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

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.

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“…21,22 Increased food insecurity during the pandemic has also been reported in other chronic diseases. 23,24 The etiologies for increased food security were multifactorial but seemed to be primarily financial. More food insecure subjects reported loss of employment, decreased household income, or difficulty obtaining food due to finances compared to food secure subjects.…”

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“…Obtaining food and groceries by supermarkets or food shops' delivery services was not common in the three countries (10%) (Lebanon, Tunisia, and Jordan) and was significantly the least reported among the Tunisians ( 17 ). All in all, it appears that households with dietary restrictions were more likely to experience both pre-pandemic and pandemic-related incident or worsening food insecurity than households without restrictions ( 38 ).…”

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