Nationwide Analysis of Food Insecurity among Individuals with Inflammatory Bowel Disease in the United States

Diet impacts symptoms and inflammation in inflammatory bowel disease (IBD), but limited food access restricts options and hampers adherence to diets that may help in the management of IBD. This study aims to measure the prevalence of food insecurity and characterize its risk factors in the adult population across the United States.

The 2023, 2016, and 2015 National Health Interview Surveys were queried for individuals with and without IBD. Food insecurity prevalence and sociodemographic characteristics were compared. Multivariable logistic regression identified factors associated with food insecurity risk, while considering the survey's complex sampling design.

In 2023, a significantly higher proportion of individuals with IBD (n = 4 289 979) reported food insecurity compared to those without IBD (n = 253 490 081) (13.48% vs 8.96%, P = 0.01). The pooled 2015-2016 data showed similar findings (12.43% vs 9.43%, P < 0.01). No significant difference was found across these periods (P = 0.63). Multivariable models linked higher food insecurity risk with IBD status (OR 1.85, P < 0.01), female sex (OR 1.16, P < 0.01), Hispanic ethnicity (OR 1.24, P < 0.01), non-Hispanic Black race (OR 1.88, P < 0.01), having Medicaid (OR 1.85, P < 0.01), being uninsured (OR 2.02, P < 0.01), and use of Supplemental Nutrition Assistance Program (SNAP) (OR 2.49, P < 0.01).

Individuals with IBD face a persistently higher risk of food insecurity. Some of the most important predictors included being non-Hispanic Black, being uninsured or having Medicaid insurance, and using SNAP. Clinicians should regularly screen patients with IBD for food insecurity and address it through a multidisciplinary approach, involving dietitians and social workers to enhance patient care and outcomes.