Abstract
Objectives
Food insecurity contributes to racial/ethnic disparities in health. This is the first
study to examine associations among food insecurity, sleep, and cardiometabolic outcomes
in urban American Indian/Alaska Native (AI/AN) youth.
Design
Participants were 142 urban AI/AN youth (mean age = 14 years, 58% female). Food insecurity
and self-reported sleep disturbance were measured using validated surveys. A multi-dimensional
sleep health composite was derived using questionnaires (ie, satisfaction, alertness)
and actigraphy-derived indices (ie, duration, efficiency, regularity, timing). Cardiometabolic
measures included body mass index, blood pressure, glycosylated hemoglobin, waist
circumference, cholesterol, and triglycerides. Covariates were sex, age, and single-parent
household.
Results
Greater food insecurity was significantly associated with greater body mass index
(b = 0.12, p = .015), higher systolic blood pressure (b = 0.93, p = .03), and greater sleep disturbance (b = 1.49, p < .001), and marginally associated with lower sleep health composite scores (b = -0.09, p = .08). There was a significant indirect path from greater food insecurity to greater
waist circumference through poorer sleep health (0.11, 95% bootstrapping CI: [0.01,
0.30]).
Conclusion
Food insecurity is an important correlate of sleep and cardiometabolic health among
urban AI/AN youth and should be addressed to reduce emerging health risks during this
important developmental period. Policies to reduce food insecurity and increase access
to healthy foods as well as sleep interventions for these youth could help, as preliminary
findings suggest that sleep health may mediate the negative impact of food insecurity
on cardiometabolic risks.
Keywords
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Article info
Publication history
Published online: October 31, 2022
Accepted:
October 2,
2022
Received in revised form:
September 13,
2022
Received:
December 8,
2021
Identification
Copyright
© 2022 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
