Journal of General Internal Medicine

, Volume 34, Issue 12, pp 2756–2762 | Cite as

Food Insecurity and Chronic Disease in US Young Adults: Findings from the National Longitudinal Study of Adolescent to Adult Health

  • Jason M. NagataEmail author
  • Kartika Palar
  • Holly C. Gooding
  • Andrea K. Garber
  • Kirsten Bibbins-Domingo
  • Sheri D. Weiser
Original Research



Food insecurity, or the limited or uncertain access to food resulting from inadequate financial resources, is associated with a higher prevalence of chronic disease in adulthood. Little is known about these relationships specifically in young adulthood, an important time for the development of chronic disease.


To determine the association between food insecurity and chronic disease including diabetes, hypertension, obesity, and obstructive airway disease in a nationally representative sample of US young adults.


Cross-sectional nationally representative data collected from Wave IV (2008) of the National Longitudinal Study of Adolescent to Adult Health was analyzed using multiple logistic regression models.


US young adults ages 24–32 years old

Main Measures

Food insecurity and general health; self-reported diabetes, hypertension, hyperlipidemia, “very overweight,” and obstructive airway disease; measured obesity derived from body mass index; and inadequate disease control (hemoglobin A1c ≥ 7.0%, blood pressure ≥ 140/90 mmHg) among those with reported diabetes and hypertension.

Key Results

Of the 14,786 young adults in the sample, 11% were food insecure. Food-insecure young adults had greater odds of self-reported poor health (2.63, 95% confidence interval (CI) 1.63–4.24), diabetes (1.67, 95% CI 1.18–2.37), hypertension (1.40, 95% CI 1.14–1.72), being “very overweight” (1.30, 95% CI 1.08–1.57), and obstructive airway disease (1.48, 95% CI 1.22–1.80) in adjusted models compared with young adults who were food secure. Food insecurity was not associated with inadequate disease control among those with diabetes or hypertension.


Food insecurity is associated with several self-reported chronic diseases and obesity in young adulthood. Health care providers should screen for food insecurity in young adults and provide referrals when appropriate. Future research should evaluate the impact of early interventions to combat food insecurity on the prevention of downstream health effects in later adulthood.


food security diabetes blood pressure cholesterol asthma chronic disease obesity young adult 



Contributers: This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website ( No direct support was received from grant P01-HD31921 for this analysis.

Funding Information

Jason Nagata is a Fellow in the Pediatric Scientist Development Program (K12HD000850-33). This project was supported by grants from the University of California Global Food Initiative Fellowship, the American Heart Association (CDA34760281), the American Academy of Pediatrics (AAP), the American Pediatric Society (APS), and the Norman Schlossberger Research Fund and the Mt. Zion Health Fund from the University of California, San Francisco. Kartika Palar is supported by NIH K01 DK 107335. Andrea Garber is supported by NIH 5R01HD082166-02. Holly Gooding is supported by NIH K23 HL122361. Sheri Weiser is supported by NIH K24AI134326.

Compliance with Ethical Standards

The University of North Carolina Institutional Review Board approved all Add Health study procedures.

Conflict of Interest

The authors declare that they do not have a conflict of interest.


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Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Jason M. Nagata
    • 1
    Email author
  • Kartika Palar
    • 2
  • Holly C. Gooding
    • 3
  • Andrea K. Garber
    • 1
  • Kirsten Bibbins-Domingo
    • 2
    • 4
  • Sheri D. Weiser
    • 2
  1. 1.Department of Pediatrics University of California, San FranciscoSan FranciscoUSA
  2. 2.Department of MedicineUniversity of California, San FranciscoSan FranciscoUSA
  3. 3.Department of PediatricsEmory University School of MedicineAtlantaUSA
  4. 4.Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoUSA

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