Table 2 Multivariable analysis of the association of food security status with obesity, hypertension, diabetes, and coronary heart disease, NHANES 1999–2018 (Data was weighted to be nationally representative)

Food security

 Full food secure

1.00 (reference)

1.00 (reference)

1.00 (reference)

1.00 (reference)

 Marginal food secure

1.19 (1.09–1.30)

< 0.001

1.11 (1.01–1.21)

0.05

1.36 (1.21–1.54)

< 0.001

1.28 (1.09–1.50)

0.01

 Low food secure

1.27 (1.16–1.38)

< 0.001

1.07 (0.97–1.19)

0.20

1.27 (1.12–1.44)

0.001

1.71 (1.41–2.06)

< 0.001

 Very low food secure

1.23 (1.09–1.39)

0.002

1.13 (1.0-1.29)

0.16

1.49 (1.28–1.75)

< 0.001

1.88 (1.48–2.39)

< 0.001

Age category (y)

 20–44

1.00 (reference)

1.00 (reference)

1.00 (reference)

1.00 (reference)

 45–64

1.28(1.20–1.37)

< 0.001

3.90 (3.62–4.20)

< 0.001

4.70 (4.28–517)

< 0.001

6.17 (5.08–7.50)

< 0.001

 ≥65

0.91 (0.84–0.98)

0.02

9.50 (8.64–10.5)

< 0.001

8.03 (7.18–8.98)

< 0.001

20.6 (17.1–24.8)

< 0.001

Sex

 Men

1.00 (reference)

1.00 (reference)

1.00 (reference)

1.00 (reference)

 Women

1.10 (1.04–1.17)

< 0.001

0.64 (0.61–0.68)

< 0.001

0.75 (0.70–0.82)

< 0.001

0.52 (0.46–0.58)

< 0.001

Race/ethnicity

 Non-Hispanic White

1.00 (reference)

1.00 (reference)

1.00 (reference)

1.00 (reference)

 Non-Hispanic Black

1.52 (1.42–1.63)

< 0.001

1.84 (1.71–1.98)

< 0.001

1.86 (1.72-2.0)

< 0.001

0.73 (0.65–0.82)

< 0.001

 Hispanic

1.12 (1.04–1.21)

< 0.001

0.80 (0.74–0.87)

< 0.001

1.57 (1.43–1.73)

< 0.001

0.58 (0.51–0.66)

< 0.001

 Others

0.56 (0.49–0.63)

< 0.001

1.11 (1.0-1.24)

0.05

1.74 (1.52-2.0)

< 0.001

0.95 (0.75–1.20)

0.29

Education

 <High school

1.00 (reference)

1.00 (reference)

1.00 (reference)

1.00 (reference)

 High school graduate or GED

1.12 (1.03–1.21)

0.004

0.96 (0.88–1.05)

0.36

0.80 (0.72–0.88)

< 0.001

0.83 (0.73–0.95)

0.009

 Some college

1.12 (1.04–1.21)

< 0.001

0.87 (0.80–0.94)

0.001

0.81 (0.74–0.88)

< 0.001

0.82 (0.73–0.93)

0.001

 College graduate or above

0.69 (0.62–0.76)

< 0.001

0.63 (0.58–0.70)

< 0.001

0.56 (0.50–0.63)

< 0.001

0.62 (0.53–0.72)

< 0.001

Family income (IPR)

 ≤ 1.0

1.00 (reference)

1.00 (reference)

1.00 (reference)

1.00 (reference)

 1.0–4.0

1.13 (1.04–1.23)

0.003

1.08 (1.0-1.17)

0.06

0.90 (0.81–0.99)

0.04

0.84 (0.72–0.97)

< 0.001

 ≥4.0

1.04 (0.90–1.11)

0.49

1.01 (0.85–1.13)

0.92

0.72 (0.62–0.82)

< 0.001

0.66 (0.54–0.79)

< 0.001

Marital status

 Married

1.00 (reference)

1.00 (reference)

1.00 (reference)

1.00 (reference)

 Separated/divorced/widowed

0.99 (0.92–1.06)

0.71

1.21 (1.13–1.30)

< 0.001

1.04 (0.94–1.14)

0.45

1.22 (1.09–1.36)

< 0.001

 No

0.82 (0.76–0.88)

< 0.001

0.80 (0.74–0.87)

< 0.001

0.86 (0.75–0.98)

0.02

0.73 (0.60–0.89)

0.002

Smoking status

 Never

1.00 (reference)

1.00 (reference)

1.00 (reference)

1.00 (reference)

 Current

0.69 (0.64–0.74)

< 0.001

0.85 (0.79–0.91)

< 0.001

0.82 (0.74–0.90)

< 0.001

1.49 (1.30–1.70)

< 0.001

 Former

1.12 (1.05–1.20)

0.001

1.07 (1.0-1.15)

0.06

1.18 (1.09–1.29)

< 0.001

1.51 (1.35–1.68)

< 0.001

Insurance coverage

 Yes

1.00 (reference)

1.00 (reference)

1.00 (reference)

1.00 (reference)

 No

0.79 (0.74–0.85)

< 0.001

0.79 (0.74–0.85)

< 0.001

0.71 (0.64–0.78)

< 0.001

0.68 (0.57–0.81)

< 0.001

SNAP participation

 Yes

1.00 (reference)

1.00 (reference)

1.00 (reference)

1.00 (reference)

 No

0.73 (0.65–0.81)

< 0.001

0.91 (0.83, 1.0)

0.06

0.82 (0.74–0.92)

0.001

0.74 (0.63–0.88)

0.001