Estimating the impact of addressing food needs on diabetes outcomes.

Autor:	Berkowitz SA; Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.; Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Ochoa A; Department of Research, OCHIN, Portland, OR, USA., Donovan JM; Department of Research, OCHIN, Portland, OR, USA., Dankovchik J; Department of Research, OCHIN, Portland, OR, USA., LaPoint M; Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Kuhn ML; Department of Social Medicine, Center for Health Equity Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Morrissey S; Department of Research, OCHIN, Portland, OR, USA., Gao M; Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Hudgens MG; Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Basu S; Clinical Product Development, Waymark Care, San Francisco, CA, USA., Gold R; Department of Research, OCHIN, Portland, OR, USA.; Kaiser Permanente Northwest Center for Health Research, Portland, OR, USA.
Jazyk:	angličtina
Zdroj:	SSM - population health [SSM Popul Health] 2024 Sep 03; Vol. 27, pp. 101709. Date of Electronic Publication: 2024 Sep 03 (Print Publication: 2024).
DOI:	10.1016/j.ssmph.2024.101709
Abstrakt:	Objective: To estimate the association between food needs and diabetes outcomes. Research Design and Methods: Longitudinal cohort study, using a target trial emulation approach. 96,792 adults with type 2 diabetes mellitus who underwent food need assessment in a network of community-based health centers were followed up to 36 months after initial assessment. We used targeted minimum loss estimation to estimate the association between not experiencing food needs, compared with experiencing food needs, and hemoglobin a1c (HbA1c), systolic and diastolic blood pressure (SBP and DBP), and LDL cholesterol. The study period was June 24th, 2016 to April 30th, 2023. Results: We estimated that not experiencing food needs, compared with experiencing food needs, would be associated with 0.12 percentage points lower (95% Confidence Interval [CI] -0.16% to -0.09%, p = < 0.0001) mean HbA1c at 12 months. We further estimated that not experiencing food needs would be associated with a 12-month SBP that was 0.67 mm Hg lower (95%CI -0.97 to -0.38 mm Hg, p < .0001), DBP 0.21 mm Hg lower (95%CI -0.38 to -0.04 mm Hg, p = .01). There was no association with lower LDL cholesterol. Results were similar at other timepoints, with associations for HbA1c, SBP, and DBP of similar magnitude, and no difference in LDL cholesterol. Conclusions: We estimated that not experiencing food needs may be associated with modestly better diabetes outcomes. These findings support testing interventions that address food needs as part of their mechanism of action. Competing Interests: SAB reports research grants from 10.13039/100000002NIH, 10.13039/100005561North Carolina Department of Health and Human Services, Blue Cross Blue Shield of North Carolina, Feeding America, the 10.13039/100000041American Diabetes Association, and the 10.13039/100000968American Heart Association, and personal fees from the 10.13039/100000903Aspen Institute, 10.13039/100000877Rockefeller Foundation, Gretchen Swanson Center for Nutrition, and 10.13039/100005977Kaiser Permanente, outside of the submitted work. ML reports research grant support from 10.13039/100005561North Carolina Department of Health and Human Services. SM reports research support from 10.13039/100000002NIH. All other authors declare nothing to report. (© 2024 The Authors.)
Databáze:	MEDLINE
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