Association between food insecurity and depressive symptoms among adolescents aged 12-15 years from 22 low- and middle-income countries

Lee Smith, Guillermo F. López Sánchez, Hans Oh, Masoud Rahmati, Mark A. Tully, Dong Keon Yon, Laurie Butler, Yvonne Barnett, Graham Ball, Jae Il Shin, Ai Koyanagi

Research output: Contribution to journalArticlepeer-review


Food insecurity may be a risk factor for depression in adolescents. However, data on this topic from low- and middle-income countries (LMICs) are scarce, despite food insecurity being most common in LMICs. Therefore, we aimed to examine the association between food-insecurity and depressive symptoms among school-going adolescents from 22 LMICs. Cross-sectional data from the Global school-based Student Health Survey were analyzed. Self-report measures assessed past 12-month depressive symptoms and past 30-day food insecurity (hunger). Multivariable logistic regression and meta-analysis were conducted to assess associations. Data on 48,401 adolescents aged 12–15 years were analyzed [mean (SD) age 13.8 (0.9) years; 51.4 % females]. The prevalence of depressive symptoms was 29.3 %, and those of moderate and severe food insecurity were 45.0 and 6.3 %, respectively. After adjustment for potential confounders, compared to no food insecurity, the pooled OR (95 %CI) of moderate and severe food insecurity were 1.36 (1.30–1.42) and 1.81 (1.67–1.97), respectively. The level of between-country heterogeneity was low. Food insecurity was associated with significantly higher odds for depressive symptoms among adolescents in LMICs. Policies to address food insecurity may also help prevent depression in this population, pending future longitudinal research.

Original languageEnglish
Article number115485
Pages (from-to)1-7
Number of pages8
JournalPsychiatry research
Early online date17 Sept 2023
Publication statusPublished (in print/issue) - Oct 2023

Bibliographical note

Funding Information:
This paper uses data from the Global School-Based Student Health Survey (GSHS). GSHS is supported by the World Health Organization and the US Centers for Disease Control and Prevention.

Funding Information:
Dr. Guillermo F. López Sánchez is funded by the European Union – Next Generation EU.

Publisher Copyright:
© 2023


  • Adolescents
  • Depression
  • Epidemiology
  • Food insecurity
  • Hunger
  • Mental health
  • Multi-country


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