COVID-19-Related Food Insecurity Among Households with Dietary Restrictions: A National Survey

Jessica D Guillaume; Jyotsna S Jagai; Jennifer A Makelarski; Emily M Abramsohn; Stacy Tessler Lindau; Ritu Verma; Christina E Ciaccio

doi:10.1016/j.jaip.2021.06.015

COVID-19-Related Food Insecurity Among Households with Dietary Restrictions: A National Survey

J Allergy Clin Immunol Pract. 2021 Sep;9(9):3323-3330.e3. doi: 10.1016/j.jaip.2021.06.015. Epub 2021 Jun 24.

Authors

Jessica D Guillaume¹, Jyotsna S Jagai², Jennifer A Makelarski³, Emily M Abramsohn³, Stacy Tessler Lindau⁴, Ritu Verma⁵, Christina E Ciaccio⁶

Affiliations

¹ Pritzker School of Medicine, The University of Chicago, Chicago, Ill.
² Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Ill; School of Public Health, University of Illinois at Chicago, Chicago, Ill.
³ Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Ill.
⁴ Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Ill; Department of Medicine-Geriatrics, The University of Chicago, Chicago, Ill.
⁵ Department of Pediatric Gastroenterology, Hepatology, and Nutrition, The University of Chicago, Chicago, Ill.
⁶ Department of Pediatric Allergy and Immunology, The University of Chicago, Chicago, Ill. Electronic address: cciaccio@bsd.uchicago.edu.

Abstract

Background: Food insecurity dramatically increased because of the COVID-19 pandemic; however, little is known about pandemic-related food insecurity in households with dietary restrictions.

Objective: To examine pre-pandemic rates of and pandemic-related change in food insecurity among households with and without dietary restrictions.

Methods: A cross-sectional, panel-based survey of 3200 U.S. women was conducted in April 2020. Pre-pandemic food insecurity and early pandemic-related change in food insecurity were assessed using the adapted Hunger Vital Sign. Weighted, multivariate logistic regression was used to model the odds of pre-pandemic food insecurity and the odds of incident or worsening pandemic-related food insecurity among households with and without dietary restrictions. In models predicting pandemic-related outcomes, interaction effects between race/ethnicity and dietary restrictions were examined.

Results: Before the COVID-19 pandemic, households with self-reported food allergy (adjusted odds ratio [aOR]: 1.5, 95% confidence interval [CI]: 1.2-1.9), celiac disease (aOR: 2.3, 95% CI: 1.4-3.5), or both (aOR: 2.1, 95% CI: 1.2-3.6) were significantly more likely to be food insecure than households without restrictions. Households with dietary restrictions were also significantly more likely to experience incident or worsening food insecurity during the early pandemic (food allergy: aOR: 1.6, 95% CI: 1.3-2.1) (celiac disease: aOR: 2.3, 95% CI: 1.5-3.5) (both: aOR: 2.0, 95% CI: 1.2-3.4). Race/ethnicity was not a significant moderator of the relationship between dietary restrictions and pandemic-related food insecurity.

Conclusion: Households with dietary restrictions were more likely to experience both pre-pandemic and pandemic-related incident or worsening food insecurity than households without restrictions. Clinical care for patients with dietary restrictions requires attention to food insecurity.

Keywords: COVID-19; Celiac disease; Dietary restrictions; Food allergy; Food insecurity; Pandemic; Race/ethnicity; Social determinants of health.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

COVID-19*
Cross-Sectional Studies
Female
Food Insecurity
Food Supply
Humans
Pandemics*
SARS-CoV-2

Abstract

Publication types

MeSH terms

Grants and funding