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Association between food insecurity and depression among older adults from low- and middle-income countries.

The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK. Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea. School of Psychology & Sport Science, Anglia Ruskin University, Cambridge, UK. Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain. Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France. Anglia Ruskin University, Cambridge, UK. School of Medicine, Vision and Eye Research Institute, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University-Cambridge Campus, Cambridge, UK. Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy. Department of Cancer Epidemiology and Prevention Research and Departments of Oncology and Prevention Research, Alberta Health Services, University of Calgary, Calgary, Canada. Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey. Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, California, USA. Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria. ICREA, Barcelona, Spain.

Depression and anxiety. 2021;(4):439-446
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Abstract

BACKGROUND To examine the association between self-reported food insecurity and depression in 34,129 individuals aged ≥50 years from six low- and middle-income countries (LMICs) (China, Ghana, India, Mexico, Russia, and South Africa). METHODS Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Self-reported past 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Questions based on the World Mental Health Survey version of the Composite International Diagnostic Interview were used for the endorsement of past 12-month DSM-IV depression. Multivariable logistic regression analysis and meta-analysis were conducted to assess associations. RESULTS In total, 34,129 individuals aged ≥50 years [mean (SD) age, 62.4 (16.0) years; 52.1% females] were included in the analysis. Overall, the prevalence of moderate and severe food insecurity was 6.7% and 5.1%, respectively, while the prevalence of depression was 6.0%. Meta-analyses based on countrywise estimates showed that overall, moderate food insecurity (vs. no food insecurity) is associated with a nonsignificant 1.69 (95% confidence interval [CI] = 0.82-3.48) times higher odds for depression, while severe food insecurity is significantly associated with 2.43 (95% CI = 1.65-3.57) times higher odds for depression. CONCLUSIONS In this large representative sample of older adults from six LMICs, those with severe food insecurity were over two times more likely to suffer from depression (compared with no food insecurity). Utilizing lay health counselors and psychological interventions may be effective mechanisms to reduce depression among food-insecure populations. Interventions to address food insecurity (e.g., supplemental nutrition programs) may reduce depression at the population level but future longitudinal studies are warranted.

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Publication Type : Meta-Analysis

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