OBJECTIVEWe sought to determine whether food insecurity is associated with worse glycemic, cholesterol, and blood pressure control in adults with diabetes.RESEARCH DESIGN AND METHODSWe conducted a cross-sectional analysis of data from participants of the 1999–2008 National Health and Nutrition Examination Survey. All adults with diabetes (type 1 or type 2) by self-report or diabetes medication use were included. Food insecurity was measured by the Adult Food Security Survey Module. The outcomes of interest were proportion of patients with HbA1c >9.0% (75 mmol/mol), LDL cholesterol >100 mg/dL, and systolic blood pressure >140 mmHg or diastolic blood pressure >90 mmHg. We used multivariable logistic regression for analysis.RESULTSAmong the 2,557 adults with diabetes in our sample, a higher proportion of those with food insecurity (27.0 vs. 13.3%, P < 0.001) had an HbA1c >9.0% (75 mmol/mol). After adjustment for age, sex, educational attainment, household income, insurance status and type, smoking status, BMI, duration of diabetes, diabetes medication use and type, and presence of a usual source of care, food insecurity remained significantly associated with poor glycemic control (odds ratio [OR] 1.53 [95% CI 1.07–2.19]). Food insecurity was also associated with poor LDL control before (68.8 vs. 49.8, P = 0.002) and after (1.86 [1.01–3.44]) adjustment. Food insecurity was not associated with blood pressure control.CONCLUSIONSFood insecurity is significantly associated with poor metabolic control in adults with diabetes. Interventions that address food security as well as clinical factors may be needed to successfully manage chronic disease in vulnerable adults.

Background Little is known about weight control strategies associated with successful weight loss among obese U.S. adults in the general population. Purpose To identify strategies associated with losing at least 5% and 10% of body weight. Methods Multivariable analysis of data from obese adult (BMI ≥30) participants in the 2001–2006 NHANES to identify strategies associated with losing ≥5% and ≥10% of body weight (conducted in 2009–2011). Results Of 4034 obese adults, 2523 (63%) reported trying to lose weight in the previous year. Among those attempting weight loss, 1026 (40%) lost ≥5% and 510 (20%) lost ≥10% weight. After adjustment for potential confounders, strategies associated with losing ≥5% weight included eating less fat (OR 1.41, 95% CI=1.14, 1.75), exercising more (OR 1.29 [95% CI=1.05, 1.60]), and using prescription weight loss medications (OR 1.77 [95% CI=1.00, 3.13]). Eating less fat (OR 1.37 [95% CI=1.04, 1.80]), exercising more (OR 1.36 [95% CI=1.12, 1.65]), and using prescription weight loss medications (OR 2.05 [95% CI=1.09, 3.90]) were also associated with losing ≥10% weight, as was joining commercial weight loss programs (OR 1.72 [95% CI=1.00, 2.96]). Adults eating diet products were less likely to achieve 10% weight loss (OR 0.48 [95% CI=0.31, 0.73]). Liquid diets, nonprescription diet pills, and popular diets had no association with successful weight loss. Conclusions A substantial proportion of obese U.S. adults who attempted to lose weight reported weight loss, at least in the short term. Obese adults were more likely to report achieving meaningful weight loss if they ate less fat, exercised more, used prescription weight loss medications, or participated in commercial weight loss programs.

Background: We report age-dependent penetrance estimates for leucine-rich repeat kinase 2 (LRRK2)-related Parkinson's disease (PD) in a large sample of familial PD. The most frequently seen LRRK2 mutation, Gly2019Ser (G2019S), is associated with approximately 5 to 6% of familial PD cases and 1 to 2% of idiopathic cases, making it the most common known genetic cause of PD. Studies of the penetrance of LRRK2 mutations have produced a wide range of estimates, possibly due to differences in study design and recruitment, including in particular differences between samples of familial PD versus sporadic PD.