Association of Food Insecurity with Nutrient Intake and Depression among Korean and US Adults: Data from the 2014 Korea and the 2013-2014 US National Health and Nutrition Examination Surveys.

Seung Jae Lee,Mi Sook Cho,Kyung Won Lee

doi:10.3390/ijerph18020506

Abstract

The purpose of this study is to understand the current status of food insecurity in Korea and the US and to compare the relationship of food insecurity with nutrient intake and depression. Data from the 2014 Korea and the 2013–2014 US National Health and Nutrition Examination Surveys were analyzed, and a total of 3102 Korean and 3234 American adults aged 20–64 years were included. Study subjects were classified into three groups according to degree of food insecurity assessed by the 18-item Household Food Security Survey Module: food secure (FS), mildly food insecure (FI 1), and moderately-to-severely food insecure (FI 2) groups. Energy and nutrient intake were assessed using a 24-h dietary recall. Depression was measured using the Patient Health Questionnaire-9 (PHQ-9) screener. The prevalence of food insecurity was 17.2% in Korea and 26.4% in the US. In both countries, the people in the FI 2 group had lower incomes and education levels and were mostly single. Energy and nutrient intake differed by food insecurity status. In both Korea and the US, adults with moderate-to-severe food insecurity (FI 2) consumed fewer proteins, fiber, potassium, and vitamin C. Additionally, the FI 2 groups had higher proportions of people not meeting the Dietary Reference Intake for protein, potassium, niacin, and vitamin C than the FS groups in Korea and the US. FI 2 people were three times more likely to be depressed than FS group; this difference was stronger in Korea than the US. We found that the prevalence of food insecurity was higher in the US than in Korea, and food insecurity was associated with reduced nutrient intake and increased odds of depression in both Korean and US adults. Therefore, food insecurity is an important public health issue at both the individual and national levels. Continuous monitoring and new intervention activities to promote food security are needed.

Highlights

Introduction nal affiliationsThe term “food insecurity” was introduced by Campbell in 1990 [1] to indicate a limited availability of nutritionally adequate and safe foods or a limitation or uncertainty in the ability to acquire acceptable foods in socially acceptable ways [2,3]
This study identified and compared the current status of food insecurity in Korean and American adults aged 20–64 years using data from the 2014 Korea NationalHealth and Nutrition Examination Survey (KNHANES) and the 2013
We found that food insecurity was strongly related to depression according to participants’ responses to the Patient Health Questionnaire-9 (PHQ-9) questionnaire

Summary

Introduction

Introduction nal affiliationsThe term “food insecurity” was introduced by Campbell in 1990 [1] to indicate a limited availability of nutritionally adequate and safe foods or a limitation or uncertainty in the ability to acquire acceptable foods in socially acceptable ways [2,3]. Food insecurity is one of the most significant global public health issues, and poor nutrition is a critical cause of chronic health issues, including mental and physical health problems [4,5,6]. In Korea, a recent study using data from the fifth Korea National. Health and Nutrition Examination Survey (KNHANES) reported that food insecurity prevalence was 11.3% among Korean adults [8]. France showed that only 14.0% were food secure, 43.3% had low food security, and 9.8%. Had very low food security [9]. It has been reported that food insecurity is

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