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

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 center dot 40; 95 % CI: 1 center dot 30, 1 center dot 58) and stress (OR = 1 center dot 34; 95 % CI: 1 center dot 24, 1 center dot 44) but not anxiety. Subgroup analysis by age showed that subjects older than >= 65 years exhibited a higher risk of depression (OR = 1 center dot 75; 95 % CI: 1 center dot 20, 2 center dot 56) than younger participants (OR = 1 center dot 34; 95 % CI: 1 center dot 20, 1 center dot 50), as well as a greater risk of depression in men (OR = 1 center dot 42; 95 % CI: 1 center dot 17, 1 center dot 72) than women (OR = 1 center dot 30; 95 % CI: 1 center dot 16, 1 center dot 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.