lastname: Ortaglia
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.
authors.forename: Robert E
authors.initials: RE
authors.lastname: McKeown
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.
authors.forename: Angela D
authors.initials: AD
authors.lastname: Liese
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005523:Food Supply; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology*; D016017:Odds Ratio; D050177:Overweight / Q000453:epidemiology*; D012307:Risk Factors; D012727:Sex Characteristics; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology
chemical_list: D007328:Insulin
keywords: Food insecurity; Gender difference; Insulin resistance; NHANES