New national data reveal that food insecurity worsens long COVID outcomes, but access to nutrition support programs like SNAP could break the cycle.
Study: Long COVID and Food Insecurity in US Adults, 2022-2023. Image Credit: Dmitry Demidovich / Shutterstock
In a recent study published in the JAMA Network Open, researchers utilized a cross-sectional, nationally representative survey-based study of United States (US) adults to investigate the associations between food insecurity and the risk of reporting current Long COVID or recovering from it.
Study findings revealed that in participants who had ever had Long COVID, food insecurity was associated with 73% higher odds of having current Long COVID (aOR 1.73) and 30% lower odds of recovery (aOR 0.70; sensitivity analysis aOR 0.76). Encouragingly, participation in food assistance programs like SNAP appeared to attenuate this association, suggesting that addressing food insecurity could be a powerful tool in reducing the burden of Long COVID.
Background
Commonly called "Long COVID", post-COVID-19 condition is a recently discovered but globally prevalent condition characterized by COVID-19 symptoms (fatigue, cognitive dysfunction, shortness of breath) that persist or develop three or more months following recovery from the original infection. More than 10% of people who had symptomatic COVID-19 are estimated to experience Long COVID (over 65 million globally), making the identification of modifiable risk factors a ray of hope to millions.
While intensive medical research has focused on the biological mechanisms of the disease, less is known about how social and economic factors (such as poverty and food insecurity) influence the risk and progression of Long COVID. Food insecurity – the lack of reliable access to sufficient, affordable, and nutritious food – is a known risk factor for a host of chronic diseases like diabetes and heart disease, as it can lead to poor nutrition, chronic stress, and difficulty managing health conditions.
While associations between food insecurity and Long COVID have never formally been investigated, Long COVID is itself a chronic condition, leading researchers to hypothesize that the same food-insecurity pressures driving diabetes and heart disease could make individuals more vulnerable to Long COVID's long-term effects.
About the study
The present study aims to address this knowledge gap and inform future public health policy by analyzing data from a large, nationally representative dataset: the 2022–2023 US National Health Interview Survey (NHIS). The analysis included 21,631 adults who had previously been infected with COVID-19 and who reported whether they currently had Long COVID or had recovered from it.
The study leveraged the validated 10-item National Center for Health Statistics food insecurity scale to categorize participants into two main cohorts: 1. Food secure, and 2. Food insecure. The primary outcomes of interest were the qualitative measure of whether an individual had "current Long COVID" (symptoms lasting three months or more and still present) or had "recovered from Long COVID" (a history of Long COVID but no current symptoms).
The study analysis included logistic regression models to calculate the odds of Long COVID as a function of food security status. Regression models were adjusted for confounding sociodemographic variables (age, sex, race/ethnicity, employment status) and preexisting medical conditions (particularly chronic diseases).
Finally, to investigate whether food security initiatives, such as the Supplemental Nutrition Assistance Program (SNAP), or being unemployed, modified the association, researchers collated and analyzed the results of logistic regressions in the context of these factors.
Study findings
The present study revealed that food insecurity and Long COVID are statistically linked, with participants in the food-insecure cohort demonstrating a 73% higher likelihood of current Long COVID (aOR 1.73; 95% CI 1.39–2.15) and a 30% lower chance of Long COVID recovery (aOR 0.70; 95% CI 0.54–0.92).
These outcomes suggest that food insecurity simultaneously exacerbates both the risk of ongoing symptoms and reduces the likelihood of recovery. Encouragingly, the study found that social safety nets substantially improved outcomes for food-insecure participants by mitigating the risk of Long COVID and enhancing recovery.
Specifically, while the association between food insecurity and Long COVID was substantial for individuals who were not receiving SNAP benefits (aOR 2.04) and for those who were employed (aOR 2.32), these links were attenuated and not statistically significant in participants receiving SNAP benefits (aOR 1.23) or in unemployed individuals (aOR 1.28).
The interaction between SNAP participation and the outcome was statistically significant (P for interaction = .04), and the interaction with employment status was also significant (P = .04).
A notable dose–response pattern was observed: individuals with more COVID-19 vaccine doses had progressively lower odds of current Long COVID, supporting the model's validity.
The association between food insecurity and Long COVID was present across income strata, and the authors noted that about 40% of food-insecure adults living below the federal poverty level were not enrolled in SNAP, underscoring enrollment barriers.
Conclusions
The present study validates the previously hypothesized link between social (food) insecurity (a modifiable risk factor) and Long COVID outcomes (risks of persistence and recovery). Its findings suggest that the inability to access nutritious food consistently appears to make people more vulnerable to developing persistent symptoms and less likely to recover from them.
Furthermore, as food insecurity worsens Long COVID, the latter's debilitating nature could impair a person's ability to work, exacerbating both conditions and triggering a sinister positive feedback loop.
The study ultimately highlights food assistance programs, such as SNAP, as powerful tools to break this cycle. By mitigating the effects of food insecurity, these programs may serve as a crucial public health intervention against this chronic disease.
However, because this was a cross-sectional survey based on self-reported data, causality cannot be inferred, and the likelihood of relapse over time cannot be determined.
Journal reference:
- Lin, J. C., McCarthy, M., Potluri, S., Nguyen, D., Yan, R., & Aysola, J. (2025). Long COVID and food insecurity in US adults, 2022–2023. JAMA Network Open, 8(9), Article e2530730. DOI – 10.1001/jamanetworkopen.2025.30730, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2838652