Poster Topical Area: Community and Public Health Nutrition
Poster Board Number: 32
Refugee survivors of starvation and trauma during the Khmer Rouge rule of Cambodia suffer myriad poor health outcomes, 30 years after the genocide. Objectives: 1) To document food insecurity of Cambodian Americans who were alive during the Pol Pot era; 2) To document their diet and 3) To explore preliminary associations between food insecurity and diabetes risk markers (Glycosylated hemoglobin, HbA1c). HbA1c reflects the average blood glucose levels over the preceding 6-10 weeks.
Methods: We analyzed cross-sectional baseline data (N=92) from the Diabetes Risk Reduction through Eat, Walk, Sleep And Medication Therapy Management for Depressed Cambodians (DREAM) study, an ongoing diabetes prevention trial. Cambodian Americans that met the eligibility requirements which included age 35-70, Khmer speaking, >=3 risk factors for diabetes and either anti-depressant medication or elevated depression symptoms on the Hopkins Symptom Checklist were enrolled. Respondents completed the 6-item validated Khmer language, version of the U. S. Household Food Security Module. A short food frequency questionnaire was completed to assess dietary intake. Fasting blood samples were collected and assayed to assess HbA1c.
Results: Respondents' mean age was 56 ± 8 yrs. old, 84% were female, 82% were unemployed, and 51% were married. Forty-three percent were enrolled in the Supplemental Nutrition Assistance Program. Seventy-three percent were classified as food secure and 27% as food insecure. There were no significant differences by food security status for age, gender, employment status, number of people in the household. Single marital status was associated with food insecurity. Overall, 98% of the respondents consumed white rice; 26% brown rice; 80% rice porridge; and 54% sweet sticky rice. Food insecure respondents have higher mean levels of HbA1c (5. 8 ± 0. 31), when compared to food secure respondents (5. 5 ± 0. 41, mean ± SD), p . 008.
Conclusions: Food insecurity was prevalent among Cambodians. Food insecurity was significantly associated with higher HbA1c levels, which the American Diabetes Association considers to be in the pre-diabetic range. Future multivariate analyses should control for dietary intake, depressive, and trauma symptoms to further establish these associations.
This work is supported by: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), R01 study, registered at clinicaltrials.gov as 1R01DK103663 -01A1
University of Connecticut Health Center