Food insecurity and mental health: a systematic review and meta-analysis

Public Health Nutr. 2020 Jul;23(10):1778-1790. doi: 10.1017/S136898001900435X. Epub 2020 Mar 16.

Abstract

Objective: Food security has been suggested to be a risk factor for depression, stress and anxiety. We therefore undertook a systematic review and meta-analysis of available publications to examine these associations further.

Design: Relevant studies were identified by searching Web of Science, Embase, Scopus and PubMed databases up to January 2019.

Setting: OR was pooled using a random-effects model. Standard methods were used for assessment of heterogeneity and publication bias.

Participants: Data were available from nineteen studies with 372 143 individual participants from ten different countries that were pooled for the meta-analysis.

Results: The results showed there was a positive relationship between food insecurity (FI) and risk of depression (OR = 1·40; 95 % CI: 1·30, 1·58) and stress (OR = 1·34; 95 % CI: 1·24, 1·44) but not anxiety. Subgroup analysis by age showed that subjects older than ≥65 years exhibited a higher risk of depression (OR = 1·75; 95 % CI: 1·20, 2·56) than younger participants (OR = 1·34; 95 % CI: 1·20, 1·50), as well as a greater risk of depression in men (OR = 1·42; 95 % CI: 1·17, 1·72) than women (OR = 1·30; 95 % CI: 1·16, 1·46). Finally, subgroup analysis according to geographical location illustrated that food insecure households living in North America had the highest risk of stress and anxiety.

Conclusions: The evidence from this meta-analysis suggests that FI has a significant effect on the likelihood of being stressed or depressed. This indicates that health care services, which alleviate FI, would also promote holistic well-being in adults.

Keywords: Anaemia risk; Anxiety; Depression; Food insecurity; Meta-analysis; Stress; Systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Anxiety / epidemiology
  • Anxiety / psychology
  • Depression / epidemiology*
  • Depression / psychology
  • Diet / psychology*
  • Family Characteristics
  • Female
  • Food Insecurity*
  • Geography
  • Humans
  • Male
  • Mental Health / statistics & numerical data*
  • Middle Aged
  • North America / epidemiology
  • Odds Ratio
  • Risk Factors