(P24-034-23) Heavy Alcohol Use Is Associated With Poor Diet Quality and Food Insecurity in U.S. Adults: An NHANES Analysis

Objectives: Heavy alcohol use may impact food security and diet quality, but evidence examining such associations is sparse. This analysis evaluated heavy alcohol use over the past year and associations with food security (FS) status and self-reported dietary quality in U.S. adults.

Methods: Data from NHANES 2017-2018 were used. Participants under 18 years of age and those missing outcome, predictor, or demographic variables were excluded. Household FS status (previous 12 months) was assessed using the U.S. Adult Food Security Survey Module and classified as high, marginal, low, or very low FS. Dietary quality was self-reported and categorized as excellent/very good, good, or fair/poor. Heavy alcohol use was indicated if participants reported consuming 4 (for females) or 5 (for males) or more drinks in a single day at least twice per week over the past year. Multinomial logistic regression was utilized to examine associations between heavy alcohol use and diet quality (reference group=excellent/very good) and FS status (reference group=high FS), adjusting for age, gender, racial and ethnic identity, and household income. Analyses included NHANES sample weights and primary sampling units and were conducted using SAS 9.4 survey procedures.

Results: The analytic sample included 3,314 adults (unweighted). Weighted mean age was 45.4 years, 50.4% identified as female, and 65.4% identified as Non-Hispanic White. Weighted prevalence of past year heavy alcohol use was 6.8%. Thirty-two percent reported fair/poor diet quality and 16.4% had food insecurity (8.2% low FS and 8.2% very low FS). In unadjusted analyses, heavy alcohol use increased odds of low FS, very low FS, and fair/poor diet compared to non-heavy use. In adjusted analyses, associations between heavy alcohol use and very low FS (aOR=3.08, 95% CI=1.93-4.90, p< 0.0001) and fair/poor diet quality (aOR=1.86, 95% CI=1.05-3.31, p=0.03) remained significant.

Conclusions: NHANES participants reported a high prevalence of fair/poor diet quality and food insecurity and nearly 7% reported past year heavy alcohol use. Since heavy alcohol use was associated with very low FS and fair/poor diet quality, we recommend screening for food and nutrition security among adults with alcohol misuse.

Funding Sources: This work was supported in part by NIAAA K08 AA030301 (PI: Boness).