Associations Between Food Insecurity and Depression, Anxiety, and Psychological Distress in Adulthood Across High-Income and Low- to Middle-Income Countries: A Systematic Review of Observational Studies

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Hadia Safarat Kirmani
Silvia Di-Bonaventura
Adriana Romina Menendez-Mite
Areerat Suputtitada
Basira Hanafi Lawal
Carolina Parra Mardones
Carolina Schibuola Crespo
Claudia Andrea Lopez
Débora Renz Barreto Vianna
Elizabeth Leon-Cuevas
Florentina Diaconescu
Giliana Melany Collado
Giovanna Brandão Saliba
Ibelema Alaere Ijeoma Datubo-Brown
Ila Marques Porto Linares
Javier Bernardo Chambi
José Elías León Donis
Jose Omar Santellán Hernández
Kendra Aira Cabrera
Maiara Cássia Pigatto
Marie Andree Cosenza Ba
Motaz Almahmood
Nagheli Fernanda Borjas-Calderón
Orleancio Gomes Ripardo
Paul Pereyra
Sofia Gnecco
Tarek Khalaf Saleh Rabiei
Vinicius Costa Assis
Walter Araujo Zin
Sara Pinto Barbosa

Abstract

Background: Food insecurity is the lack of consistent access to enough food for an active, healthy life, affects millions globally, including high-income countries. It is linked to adverse mental health outcomes like depression, anxiety, and stress.


Objectives: To synthesize literature on the impact of food insecurity on depression, anxiety, and stress across various populations and regions.


Methods: This mini systematic review follows PRISMA guidelines. Observational studies published from 2014 onwards, involving participants aged 18 and older exposed to food insecurity were included. Studies involving COVID-19, pregnant individuals, and cancer patients were excluded. A search was conducted in PubMed, Cochrane, and Google Scholar between April and June 2024. Covidence was used for screening, data extraction, and quality assessment. Risk of bias was evaluated using the Newcastle–Ottawa Scale.


Results: 871 papers identified, 11 met the inclusion criteria. Six studies were conducted in the USA, while others included Canada, India, Panama, China, Mexico, and Russia. Food insecurity was assessed using validated scales like the USDA 10-Item Adult Food Security Module. The review found that individuals with food insecurity had significantly higher odds of experiencing depression (adjusted ORs 2.5-3.4), anxiety (adjusted ORs 2.3-3.1), and stress (adjusted ORs 2.0-2.8). These associations were consistent across different demographic groups and regions.

Discussion: Food insecurity significantly increases risks of depression, anxiety, and stress, persisting after adjustments for sociodemographic and health factors.


Conclusions: Food insecurity profoundly impacts mental health, highlighting the need for targeted interventions and policies to improve food security and mental health, especially for vulnerable populations.

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Associations Between Food Insecurity and Depression, Anxiety, and Psychological Distress in Adulthood Across High-Income and Low- to Middle-Income Countries: A Systematic Review of Observational Studies. (2025). Principles and Practice of Clinical Research, 10(4). https://doi.org/10.21801/ppcrj.2024.104.6
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How to Cite

Associations Between Food Insecurity and Depression, Anxiety, and Psychological Distress in Adulthood Across High-Income and Low- to Middle-Income Countries: A Systematic Review of Observational Studies. (2025). Principles and Practice of Clinical Research, 10(4). https://doi.org/10.21801/ppcrj.2024.104.6