BMI mediates link between diabetes, food insecurity

A recent study has shown the significant role that BMI plays in the relationship between food insecurity and diabetes. 

Of the 74,174 patients included in the analysis, 6.2 percent were newly diagnosed with diabetes during the 5-year period. 

After multivariate adjustment, food insecurity showed a significant association with an increased risk of diabetes (relative risk [RR], 1.19, 95 percent confidence interval [CI], 1.03–1.36). Mediation analysis revealed that BMI significantly mediated the relationship between food insecurity and diabetes (natural indirect effect: RR, 1.10, 95 percent CI, 1.06–1.14). 

BMI remained a significant mediator even after accounting for an interaction with BMI (natural indirect effect: RR, 1.12, 95 percent CI, 1.0–1.17). 

Subgroup analyses revealed a stronger mediator–moderator effect of BMI among adults aged <45 years and among female patients. No differences were noted by race or ethnicity. 

“Our findings support BMI as a mediator and moderator of the association between food insecurity and diabetes,” the researchers said.  

Data from this analysis were obtained from the electronic health records of primary care patients at a large academic medical centre. 

The researchers explored the relationship between food insecurity and diabetes using multivariate Poisson regression models. They also examined the direct and indirect effects by which BMI mediated and moderated such association, as well as the extent to which these effects varied by age, sex, and race and ethnicity, using causal mediation analysis.