VETERANS AND DIABETES: DOES FOOD ACCESS INCREASE RISK?

Type 2 diabetes is currently on the rise affecting about 15.9% of Americans (up nearly 3% in the last three years) and ranking as the seventh cause of death in the U.S.[1, 2] And this might be affecting the veteran population in the United States in unseen and detrimental ways. 

Compared to civilians, U.S. veterans are faced with additional financial burdens and higher risks of disability, chronic conditions, and obesity, all of which put them at an increased risk for diabetes. 

While the risk of diabetes isn’t limited to certain geographic regions, an October 2021 study in The Journal of The American Medical Association suggests that food availability could play a big role in the incidence of diabetes in veterans.[3] 

Study Details 

Does food access impact the rates of diabetes in specific populations? Researchers decided to look at the availability of fast-food restaurants compared with all other restaurants as well as supermarkets in areas associated with a higher risk of diabetes in veterans.

To improve validity, they included factors that could affect findings, such as unemployment rate, annual income, financial need, age, sex, race, disability, ethnicity, just to mention a few. 

Study Findings and Statistics

The approximately 4, 100, 650 veterans in this study were 92.2% male, with a majority being non-Hispanic whites (76.3%). In addition, most of the veterans (about 70%) lived with at least one disability (34.8%), and nearly 38% had below-average earnings. 

Researchers monitored participants for about five years. At the end of five years, researchers concluded that of the observed veterans, 539,369 developed diabetes, with seniors aged 60-79 and middle-aged adults aged 40-59 being affected the most.

There were also variations amongst ethnic groups and minorities. For instance, non-Hispanic Black adults had the highest case of diabetes at 16.9% compared to non-Hispanic Native Hawaiian, Pacific Islanders, American Indian, and Alaska Native veterans, which were 15% and 14.2%, respectively.

They also found that non-Hispanic white veterans had lower cases of type 2 diabetes (12.9%), while non-Hispanic Asian and Hispanic veterans had 12.8%. And more men in the cohort (13.6%) were diagnosed with type 2 diabetes than women (8.2%). 

Their findings also suggest that veterans living with a disability and low annual income were at higher risks of living with type 2 diabetes. 

How Fast Food Availability Changed Diabetes Risk

This study shines a light on several potential diabetes risk factors, including food availability, income, and pre-existing conditions. But we’re going to highlight the role that fast food plays in the incidence of diabetes.

The ratio of fast-food restaurants to other restaurants varied per environment. 

The summary showed:

• 26% in high-density urban areas
• 29% in rural areas 
• 31% in low-density metropolitan areas
• 32% in suburban areas

Researchers drew a direct link between the increase in fast-food availability and the risk of type 2 diabetes across communities for veterans. For every 10% increase in fast-food spots compared to other outlets, there was a: 

• 1% increase in the risk of diabetes risk in high-density and low-density urban and rural communities
• 2% increase in the risk of diabetes in suburban areas

People that lived in high-density urban communities had the most prominent cases of diabetes, followed by low-density urban environments and rural participants. The fewest cases of diabetes were found among the suburban veterans with 12.6%.

The Takeaway

If there’s a direct correlation between fast food availability and diabetes, it only makes sense that healthier options may decrease the incidence of diabetes and other metabolic issues. 

In this particular study, higher availability of supermarkets had an inverse association with the rate of diabetes in suburban and rural communities. In other words, when people are given the choice of healthier foods over fast food, they usually make the right decision.

Since supermarket availability has been shown to reduce the risk of type 2 diabetes by 10% in veterans, the best way to avoid diabetes-related health issues is to increase the availability of natural, whole foods and provide transportation in cases where distance is an issue. 

While this study does shed light on the impact of food availability on health, the study had some limitations. For example, researchers couldn’t check the veteran’s diets, lifestyle habits, or updated medical records. Further research that tracks and accounts for these variables would provide a more complete picture of the problem and potential solutions.

Since reducing the availability of fast food is unlikely, other options include improving menu options and raising awareness around healthier food options in general.