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Trends in Prevalence of Food Insecurity in U.S. Adults

Trends in Prevalence of Food Insecurity in U.S. Adults

The prevalence of food insecurity trended higher among adults with or without CKD. During 2017–March 2020, the crude prevalence of food insecurity was 31.0% among adults with CKD and 27.7% among adults without CKD. In 2017–March 2020, the age-standardized prevalence of food insecurity was higher among women, younger adults, Hispanics, and individuals with diabetes than their counterparts.

Data Source: NHANES

To view the prevalence of food insecurity by risk categories, select from the drop-down menu below. Risk categories include: Overall, Age Category, Sex, Race/Ethnicity, CKD, Diabetes, and Hypertension.


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Data includes CKD stages 1–5. Age-standardized estimates were standardized to the 2010 U.S. Census population for adults.

NHANES is a nationally representative, cross-sectional survey that is currently conducted every two years (since 1999) by CDC's National Center for Health Statistics among noninstitutionalized US civilian residents. The survey consists of a standardized in-home interview and a physical examination with blood and urine collected at a mobile examination center. Data were examined by combining two NHANES cycles to represent four-year periods from 2001 to 2016 and the 2017–March 2020 pre-pandemic cycle. 

Note: Not all NHANES variables are collected for all years; therefore, some NHANES indicators may not utilize the full 20-year span.

Description of Measure

Prevalence of Food Insecurity in U.S. Adults.

Data Set

National Health and Nutrition Examination Survey (NHANES).


Noninstitutionalized US adults aged ≥ 18 years, pregnant women excluded.

Years Included

2001–March 2020.


U.S. adults aged ≥ 18 years who are food insecure.


U.S. adults aged ≥ 18 years with serum creatinine, urine albumin, and valid answers to food security questionnaire.

Definition of CKD

CKD is defined by an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m² or albuminuria (urine albumin to creatinine ratio [UACR] ≥ 30 mg/g). Estimates are based on single estimates of eGFR and UACR.

Estimated Glomerular Filtration Rate (eGFR)

Based on the CKD-EPI (2021) equation for calibrated creatinine: eGFR=142 x [min(serum creatinine in mg/dL) /κ, 1)]**α x [max(serum creatinine/κ, 1)]**-1.20 x 0.9938**age x (1.012 if female).

κ = 0.7 if female and 0.9 if male
α = -0.241 if female and -0.302 if male
** = raise to the power


UACR is calculated as urine albumin divided by urine creatinine. Albuminuria is defined as UACR ≥ 30 mg/g.

Serum Creatinine

Serum creatinine values used for eGFR calculation are calibrated against isotope dilution mass spectrometry (IDMS).

Urine Albumin

Measured in random urine collection by fluorescent immunoassay.

Definition of Food Insecurity

Food insecurity is defined as self-reported household food security in the categories “marginal”, “low”, or “very low”, based on the U.S. Food Security Survey Module questions (Bickel G, et al, 2000).

Age Standardization

Estimates were standardized to the 2010 U.S. Census population for adults by age category (18−39 years, 40−59 years, 60−69 years, and 70+ years).

Limitations of Indicator

Household food security, albuminuria and kidney function are assessed from one-time cross-sectional measurements, possibly overestimating prevalence.

Analytical Considerations

Appropriate NHANES survey weights are used for all analyses; if relative standard error is greater than 30%, the estimates are not shown. Serum creatinine measurements are assay corrected for NHANES years 2005 and 2006 and prior to be combined with later years.