Food Insecurity and Gastrointestinal Health: Examining Links Between Food Security, Constipation, and Diarrhea in the National Health and Nutrition Examination Survey.

Madeline Berschback, Christopher Vélez, Adjoa Anyane-Yeboa, Braden Kuo, Kyle Staller

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Article in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

5 authors.

Madeline BerschbackDivision of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA. mberschback@mgh.harvard.edu.

Christopher VélezDivision of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.

Adjoa Anyane-YeboaDivision of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.

Braden KuoDivision of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.

Kyle StallerDivision of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.

Funding

The Role of Fiber in the Etiopathogenesis of Fecal IncontinenceK23DK120945 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI STALLER, KYLE · 2020 to 2024

$1.0M

NIH HHS K23 DK120945

6 · The paper itself

Abstract

purposeFood insecurity impacts health in a multifactorial fashion, but the relationship with bowel habits is poorly understood. We aimed to examine the association between food insecurity status and bowel habits in a large cohort of US adults.

methodsWe analyzed adults (age 20-59 years) who completed both the bowel habits questionnaire and the food security survey module in the National Health and Nutrition Examination Survey over a 6-year period from 2005 to 2010 (n = 9,637). Constipation and diarrhea were defined according to Bristol Stool Form Scale and/or stool frequency. Adjusted odds ratios (AORs) for the likelihood of constipation or diarrhea were estimated in a multinomial logistic model across levels of food security.

resultsConstipation and diarrhea were more prevalent among individuals with lower food security compared to those with full food security (constipation: 19.6% vs. 14.2%; diarrhea: 14.8% vs. 11.0%; both p < 0.0001). Very low food security was associated with nearly twice the odds of constipation (OR 1.90, 95% CI: 1.48-2.42) and 54% greater odds of diarrhea (OR 1.54, 95% CI: 1.22-1.93). After stepwise adjustments for demographic, BMI, and dietary factors, these associations persisted (constipation AOR: 1.39, 95% CI 1.06-1.83; diarrhea AOR: 1.27, 95% CI 1.00-1.61). Adjustment for depression attenuated the significance of this association (constipation AOR: 1.25, 95% CI 0.97-1.63; diarrhea AOR: 1.16, 95% CI 0.90-1.51), suggesting a potential mediating role.

conclusionIn a nationally representative sample of community-dwelling US adults, decreasing food security was associated with increased odds of constipation and diarrhea. However, when multivariable adjustment included depression, this impact was attenuated, suggesting that depression may confound this relationship.

Indexed as

ConstipationDiarrheaFood InsecurityAdultFemaleHumansLogistic ModelsMaleMiddle AgedNutrition SurveysOdds RatioPrevalenceRisk FactorsUnited StatesYoung AdultBowel habitsConstipationDepressionDiarrheaFood insecurityNHANES

Identifiers

PMID42029966

DOI10.1007/s10620-026-09927-1

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.