Food insecurity is on the rise around the world. The COVID-19 pandemic has swelled the ranks of the unemployed and, therefore, those in need. COVID-19 outbreaks in food processing plants have strained the food supply chain, which, in turn, has led to higher prices for basic staples at the supermarket.
The consequences of prolonged food insecurity will be devastating, leading to higher rates of hunger, disease, malnutrition, and death. While developing nations will be particularly hard hit, developed nations will not be spared.
This two-part blog post highlights key studies published in ASN’s four journals to help nutrition scientists, public health advocates, health care providers, and the general public better understand food insecurity. Part One explores health outcomes associated with food insecurity; Part Two offers potential solutions that can help the world address rising food insecurity as a consequence of the COVID-19 pandemic.
Diabetes patients living in food-insecure households were less able to effectively manage their disease, as evidenced by a higher reported rate of hypoglycemic reactions.
In March 2013, Advances in Nutrition, ASN’s international review journal, published “Food Insecurity and Chronic Disease.” Among the findings, author Barbara A. Laraia found a strong link between food insecurity and the incidence of type 2 diabetes. One study mentioned in the review, for example, found food-insecure individuals were about 12 percentage points more likely to report diabetes than food-insecure individuals. Moreover, diabetes patients living in food-insecure households were less able to effectively manage their disease, as evidenced by a higher reported rate of hypoglycemic reactions.
Although the author found consistent associations between household food insecurity and chronic disease in general, she did note that “the measure used for household food insecurity, sample restrictions, and clinical markers varied with each study,” making it difficult to assess the strength of the associations.
This Advances in Nutrition review also noted that “household food insecurity experienced during critical developmental states (e.g., in utero, infancy, peripubertal, pregnancy) is more damaging.” In other words, food insecurity experienced during these critical life phases may lead to a higher likelihood of developing chronic disease.
A February 2010 study published in The Journal of Nutrition, “Food Insecurity Is Associated with Chronic Disease among Low-Income NHANES Participants,” echoes many of the findings from the Advances in Nutrition review. Authors Hilary K. Seligman et al. found “the risk of clinical diabetes was ∼50% higher among adults living in food-insecure households compared with adults living in food-secure households.”
Food-insecure children have 1.17 times the odds of being overweight/obese compared with food-secure children.
A June 2019 article published in Current Developments in Nutrition, “Household Food Insecurity Is Associated with Higher Adiposity Among U.S. Schoolchildren Ages 10–15 Years” underscored the impact of food insecurity on children. Working with a sample of 5,138 U.S. schoolchildren, ASN member Lauren Au et al. found “food-insecure children have 1.17 times the odds of being overweight/obese compared with food-secure children.” As a result, food-insecure children are at higher risk for increased risk of asthma, type 2 diabetes, and orthopedic disorders. As they move into adulthood, they will be at higher risk for coronary artery disease, hypertension, stroke, chronic kidney and liver disease as well as many types of cancer.
Prenatal exposure to famine remarkably increases hyperglycemia risk in 2 consecutive generations of Chinese adults.
Food insecurity may also have an impact on the health of subsequent generations even if those generations have not experienced food insecurity. Evidence of this phenomenon is presented in “Prenatal Exposure to Famine and the Development of Hyperglycemia and Type 2 Diabetes in Adulthood across Consecutive Generations: A Population-based Cohort Study of Families in Suihua, China,” a January 2017 study published in The American Journal of Clinical Nutrition. ASN member Jie Li et al. noted that “prenatal exposure to famine remarkably increases hyperglycemia risk in 2 consecutive generations of Chinese adults independent of known type 2 diabetes risk factors.” Overall, the authors observed that “the offspring of one or both parents exposed to famine had 1.87-fold higher risk of hyperglycemia than that of offspring of nonexposed parents.”
The impact of food security extends beyond physical health, affecting mental health as well. Working with data from the 2005–2010 NHANES, ASN member Cindy W. Leung et al. discovered “a dose-response relation between the level of food insecurity and the prevalence of all depressive symptoms, with most very low food-secure adults experiencing lethargy, trouble sleeping, and feelings of depression or hopelessness.” These findings come from a March 2015 study published in The Journal of Nutrition, “Household Food Insecurity Is Positively Associated with Depression among Low-Income Supplemental Nutrition Assistance Program Participants and Income-Eligible Nonparticipants.” Other studies published in ASN journals have linked food insecurity to accelerated cognitive decline and poor sleep quality.
The dangers of food insecurity are significant and varied, affecting both physical and mental health outcomes as well as having lasting impact for subsequent generations. Fortunately, nutrition researchers have devised practical solutions to combat food insecurity as we’ll see in Part Two of this blog post.