Food Insecurity and Mental Health
The Food Insecurity and Mental Health Research Category consolidates research exploring the relationship between food insecurity and mental health. Tara Cristobal-Rivera, CN, PsyD, is CNP’s Food Insecurity and Mental Health Contributor. To view each original study on the open internet, click Original. To view the CNP-written abstract summary, click CNP Summary. While only some of the CNP-written abstract summaries are available below for free, all abstract summaries are available to CNP members through the CNP Library Membership.
To learn more about food insecurity, visit Peace Corps’ Global Issues: Food Insecurity. For U.S. federal food assistance programs, click here. To learn about and support food banks globally, click here, and for information on food assistance in conflict zones, please visit the World Food Programme.
Since the poor health outcomes related to food insecurity may be more apparent in later life, Gyasi et al. (2020) analyzed the age and gender differences in the association between food insecurity with psychological disorders (PD) among older people in Ghana. The dataset was obtained from the 2016-2017 AgeHeaPsyWel-HeaSeeB Study, which included 1,200 individuals aged ≥50 years. Thirty-six percent complained of hunger, while other signs of food insecurity were breakfast skipping (29% prevalence) and consuming the first meal of the day late (observed in 5%). After adjusting the analysis model, presence of food insecurity significantly correlated with higher scores in the psychological disorder assessment, compared to absence of food insecurity. Additionally, having the first meal of the day late was related with a higher risk of having psychological disorders. These relationships were moderated by age and gender - men and those 65 years and over were more likely to have PD compared to women and those in the 50-64 age group. These results demonstrate that food insecurity independently increases incidence of psychological disorders in older people, which hopefully informs public health and policy interventions that support mental health enhancement in the elderly.
2022
Systematic evidence and gap map of research linking food security and nutrition to mental health
Coming Soon.
2022
Campus food pantry use Is linked to better health among public university students
Martinez et al. (2022) conducted this retrospective cross-sectional investigation to look into the impact of campus food pantry (CFP, a program that allows students access to a variety of non-perishable and/or perishable goods) on sleep quality, physical health, and mental health in public university college students. By submitting an online survey completed in the summer of 2019, a sum of 1,855 students across 10 university campuses recounted their health status, symptoms of depression, and quality of sleep before and after being granted access to CFP, in addition to the number of CFP visits per week/month. Analysis of the survey results revealed a positive significant relationship between CFP visits/month, health perception enhancement, and the improvement of depressive symptoms, which were postulated to further decline as a result of the positive effect of CFP on sleep quality. Enhanced sleep quality was also linked to an improved self-perception of health. The authors comment that their results demonstrate the benefits to student health resulting from emergency food access on-campus, which was linked to food security. CFP presents a suitable interim measure while more permanent solutions to enhance college student nutrition are implemented. [NPID: Food insecurity, health, mental health, sleep, student support services]
2021
Prevalence of food insecurity in people with major depression, bipolar disorder, and schizophrenia and related psychoses: A systematic review and meta-analysis
Severe mental illnesses (SMI, e.g. Major depression, bipolar disorder, schizophrenia) are associated with several complications that predispose individuals to food insecurity, and despite the pervasiveness of this, the understanding of its impacts on the overall health of individuals suffering from SMI remains insufficient. In this systematic review and meta-analysis by Teasdale et al. (2021), the authors investigated the pervasiveness of food insecurity and its links to individuals with SMI. Through conducting an electronic search (up to March 2021), a total of 31 relevant studies were analyzed, revealing that up to 40% of individuals with SMI suffered from food insecurity and that individuals with SMI were 2.71 times more likely to disclose food insecurity than their control peers. Furthermore, individuals with SMI belonging to high/high-middle income countries were found to have higher odds of food insecurity compared to their SMI peers in low/low-middle income countries. This is probably because of the high amounts of food insecurity in the lower-income countries overall. The authors conclude by urging health professionals to account for food insecurity while treating community-dwelling individuals with SMI. [NPID: Food security, food access, mental illness, mood disorder, psychosis]
2022
Food insecurity and mental well-being in immigrants: A global analysis
This study by Nan Dou et al. (2022) evaluates the pervasiveness of food insecurity, mental well-being, and the links between them in immigrant vs. nonimmigrant populations on regional and global levels. Using data from the Gallup World Poll (2014 to 2019), 36,313 immigrants and 705,913 nonimmigrants were investigated through the Food Insecurity Experience Scale, the Negative Experience Index, the Positive Experience Index, and a community attachment index, with additional accounting for sociodemographic factors, survey years and country fixed effects. Analysis of the results revealed that 38.6% of immigrants suffered from food insecurity throughout the poll years and that a significant relationship existed between the degree of food insecurity experienced, higher Negative Experience Index, and lower Positive Experience Index results. This pattern was also observed in nonimmigrant populations and in specific regions. On the other hand, community attachment had a marginal impact on the relationship between food insecurity and mental well-being. Immigration, however, substantially impacted the relationship between food insecurity and mental well-being negatively, with immigrants experiencing abject mental well-being conditions more than their nonimmigrant counterparts, despite accounting for community attachment and food insecurity. The authors highlight the prevalence of food insecurity and its links with poor mental well-being in immigrants across the world. Further work is necessary to mediate food insecurity, enhance community involvement and improve mental health among immigrants, particularly in Asian and Pacific regions. [NPID: Food insecurity, community attachment, mental well-being, immigrants, nonimmigrants, Gallup World Poll]
2017
Food insecurity and risk of depression among refugees and immigrants in South Africa
The growing number of refugees in South Africa raises the need to evaluate the relationship between food insecurity and mental health in this vulnerable population. Maharaj et al. (2017) recruited 335 adult refugees for their study, evaluating their status via a self-report of food insecurity and the Hopkins Symptom Checklist-25. Participant reports showed that 23.1% of the participants often did not have enough to eat, while 54.3% reported eating less. Moreover, 49.4% of the participants reported substantial levels of anxiety, while 54.6% were depressed. Analysis of the results revealed a substantial relationship between not eating enough, or eating less with anxiety and depression. The authors comment that prevailing food insecurity and its relationship with mental illness demonstrates the critical vulnerability of the refugee population and highlights their lack of basic resources. [NPID: Refugees, South Africa, depression, anxiety, food security]
2021
Food insecurity is associated with cognitive function: A systematic review of findings across the life course
This 2021 literature review was undertaken to better understand how food insecurity relates to cognitive function or brain structure across the life course. The authors conducted systematic database searches on Google Scholar and PubMed for studies that used measures of food insecurities and cognitive function/brain structure in humans. In total, 17 studies met the inclusion criteria. Of these, 13 assessed general cognition, 10 included executive function, 8 measured verbal memory, and 4 evaluated visuospatial abilities. No studies examined brain structure. Most of the studies showed a link between higher food insecurity and poorer cognitive function across all stages of the life course, particularly for general cognition and executive function. Significant inverse associations were found between food insecurity and either general cognition or executive function among children and adults. Overall, these findings indicate that food insecurity is connected to lower cognitive function across the life course. Royer et al. suggest future research to investigate the effect of varying food security status on cognitive function and brain structures. This would hopefully allow the development of optimal food insecurity interventions and as a result enhance cognitive health. [NPID: cognition, food security, food insecurity, review, cognitive function]
2021
Prevalence of food insecurity in people with major depression, bipolar disorder, and schizophrenia and related psychoses: A systematic review and meta-analysis
Teasdale et al. (2021) conducted a review and meta-analysis to report the prevalence of food insecurity in people with severe mental illnesses. It is believed that these patients with major depression, bipolar disorder, or schizophrenia experience several risk factors that may predispose them to food insecurity. But there has been limited research done on the incidences and effects of food insecurity among this population. The review identified 29 unique datasets (including 31 publications related to food insecurity in severe mental illnesses). The average prevalence rate of severe mental illnesses among the studies was 40%. Compared to the general population/control group, people with severe mental illness were 2.71 times more likely to show food insecurity. The odds of people with severe mental illness demonstrating food insecurity were higher in high/high-middle income countries compared to low/low-middle income countries. The authors hypothesized that this is due to the general population of lower income countries having higher rates of food insecurity. In terms of diagnosed food insecurity, there were no differences in prevalence rates. Thus, healthcare professionals working with patients with severe mental illness should consider food insecurity. [NPID: food insecurity, severe mental illness, depression, bipolar disorder, schizophrenia]
CNP Research Summary can be found in the CNP Library Membership
2021
Unpacking the “black box” of global food insecurity and mental health
This 2021 study was an attempt to better understand the mechanism by which food insecurity and poorer mental health is linked. One hypothesis is that nutrient deficiency affects the proper functioning of the brain, and thus produces signs of depression and anxiety. While others in the social sciences field postulate that the social consequence of having to eat non-preferred foods or get food in socially unacceptable ways may induce stress and compromise mental health. This present article specifically looked at case studies in rural Brazil and urban Ethiopia to find out more about the mechanisms possibly connecting food insecurity with mental health. The study questioned the person who made the decisions for their family. Among these 200-household decision-makers, the relationship between food insecurity and mental health was not found to be mediated by social and nutritional factors. Moreover, nutritional status variables did not correlate with food insecurity. Thus, it is likely that food insecurity directly influences mental health through forms of basic needs deprivation, such as worrying about where the next meal is going to come from, and not by acting as a social signal or by affecting nutritional status. [NPID: food insecurity, mental health, eating, diet, Brazil, Ethiopia, depression, anxiety]
2021
Food insecurity is associated with depression, anxiety, and stress: Evidence from the early days of the COVID-19 pandemic in the United States
This 2021 study aimed to understand the interaction between food insecurity and depression, anxiety, and stress during the COVID-19 pandemic among low-income adults in the United States. Between the 19th and 24th March 2020, a web-based survey was conducted to gather data on food security among low-income adults (those under the 250% Federal poverty line). More than one-third of the respondents screened positive for depression (33%), anxiety (39%), and stress (39%). There was a dose-dependent relationship between higher food insecurity and all the psychological distress outcomes and COVID-19-related worries. Moreover, adults with very low food security were more likely to test positive for depression, anxiety, and high perceived stress, when compared with food-secure individuals. In addition, very low food security was linked with increased concerns on COVID-19’s effects on health, income, and ability to keep providing for the family. This coronavirus pandemic is negatively affecting the mental health of low-income adults in the U.S., particularly those with food insecurity. This may result in greater disparities in mental health in the future. [NPID: COVID, coronavirus, pandemic, food, diet, food insecurity, depression, anxiety, stress, US, United States, Americans, low income, poor, poverty, health]
CNP Research Summary can be found in the CNP Library Membership
2019
Food insecurity among people with severe mental disorder in a rural Ethiopian setting: A comparative, population-based study
Although mental illness has been repeatedly reported to be connected with poverty, Tirfessa et al. (2019) comment on the lack of research considering the impact of food insecurity. The aim of this study was to compare the food insecurity levels of patients with severe mental disorders with that of the general population in rural Africa, where there is a high burden of food insecurity. The researchers examined households of 292 people living with diagnosed severe mental disorders (SMD), and 284 households without a person with SMD in a rural district in south Ethiopia. It was noted that mental health services were not available within this district. Severe food insecurity was reported by 32.5% of SMD sufferers, and 15.9% of individuals not living with SMDs. It was determined that the odds of experiencing food insecurity dropped as annual income increased. Another finding was the non-significant association between SMD and food insecurity when total disability scores were taken into account, suggesting a possible mediatory role of disability. Overall, the results indicate that people with severe mental disorders are vulnerable to food insecurity, and that addressing the disability factor of SMDs may help reduce food insecurity. While plans are in place to improve access to mental health care in this district, the effects of treatment on disability and food insecurity will need to be continually monitored. [NPID: food insecurity, mental health, poverty, Africa, Ethiopia]
2019
Food insecurity, mental distress and suicidal ideation in rural Africa: Evidence from Nigeria, Uganda and Ghana
One of the aims of this 2019 study was to find out the prevalence of food insecurity, mental distress, and suicidal ideation among 1,142 individuals living in rural villages in Nigeria (n = 380), Uganda (n = 380) and Ghana (n = 382). The second objective was to examine how these 3 measures interact with one another. Food insecurity was determined based on the number of months in the previous year that the respondent's family were 'unable to eat two square meals per day'. The Kessler non-specific psychological distress scale (K6) indicated that 35.5%, 30.8%, and 30.4%, of participants from Nigeria, Uganda and Ghana, had moderate or severe mental distress, respectively. Moreover, suicidal ideation was reported by 29.7% of Nigerians, 21.3% of Ugandans, and 10.9% of Ghanians. There was no variation in mental distress between the men and the women of any of these countries. Less mental distress appeared to be related to being a farmer in Uganda and Ghana, but no other social factors were significantly associated with mental distress. Across the 3 study sites, risk of having suicidal thoughts was different too. Suicidal ideation was linked with food insecurity in Nigeria, female sex in Uganda, and advancing age in Uganda. Sweetland et al. have exposed the higher than previously thought prevalence of mental distress and suicidal ideation in 3 areas in Nigeria, Uganda, and Ghana. Further research is encouraged to better understand the social etiology of mental distress in these poverty-stricken countries in sub-Saharan Africa. [NPID: food insecurity, mental health, Nigeria, Uganda, Ghana, suicide, suicidal ideation, female, Africa]
CNP Research Summary can be found in the CNP Library Membership
2020
Poor mental health of livestock farmers in Africa: A mixed methods case study from Ghana
Since there is a lack of research on the mental health of livestock farmers living in developing countries, Nuvey et al. (2020) conducted guided interviews, and collected data from 287 livestock farmers and 24 key-informants in the Northern and Southern Belts of Ghana. Roughly 85% of the farmers lost cattle within 1 year due to animal diseases (91%), theft (50%), and pasture shortages (27%). Poor access to veterinary services has resulted in farmers treating livestock diseases themselves using drugs from unregulated sources. To recover losses, these diseased cows are often sold off for meat. Furthermore, poor mental health was exhibited by 60% of these livestock farmers, and 72% of these individuals were depressed, 66% were anxious, and 59% were stressed. Poorer mental health was associated with an increasing number of adverse events experienced, as well as a rising ratio of livestock lost, greater emotional attachment to the animals, and self-reported personal physical illnesses. But mental wellbeing improved as the herd multiplied in size. In conclusion, the mental wellbeing of these Ghanian livestock farmers is worsening due to the deaths of their animals, and the lack of access to veterinary services have led to farmers using possibly unreliable drugs and selling diseased cattle - posing health risks to the public. Now Ghana needs to evaluate their veterinary services and investigate the effects of high-risk meat consumption on the mental and physical health of the public. [NPID: food insecurity, mental health, Ghana, animal disease, theft, pasture shortages, livestock disease, depression]
2018
Family socioeconomic status and maternal depressive symptoms: Mediation through household food insecurity across five years
To assess the relationship between poverty, depression, and food insecurity, Wu et al. (2018) designed this study to inspect family socioeconomic status (SES), maternal depression, and household food insecurity across children's first five years of life. Data were extracted from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B), a dataset nationally representative of all children born in the United States in 2001. Socioeconomic status was documented by the mother when their children were nine months, 24 months, four years, and at kindergarten entry, while ratings on maternal depressive symptoms were collected at nine months, four years, and kindergarten entry. The research found that family socioeconomic status was predictive of subsequent household food insecurity, which was in turn linked with maternal depressive symptoms further down the timeline. There was also evidence showing household food insecurity mediates the relationship between family socioeconomic status and maternal depressive signs. Household food insecurity may play a big role in the development of the mother’s depression, particularly in poorer families. This study highlights the importance of taking into account food insecurity in service provision to depressed mothers and their under-resourced family. [NPID: food insecurity, mental health, depression, poverty, maternal depression, socioeconomic status]
CNP Research Summary can be found in the CNP Library Membership
2019
Disability and mental health status as determinants of food Insecurity among immigrants in California
The aim of this 2019 study was to determine if disability, BMI, and serious psychological distress are linked with food insecurity among residents of California. Secondary data was collected from the California Health Interview Survey (CHIS) from 2013-2015. Disability was defined by presence of a physical, mental, or emotional condition, while food security of the respondents was categorized as either food secure, food insecure without hunger, or food insecure with hunger. Out of the 61,274 Californian participants, food insecurity was reported in 15.4%. Those born outside of the U.S. accounted for 54.8% of the population with food insecurity, and a large proportion of these food insecure people were Latinos (60.1%). Other statistics include subgroups such as residents on food stamps, with serious psychological distress, disability, and obesity, made up 24.7%, 11.7%, 45.1%, and 34.5% of the food insecure, respectively. Further analysis results revealed that people were more likely to experience food insecurity if they were on food stamps (by 250%), had serious psychological distress (by 142%), were foreign-born (by 138%), or had a disability (by 92%). These significant associations between food insecurity with the Supplemental Nutrition Assistance Program, serious psychological distress, disability, and being overweight/obese among Californian citizens indicates a need for culturally appropriate interventions that will help immigrants manage their mental, physical, and emotional health. [NPID: food insecurity, mental health, psychological distress, California, Latinos, food stamps, disability, obesity, immigrants]
2019
A systematic review and meta-analysis of depression, anxiety, and sleep disorders in US adults with food Insecurity
This 2019 review examined the literature available on the study of the association between food insecurity and depression, anxiety, and sleep disorders. A systematic search on 5 research libraries produced 57 studies that assessed the relationship between food insecurity and depression (n = 169,433), 13 on the link with anxiety and psychological distress (n = 91,957), and 8 studies on sleep disorders (n = 85,788). The meta-analyses performed revealed several correlations between food insecurity with increased risks of depression [odds ratio (OR) = 2.74], anxiety (OR = 2.41), and sleep disorders (OR = 1.80). These results were robust to covariates and population groups. Thus, food insecurity was strongly associated with risk of depression, anxiety, and sleep disorders, although Arenas et al. bring up the need for additional longitudinal studies that would improve understanding of effect sizes and causal relationships. [NPID: food insecurity, mental health, food insecurity, depression, anxiety, sleep disorders, psychological distress, sleep disorders]
CNP Research Summary can be found in the CNP Library Membership
2021
Relative food insecurity, mental health and wellbeing in 160 countries
In this 2021 article, Elgar et al. comment that the link between food insecurity and mental illness is shown to be stronger in the more affluent countries because of the relative deprivation in these participants. The hypothesis was that the severity of individual food insecurity relative to others in a reference group determines its associations with mental health and wellbeing (after variation in absolute food insecurity are controlled for). After dissecting data collected by the Gallup World Poll on residents of 160 countries, it was discovered that relative food insecurity was associated with increased mental health symptoms, lower positive wellbeing and lower life satisfaction (after controlling for absolute food insecurity, household income, and country differences). This correlation between food insecurity with mental health and wellbeing was stronger where the prevalence of food insecurity was lower. These findings supported the relative deprivation theory, as individuals who constantly worry about not getting sufficient amounts of food, skip meals, or experience chronic hunger, are receiving inadequate mental health support, especially in areas where food insecurity prevalence is low. [NPID: food insecurity, mental health, deprivation, well-being, quality of life, life satisfaction, skipping meals, chronic hunger]
2019
Coping with food insecurity among African American in public-sector mental health services: A qualitative study
Since there is very little research on the ways in which African Americans in public-sector mental health services cope with food insecurity, Myers et al. (2019) decided to analyze the qualitative data from a study on the prevalence and management of food insecurity among African Americans using public sector mental health services. Interviews were held with 21 participants to get their accounts on their everyday experiences with food insecurity and the strategies used to cope with it. High levels of food insecurity were reported. Coping strategies included sharing foods and cooking meals together. These methods appeared to reduce the negative aspect of living with high food insecurity and serious mental illnesses. As a result, Myers et al. concluded that provision of communal gardens and kitchens through public mental health services may help people cope with food insecurity and potentially reduce incidences of mental illness. [NPID: food insecurity, mental health, African Americans, mental illness]
CNP Research Summary can be found in the CNP Library Membership
2020
Combined effects of disease management and food insecurity on physical and mental health in Korean adults
Kim & Kim (2020) evaluated the combined impact of disease management and food insecurity on the physical and mental health of Korean adults (aged 30+). Data was taken from the Korea National Health and Nutrition Examination Survey (KNHANES) 2012-2015. Results showed that men with food insecurity were more likely to be underweight compared to men with food security. On the other hand, there was a greater chance of food insecure women being overweight, compared with food secure women. Food security was found to be associated with a high risk of all mental health outcomes. Moreover, unmet healthcare needs and mental health counselling were more prevalent in adults with food insecurity. The researchers reveal that these unmet healthcare needs are related with an increased risk of obesity among food-insecure men. In addition, among adults with food insecurity correlations were found with higher risk of mental health outcomes. Among food insecure ladies, low participation levels in nutrition education or counselling was linked with higher prevalence of obesity. To conclude, unmet healthcare needs may amplify the obesity rates in food insecure men and worsen mental health issues in both men and women with food insecurity. Lack of participation in the nutrition education program or counselling may result in increased obesity in food-insecure women. [NPID: women, food insecurity, mental health, Korea, overweight, obesity]
2021
Addressing the interaction between food insecurity, depression risk and informal work: Findings of a cross-sectional survey among informal women workers with young children in South Africa
In this 2021 study, surveys and interviews were carried out with 265 informal women workers in South Africa with the intention of analyzing work conditions and settings, food security and risk of depression among these working women with young children (0-3 years old). One-third of working women in South Africa are in informal work, which is believed to be linked with socioeconomic vulnerability. The types of works the participants had were domestic work or home-based work. Most were informal traders, but others included informal employees and own account workers. Many of the mothers (56.2%) earned between US$70-200 per month, meanwhile some earned less than $70/month and a few (14%) brought in over $200 per month. This study discovered that income was related with food insecurity among these women: detection of severe food insecurity was significantly higher among those with the lowest income relative to the highest earners. Many of the subjects experienced either mild (14.3%), moderate (27.2%), or severe (16%) food insecurity. Horwood et al. also found that women who received financial support from the baby’s father were more likely to be food insecure. Another significant relationship was identified between household food insecurity and depression risk. The risk of depression, according to Edinburgh Postnatal Depression Scores, was 8.3% among the sample. Similar rates were seen for postnatal women and mothers with older children. The calculated depression risk was low compared to previous estimates in South Africa, which suggests that these informal workers possess high resilience levels. But the women with low incomes and increased odds of food insecurity remain vulnerable, possibly leading to worsening of maternal health. Interventions that help enhance social protection, health service access, and ensure safe childcare in the workplace are encouraged. [NPID: food insecurity, mental health, South Africa, depression, income, low income, financial support]
CNP Research Summary can be found in the CNP Library Membership
2021
A call to action to address COVID-19–induced global food insecurity to prevent hunger, malnutrition, and eating pathology
Paslakis et al. (2021) explain that the coronavirus 2019 disease (COVID-19) pandemic has led to food shortages, rising food prices, and income loss, resulting in global food insecurity alerts to be issued. The mounting problems caused by the pandemic for millions of children and adolescents and their families, currently living with or at risk for development of food insecurity, coupled with the past studies on food insecurity and eating pathology have raised concerns about the dietary behaviors of children and adolescents. Non-constant access to nutritious food is associated with chronic physical and mental health issues and death. This present article aims to raise awareness of this threat and to help make food security and healthy dietary attitudes and behaviors a global priority during the COVID-19 pandemic to ensure the health and well-being of our children and adolescents.[NPID: food insecurity, mental health, COVID, pandemic, food shortages, well-being]
2020
Associations between food insecurity and psychotropic medication use among women living with HIV in the United States
This 2020 study evaluated whether food insecurity is associated with psychotropic medication use independent of depression and anxiety symptoms among HIV-positive women in the U.S. Few studies had previously examined the social-structural factors that may play a role in the use of psychotropic medication, which has increased in America. Using data from the national study Women's Interagency HIV Study (WIHS), Whittle et al. looked into interactions between food insecurity and the use of any psychotropic medications (including antidepressants, sedatives and antipsychotics). Two-thirds of the 905 women included were African American. Results showed a correlation between worse food insecurity with increased symptoms of depression and anxiety in a dose-response manner. In models unadjusted for depression and anxiety, marginal and low food security were linked with higher odds of using any psychotropic medication. There was a 1.93 times greater chance of using any psychotropics after adjusting for depression and anxiety symptoms. Very low food security was not found to be significantly related to psychotropic use but was significantly associated with less risk of antidepressant use. These complex results may signify the presence of barriers to mental health service access that people with very low food security face, and the higher psychotropic prescription rate for distress (likely to have arisen from social and structural factors) in those experiencing marginal food security with services access. [NPID: food insecurity, mental health, psychotropic medication, HIV, women, antidepressants, sedatives, anxiety, depression]
CNP Research Summary can be found in the CNP Library Membership
2018
Complicating narratives of women’s food and nutrition insecurity: Domestic violence in rural Bangladesh
Although there is strong evidence linking maternal exposure to domestic violence with her children’s poor nutrition, Lentz (2018) remarks the less researched relationship between domestic violence, nutrition, and food security. The literature has proposed the ideas that the victims’ poor nutrition could be a result of the offenders restricting food as a form of violence or control, and that women’s food preparation and portion allocation could trigger violence in the culprit. Interviews were carried out with over 100 women in rural Bangladesh to reveal an association between violence and food practices. The author believes that domestic violence plays a part in the women’s choices on food consumption and distribution, often leading to the intake of lower quality foods and less quantity. Thus, it was recognized that there are a complex set of relationships involved between hunger, undernutrition, agency and domestic violence, which differ from the 2 previously hypothesized causal pathways. According to Lentz, women often demonstrate agentic decision-making in a context of violence, referred to as “burdened agency”. This “burdened agency” may explain how ladies make decisions around food practices, and why interventions designed around food security and nutrition may not be popular in this target group. [NPID: food insecurity, mental health, domestic violence, burdened agency]
2017
Food insecurity and emotional health in the USA: A systematic narrative review of longitudinal research
Bruening et al. (2017) conducted a systematic search for relevant literature on the longitudinal association between food insecurity and emotional well-being. The aim of this review was to determine the causal relationship between food insecurity and emotional health among US-based populations. Twelve out of the 4161 peer-reviewed articles met the inclusion criteria. Three of these studies analyzed the impact of emotional health on food insecurity, while five examined the effect of food insecurity on emotional well-being, and four studies investigated a bidirectional relationship. The majority of studies (83%) positively associated negative emotional well-being with food insecurity over time. Although additional studies are required, these observations suggest a bidirectional relationship whereby food insecurity raises the risk of poor emotional health, and poor emotional well-being elevates the risk of food insecurity. [NPID: food insecurity, mental health, emotional well-being, bidirectional relationship]
CNP Research Summary can be found in the CNP Library Membership
2019
Moderation of the association between individual food security and poor mental health by the local food environment among adult residents of Fling, Michigan
Bergmans et al. (2019) evaluated whether the local food environment moderates the association between individual food insecurity with poor mental health by analyzing survey data collected from 291 adult residents of Flint, Michigan in 2015. In this survey, respondents were asked to rate their overall "mental or emotional health" using a 5-point Likert scale, before being classed as having either good mental health (good, very good, or excellent rating) or poor mental health (fair or poor rating). Fully adjusted models revealed the 3.2 times increased odds of having poor mental health associated with food insecurity. But it was also found that the participants in the 25th percentile for access to vegetables were 7.4 times likely to report poor mental health, while those in the top 25th percentile for vegetable access were weakly linked with poor psychological health. This means the proximal access to fruits and vegetables moderate the relationship between food security and mental health. The researchers support the longitudinal analysis of programs and policies aimed at improving nutritious food availability since it would suggest if they induce mental health benefits. [NPID: food insecurity, mental health, emotional health, vegetables, fruits, psychological health, food availability]
2018
Association between adherence to the Dietary Approaches to Stop Hypertension diet with food security and weight status in adult women
In this 2018 study, 227 women between 20-50 years old were assessed on their diet to calculate their adherence to the Dietary Approaches to Stop Hypertension (DASH) diet (a diet rich in fruits, vegetables, whole grains, nuts and legumes, low-fat dairy, and low in red and processed meats, sweetened beverages and sodium). The objective was to investigate the relationship between this adherence to the DASH diet with food security and weight status among female adults. While the overall prevalence of food insecurity was 33.9%, the majority of obese and overweight participants were food insecure. Also, greater adherence to the DASH diet was associated with less occurrence of obesity and overweight. In fact, after controlling for age and energy intake, those subjects in the highest tertile for adherence to the DASH diet were 66% less likely to be overweight or obese, compared to those in the lowest tertile. This significant relationship between DASH diet adherence tertile and overweight/obesity was indicated in both food secure and insecure women. To summarize, Tabibian et al. discovered that adherence to the DASH diet correlates is related with a reduced risk of overweight and obesity (based on BMI) in both food secure and insecure women. [NPID: food insecurity, mental health, DASH, hypertension, obesity, overweight]
CNP Research Summary can be found in the CNP Library Membership
2020
An overview of the sociological and environmental factors influencing eating food behavior in Canada
This 2020 review examines the role of biotechnology in the enhancement of food security and inspects its significant impact on agriculture and the food market. The goal was to expand the understanding of the social economic environment and the dietary behaviors of Canadian residents. Several socio-environmental factors that influence the public’s eating behaviors were discussed, including the development and implementation of national policies. Healthy eating can be determined by individual determinants, as well as social, physical, and economic environments, according to a framework used. Marcone et al. concludes that there is a gap in research and a great need for new policies in the food and nutrition environments. [NPID: food insecurity, mental health, food policies, national policies, Canada]
2020
Food insecurity and psychological distress: A review of the recent literature
Myers (2020) provides a review of the association between food insecurity (low quantity and/or quality of food intake) and psychological distress (depression and anxiety). The author comments on the studies published in the last 5 years that have positively associated food insecurity with multiple indicators of psychological distress. These include cross-sectional and longitudinal studies, those in which primary and secondary data were collected, and those that investigated populations in countries of varying income levels. There was a diverse portfolio of studied samples, including adults of all ages, college students, people with chronic disease, and parents. The conclusion was that food insecurity is interconnected with psychological distress, although there are several important gaps in the literature that future research ought to consider. The reviewers would welcome the development of interventions aimed at improving both food insecurity and psychological health at the same time. [NPID: food insecurity, mental health, quality of food, psychological distress, depression, anxiety, income levels, income, college students, chronic disease]
CNP Research Summary can be found in the CNP Library Membership
2020
Impact of food insecurity with hunger on mental distress among community-dwelling older adults
In this 2020 study, Gyasi et al. take a look at the associations between food insecurity with hunger and psychological distress among older people in Ghana, since hunger is a frequent and continuous problem in Sub-Saharan Africa and other low-income countries. Using the data on 1200 older (aged 50+) participants of the 2016/2017 Ageing, Health, Psychological Well-being and Health-seeking Behavior Study, the researchers discovered a food insecurity prevalence rate of 36% with roughly 27% and 9% for moderate and severe hunger levels, respectively. Both moderate and severe hunger were significantly linked with increased psychological distress compared to absence of hunger. Subgroup analyses suggested that this interaction between hunger and psychological distress worsens with advancing age and in men. These results can hopefully inform social policy initiatives and health promotion interventions designed to help the older population showing signs of food insecurity. [NPID: food insecurity, mental health, psychological distress, Ghana, Africa, low income, severe hunger, elderly]
2020
Association of food insecurity with psychological disorders: Results of a population-based study among older people in Ghana
Since the poor health outcomes related to food insecurity may be more apparent in later life, Gyasi et al. (2020) analyzed the age and gender differences in the association between food insecurity with psychological disorders (PD) among older people in Ghana. The dataset was obtained from the 2016-2017 AgeHeaPsyWel-HeaSeeB Study, which included 1,200 individuals aged ≥50 years. Thirty-six percent complained of hunger, while other signs of food insecurity were breakfast skipping (29% prevalence) and consuming the first meal of the day late (observed in 5%). After adjusting the analysis model, presence of food insecurity significantly correlated with higher scores in the psychological disorder assessment, compared to absence of food insecurity. Additionally, having the first meal of the day late was related with a higher risk of having psychological disorders. These relationships were moderated by age and gender - men and those 65 years and over were more likely to have PD compared to women and those in the 50-64 age group. These results demonstrate that food insecurity independently increases incidence of psychological disorders in older people, which hopefully informs public health and policy interventions that support mental health enhancement in the elderly. [NPID: food insecurity, mental health, psychological disorders, Ghana, breakfast, skipping breakfast, public health, elderly]
CNP Research Summary can be found in the CNP Library Membership
2018
Food insecurity and mental health among females in high-income countries
This 2018 review takes a look at evidence on the link between food insecurity and mental health among women in high-income countries. Thirty-nine articles were found through searching the PubMed, EMBASE, and psycINFO databases, 31 of which were unique studies or surveys. Maynard et al. identified that 75% of the articles utilized data from a version of the United States Department of Agriculture Household Food Security Survey Module, and that a variety of mental health measures were used to determine depression, depressive symptoms, anxiety, and stress. The majority of the research indicated associations between depression and food insecurity, while bidirectional relationships (food insecurity increasing the risk of depressive symptoms or diagnosis/depression predicting food insecurity) were also suggested. Some articles analyzed vulnerable subgroups such as pregnant women, women at risk of homelessness, refugees, and those with a history of experiencing violence or substance abuse. In essence, this review shows the connection between food insecurity and mental health among women in high-income countries. [NPID: food insecurity, mental health, depression, anxiety, stress, homelessness, refugees, substance abuse, women]
2019
Food insecurity is associated with anxiety, stress, and symptoms of posttraumatic stress disorder in a cohort of women with or at risk of HIV in the United States
While food insecurity has been associated with depression, this 2019 study set out to examine its correlation with symptoms of generalized anxiety disorder (GAD), stress, and posttraumatic stress disorder (PTSD). The study applied data collected in the Women's Interagency HIV Study (WIHS), an American cohort study of 2553 women (71.6% African American/black) with/at risk of HIV. Questionnaires were administered every 6 months from April 2013 until March 2016. Current marginal, low, and very low food securities were discovered to be linked with higher GAD-7 scores (generalized anxiety disorder assessment), and with a significantly greater likelihood of screening positive for moderate-to-severe GAD. Furthermore, low and very low food security 6 months earlier was associated with generalized anxiety disorder outcomes at the present visit. Food security also showed similar dose-response relationships with the measures of perceived stress (PSS-10 score) and PTSD (PCL-C score). In fact, those with very low food security were 1.93 times likely to screen positive for PTSD. Whittle et al. have produced evidence connecting food insecurity with several poor mental health outcomes among women in the United States with or at risk of HIV. [NPID: food insecurity, mental health, GAD, anxiety, generalized anxiety disorder, HIV, stress, perceived stress, women]
CNP Research Summary can be found in the CNP Library Membership
2019
Needs and perceptions regarding healthy eating among people at risk of food insecurity: A qualitative analysis
According to Van der Velde et al. (2019), people at risk of experiencing food insecurity generally exhibit poor dietary behaviors also due to factors such as perceived higher prices of healthy foods, monetary problems, lack of nutritional knowledge, and inadequacy in preparing healthy foods. This study aimed to gather more information on the needs and perceptions of people at risk of having food insecurities by conducting inductive analysis. Overall, the ten participants demonstrated adequate nutritional knowledge, but their eating behaviors were influenced by social and physical factors. For example, subjects considered the food preferences of their kids, cultural food habits, and physical temptations to eat. Moreover, poor mental health, financial stress, and high food prices were reported as the perceived barriers for healthy eating behaviors. Generally, there was a conscious attitude towards their financial state, which results in the coping strategies on a restricted budget. Food insecurity was mostly mentioned when talking about the past or others but not about the individual’s own current experiences. Debt assistance and other resources that can assist with financial strain were perceived in a generally positive way except from the Food Bank. The participants recommended the distribution of free meals, the facilitation of social contacts, the lowering of healthy food prices, and the increase of healthy food supply in the neighborhood. The insights of these people at risk of food insecurity can hopefully inform health promotion programs and help develop interventions designed to enhance diet and thus decrease risk of disease. [NPID: food insecurity, mental health, monetary problems, nutritional knowledge, budget, financial strain]
2015
Association of moderate and severe food insecurity with suicidal ideation in adults: National survey data from three Canadian provinces
Davison et al. (2015) applied data obtained from the 2007 Canadian Community Health Survey to examine the suspected link between household food security and suicidal ideation. The national survey conducted across 3 Canadian provinces (n=5270) included adults over the age of 18 and asked the respondents questions such as whether they had seriously considered committing suicide in the previous 12 months. The Household Food Security Survey Module allowed the researchers to determine the participants’ food insecurity status, classing those who show compromise in quality and/or quantity of food consumption as ‘moderate’, and those with disrupted dietary patterns and lower intake levels as ‘severe’. Although there were variations in the proportion of people with ‘moderate’ and ‘severe’ food insecurities experiencing suicide ideation, there was a significant association between suicidal ideation with moderate and severe food insecurity. These findings suggest that promoting food security could potentially reduce suicide-related morbidity and mortality. It would be even more helpful collecting further longitudinal data to expand the current knowledge on the etiological pathways involved in the interaction between food security and suicide. [NPID: food insecurity, mental health, Canada, suicide, suicidal ideation]
CNP Research Summary can be found in the CNP Library Membership
2017
Food insecurity and mental health status: A global analysis of 149 countries
In this 2017 study, data from nationally representative surveys such as the 2014 Gallup World Poll was used to assess the relationship between food insecurity and mental health across the world. The participants reported their experiences of food insecurities through the Food Insecurity Experience Scale Survey Module, while their depression and mental state were indicated by their Negative Experience Index and Positive Experience Index scores. Reports of food insecurity ranged from 18.3% in East Asia to 76.1% in Sub-Saharan Africa. Across the 149 countries included in the surveys, food insecurity was found to be associated with poorer mental health indices in a dose-response manner. This trend was also observed within regions. Food insecurity correlated with poorer mental health and psychosocial stressors across global regions. The author states that there are likely to be many pathways in which food insecurities can predispose or contribute to common mental disorders. [NPID: food insecurity, mental health, depression, Africa]
2020
'Eating to survive': A qualitative analysis of factors influencing food choice and eating behaviour in a food-insecure population
Since food insecurity in Europe is regarded to be in its worst levels, this 2020 study was designed to find out what influences food choice and dietary behavior in a food-insecure sample in the U.K.. Twenty-four consumers at a foodbank in Liverpool were interviewed using questions that focussed on food access, factors affecting food choices, and strategies used to conserve food. Upon analyzing the interview, Puddephatt et al. found six themes: 'income', 'cost of food', 'accessibility of shops', 'health issues', 'food rationing strategies' and 'worsened health outcomes'. The most notable factor impacting the respondents’ food choices was the continuous struggle to afford food. The majority valued food healthiness but the decisions are ultimately based on the cost of the food. The participants have tried to ration by skipping meals, eating small portions, cooking in bulk, and prioritizing the children’s food consumption. Moreover, these subjects reported pre-existing physical and mental health issues that were worsened by poor access to food and resulted in a vicious cycle of stress and poorer health conditions. This study demonstrates the strong impact of a person’s income on their food choices and eating behaviors, and exposes the need to address important matters such as income and cost of healthy food. [NPID: food insecurity, mental health, United Kingdom, cost of food, income, food rationing, cooking in bulk, stress]