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

Chiara de Lucia; Anastasia Aliferi; Sorrel Burden; Dilara Dericioglu; Elizabeth M.L. Duxbury; Sarah Gregory; John McLaughlin; Manpreet Kaur  Mujral; Courtney Neal; Elena Philippou; Natalie Riddell; Anna C. Whittaker; Oliver M Shannon

doi:10.1007/s10389-026-02700-8

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

Chiara de Lucia, Anastasia Aliferi, Sorrel Burden, Dilara Dericioglu, Elizabeth M.L. Duxbury, Sarah Gregory, John McLaughlin, Manpreet Kaur Mujral, Courtney Neal, Elena Philippou, Natalie Riddell, Anna C. Whittaker, Oliver M Shannon^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Aim: Explore the associations between food insecurity (FI) with dietary quality and markers of mental wellbeing, 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 6-item U.S. Department of Agriculture (USDA) Household Food Security Survey. Diet quality was assessed using the Easy Diet Screener. Health outcomes included markers of mental wellbeing (Perceived Stress Scale and Generalised Anxiety Disorder-7 Scale), gastrointestinal symptoms (Short Health Scale for Gastrointestinal Symptoms) and self-reported immune status (Immune Status Questionnaire, 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.

Original language	English
Pages (from-to)	1-11
Number of pages	11
Journal	Journal of Public Health
DOIs	https://doi.org/10.1007/s10389-026-02700-8
Publication status	Published - 18 Feb 2026

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 2 Zero Hunger
SDG 3 Good Health and Well-being

Keywords

Food insecurity
Diet quality
Mental health
Gastrointestinal health
Immune status

Access to Document

10.1007/s10389-026-02700-8Licence: CC BY

deLucia-et-al-2026-Food-insecurity-and-self-reported-JPubHealth-02700-8-CCBY
Copyright © The Author(s) 2026. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Final published version, 655 KBLicence: CC BY

Cite this

de Lucia, C., Aliferi, A., Burden, S., Dericioglu, D., Duxbury, E. M. L., Gregory, S., McLaughlin, J., Mujral, M. K., Neal, C., Philippou, E., Riddell, N., Whittaker, A. C., & Shannon, O. M. (2026). Food insecurity and self-reported markers of health across multiple bodily systems: associations with diet quality, mental wellbeing, gut symptoms, and immunity. Journal of Public Health, 1-11. https://doi.org/10.1007/s10389-026-02700-8

@article{ade85e41ff3e4ee0aa659dd61f03d536,

title = "Food insecurity and self-reported markers of health across multiple bodily systems: associations with diet quality, mental wellbeing, gut symptoms, and immunity",

abstract = "Aim: Explore the associations between food insecurity (FI) with dietary quality and markers of mental wellbeing, 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 6-item U.S. Department of Agriculture (USDA) Household Food Security Survey. Diet quality was assessed using the Easy Diet Screener. Health outcomes included markers of mental wellbeing (Perceived Stress Scale and Generalised Anxiety Disorder-7 Scale), gastrointestinal symptoms (Short Health Scale for Gastrointestinal Symptoms) and self-reported immune status (Immune Status Questionnaire, 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. ",

keywords = "Food insecurity, Diet quality, Mental health, Gastrointestinal health, Immune status",

author = "\{de Lucia\}, Chiara and Anastasia Aliferi and Sorrel Burden and Dilara Dericioglu and Duxbury, \{Elizabeth M.L.\} and Sarah Gregory and John McLaughlin and Mujral, \{Manpreet Kaur\} and Courtney Neal and Elena Philippou and Natalie Riddell and Whittaker, \{Anna C.\} and Shannon, \{Oliver M\}",

note = "Funding: This research was supported by the UK Research and Innovation (UKRI) funded Food4Years Network.",

year = "2026",

month = feb,

day = "18",

doi = "10.1007/s10389-026-02700-8",

language = "English",

pages = "1--11",

journal = "Journal of Public Health",

issn = "0943-1853",

publisher = "Springer-Verlag",

}

de Lucia, C, Aliferi, A, Burden, S, Dericioglu, D, Duxbury, EML, Gregory, S, McLaughlin, J, Mujral, MK, Neal, C, Philippou, E, Riddell, N, Whittaker, AC & Shannon, OM 2026, 'Food insecurity and self-reported markers of health across multiple bodily systems: associations with diet quality, mental wellbeing, gut symptoms, and immunity', Journal of Public Health, pp. 1-11. https://doi.org/10.1007/s10389-026-02700-8

TY - JOUR

T1 - Food insecurity and self-reported markers of health across multiple bodily systems

T2 - associations with diet quality, mental wellbeing, gut symptoms, and immunity

AU - de Lucia, Chiara

AU - Aliferi, Anastasia

AU - Burden, Sorrel

AU - Dericioglu, Dilara

AU - Duxbury, Elizabeth M.L.

AU - Gregory, Sarah

AU - McLaughlin, John

AU - Mujral, Manpreet Kaur

AU - Neal, Courtney

AU - Philippou, Elena

AU - Riddell, Natalie

AU - Whittaker, Anna C.

AU - Shannon, Oliver M

N1 - Funding: This research was supported by the UK Research and Innovation (UKRI) funded Food4Years Network.

PY - 2026/2/18

Y1 - 2026/2/18

N2 - Aim: Explore the associations between food insecurity (FI) with dietary quality and markers of mental wellbeing, 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 6-item U.S. Department of Agriculture (USDA) Household Food Security Survey. Diet quality was assessed using the Easy Diet Screener. Health outcomes included markers of mental wellbeing (Perceived Stress Scale and Generalised Anxiety Disorder-7 Scale), gastrointestinal symptoms (Short Health Scale for Gastrointestinal Symptoms) and self-reported immune status (Immune Status Questionnaire, 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.

AB - Aim: Explore the associations between food insecurity (FI) with dietary quality and markers of mental wellbeing, 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 6-item U.S. Department of Agriculture (USDA) Household Food Security Survey. Diet quality was assessed using the Easy Diet Screener. Health outcomes included markers of mental wellbeing (Perceived Stress Scale and Generalised Anxiety Disorder-7 Scale), gastrointestinal symptoms (Short Health Scale for Gastrointestinal Symptoms) and self-reported immune status (Immune Status Questionnaire, 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.

KW - Food insecurity

KW - Diet quality

KW - Mental health

KW - Gastrointestinal health

KW - Immune status

U2 - 10.1007/s10389-026-02700-8

DO - 10.1007/s10389-026-02700-8

M3 - Article

SN - 0943-1853

SP - 1

EP - 11

JO - Journal of Public Health

JF - Journal of Public Health

ER -

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

Abstract

UN SDGs

Keywords

Access to Document

Fingerprint

Cite this