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 = 1.40; 95 % CI: 1.30, 1.58) and stress (OR = 1.34; 95 % CI: 1.24, 1.44) but not anxiety. Subgroup analysis by age showed that subjects older than >/=65 years exhibited a higher risk of depression (OR = 1.75; 95 % CI: 1.20, 2.56) than younger participants (OR = 1.34; 95 % CI: 1.20, 1.50), as well as a greater risk of depression in men (OR = 1.42; 95 % CI: 1.17, 1.72) than women (OR = 1.30; 95 % CI: 1.16, 1.46). 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.