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

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

Jessica D Guillaume  1 , Jyotsna S Jagai  2 , Jennifer A Makelarski  3 , Emily M Abramsohn  3 , Stacy Tessler Lindau  4 , Ritu Verma  5 , Christina E Ciaccio  6
Affiliations

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

Jessica D Guillaume et al. J Allergy Clin Immunol Pract. 2021 Sep.

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.

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Figures

Figure 1
Figure 1
Odds of pre-pandemic food insecurity. Analyses are adjusted for race/ethnicity, education, household income, marital status, household size, number of household children, region, and respondent self-rated general and mental health. aOR, Adjusted odds ratio; CeD, celiac disease; CI, confidence interval; FA, food allergy.
Figure 2
Figure 2
Odds of pandemic-related incident or worsening food insecurity. Analyses are adjusted for race/ethnicity, education, household income, marital status, household size, number of household children, region, and respondent self-rated general and mental health. aOR, Adjusted odds ratio; CeD, celiac disease; CI, confidence interval; FA, food allergy.
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