Food Insecurity, Poor Diet Quality, and Suboptimal Intakes of Folate and Iron Are Independently Associated with Perceived Mental Health in Canadian Adults.

Karen Davison,Bonnie Kaplan,Lovedeep Gondara

doi:10.3390/nu9030274

Abstract

Background: To address nutrition-related population mental health data gaps, we examined relationships among food insecurity, diet quality, and perceived mental health. Methods: Stratified and logistic regression analyses of respondents aged 19–70 years from the Canadian Community Health Survey, Cycle 2.2 were conducted (n = 15,546). Measures included the Household Food Security Survey Module, diet quality (i.e., comparisons to the Dietary Reference Intakes, Healthy Eating Index), perceived mental health (poor versus good), sociodemographics, and smoking. Results: In this sample, 6.9% were food insecure and 4.5% reported poor mental health. Stratified analysis of food security and mental health status by age/gender found associations for poor diet quality, protein, fat, fibre, and several micronutrients (p-values < 0.05); those who were food insecure tended to have higher suboptimal intakes (p-values < 0.05). After adjustment for covariates, associations in relation to mental health emerged for food insecurity (OR = 1.60, 95% CI 1.45–1.71), poor diet quality (1.61, 95% CI 1.34–1.81), and suboptimal intakes of folate (OR = 1.58, 95% CI 1.17–1.90) and iron (OR = 1.45, 95% CI 1.23–1.88). Conclusions: Population approaches that improve food security and intakes of high quality diets may protect people from poor mental health.

Highlights

A growing body of evidence indicates relationships among food insecurity, diet quality, and mental health; their simultaneous effects are rarely studied
Food insecurity occurs when people are physically or economically unable to consume a sufficient quantity of food or have uncertainty in their ability to do so [1], and it has been associated with various indicators of mental ill health such as depression, mania, disordered eating, impaired cognition, higher internalizing and externalizing behaviours, and suicidal ideation [2,3,4,5]
After adjusting for the covariates, those with poor mental health status had an increased odds of being food insecure (OR = 1.60, 95% CI 1.45 to 1.71), having poor diet quality as measured by the Healthy Eating Index (HEI) (1.61, 95% CI 1.34 to 1.81), protein intakes below the Acceptable Macronutrient Distribution Ranges (AMDR) (OR = 1.01, 95% CI 1.00 to 1.02), and potentially inadequate intakes of folate (OR = 1.58, 95% CI 1.17 to 1.90) and iron

Summary

Introduction

A growing body of evidence indicates relationships among food insecurity, diet quality, and mental health; their simultaneous effects are rarely studied. Food insecurity occurs when people are physically or economically unable to consume a sufficient quantity of food or have uncertainty in their ability to do so [1], and it has been associated with various indicators of mental ill health such as depression, mania, disordered eating, impaired cognition, higher internalizing and externalizing behaviours, and suicidal ideation [2,3,4,5]. For indicators such as depression, the links with food insecurity and nutrition may be bidirectional [6]. Conclusions: Population approaches that improve food security and intakes of high quality diets may protect people from poor mental health

Methods

Results

Discussion

Conclusion