Food insecurity’s mental toll extends beyond nutritional impact

The uncertainty of where a next meal is coming from is enough to bring about long-term changes to mental health, a global study has determined.

Data gathered from 149 countries revealed that food insecurity (FI) may be a key contributor to common mental disorders. These include depression, anxiety, and somatic symptom disorders.

It is thought that these conditions can be aggravated by food availability, affordability, utilisation, and even social norms that can affect people’s well-being besides the impact on nutrition. These findings were independent of individuals’ socioeconomic status.

“Anxiety related to one’s ability to acquire sufficient food in the future may be provoked even under conditions of mild FI, and is likely to increase with moderate and severe FI,” said the study’s author Dr Andrew Jones, professor at the Department of Nutritional Sciences based at the University of Michigan.

“Individuals may resort to acquiring food in socially unacceptable ways as a coping strategy. The feelings of shame and guilt associated with this behaviour could compound pre-existing anxiety precipitated by mild FI to yield even poorer mental health conditions.”

Despite increasing global food production, nearly 795 million people worldwide remain food insecure. 

Closer to home, the issue of FI has been laid bare by The Poverty and Social Exclusion research project, which conducted a survey in 2012.

The project found that 4% of UK children lived in families who could not afford to feed them properly.

FI has been linked with nutrition-related health outcomes including dietary inadequacies, early child growth faltering, obesity, poor physical health, low educational achievement, and developmental deficits in children. 

This study serves to highlight mental health outcomes among food-insecure individuals, not necessarily linked to nutritional deficiencies or excesses, that are of increasing concern.

Study details

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Overall, the extent of FI ranged from 18.3% in East Asia to 76.1% in Sub-Saharan Africa. ©iStock

The study took cross-sectional data from a series of nationally representative surveys that made up the 2014 Gallup World Poll.

FI was evaluated using the Food Insecurity Experience Scale Survey Module for Individuals consisting of eight questions that asked about individuals’ FI experiences.

Mental health status was determined using the Negative Experience Index (NEI) and the Positive Experience Index (PEI), two five-question surveys that explored issues such as pain, sadness, enjoyment, feelings of respect, and other factors.

Data for the mental health indices were available for 152,696 individuals. The PEI was highest in Latin America and the Caribbean region (79.4) and lowest in Russia and the Caucasus (59.2),

Meanwhile, NEI was lowest in Central Asia (17.4) and highest in the Middle East and North Africa region (34.9).

Overall, the extent of FI ranged from 18.3% in East Asia to 76.1% in Sub-Saharan Africa.

Dr Jones also made associations with FI and poorer mental health status in a dose-response fashion when he compared NEI vs. FI for multiple age ranges. An inverse effect was also observed for PEI vs. FI data.

Cross-cultural consistency’

“FI is associated with poorer mental health and specific psychosocial stressors across global regions independent of SES. The numerous pathways via which FI may contribute to common mental disorders, and the broad social implications of FI linked to cultural norms and self-efficacy, may contribute to the cross-cultural consistency of the findings,” Dr Jones concluded.

“Developing robust monitoring to more comprehensively understand their relation across contexts may help to effectively address the mental health consequences of FI,” he added.

Source: American Journal of Preventative Medicine

Published online ahead of print: doi.org/10.1016/j.amepre.2017.04.008

“Food Insecurity and Mental Health Status: A Global Analysis of 149 Countries.”

Authors: Andrew Jones