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Objective:  Food insecurity has been linked to adverse health consequences. We sought to determine if food insecurity was related to obesity and prediabetes risk in U.S. adolescents. We also investigated if Supplemental Nutrition Assistance Program (SNAP) utilization mitigated any observed risks.  Materials and Methods:  We used linear and logistic regression analysis of cross-sectional data from a nationally representative sample of U.S. adolescents aged 12-19 years participating in the National Health And Nutrition Examination Survey 2003-2014 who had an income:poverty ratio of &lt;5.0 and had complete data regarding metabolic laboratory assessments, food security, and socioeconomic status ( n  = 2662).  Results:  Food insecurity was present in 18.40% (95% confidence interval (CI): 16.47-20.37) among U.S. adolescents meeting inclusion criteria. Food insecurity was associated with increased odds of elevated blood pressure (adjusted odds ratio [aOR] = 1.57, 95% CI: 1.11-2.22) and prediabetes (aOR = 1.94, 95% CI: 1.16-3.25). SNAP usage was associated with higher body mass index z -score ( e.g. , mean: 0.80 vs. 0.59, P  = 0.02), increased insulin resistance, and increased prediabetes odds among food-secure adolescents relative to nonusage.  Conclusions:  Food insecurity is relatively prevalent among U.S. adolescents with an income:poverty ratio of &lt;5.0. Food insecurity is related to laboratory abnormalities and corresponding adverse health outcomes among U.S. adolescents in this relatively large sample. SNAP usage was associated with adverse health observations among food-secure adolescents. Ongoing efforts are still needed toward food assistance as important public health efforts aimed at mitigating the adverse outcomes related to food insecurity.

Food Insecurity Is Associated with Prediabetes Risk Among U.S. Adolescents, NHANES 2003–2014