Food Insecurity Is Associated With Current Asthma, Wheeze, and Lung Function in Children and Adults

Food insecurity (FI) has been a global threat, as a social determinant in connection with the prevalence of diseases requiring dietary interventions, such as asthma, has been established. This study aims to examine the relationship between FI and respiratory health outcomes.

This cross-sectional study included 7626 children and 17 530 adults from the 2007 to 2012 National Health and Nutritional Examination Surveys (NHANES) in the United States. Weighted multivariate regression models were used to evaluate the associations between FI and respiratory outcomes, including current asthma, wheezing, fractional exhaled nitric oxide (FeNO), and lung function.

The weighted prevalence of high FI was 19.68% in children and 13.74% in adults. In adults, high FI was significantly associated with current asthma (OR: 1.41, 95% CI: 1.19-1.67) and wheezing (OR: 1.72, 95% CI: 1.48-1.99). The association with asthma was stronger in women (p for interaction = 0.02) and non-Hispanic Whites (p for interaction = 0.04), whereas wheezing showed stronger associations in non-Hispanic Whites (p for interaction = 0.01). High FI was linked to lower percent-predicted forced expiratory volume in 1 s (FEV₁) in children (β: -15.93%, 95% CI: -27.82%, -4.03%) and adults (β: -1.13%, 95% CI: -2.22%, -0.04%) without asthma or wheezing. Additionally, high FI was inversely associated with FeNO in adults with current asthma (β: -3.36, 95% CI: -5.54, -1.17) and wheezing (β: -4.40, 95% CI: -7.79, -1.02).

FI is associated with increased asthma and wheezing in adults, particularly among women and non-Hispanic Whites, and with reduced FEV1 in both adults and children without asthma and wheezing.