BACKGROUND Evidence suggests both that chronic inflammation mediates the association of food insecurity with adverse health outcomes and that diet may be a significant source of inflammation among food insecure individuals. OBJECTIVE To examine whether food security status is associated with dietary inflammatory potential. DESIGN AND PARTICIPANTS Cross-sectional data came from the National Health and Nutrition Examination Survey (NHANES), cycles 2007 to 2014 (n=10,630). The analysis sample is representative of noninstitutionalized US adults with an income-to-poverty ratio ≤3.00. MAIN OUTCOME Dietary Inflammatory Index (DII) score, calculated using the average of two 24-hour dietary recalls, was the main outcome measure. STATISTICAL ANALYSIS Type III F tests or χ2 tests compared population characteristics by food security status, defined using the US Food Security Survey Module. Multivariable linear regression was used to estimate the association between food security status and the DII score and moderation by demographic factors. Survey weighting procedures accounted for the effects of stratification and clustering used in the NHANES study design. RESULTS When accounting for socioeconomic status, demographic factors, and health status, DII score was higher at greater levels of food insecurity (P=0.0033). Those with very low food security had a 0.31 (95% CI=0.12 to 0.49) higher DII score than those with high food security. Age moderated the association between food security status and DII score (interaction P=0.0103), where the magnitude of the association between DII score and severity of food insecurity was higher for those >65 years than for younger age groups. CONCLUSION Food security status may be associated with dietary inflammatory potential, which is hypothesized to play a role in multiple chronic health conditions. Further research is needed to determine the causal nature of this relationship and evaluate how best to implement programs designed to address health disparities within food insecure populations.

中文翻译：

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2007 年至 2014 年美国国家健康和营养检查调查中低收入成年人的食品安全状况与膳食炎症潜能之间的关联

背景 有证据表明，慢性炎症介导了粮食不安全与不良健康结果之间的关联，而且饮食可能是粮食不安全个体炎症的重要来源。目的 检验食品安全状况是否与膳食炎症潜能相关。设计和参与者 横断面数据来自全国健康和营养检查调查 (NHANES)，周期为 2007 年至 2014 年（n=10,630）。分析样本代表收入与贫困比率≤3.00 的非机构化美国成年人。主要结果 饮食炎症指数 (DII) 评分是主要结果指标，使用两次 24 小时饮食回忆的平均值计算。统计分析 III 型 F 检验或 χ2 检验按粮食安全状况比较了人口特征，使用美国食品安全调查模块定义。多变量线性回归用于估计粮食安全状况与 DII 评分和人口因素调节之间的关联。调查加权程序考虑了 NHANES 研究设计中使用的分层和聚类的影响。结果 当考虑到社会经济地位、人口因素和健康状况时，粮食不安全水平越高，DII 得分越高 (P=0.0033)。食品安全性极低的人群的 DII 得分比食品安全性高的人群高 0.31（95% CI=0.12 至 0.49）。年龄调节了粮食安全状况与 DII 评分之间的关​​联（交互作用 P=0.0103），其中 DII 评分与粮食不安全严重程度之间的关联程度在 65 岁以上的人群中高于年轻年龄组。结论 食品安全状况可能与膳食炎症潜能有关，据推测，这在多种慢性健康状况中发挥作用。需要进一步研究以确定这种关系的因果性质，并评估如何最好地实施旨在解决粮食不安全人群健康差异的计划。