Poor access to safe and nutritious foods can pose serious health challenges for diabetes patients

Preparing a healthy meal loaded with fresh vegetables seems like an easy thing to do. But for some people living with diabetes, having access to nutritious food can be difficult --- and may have a detrimental effect on their health and well-being, according to a new study led by Ryerson University.

"Diabetes is a chronic condition that requires a healthy diet to manage the disease," says Enza Gucciardi, an assistant professor in Ryerson's School of Nutrition. "Being food insecure and having diabetes appears to make this population extremely vulnerable to poor mental and physical health." According to the Canadian Diabetes Association, three million Canadians are expected to have this disease by 2010.

Household food insecurity (HFI) refers to the inability of people to access safe and nutritious foods, which can pose serious health challenges for some people with diabetes. Some possible causes may be limited income, poor access to fresh fruits and vegetables for people living remote communities, or lack of ethnic foods consumed by individuals from diverse backgrounds in their daily diets.

Enza Gucciardi is the lead author of the study, "An Exploration Between Household Food Insecurity and Diabetes in Canada," published in the December issue of the journal Diabetes Care. She is also an affiliate scientist at the University Health Network (UHN) Women's Health Program and the Toronto General Hospital Research Institute. Janet Vogt and Margaret DeMelo of the UHN Diabetes Education Centre and Donna Stewart of University of Toronto's Faculty of Medicine are the study's co-authors.

Using data from a 2005 Canadian Community Health Survey of more than 132,000 people, the researchers looked at the prevalence of household food insecurity in Canadians with diabetes compared to those who did not have the health condition. For example, participants were asked whether their financial situation was a barrier to purchasing healthy foods. The researchers also examined the relationship between HFI and access to diabetes management services and health status.

The study found that Canadians with diabetes had more difficulty accessing nutritious foods than those without the health condition. This, according to the authors, is associated with unhealthy food choices such as eating less fruits and vegetables. The researchers also found that people with diabetes exhibited other unhealthy behaviours such as being less physically active and smoking. Rates of HFI, however, were higher for people on social assistance, regardless if they had diabetes or not.

HFI is also connected to mental health, according to the authors. They found that HFI was linked with such issues as mood disorders, lower satisfaction with life and higher self-perceived stress levels.

Moreover, the odds of experiencing HFI were greater for two groups of people diagnosed with diabetes: adults under the age of 40 and women between ages 12 to 45.

But, despite being food insecure, people did not encounter any barriers when it came to accessing diabetes management services, such as having their blood sugars checked and receiving eye exam referrals by their physician. This is not surprising, says Gucciardi, given Canadians' universal access to health-care services.

Guccardi says for people living with diabetes, managing their health condition comes down to basic necessities. "If you don't have enough money to purchase food for your household, this is a stressor that will impact not only your illness management but your overall well-being adversely."

"To prevent diabetes complications, we need to tackle the various economic issues that challenge many individuals and households. But doing so will require an upfront investment from the government."