Home Food Availability, Food Choices, and Intervention Strategies among Prediabetes and Type 2 Diabetes Patients

Chronic metabolic diseases such as type 2 diabetes are critical public health concerns as rates have reached epidemic proportions in the United States. Nutrition and physical activity remain critical in the prevention and management of type 2 diabetes. In addition, awareness of an individual’s food security status and the quality of their home food environment are important considerations when developing prevention strategies designed to reduce the prevalence and onset of type 2 diabetes. The current research project consisted of three studies with cross-sectional analyses. The first two studies used a nationally representative sample from 2007-2010 National Health and Nutrition Examination Survey (NHANES). The third study is a mobile phone text message intervention for diabetes education using a quasi-experimental design. The objectives of the project were to examine: 1) associations of food security status with availability of healthy and unhealthy foods at home; 2) associations of availability of healthy and unhealthy foods at home with adult prediabetes or type 2 diabetes status; and 3) effects of educational text messages on diabetes self-care activities, and awareness of cardiovascular disease (CVD) risk and food choices among patients with type 2 diabetes. The results of the project show: 1) food insecurity was associated with low availability of healthy foods (fruits, green vegetables, and fat-free/low-fat milk) at home independent of other important socioeconomic status indicators (income, education, and race/ethnicity); 2) low availability of healthy (green vegetables and low-fat/fat-free milk) and high availability of unhealthy foods (sugary drinks) at home were associated with increased odds of adult prediabetes; and 3) educational text message intervention significantly increased CVD risk awareness, physical activity and availabilities of fresh fruits and vegetables at home among patients with type 2 diabetes, suggesting the feasibility and usefulness of the current text message program for diabetes education