Association between Depressive Symptoms and Food Insecurity among Indonesian Adults: Results from the 2007-2014 Indonesia Family Life Survey

Comparison of the Associations between Self-Reported Sleep Quality and Sleep Duration Concerning the Risk of Depression: A Nationwide Population-Based Study in Indonesia

There is substantial evidence that a lack of sleep quality and duration can increase the risk of depression in adults. Still, few studies have compared sleep quality and duration to the risk of depression in Indonesia. Therefore, this study aimed to compare the prevalence and risk of depression associated with both sleep quality and duration and identified those factors associated with sleep quality with sleep duration. This study was a cross-sectional study, and the data were obtained from the 2014 Indonesian Family Life Survey, with a total sample comprised of 19,675 respondents aged older than 15 years old. A self-reported questionnaire was used to assess sleep quality and duration. Depression was assessed using the Center for Epidemiologic Studies Depression (CESD-10) questionnaire. Logistic regression was used to examine the risk of depression, and multinomial logistic regression was used to examine the risk of poor sleep quality with consideration to sleep duration. The prevalence of depression was the highest in the poor sleep quality and long sleep duration groups (48.5%). After all variables associated with depression were adjusted, poor sleep quality was identified as a factor leading to a higher risk of depression (OR = 4.2; 95% CI: 3.7-4.6; p < 0.001) than long sleep duration (OR = 1.4; 95% CI: 1.2-1.6; p < 0.001). Furthermore, the interaction between poor sleep quality and long sleep duration gave the highest risk of depression (OR = 4.4; 95% CI: 3.6-5.3); p < 0.001). Multinomial logistic regression revealed that the factors leading to a significant increase in the risk of poor sleep quality, with consideration to sleep duration, in the population were age, gender, marital status, education, wealth index, physical activity, chronic illness, season, and urban area (p < 0.05). Sleep quality was found to be associated with a higher risk of depression than sleep duration. The findings of this study may be beneficial to healthcare professionals who develop health promotion strategies for reducing the incidence of depression in communities.

Relationship between dietary niacin intake and diabetes mellitus in the National Health and Nutrition Examination Survey (NHANES) 2003-2018

PURPOSES

Previous studies show inconsistent associations between niacin supplementation and diabetes mellitus (DM) in high-risk population, but little is known about the relationship between dietary intake of niacin and DM in the generation population. Our study aimed to explore the associations of dietary niacin intake with the risk of DM in the United States (US) adult population.

METHODS

These data were derived from the National Health and Nutrition Examination Survey (NHANES) 2003-2018 of 35,606 individuals aged 20 years or older. Niacin intake and food sources were measured by two 24-h dietary recall interviews. The diagnosis of DM was established according to the American Diabetes Association (ADA) criteria. Binary logistic regression and restricted cubic spline models were applied to evaluate the association of dietary niacin intake and DM.

RESULTS

Among the 35,606 individuals, the prevalence of DM was 11.47%. The full-adjusted odds ratio(aOR) of DM was 1.27(95%CI 1.06-1.52) for quartile (Q) 4 v. Q1 of dietary niacin intake. In the dose-response analysis, the shape of the association of niacin intake with the risk of DM was approximately J-shaped (non-linear, p < 0.05). Energy-adjusted niacin of 26.08 mg/day was the optimal cut-off value for predicting DM.

CONCLUSIONS

High dietary niacin intake was positively associated with DM among US adults.

LEVEL OF EVIDENCE

Level V: Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Childhood socioeconomic status and adulthood dietary diversity among Indonesian adults

Food insecurity problems still exist among people in low-to-middle income countries. The long-term disadvantages of socioeconomic status may contribute to chronic food insecurity. However, whether childhood socioeconomic status factors are related to food insecurity in adulthood remains unclear. Thus, the aim of this study was to test the association between childhood socioeconomic status factors and one of the proxies for adulthood food security, dietary diversity. This study used the 2014 RAND Indonesia Family Life Survey dataset with 22,559 adult participants as study samples. The childhood socioeconomic status factors consisted of 16 questions about the participants’ conditions when they were 12 years old. Adult dietary diversity was assessed using the United Nations World Food Programme’s food consumption score. A linear regression model was used to analyze the association between variables. This study found that the number of owned books (β coef.: 3.713–7.846, p < 0.001), the use of safe drinking-water sources (β coef.: 0.707–5.447, p < 0.001–0.009) and standard toilets (β coef.: 1.263–4.955, p < 0.001–0.002), parents with the habit of alcohol consumption (β coef.: 2.983, p = 0.044) or the combination with smoking habits (β coef.: 1.878, p < 0.001), self-employed with the permanent worker (β coef.: 2.904, p = 0.001), still married biological parents (β coef.: 1.379, p < 0.001), the number of rooms (β coef.: 0.968, p < 0.001), people (β coef.: 0.231, p < 0.001), and younger siblings (β coef.: 0.209–0.368, p < 0.001–0.039) in the same house were positively and significantly associated with the outcome variable. Furthermore, in the order of childhood socioeconomic status factors, self-employment without permanent workers and casual work types (β coef.: –9.661 to –2.094, p < 0.001–0.001), houses with electricity facilities (β coef.: –4.007, p < 0.001), and parents with smoking habits (β coef.: –0.578, p = 0.006) were negatively and significantly associated with the food security proxy. In conclusion, childhood and early socioeconomic disadvantage is related to adult food security status and may lead to poor health.

Depression is Associated with the Increase Risk of Multimorbidity Among the General Population in Indonesia

Purpose

Depression is common among patients with chronic disease. However, little is known about the association between depression and the risk of developing multimorbidity. This study aims to identify the association between depression and the incidence of multimorbidity among the general population in Indonesia.

Patients and Methods

The national cross-sectional population-based survey used publicly available data from the Indonesian Family Life Survey (IFLS-5) for 2014 among respondents aged ≥15 years. Depression was assessed using the Center for Epidemiologic Studies-Depression (CES-D) scale. The number of chronic diseases and amount of sociodemographic information were obtained from self-reported data. A logistic regression analysis was used to assess the association between depression and multimorbidity, adjusting for confounders. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported.

Results

The study recruited 2222 respondents; the majority of them were male (68.0%) and aged 55–64 years (34.7%). Of the total number of respondents, 69.6% have depression and 36.5% have multimorbidity. The prevalence of depression in respondents increases with age. Depressive symptoms were more likely to report multimorbidity (OR 2.05, 95% CI: 1.66–2.52).

Conclusion

Depression is associated with the increased risk of multimorbidity among the general population in Indonesia. Therefore, screening for and treatment of depression for those at risk of developing multimorbidity are urgently needed.

Chronic pain and depressive symptoms are related to food insecurity among urban food bank users

BACKGROUND

Food bank users suffer high food insecurity. Food insecurity increases risk for chronic health conditions. However, chronic pain and its relation to food insecurity among food bank users is unknown. Knowledge about populations with chronic pain is important to direct appropriate public health nutritional strategies.

METHODS

Participants completed a survey including sleep, pain, depressive symptoms and food insecurity measures. Descriptive statistics characterized the burden of chronic pain among the sample, and a series of chi-square and t-tests assessed for demographic differences between food bank users who reported pain compared to those who did not. Logistic regression tested for variables predicting food insecurity.

RESULTS

Within the sample (N = 207), 53% reported a chronic pain diagnosis. Adults with pain were more likely to receive food stamps and to have a mental health condition than those without pain. Regression analyses revealed that depressive symptoms and chronic pain significantly predicted food insecurity when controlling for age and gender.

CONCLUSIONS

Exploring the link between depression, pain and nutritional resources may enhance understanding of causal relationships driving food insecurity. Public health officials should address nutritional needs of adults including those with chronic pain who use food bank services.

The longitudinal relation between depressive symptoms and change in self-rated health: A nationwide cohort study

OBJECTIVE

This study aimed to prospectively assess the relationship between depressive symptoms and change in self-rated health (SRH) in middle-aged and elderly Chinese adults.

METHODS

We used data from the China Health and Retirement Longitudinal Study (CHARLS). The final analysis included 8169 participants (≥45 years old) and a multinomial logistic regression model was used to assess the association between baseline depression and follow-up change in SRH.

RESULTS

Taking no change in SRH as the reference, depressive symptoms at baseline were positively associated with a 2-year decline in SRH (OR: 1.38, 95% CI: 1.15-1.65) and negatively associated with a 2-year improvement in SRH (OR: 0.74, 95% CI: 0.63-0.85). Over a 4-year period, the OR (95% CI) values increased to 1.41 (1.19-1.67) and decreased to 0.69 (0.59-0.80) for decline and improvement in SRH, respectively. In stratified analyses, the association between depression and 2- or 4-year decline/improvement in SRH persisted in all sex and age subgroups.

CONCLUSIONS

Baseline depression is an independent predictor of change in SRH among Chinese people aged 45 and above. Early monitoring and management of depressive symptoms may be worthwhile to maintain and improve SRH in the middle-aged and elderly population.

Association between food insecurity and depression among older adults from low- and middle-income countries

BACKGROUND

To examine the association between self-reported food insecurity and depression in 34,129 individuals aged ≥50 years from six low- and middle-income countries (LMICs) (China, Ghana, India, Mexico, Russia, and South Africa).

METHODS

Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Self-reported past 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Questions based on the World Mental Health Survey version of the Composite International Diagnostic Interview were used for the endorsement of past 12-month DSM-IV depression. Multivariable logistic regression analysis and meta-analysis were conducted to assess associations.

RESULTS

In total, 34,129 individuals aged ≥50 years [mean (SD) age, 62.4 (16.0) years; 52.1% females] were included in the analysis. Overall, the prevalence of moderate and severe food insecurity was 6.7% and 5.1%, respectively, while the prevalence of depression was 6.0%. Meta-analyses based on countrywise estimates showed that overall, moderate food insecurity (vs. no food insecurity) is associated with a nonsignificant 1.69 (95% confidence interval [CI] = 0.82-3.48) times higher odds for depression, while severe food insecurity is significantly associated with 2.43 (95% CI = 1.65-3.57) times higher odds for depression.

CONCLUSIONS

In this large representative sample of older adults from six LMICs, those with severe food insecurity were over two times more likely to suffer from depression (compared with no food insecurity). Utilizing lay health counselors and psychological interventions may be effective mechanisms to reduce depression among food-insecure populations. Interventions to address food insecurity (e.g., supplemental nutrition programs) may reduce depression at the population level but future longitudinal studies are warranted.

Food insecurity, state fragility and youth mental health: A global perspective

Youth in fragile settings face disproportionate risks of experiencing food insecurity and poor mental health. Cross-national evidence is lacking on the association between food insecurity and mental health in youth populations, and on state fragility as a social determinant of these experiences. We analysed data from six cycles of the Gallup World Poll (2014–2019), an annual survey that contains multi-item scales of food insecurity, mental health problems and positive wellbeing. The analytic sample included 164,118 youth aged 15–24 years in 160 states. We linked individual responses to state-level data from the Fragile States Index—an aggregate measure of state vulnerability to collapse or conflict (coded: sustainable, stable, warning, or alert) and estimated adjusted relative risk (RR) of food insecurity as a function of state fragility. We then used linear regression to examine associations of state fragility and food insecurity with mental health and wellbeing. The prevalence of moderate or severe food insecurity rose from 22.93% in 2014 to 37.34% in 2019. State fragility (alert vs. sustainable) was related to an increased risk of food insecurity (RR = 2.28 [95% CI 1.30 to 4.01]), more mental health symptoms (b = 6.36 [95% CI 1.79 to 10.93]), and lower wellbeing (b = −4.49 [95% CI -8.28 to −0.70]) after controlling for state wealth and household income. Increased food insecurity (severe vs. none or mild) was uniquely related to more mental health symptoms (b = 18.44 [95% CI 17.24 to 19.64]) and reduced wellbeing (b = −9.85 [95% CI -10.88 to −8.83]) after state fragility was also controlled. Globally, youth experience better mental health where states are more robust and food access is more secure. The findings underscore the importance of strong governance and coordinated policy actions that may improve youth mental health.

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More than 2 billion people lack reliable access to sufficient and nutritious food.

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Globally, food security is foundational to youth mental health and well-being.

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Youth in more fragile states are less food secure and have worse mental health.

Associated factors of depression among young adults in Indonesia: A population-based longitudinal study

BACKGROUND/PURPOSE

Depression is highly prevalent among young adults in Indonesia; despite this, information pertaining to the associated factors of depression remains scarce. In this study, we aimed to identify these associated factors among young adults in Indonesia by using a longitudinal study design.

METHODS

We undertook secondary data analyses of the Indonesia Family Life Survey. Questionnaires related to smoking behavior, acute morbidities, perceived health, experience of natural disasters, and sociodemographic records from 2007 were used as independent variables and depression in 2014 was used as the outcome variable. The generalized estimating equation (GEE) approach was used to investigate the associated factors of depression.

RESULTS

The prevalence of depression among 1960 young adults was 27.86%. Based on the GEE results, perceived health was significantly negatively correlated with depression in 2014 (p < .001), whereas smoking behavior, smoking cessation, and acute morbidities in 2007 were significantly positively correlated with depression in 2014 (p < .001).

CONCLUSION

We report that the early identification of depression in this population is pivotal and relevant associated factors should be considered when developing preventive programs to avoid depression in the community.

The Relationship between Food Security Status and Sleep Disturbance among Adults: A Cross-Sectional Study in an Indonesian Population

Background: The relationship between food insecurity and the experience of sleep disturbance has received little attention among researchers, although food insecurity is associated with poor physical and mental health globally. This study aimed to investigate the relationship between food security status and sleep disturbance among adults 20–64 years old. Methods: The study’s population-based sample included 20,212 Indonesian adults who participated in the fifth wave of the Indonesia Family Life Survey (IFLS5) in 2014. Dietary intake data, gathered using a food frequency questionnaire (FFQ), were used to assess the food security status. Sleep disturbance was assessed using the 10-item Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaire. We used multiple linear and logistic regression models to test the study hypothesis. Results: A higher likelihood of experiencing sleep disturbance was recorded in people aged older than 56 years (OR = 1.78, 95% CI: 1.17–2.72, p = 0.007), people with depressive symptoms (OR = 3.57, 95% CI: 2.77–4.61, p < 0.001), and food-insecure people (OR = 1.32, 95% CI: 1.02–1.70, p = 0.036). A lower likelihood of experiencing sleep disturbance was recorded in people with low educational attainment (OR = 0.41, 95% CI: 0.30–0.57, p < 0.001). Sleep disturbance was dependent on the food consumption groups and food security status among men (p = 0.004). Conclusions: Sleep disturbance may be affected by the food-insecure status of adults, and later, may lead to serious health outcomes.