2308-P: Disparities in Diet Quality of Retail Food Purchases among Households That Include a Person with Diabetes

Introduction and Objective: Households that include a person with diabetes (households with DM) demonstrate lower diet quality than those without DM. Understanding sociodemographic and geographic disparities can inform public health interventions. This study compared retail food purchase Healthy Eating Index (HEI)-2015 scores by household DM status and examined characteristics associated with higher and lower diet quality quantiles among DM households. Methods: We linked 2017-2018 IRI Consumer Network Panel with IRI MedProfiler and USDA nutrition databases to capture household-level retail food purchases and DM status. Linear models were used to estimate adjusted HEI-2015 total and component scores according to DM status; higher scores reflect better adherence to the Dietary Guidelines for Americans. Among households with DM, we used unconditional quantile regression to estimate associations between sociodemographic characteristics and diet quality at the top and bottom quintiles. Results: Among all households, those without DM had higher scores for total HEI-2015 (adjusted HEI 50.9 vs. 49.3; p<0.001) and most component scores than households with DM. Among households with DM, the HEI score varied substantially (adjusted HEI: 64.0 vs. 36.0 in top and bottom quintiles) with large component-level score differences. Higher income was associated with higher HEI scores in both the top and bottom quintiles, along with higher component scores for whole fruit, greens and beans, and whole grains. Higher education was associated with higher scores only in the higher-HEI group. Living in rural areas showed lower HEI scores at both ends of the distribution overall and for whole fruit, whole grain, and added sugar. Conclusion: Households with DM exhibit poorer diet quality. Disparities across socioeconomic and geographic factors associate differently among households with higher or lower diet quality, underscoring opportunities for targeted nutrition interventions.