J Allergy Clin Immunol Pract. 2021 Jun 23;S2213-2198(21)00680-2.doi: 10.1016/j.jaip.2021.06.015. Online ahead of print.

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

Author information

• ¹The University of Chicago, Pritzker School of Medicine, Chicago, IL.
• ²The University of Chicago, Department of Obstetrics and Gynecology, Chicago, IL and University of Illinois at Chicago, School of Public Health, Chicago, IL.
• ³The University of Chicago, Department of Obstetrics and Gynecology, Chicago, IL.
• ⁴The University of Chicago, Departments of Obstetrics and Gynecology and Medicine-Geriatrics, Chicago, IL.
• ⁵The University of Chicago, Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Chicago, IL.
• ⁶The University of Chicago, Department of Pediatric Allergy and Immunology, Chicago, IL. Electronic address: cciaccio@bsd.uchicago.edu.

Abstract

Background: Food insecurity dramatically increased due to the COVID-19 pandemic; however, little is known about pandemic-related food insecurity in households with dietary restrictions.

Objective: Examine pre-pandemic rates of and pandemic-related change in food insecurity among households with and without dietary restrictions.

Methods: Cross-sectional, panel-based survey of 3,200 U.S. women conducted in April 2020. Pre-pandemic food insecurity and early pandemic-related change in food insecurity were assessed using the adapted Hunger Vital Sign^TM. 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: Prior to the COVID-19 pandemic, households with self-reported food allergy (aOR 1.5, 95% 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.