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Mexican Americans are the largest segment of Hispanics in the United States of America (U.S.). Hispanics and Mexican Americans are more likely to have higher rates of type 2 diabetes (T2D) and its risk factors such as obesity, physical inactivity, low socioeconomic status (SES), and food insecurity compared to non-Hispanic Whites (NHW). However, the research looking into the associations between these risk factors and T2D, and the potential racial/ethnic differences is limited. This study examined whether food insecurity was related to T2D independently of low SES and a wide range of T2D risk factors among Mexican Americans and non-Hispanic Whites (NHW) in a nationally representative sample in the U.S. About 12,944 adults, including 2,955 Mexican Americans and 6,363 non-Hispanic Whites, 20-84yr, from the National Health and Nutrition Examination Survey (NHANES) 1999-2004 were included in the analyses. Multivariate logistic regression analyses indicated that participants with marginal or very low food security (vs. high food security) at the household level were more likely to have T2D after adjusting for education, employment, poverty, race/ethnicity, age, gender, and country of birth (p<0.05). Following further adjustment for obesity, lifestyle factors (physical activity, cigarette smoking, alcohol and dietary intakes), family history of diabetes, and comorbidities, participants with very low (household) food security remained more likely to have T2D (OR 1.84, CI 1.02-3.31). When the two racial/ethnic groups were examined separately, very low food security became a stronger determinant of T2D among NHWs (OR 3.53, CI 1.58-7.87), but this association was attenuated among Mexican Americans. Low SES, as determined by education and employment levels, were marginally related to higher likelihood of having T2D among Mexican Americans (p=0.050) but not among NHWs. These results suggest that associations of food insecurity and SES with T2D vary between Mexican American and NHW adults. This may require different approaches for prevention efforts tailored to the needs of each racial/ethnic group.
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