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Food insecurity has long been a global challenge associated with negative health outcomes. The spectrum of food insecurity corresponds to a spectrum of negative health outcomes that range from kwashiorkor and marasmus to obesity and chronic disease. The burden of food insecurity is a stressor that additionally negatively effects mental health. In this study, the relationship between food insecurity and mental health was examined using data from the National Health and Nutrition Examination Survey (NHANES). Food insecurity was assessed with the 18-item United States Food Security Survey Module, and participants were classified into one of four categories based on their responses: (1) full food security (FFS), for households with no concerns related to obtaining adequate food, (2) marginal food security (MFS), for households that occasionally had problems obtaining adequate food, (3) low food security (LFS), for households that had to reduce the quality, variety, or desirability of the food they ate, and (4) very low food security (VLFS), for households where at least one member had their food intake reduced due to a lack of money for food. Food insecurity survey scores were classified as FFS if zero affirmative responses were reported, MFS for 1 or 2 affirmative responses, LFS for 3 to 5 affirmative responses, and VLFS for 6 to 10 affirmative responses. Depression was assessed with the Patient Health Questionnaire-9 with scores ≥ 10 indicating depression. Data were analyzed from 28,448 adults aged 20 and older who participated in NHANES from 2005 to 2016. Food insecurity was present in 19.2% of the sample population (n=5,452). Food security status was significantly associated with gender, race, education level, marital status, smoking status, and BMI (Rao-Scott chi-square, p < 0.05). Adults with FFS and VLFS experienced depression at rates of 5.1% and 25.8%, respectively. Participants with VLFS had a significantly greater odds of depression than FFS adults, OR=3.50 (95% CI: 2.98, 4.12). These findings suggest that food insecurity is a significant risk factor for depression among US adults. To address this issue in our citizenry, policy initiatives and public health interventions addressing both food access and mental health should be prioritized.

Adolescent prevalence of obesity and at-risk WC has continued to rise worldwide. Sleep duration, sleep quality, and physical activity have been hypothesized as contributing factors to this increase. PURPOSE: This study aimed to examine the sleep–obesity relation in adolescents. METHODS: Using data from the 2015-2016 NHANES(n=454; ages 16-18 years), the effect of sleep duration, sleep quality, and MVPA on BMI and WC by gender was analyzed using appropriate sampling weights. RESULTS: Longer sleep duration was associated with increased BMI (β=0.07; 0.065, p<0.05) and WC (β=0.069; 0.13, p<0.05) among males and females. Poor sleep quality was associated with increased BMI among males and females (β= 0.04; 0.08, p< 0.05). A significant main effect was observed across sleep duration, sleep quality and MVPA via multiple regression for both BMI and WC. CONCLUSIONS: For both males and females, BMI and WC were impacted by excessive sleep, poor sleep quality, and low MVPA, with greater associations among males.

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Four in ten people in the US will be diagnosed with cancer during their lifetime. Environmental exposures are important determinants of cancer risk, causing as many as 19% of cancers worldwide. Phthalates are a group of chemicals used to increase the flexibility of plastics and vinyl in household materials such as food packaging, plastic toys, wood finishes and adhesives. Some phthalates may act as endocrine disruptors with hypothesized links to endometriosis, breast cancer, and reproductive outcomes. However, no research yet exists on phthalate exposure and all-cancer mortality. We investigated the relationship between seven urinary phthalate metabolites among 5,205 adults in National Health and Nutrition Examination Survey (NHANES), from 1999 to 2006 with mortality data through 2011. Urinary phthalate metabolites were measured in spot urine samples using HPLC-MS/MS and HPLC-ESI-MS/MS. Cox proportional hazard regressions were conducted to calculate hazard ratios and 95 percent confidence intervals for all-cancer mortality, stratified by gender. Mean creatinine adjusted metabolite concentrations ranged from 0.03 – 3.86 ug/mg in males and 0.07 – 4.37 ug/mg in females. Age-adjusted and multivariate Cox proportional hazard models did not yield statistically significant results for any metabolites. Hazard ratios in the multivariate model for continuous, creatinine adjusted, log transformed metabolite concentrations, ranged from 0.90 to 1.27 in men and 0.86 to 1.07 in women. There was no evidence for a dose-response relationship in the quartile analyses, with p-values for trend above 0.12. This research contributes to the limited cancer literature on phthalate exposure that helps direct future regulations on plasticizers in consumer products.

A research report from the Centers for Disease Control and Prevention (CDC) indicated that more than 50% of people with diabetes mellitus (DM) in the United States (U.S.) also have arthritis. The diabetes population is disproportionately affected by arthritis, but there has been limited and inconsistent research to confirm the association between type 2 diabetes mellitus (T2DM) and rheumatoid arthritis (RA). The current study aimed to identify an association between T2DM and RA for noninstitutionalized U.S. adults between 1999 and 2012 using a nationally representative sample from the National Health and Nutrition Examination Survey (NHANES) database (n =31,488 ). A quantitative, cross-sectional investigation was conducted to determine if patients with T2DM had an increased prevalence of RA. The current study also sought to identify characteristics that could affect the association between both groups and the prevalence of cardiovascular disease (CVD) in this population. Prevalence and adjusted odds ratios (OR) using logistic regression were calculated. The results show evidence of a strong association between T2DM and concomitant RA. Prevalence of RA was significantly higher in participants with T2DM compare to those without T2DM. Important factors in this association were gender, ethnicity, education, disability, and work functioning. The prevalence of CVD and adjusted OR of association were doubled in participants with T2DM and RA when compared to participants who had just one of the conditions; the OR of association was quadrupled when compared to those without this comorbidity. This study may provide patients and health care providers with a better understanding of the need for management of both conditions in a interdisciplinary manner

ABSTRACT Background: Polyunsaturated fatty acids (PUFA) are found in nuts and seeds, salad dressings and vegetable oil and are prone to oxidation during storage and food preparation. Evidence supports that consumption of oxidized lipids promotes atherosclerosis and glucose intolerance in animal models. However there is a dearth of evidence with regard to the amount of oxidized lipids consumed and its association with parameters of adiposity and glucose homeostasis in humans. Objective: The objective of this study is to estimate the amount of oxidized lipids in common foods and the oxidized lipid consumption in the US population using the data from National Health and Nutrition Examination Survey (NHANES) 2005-06. The second objective of this study is to investigate if there is an association between consumption of oxidized lipids with markers of adiposity and glucose tolerance. Methods- Foods with possible high oxidized lipid content were selected from the NHANES food frequency questionnaire. Oxidized lipid content /Peroxide Values (PV) of these foods were determined from published values in the literature. Oxidized lipid consumption was stratified into tertiles to determine the relationship between consumption of oxidized lipids and markers of adiposity. Regression analysis was used to explore to the extent to which body fat % and HOMA- IR scores could be attributed to oxidized lipid intake. Results- The estimated mean daily consumption of oxidized lipids was 0.625 meq/kg of fat for the US population. Estimated mean consumption of oxidized lipids was significantly greater in men compared to women, in children compared to adults and among African Americans compared to other races. In both men and women it was observed that the markers of adiposity like body fat%, waist circumference, triceps skinfold decreased significantly with increased consumption of oxidized lipids. However in women (below 18 years) there was a significant increase in HOMA-IR with increased consumption of oxidized lipids. Conclusion- Increased consumption of oxidized lipids is associated with decreased fat mass but increased glucose intolerance in women, but not in men.

Background: Prediabetes (PD) defined as having glucose values above normal but not high enough to be diagnosed as diabetes, is known to be a risk factor for type 2 diabetes and associated complications. Early prevention efforts can reverse the condition or delay the development of type 2 diabetes. This study examines the sociodemographic risk factors for PD in women. Methods: Using secondary data from National Health and Nutrition Examination Survey NHANES 2005-2006, chi-square analysis was done to find the prevalence of the disease among different categories of women with respect to age, ethnicity, and socioeconomic status. Univariate and multivariate analyses were performed to determine the associations of the sociodemographic factors with PD among women. A p-value of <0>.05 and 95% confidence intervals were used to determine statistical significance throughout all the analyses performed. Results: In total, 3,461 cases were included in the study analysis. Cases with indications of PD were found in 716 (20.7%) of the sample. Increased age was consistently associated with PD in women [χ=392.3(3), p<.001]. Prevalence of PD peaked for those aged 60 and above. Results of multivariate analysis suggested that being non-Hispanic Blacks was associated with increased likelihood of PD. Education was found to be significantly associated with PD but an inverse relationship could not be established. Conclusions: As an increase in age was found to be associated with PD in women, early screening and education regarding lifestyle changes can help reverse the condition. Minority groups should be an important focus for PD prevention efforts.