Is Food Insecurity Linked to Mental Health?

Dr. David Wiss

April 10, 2021

Mental Health

Food Insecurity is defined by the United States Department of Agriculture (USDA) as a “limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways” [1]. Only recently has it become evident that limited access to food can be considered a form of childhood adversity, increasingly referred to as “adverse food-related experiences.” Many people who are feeling stressed and seek nutritional advice discover that they have some form of adverse food-related experiences at some point in their life.

Estimates from a 2017 study showed that 11.8% of US households are food insecure, with higher rates among adults living alone, non-whites, and low-income households [2]. The National Health and Nutrition Examination Survey (NHANES) showed that the rate of food insecurity doubled from approximately 9% in 2005-2006 to 18% in 2011-2012 [3]. This change has been partially attributed to the Economic Recession of 2007-2009, which has subsequently improved although not to pre-recession rates [4,5]. Food insecurity may be one contributor to a depressed mood.

Prevalence estimates of food insecurity are much higher in underserved and substance-using individuals and communities, with estimates ranging from 42-71% [6–10]. The COVID-19 pandemic and its economic impact has led to increased food insecurity across several disadvantaged groups [11]. According to this national data from July 2020, 21.2% of people making less than $50,000/year report sometimes or often not having enough food to eat. In other words, food insecurity is a serious, growing problem in the US, and it is often ignored by or invisible to those of us with access to proper nutrition.

In addition to socioeconomic factors, multiple cross-sectional studies have described an increased risk of food insecurity being associated with exposure to Adverse Childhood Experiences (ACEs) [12–14]. It has been shown that exposure to a single ACE is significantly associated with elevated risk for household food insecurity [14]. ACEs carry consequences for food insecurity into young adulthood, especially if they accumulate. One known consequence is binge eating and bulimia nervosa. One of the best lifestyle interventions for people with binge eating is to remove stressors and sources of both nutritional and emotional deprivation.

In a nationally representative longitudinal study, exposure to four or more ACEs was associated with more than three-fold increase in the odds of food insecurity in young adulthood [15]. In this study, income, drug use, and depressive symptoms were found to partially reduce the magnitude of this association. Using a social determinants of health framework, a recent review suggested that adolescent food insecurity research should explore parenting factors, family dynamics, psychological factors, other health behaviors, and the accumulation of stress [16]. Our program is designed to teach you how to stop stress eating, emotional eating, and to improve your body image, no matter what you have been through. We get it.

Food insecurity provides important context for both adverse childhood experiences as well as adult mental health. A systematic review and meta-analysis of 57 US studies showed that food insecurity is associated with a nearly three-fold increase in the odds of developing depression [17]. A more recent systematic review and meta-analysis found that those above 65 years of age exhibited a higher risk for depression than younger participants [18]. In a longitudinal study from Canada, those with co-occurring disorder (substance use disorder plus mood disorder) were more likely to remain in the persistently high food insecurity group over time [19]. Other data suggest that food insecurity is associated with multiple indicators of psychological distress [20]. Taken together, food insecurity has strong associations with both the causes and consequences of ACEs, and therefore should be considered in any comprehensive nutrition evaluation that looks at eating habits over the lifespan.

If you have ever experienced food insecurity at any point in your life, there is a chance that it may have impacted your relationship with food. There are well-established links between trauma and addictions. Deprivation can set you up for binge eating in the short-term or even later in life. Periods of malnourishment can have lasting effects, particularly during sensitive periods of development, although some of them are reversible. Food insecurity and mental health is an important topic that most people have not thought about—at Wise Mind Nutrition, our goal is to cover all of the biopsychosocial bases, explore all the intersections and create greater awareness for anyone concerned with health and wellbeing. We can help with both the biological and psychological recovery from food insecurity and other forms of ACEs.

We are especially skilled in helping you recover from stress eating through practices such as mindfulness and meditation, which help you live in the present moment. Our personalized nutrition program integrates an understanding of the social determinants of health, functional medicine, and the latest advances in the fields of nutritional psychology and nutritional psychiatry. We use a food-first trauma-informed approach to help you achieve the kind of wellness you may have never felt before. Safety and security should always come first, particularly for people with depression and other types of mood disorders, anxiety, history of trauma, and substance use disorders. We believe in healing work and we strongly believe that access to nutritious food should be a part of it!

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