Food insecurity and self-reported markers of health across multiple body systems: associations with diet quality, mental well-being, gut symptoms, and immunity

Aim: To explore the associations between food insecurity (FI) with dietary quality and markers of mental well-being, gastrointestinal symptoms, and immune status among United Kingdom (UK)-based adults. Subject and methods: An online questionnaire was administered to 953 UK-based adults, including 210 individuals living with FI, to evaluate FI status, diet quality, and a series of health outcomes. FI was measured using the six-item US Department of Agriculture (USDA) Household Food Security Survey. Diet quality was assessed using the Easy Diet Screener. Health outcomes included markers of mental well-being (Perceived Stress Scale and GAD-7 [generalised anxiety disorder seven-item scale]), gastrointestinal symptoms (Short Health Scale for gastrointestinal symptoms), and self-reported immune status (Immune Status Questionnaire, cumulative incidence of self-reported infections [CISRI] score, and antibiotic use). Cross-sectional associations were explored using logistic regression, with data presented as odds ratios (OR) with 95% confidence intervals (CIs). Results: Participants living with FI had almost threefold greater odds of following a Western dietary pattern (OR = 2.67, 95% CI [1.85, 3.91], p < 0.001). FI was associated with multiple negative health outcomes including greater odds of high perceived stress (OR = 3.12, 95% CI [2.10, 4.63], p < 0.001), reduced self-reported immune status (OR = 1.91, 95% CI [1.31, 2.77], p < 0.001), and gastrointestinal symptoms (OR = 2.30, 95% CI [1.39, 3.75], p < 0.001). Conclusion: These findings support the accumulating body of evidence that FI is linked with multiple adverse health outcomes and highlight it as a multi-system health risk factor. Tackling FI should be a major public health and policy priority.