Exploring the Association Between Food Insecurity, Bowel Health, and All-Cause Mortality in the United States: Insights from NHANES 2005-2010.

Background and aim: Functional gastrointestinal disorders such as chronic constipation (CC) and chronic diarrhea (CD) impose a significant burden on global healthcare resources. Food insecurity, a crucial social determinant of health, remains unclearly associated with CC and CD. We aim to explore the association between food insecurity and CC and CD, and its impact on all-cause mortality among participants with abnormal bowel health.

Methods: We used data from National Health and Nutrition Survey 2005-2010. We assessed food insecurity using the Household Food Security Survey Module, and bowel health, including CD and CC, was evaluated using fecal characteristics and bowel movement frequency from the Bowel Health Questionnaire. Finally, 13 199 participants were included.

Results: A total of 15.26% (2014) participants experienced food insecurity. Multivariate analysis revealed that food insecurity was associated with a higher proportion of CD (odds ratio [OR]: 1.24, 95% confidence interval [CI]: 1.02-1.52, p = 0.03), especially in women. CC did not exhibit a significant association with food insecurity (OR: 1.10, CI: 0.86-1.40, p = 0.41). Furthermore, food insecurity was significantly linked to higher all-cause mortality in patients with CD (OR: 1.59, CI: 1.01-2.50, p = 0.046) and CC (OR: 2.01, CI: 1.20-3.46, p = 0.01).

Conclusions: Assessing food insecurity's impact on bowel health is crucial for policy formulation and risk identification. Research should explore links between food insecurity and CD or CC severity, treatment, and psychosocial aspects to improve patient quality of life.