Food Insecurity, Depression, and Race: Correlations Observed Among College Students at a University in the Southeastern United States

Incorporating Halal Into Healthy and Equitable Dietary Patterns to Address Food and Nutrition Security Among K-12 and University Students: A Perspective

Food and nutrition insecurity exist at an alarming rate in the US educational system, ranging from 17% among K-12 students up to 58.8% among university students. Many Muslim American students face food and nutrition insecurity due, in part, to a lack of acknowledgment of student adherence to halal dietary guidelines and the availability of certified halal options at school. This has implications for health, learning, and social outcomes. In this perspective paper, we provide short-term, mid-term, and long-term recommendations to address food and nutrition insecurity among halal-observant students to advance healthy dietary patterns.

Research trends and gaps concerning food insecurity in college students in the United States: a scoping review

OBJECTIVE

This scoping review explores the broad body of peer-reviewed research measuring food insecurity in post-secondary students in the U.S. to identify trends and gaps to inform future research.

METHODS

Three search engines (PubMed, Web of Science, and CINHAL Full Text) were systematically searched for articles reporting on food security status in U.S. college students.

RESULTS

One-hundred and sixty studies met inclusion criteria. Emerging high-risk student characteristics include gender non-conforming (GNC) and non-binary, financial independence in college, and pregnant and parenting students. Emerging correlates include lack of transportation, anxiety, and eating disorders.

CONCLUSIONS

Prevalence data can be used by colleges to advocate for services and programs. Additional multi-institutional cohort, longitudinal and qualitative studies are needed to identify timely interventions and effective solutions. A new "rights-based" approach to food security solutions that includes nutrition and food literacy for all students is needed.

Public Health Challenges for Post-secondary Students During COVID-19: A Scoping Review

Research about public health impacts of COVID-19 on post-secondary students is slowly beginning to emerge. This scoping review identified common public health challenges among post-secondary students in higher-income countries during the COVID-19 pandemic. Five databases were searched to find relevant peer-reviewed literature up to March 2022. Results were categorized according to reported public health challenges and relevant socio-economic variables. After screening, 53 articles were reviewed. Most articles were from the USA (39/53). The seven main public health challenges identified were mental health (35/53), financial instability (25/53), physical health (13/53), food insecurity (12/53), social well-being (8/53), digital access (7/53), and housing or relocation (6/53). Students with low socioeconomic status experienced heightened public health challenges. This review offers insight and opportunities for the development of longitudinal tools to support social determinants of health in post-secondary populations in high-income countries and may offer insight into similar experiences for students in other settings.

Persistent and Changing Food Insecurity Among Students at a Midwestern University is Associated With Behavioral and Mental Health Outcomes

PURPOSE

To assess associations between persistent and changing food insecurity and behavioral and mental health outcomes in college students.

DESIGN

Online surveys conducted November 2018 and March 2019 (freshman year), and March 2020 (sophomore year) were used to assess food insecurity, which was then used to create 4 food security transitions: persistent food insecurity, emergent food insecurity, emergent food security, and persistent food security.

SETTING

Large Midwestern university.

SAMPLE

593 students completing all 3 surveys.

MEASURES

Dietary intake and behavioral and mental health outcomes (eating disorders, anxiety, depression, sleep quality) were assessed using validated instruments.

ANALYSIS

Associations between food security transitions and dietary intake, behavioral, and mental health outcomes were examined using generalized linear models.

RESULTS

Compared to persistent food security, emergent and persistent food insecurity was associated with lower (7% and 13% respectively) intake of fruits and vegetables combined; persistent food insecurity was associated with 17% lower intake of fruits, 6% lower intake of fiber and 10% higher intake of added sugar from beverages. Compared to persistent food secure students, eating disorder symptom risk was higher for emergent food insecure (OR = 7.61, 95% CI: 3.32, 17.48), and persistent food insecure (OR = 6.60, 95% CI: 2.60, 16.72) students; emergent (OR = 2.05, 95% CI: 1.14, 3.71) and persistent (OR = 2.55, 95% CI: 1.34, 4.87) food insecure students had higher odds of poor sleep quality, and persistent food insecure, emergent food insecure, and emergent food secure students had higher odds of anxiety and depression (OR range 2.35-2.85).

CONCLUSION

Food security transitions were associated with aspects of low diet quality and poorer behavioral and mental health outcomes among college students.

Investigating the linkages between food insecurity, psychological distress, and poor sleep outcomes among U.S. college students

OBJECTIVE

Research overwhelmingly demonstrates that sleep is key to human health and wellbeing. Several factors likely contribute to sleep quality, including factors, such as food security and low income. In addition, exposure to structural inequalities early in life likely have downstream effects upon multiple dimensions of health. The objective of this study is to fill gaps in literature by specifically examining the associations between childhood food insecurity, current food insecurity, psychological distress, and sleep among college students.

METHODS

QR codes were randomly distributed to students, linking them to an online quantitative survey. The survey measured sociodemographic variables, food security (current and childhood), diet, mental distress, and sleep quality. A total of n = 134 completed the entire survey. Data were analyzed using binary and multiple linear regressions, as well as cross-tabulations.

RESULTS

The findings revealed that psychological distress was the primary factor influencing sleep health (𝛽 = 1.51, p < .01). Students reporting higher childhood food insecurity were more likely to experience extreme psychological distress (OR = 4.61), food insecurity in college (OR = 8.41), and lack of stable housing (OR = 5.86).

CONCLUSION

This study demonstrates that potential linkages exist between childhood food insecurity, poor sleep, and greater psychological distress. While acknowledging the contribution of other factors, the study highlights the importance of addressing food insecurity in relation to sleep health, considering the significant impact of sleep to overall health and wellbeing.

Examining the association of student mental health and food security with college GPA

BACKGROUND

Low food security and poor mental health are a persistent concern for college students.

OBJECTIVE

Examine how food security and mental health are associated with college student's grade point average (GPA).

METHODS

American College Health Association (ACHA)-National College Health Assessment III survey data Spring 2020 of students from 75 US universities (n = 48,103) were utilized to examine relationships among mental health, food security and academic performance (GPA).

RESULTS

The majority of the population self-reported high food security (58.3%) and moderate psychological distress (50.8%). Very low food security (B = -.523, OR = .59, p < .001) and moderate psychological distress (B = -0.19, OR = .83, p < .001) were inversely associated with high GPA. Reduced food security was associated with worse mental health measures.

CONCLUSIONS

Food security and mental health are negatively associated with GPA. To improve student success, universities must enhance services that address food insecurity and mental health.

COVID-Related Stressors and Psychological Distress Among Chicago Residents: the Moderating Role of Race

BACKGROUND

Racial and ethnic minorities have been disproportionately affected by the COVID-19 pandemic and have experienced greater financial loss, housing instability, and food insecurity due to COVID-related restrictions. As a result, Black and Hispanic communities may be at greater risk of experiencing psychological distress (PD).

METHODS

Using data collected between October 2020 and January 2021from 906 Black (39%), White (50%), and Hispanic (11%) adults, we assessed racial/ethnic differences in the effect of three COVID-related stressors-employment stress, housing instability, and food insecurity-on PD using ordinary least square regression.

RESULTS

Black adults reported lower PD levels compared to White adults (β =  - 0.23, P < 0.001), but Hispanic adults did not differ significantly from White adults. COVID-related housing instability (β = 0.46, P < 0.001), food insecurity (β = 0.27, P < 0.001), and employment stress (β = 0.29, P < 0.001) were associated with higher PD. Employment stress was the only stressor to differentially affect PD by race/ethnicity. Among those that reported employment stress, Black adults had lower levels of distress compared to Whites (β =  - 0.54, P < 0.001) and Hispanics (β =  - 0.04, P = 0.85).

CONCLUSION

Despite relatively high exposure to COVID-related stressors, Black respondents had lower levels of PD compared to Whites and Hispanics which may reflect differences in race-specific coping mechanisms. Future research is needed to elucidate the nuances of these relationships and identify policies and interventions that prevent and minimize the impact of employment, food, and housing-related stressors and support coping mechanisms that promote mental health among minority populations, such as policies that support easier access to mental health and financial and housing assistance.

Assessing the prevalence and potential drivers of food insecurity and the relationship with mental wellbeing in UK university students: A cross-sectional study

Food insecurity (FI) among university students in the United States has been associated with poor mental wellbeing, but very little is known about the relationship between FI and mental wellbeing in the UK university population. Here we examined the prevalence of FI, determined potential drivers for it and its relationship with mental wellbeing and coping ability. Students studying at UK universities (n = 289) completed an online self-reported questionnaire to obtain socio-economic characteristics including financial status, FI status (Household Food Insecurity Access scale), mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale) and coping ability (coping flexibility scale). FI was observed in 28% of the participants and was associated with financial independence, running out of money, borrowing money and lacking confidence to purchase healthy foods (p < 0.05). Although we cannot determine directionality, logistic regression analysis revealed those who were judged as FI were more likely to shop often (OR = 3.139 95% CI 1.533-6.429), never snacked between meals (OR = 4.261 95% CI 1.309-13.875) and the amount of food purchased was affected by perceptions of the price of food in general (OR = 2.954 95% CI 1.675-5.210). Financial instability and the inability to access nutritious food may contribute to the decrease in mental wellbeing (p < 0.01) and lower ability to cope with stressful situations (p < 0.01) in food-insecure students although the direction of these relationships cannot be determined from this cross-sectional study. This study has identified that there is a need to develop appropriate strategies to combat FI in university students and to improve mental health.

Food insecurity, Mediterranean diet adherence, and psychosocial health among university students in Türkiye

The aim was to examine the relationship between food insecurity and adherence to the Mediterranean diet, academic achievement, depression, anxiety, and stress among university students. This cross-sectional study was conducted with 2039 university students studying in Türkiye. Sixty-eight point two per cent of the students were food insecure. Food security (FS) scores were negatively associated with adherence to the MD and academic achievement, and positively associated with depression, anxiety, and stress scores. A 1-unit increase in FS score resulted in a statistically significant increase of 0.458, 0.468, and 0.400 units in depression, anxiety, and stress scores, respectively, and a significant decrease of 0.140 units in the MD adherence screener score. Food insecurity among university students in Türkiye is very common, and students with food insecurity have low adherence to the MD and low academic achievement and high depression, anxiety, and stress scores. Financial support as well as financial and food literacy provided to students play an important role in managing food insecurity.

Methods for Assessing Health Outcomes Associated with Food Insecurity in the United States College Student Population: A Narrative Review

In the United States, college students experience disproportionate food insecurity (FI) rates compared to the national prevalence. The experience of acute and chronic FI has been associated with negative physical and mental health outcomes in this population. This narrative review aims to summarize the current methodologies for assessing health outcomes associated with the experience of FI in college students in the United States. To date, assessing the health outcomes of FI has predominately consisted of subjective assessments, such as self-reported measures of dietary intake, perceived health status, stress, depression, anxiety, and sleep behaviors. This review, along with the emergence of FI as an international public health concern, establishes the need for novel, innovative, and objective biomarkers to evaluate the short- and long-term impacts of FI on physical and mental health outcomes in college students. The inclusion of objective biomarkers will further elucidate the relationship between FI and a multitude of health outcomes to better inform strategies for reducing the pervasiveness of FI in the United States college student population.

Food Insecurity during the Pandemic in South Korea: The Effects of University Students' Perceived Food Insecurity on Psychological Well-Being, Self-Efficacy, and Life Satisfaction

This study examined the impact of university students' perceptions of food insecurity on psychological well-being, self-efficacy, and life satisfaction and observed that the students' gender plays a moderating role in this causal relationship, based on a total of 491 university students who participated in this empirical study. This study used SPSS (Version 22.0) and AMOS (Version 20.0) for the analyses. This study examines the structural relationship of this causal model. Our findings suggest that students' perceived food insecurity negatively affects the status of their psychological well-being and self-efficacy. However, contrary to expectations, perceived food insecurity has no negative effects on students' life satisfaction. In addition, the level of students' psychological well-being positively influences their life satisfaction, while self-efficacy does not. The moderating effects of gender differences in this research were also disclosed. Limitations and future research directions are also discussed.

Mental Health Needs and Services Utilization among Undergraduate and Graduate Students in Texas during the COVID-19 Pandemic

COVID-19 created a global crisis, exacerbating disparities in social determinants of health (SDOH) and mental health (MH). Research on pandemic-related MH and help-seeking is scarce, especially among high-risk populations such as college/university students. We examined self-rated MH and psychological distress, the perceived need for MH services/support, and the use of MH services across the SDOH among college/university students during the start of the pandemic. Data from the COVID-19 Texas College Student Experiences Survey (n = 746) include full- and part-time undergraduate/graduate students. Regressions examined self-rated MH, psychological distress, perceived need, and service use across SDOH, controlling for pre-pandemic MH, age, gender, and race/ethnicity. Economic stability was associated with higher risk of poor MH and need for MH services/support. Aspects of the social/community context protected student MH, especially among foreign-born students. Racial discrimination was associated with both greater psychological distress and use of services. Finally, beliefs related to the sufficiency of available institutional MH resources shaped perceived need for and use of services. Although the worst of the pandemic is behind us, the inequitable distribution of the SDOH among students is unwavering. Demand for MH support is high, requiring higher education institutions to better mobilize MH services to meet the needs of students from diverse social contexts.

Assessing the relationship between food insecurity and lifestyle behaviors among university students: a comparative study between Lebanon and Germany

BACKGROUND

Food insecurity is a common public health problem in both developed and developing countries. This study aimed to profile food insecurity among university students in a developed country with stable economic circumstances (Germany) and a developing Mediterranean country undergoing a severe economic and financial crisis (Lebanon) and examine the associations between food insecurity and lifestyle behaviors (i.e., physical activity, sleep, and adherence to a healthy eating pattern, such as the Mediterranean diet), stress, and financial well-being.

METHOD

This online cross-sectional study was conducted between September 2021 and March 2022. Subjects were recruited through social media platforms (Facebook, WhatsApp, Instagram, and personal email) and in-class announcements by several university professors of various majors and from different universities in Lebanon and Germany. The final sample included 547 participants (197 from Lebanon and 350 from Germany).

RESULTS

Our findings showed a higher food insecurity rate in Lebanon compared with Germany (59% versus 33%). In the bivariate analysis, food insecurity was associated with insomnia (r = 0.230; p < 0.001) and stress (r = 0.225; p = 0.001); German university students had higher physical activity (p < 0.001), better diet quality (p < 0.001), and lower adherence to the Mediterranean diet (p < 0001) than Lebanese students. In the multivariable analyses, more stress was related to insomnia (B = 0.178; p < 0.001), while financial well-being was not associated with any of the lifestyle behaviors. Physical activity, insomnia, and Mediterranean diet adherence were not associated with the country or food insecurity (p > 0.05); however, living in Germany was associated with better diet quality (B = -7.85; p < 0.001).

CONCLUSION

The high prevalence of food insecurity reported in this study is alarming, particularly among Lebanese students; German students had better diet quality and higher physical activity but worse adherence to the Mediterranean diet. Moreover, food insecurity was also associated with worse sleep and stress. Further studies are necessary to assess the role of food insecurity as a mediating factor between sociodemographic characteristics and lifestyle behaviors.

Food insecurity and academic function among college students during the COVID-19 pandemic: A moderating role of the first-generation college student status

OBJECTIVE

To examine food insecurity (FI) prevalence among college students during the COVID-19 pandemic (April 2021) using cross-sectional design, and the moderating role of the first-generation student status in the relationship between FI and grade point average (GPA).

PARTICIPANTS

Three-hundred sixty students recruited mostly from upper-level kinesiology courses.

METHODS

General linear model was used to predict GPA based on food security status, psychological health, and bodily pain, with subgroup analysis performed by first-generation student status.

RESULTS

Approximately 19% were classified as having FI. Those with FI showed lower GPA and poor health compared to those without FI. The link between FI and GPA was moderated by first-generation student status, with the negative impact of FI on GPA more clearly observed among non-first-generation students.

CONCLUSION

First-generation student status could play a role in determining the impact of FI on academic performance.

Correlates of psychological distress among undergraduate women engaged in remote learning through a New York City college during the COVID-19 pandemic

OBJECTIVE

The study's objective is to explore psychological distress (PD) among remote learners during COVID-19.

PARTICIPANTS

Female undergraduates matriculated at an NYC college in Winter 2020.

METHODS

Using the Kessler-6 scale, we defined PD as no/low (LPD), mild/moderate (MPD), and severe (SPD) and assessed if residing in/near NYC modified associations.

RESULTS

PD was common (MPD: 34.1%, SPD: 38.9%). Students identifying as Other/Multiracial had lower MPD odds (aOR = 0.39 [0.17-0.88]). SPD was associated with identifying as White (aOR = 2.02 [1.02-3.99]), unbalanced meals (aOR = 2.59 [1.06-6.30]), violence experience (aOR = 1.77 [1.06-2.94]), no social support (aOR = 3.24 [1.37-7.64]), and loneliness (aOR = 2.52 [1.29-4.95]). Among students in/near NYC, moderate/high drug use (aOR = 2.76 [1.15-6.61]), no social support (aOR = 3.62 [1.10-1.19]), and loneliness (aOR = 2.92 [1.11-7.63]) were SPD correlates.

CONCLUSIONS

PD was high and associated with food insecurity, violence experience, no social support, and loneliness. Living in/near NYC modified drug use, loneliness, and social support associations. Mental health initiatives should address modifiable risk factors to ameliorate pandemic-associated PD.

Food security and part-time work for students: do race and region play a role?

OBJECTIVE

This study explored the relationship between weekly hours worked and food security among full-time college students in the United States, as well as the extent to which this relationship depends on racial identity and regional location.

PARTICIPANTS/METHODS

We performed a secondary analysis of data from 1,450 full-time college students in the labor force who completed the 2019 Food Security Supplement to the Current Population Survey. Moderated multiple logistic regression was used to analyze the data.

RESULTS

We found that among full-time college students in the labor force, working a greater number of hours per week was not related to one's likelihood of being food insecure, with an exception for students who identified as Asian.

CONCLUSIONS

These findings highlight the importance of considering the intertwined nature of contributing factors to food security for specific groups of students.

Food Insecurity and Depression among US Adults: NHANES 2005-2016

A growing body of evidence suggests that food insecurity is associated with adverse mental health outcomes such as depression and anxiety. In this study, the relationship between food insecurity and depression was examined using data from the 2005−2016 National Health and Nutrition Examination Survey (NHANES). Food insecurity was assessed with the 18-item United States Food Security Survey Module with zero affirmative responses indicating high food security, 1 or 2 affirmative responses indicating marginal food security, and ≥3 affirmative responses indicating food insecurity. Depression was assessed with the Patient Health Questionnaire-9 with scores ≥10 indicating depression. Data were analyzed from 28,448 adult participants aged 20 or older. Food insecurity was present in 19.2% of the sample population (n = 5452). Food security status was significantly associated with gender, race, education level, marital status, smoking status, and BMI (Rao-Scott chi-square, p < 0.05). Fully food secure and very low food security adults experienced depression at a rate of 5.1% and 25.8%, respectively (Rao-Scott chi-square, p < 0.0001). Participants with very low food security had a significantly greater odds of depression than food secure adults, OR = 3.50 (95% CI: 2.98, 4.12). These findings suggest that food insecurity is a significant risk factors for depression in US adults over 20 years of age. To address this issue in our citizenry, police initiatives and public health interventions addressing both food access and mental health should be prioritized.

Food insecurity in college students: A concept analysis

AIM

This concept analysis provides an analysis of the concept of food insecurity among college students. The purpose was to support improved identification of the population and allow for targeted assessment and intervention strategies.

BACKGROUND

Food insecurity is a problem among college students. College students experience this more than the general population and have a unique set of risk factors and consequences. This requires a comprehensive understanding of this concept to design effective interventions.

DESIGN

Concept analysis using Walker and Avant.

DATA SOURCES

Databases were searched for articles in English related to food insecurity among college students. Government reports and gray literature were also reviewed. No date limit was set.

REVIEW METHODS

Articles and reports were read and reviewed. Thirty-nine sources were included in the analysis.

RESULTS

Five defining attributes were identified: Lack of sufficient food, negative academic implications, negative physical health impacts, negative psychosocial health impacts, learning to identify, and use food resources. Definitions, antecedents, consequences, and empirical referents are described. Cases are presented.

CONCLUSIONS

The proposed definition expounds upon current definitions and identifies the unique experiences and needs of college students who experience the phenomenon. This allows for early identification and support of college students' needs regarding food.

Psychosocial Factors as Mediator to Food Security Status and Academic Performance among University Students

The interrelation between food security, academic performance, and psychosocial factors remains unclear. This study aims to identify psychosocial factors as mediators of food security status and academic performance among university students at one of Malaysia’s public universities. Respondents included 663 bachelor’s degree students from seven randomly selected programmes at the university. Data on demographic and socioeconomic characteristics, food security status (US Adult Food Security Survey Module, FSSM), psychosocial factors (DASS-21), and academic performance were collected using an online survey. The SPSS PROCESS macro was used to perform mediation analysis. The result (β = −0.0182, p < 0.001) indicates that food insecurity is associated with poor academic performance. As well as that, an increase in anxiety (β = −0.0027, p < 0.05) and depression (β = −0.0025, p < 0.05) was significant associated with a decrease in academic performance. Furthermore, anxiety and depression serve as significant mediators in the relationship between food security and academic performance. Alleviating food insecurity is not only a way to improve academic performance; it can also improve academic performance by reducing anxiety and depression.

Food insecurity is associated with eating disorders independent of depression and anxiety: Findings from the 2020-2021 Healthy Minds Study

OBJECTIVE

To examine the association between food insecurity and eating disorder (ED) risk independent of co-occurring anxiety/depression.

METHOD

Data were provided by 121,627 undergraduate/graduate students who participated in the 2020-2021 Healthy Minds Study (HMS). Participants responded to questionnaire measures of food insecurity and risk for EDs, depression, and anxiety. Established cut-offs were used to identify students with food insecurity and probable psychopathology. Separate modified Poisson regressions adjusted for age, gender, race/ethnicity, and socioeconomic background examined the association between food insecurity and each form of psychopathology. The association between food insecurity and probable ED was then examined in a regression further adjusted for probable depression and anxiety.

RESULTS

Food insecurity was significantly associated with all three forms of psychopathology when examined separately (prevalence ratios ranged from 1.41 to 1.54, all p's < .001). When accounting for probable depression/anxiety, food insecurity was significantly associated with 1.19 times greater prevalence of a probable ED (p < .001).

DISCUSSION

The association between food insecurity and EDs was replicated in a large, national sample of university students. To our knowledge, this is the first study to examine the independence of this relationship after adjusting for depression/anxiety. This finding supports the hypothesis that specific mechanisms, rather than general psychological distress, likely underlie the food insecurity-ED relationship.

Prevalence of Food Insecurity in the General College Population and Student-Athletes: a Review of the Literature

PURPOSE OF REVIEW

The purpose of this review is to examine the prevalence of food insecurity (FI) among the general college student population with a focus on student-athletes and the impact of the COVID-19 pandemic on FI in these groups.

RECENT FINDINGS

FI is estimated to be more prevalent in college students than in the general population, although ranges vary widely. Less is known about FI among college student-athletes. Data on changes in FI prevalence pre-pandemic and during is mixed. Colleges and universities should invest in interventions to address FI on their campuses, and further research on FI among student-athletes and the impact of the COVID-19 pandemic on FI is needed.

Associations Between Food Insecurity and Common Mental Health Problems Among Reproductive-Aged Women in Kabul-Afghanistan

Background: Food insecurity has been linked to poor health outcomes, however this relationship is poorly understood among women of reproductive age. Therefore, we investigated the relationship between food insecurity and common mental health problems (CMHPs) in this population of women in Kabul, Afghanistan.

Method: A cross-sectional study was conducted with 421 women of reproductive age from four health centers located in four randomly selected zones in the city of Kabul. We used the United State Department of Agriculture (USDA) food-insecurity questionnaire, multiple 24-h recall for dietary intake, the Depression, the Anxiety and Stress Scale (DASS-21) to assess major mental health problems, and the International Physical Activity Questionnaire (IPAQ) to assess physical activity.

Result: Food insecurity affected 69.6% of reproductive-aged women. In total, 44.9, 10.9, and 13.9% of food-insecure participants had food insecurity without hunger, food insecurity with hunger, and food insecurity with severe hunger, respectively. Depression, anxiety, and stress were prevalent among food-insecure participants at 89.4, 90.8, and 85.7%, respectively. Food insecurity was associated with depression (OR = 4.9, 95% CI: 2.7–8.9), anxiety (OR = 4.7, 95% CI: 2.5–8.8), and stress (OR = 3.8, 95% CI: 2.2–6.7). Women's household ownership, family size, and hypertension, on the other hand, were not associated with food insecurity.

Conclusion: This study found food insecurity was associated with CMHPs among a sample of reproductive-aged women in Kabul, Afghanistan. Further longitudinal studies are needed to confirm these findings.

Food Insecurity and Associated Factors in Brazilian Undergraduates during the COVID-19 Pandemic

Undergraduates may face challenges to assure food security, related to economic and mental distress, especially during the COVID-19 pandemic. This study aimed to assess food insecurity and its associated factors in undergraduates during the COVID-19 pandemic. An online cross-sectional study was conducted from August 2020 to February 2021 with 4775 undergraduates from all Brazilian regions. The questionnaire contained socio-economic variables, the validated Brazilian food insecurity scale, and the ESQUADA scale to assess diet quality. The median age of the students was 22.0 years, and 48.0% reported income decreasing with the pandemic. Food insecurity was present in 38.6% of the students, 4.5% with severe food insecurity and 7.7% moderate. Logistic regressions showed students with brown and black skin color/race presented the highest OR for food insecurity; both income and weight increase or reduction during the pandemic was also associated with a higher OR for food insecurity, and better diet quality was associated with decreased OR for food insecurity. Our study showed a considerable presence of food insecurity in undergraduates. Policy for this population must be directed to the most vulnerable: those with brown and black skin color/race, who changed income during the pandemic, and those presented with difficulties maintaining weight and with poor diet quality.

Digital Technology, Knowledge Level, and Food Safety Governance: Implications for National Healthcare System

Exploring the intrinsic relationship between digital technology and the efficiency of food safety supervision contributes to a better understanding of the role of digital technology in food safety supervision and how to maximize its influence. This study employed sample data from 31 regions in China between 2015 and 2017 for an empirical analysis of the correlation between the two and to examine the moderating effects of the knowledge levels of food producers and consumers. The results show that the development of digital technology contributes to enhancing the efficiency of food safety supervision. In this process, the higher the knowledge level of consumers, the greater the positive promotional effect of digital technology. On the contrary, when the knowledge level of producers is higher, it is not conducive to enhancing the effect of digital technology on the efficiency of food safety supervision. The author holds the view that this is related to the fact that employees in the food production and manufacturing industry have insufficient moral and legal knowledge. This not only limits the effect of digital technology on enhancing the efficiency of food safety supervision, but also opens the door to illegal production for some unprincipled producers. The policy implications are that digital technology should be used to improve food safety supervision, the moral and legal knowledge of food producers should be improved, and consumers should be encouraged to use digital technology more in the pursuit of food safety. Implications for national healthcare system would be also discussed in our paper.

Prevalence of food insecurity in people with major depression, bipolar disorder, and schizophrenia and related psychoses: A systematic review and meta-analysis

People with severe mental illness (SMI), such as major depression, bipolar disorder, and schizophrenia, experience numerous risk factors that may predispose them to food insecurity; however, the prevalence of food insecurity and its effects on health are under-researched in this population group. This systematic review and meta-analysis aimed to describe the prevalence and correlates of food insecurity in people with SMI. A comprehensive electronic search was conducted up to March 2021. Random effects meta-analysis was employed to determine the prevalence of food insecurity in SMI, and odds ratio (OR) of food insecurity in people with SMI compared to non-psychiatric controls/general population. Twenty-nine unique datasets (31 publications) were included. Prevalence estimate of food insecurity in people with SMI was 40% (95% CI 29-52%, I² = 99.7%, N = 27). People with SMI were 2.71 (95% CI 1.72-3.25) times more likely to report food insecurity than the comparator group (Z = 11.09, p < 0.001, I² = 95%, N = 23). The odds of food insecurity in SMI were higher in high/high-middle income countries compared to low/low-middle income countries, likely due to the high food insecurity rates in the general population of lower income countries. There was no difference in food insecurity rates by diagnosis. Food insecurity should be a consideration for health professionals working with community-dwelling people with SMI.

Food Insecurity: Is It a Threat to University Students' Well-Being and Success?

Food insecurity is a growing concern among university students. The high prevalence of food insecurity is a threat to students' health and success. Therefore, this study aims to determine an association between food security status, psychosocial factors, and academic performance among university students. A total of 663 undergraduate students in seven randomly selected faculties in Universiti Putra Malaysia participated in this study. An online survey was conducted to obtain demographic and socioeconomic characteristics, food security status (six-item USDA; food security survey module, FSSM), psychosocial factors (depression, anxiety and stress scale, DASS-21) and academic performance. Among the abovementioned participating students, 32.4% are male. About 62.8% reported to have experienced food insecurity. Binary logistic regression revealed that students whose fathers were working (AOR = 6.446, 95% CI: 1.22, 34.01) came from low- (AOR = 14.314, 95% CI: 1.565, 130.954) and middle-income groups (AOR = 15.687, 95% CI: 1.720, 143.092), and those receiving financial aid (AOR = 2.811, 95% CI: 1.602, 4.932) were associated with food insecurity. Additionally, food insecurity students were less-likely reported, with CGPA ≥ 3.7 (AOR = 0.363, 95% CI: 1.22-34.014). Food insecurity respondents had higher odds for stress (AOR = 1.562, 95% CI: 1.111, 2.192), anxiety (AOR = 3.046, 95% CI: 2.090, 4.441), and depression (AOR = 2.935, 95% CI: 2.074, 4.151). The higher institutions should identify students with food insecurity problems and future intervention programs need to be conducted to combat food insecurity among students, thus yielding benefits to their health and success.