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      Impact of food insecurity with hunger on mental distress among community-dwelling older adults

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          Abstract

          Background

          Hunger frequently and persistently occur in older populations in low-income countries especially in sub-Sahara Africa. The aim of this study was to examine the associations between food insecurity with hunger and psychological distress among older people in Ghana.

          Methods

          A total of 1200 individuals aged ≥50 years were recruited during 2016/2017 Ageing, Health, Psychological Well-being and Health-seeking Behavior Study. Associations between psychological distress (assessed with the Kessler Psychological Distress Scale) and hunger (assessed with a 30-day subjective scale) were evaluated using linear regression modeling.

          Results

          The overall prevalence of food insecurity was 36% with approximately 27% and 9% respectively for moderate and severe levels of hunger whilst the mean score of psychological distress was 9.5 (±4.10). Persons experiencing moderate hunger (β = 0.71, SE = 0.160, p < 0.001) and severe hunger (β = 1.81, SE = 0.280, p < 0.001) significantly reported increased psychological distress outcome compared to those without hunger. These associations varied between women (β = 1.59, SE = 0.359 p < 0.001) and men (β = 2.33, SE = 0.474, p < 0.001) as well as 50–64 age group (β = 1.48, SE = 0.368, p < 0.005) and 65+ age group (β = 2.51, SE = 0.467, p < 0.001).

          Conclusions

          The results suggest that experiencing hunger is associated with psychological distress and the effect may be aggravated with advancing age and in men. These findings may inform social policy initiatives and health programmatic interventions for older people exposed to food insecurity.

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          Most cited references24

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          Moving beyond hunger and nutrition: a systematic review of the evidence linking food insecurity and mental health in developing countries.

          Food insecurity is a significant problem in the developing world, and one that is likely to increase given the current global food crisis spurred by rising oil prices, conversion of food to biofuels, and reduced harvests in the wake of natural disasters. The impacts of food insecurity on nutrition status, growth, and development are well substantiated; less is known about the non-nutritional impacts of food insecurity, such as its effects on mental health. This systematic review assesses current findings regarding the impacts of food insecurity on mental health in developing countries. Both qualitative and quantitative studies are considered. The results of the search reveal that little work has examined these issues directly, and serious methodological flaws are present in many of the existing studies. Gaps in the literature, implications, and research priorities are discussed.
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            Food Security and the 2015–2030 Sustainable Development Goals: From Human to Planetary Health

            Abstract Food security exists when “all people, at all times have physical and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life” (http://www.fao.org/wfs/index_en.htm). Close to 800 million individuals do not have access to enough food, >2 billion individuals experience key micronutrient deficiencies, and ∼60% of individuals in low-income countries are food insecure. Food insecurity negatively affects human physical, social, emotional, and cognitive development throughout the life course and is a major social and environmental disruptor with serious repercussions for planetary health (i.e., the health of human civilization and the state of the natural systems on which it depends). Food security is related to all of the United Nations Sustainable Development Goals (SDGs). Improved food security governance based on sound, equitable, and sustainable food systems that benefit from modern information and sustainable and equitable agricultural technologies is essential for countries to meet the SDGs.
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              Food insecurity in rural Tanzania is associated with maternal anxiety and depression.

              Food insecurity is a major health problem that has pervasive effects on many human biological outcomes. In particular, there are compelling theoretical and empirical reasons to expect that the relationship between food insecurity may be directly related to mental health morbidities, and may be quantifiable in developing country settings. This preliminary study examined whether caretaker reports of food insecurity were associated with anxiety and depression among four ethnic groups in two communities of rural Tanzania. In-home interviews were conducted in June-August of 2005 among female caretakers (n = 449). In addition to collecting household and demographic data, modified versions of the USDA's food security module and Hopkins Symptom Checklist (HSCL) were used to measure food insecurity and anxiety and depression. Consistent with predictions, the results showed a strong positive correlation between a caretaker's score on the food insecurity instrument and her summed response on the HSCL (P < 0.0001). This association was maintained in all four ethnic groups, even when controlling for individual-level covariates such as caretaker's age and marital status. Issues of causality and hypotheses that might explain this robust finding are discussed, as are methodological and theoretical implications.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: Data curationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                31 March 2020
                2020
                : 15
                : 3
                : e0229840
                Affiliations
                [1 ] African Population and Health Research Center (APHRC), Nairobi, Kenya
                [2 ] Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
                [3 ] Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
                Universidad de La Frontera, CHILE
                Author notes

                Competing Interests: The authors have declared that no competing interests exist

                Author information
                http://orcid.org/0000-0002-6733-1539
                Article
                PONE-D-19-29744
                10.1371/journal.pone.0229840
                7108730
                32231372
                62fb095e-b50d-4c18-8fdc-4c7afc57b755
                © 2020 Gyasi et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 25 October 2019
                : 14 February 2020
                Page count
                Figures: 0, Tables: 3, Pages: 11
                Funding
                Funded by: Lingnan University
                Award ID: RPG1129310
                Award Recipient :
                This work was supported by Lingnan University, Hong Kong [RPG 1129310] to RMG ( https://www.ln.edu.hk/about-lu/introducing-lingnan). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                People and Places
                Population Groupings
                Age Groups
                Elderly
                Medicine and Health Sciences
                Health Care
                Socioeconomic Aspects of Health
                Medicine and Health Sciences
                Public and Occupational Health
                Socioeconomic Aspects of Health
                Medicine and Health Sciences
                Mental Health and Psychiatry
                People and Places
                Population Groupings
                Age Groups
                Biology and Life Sciences
                Developmental Biology
                Organism Development
                Aging
                Biology and Life Sciences
                Physiology
                Physiological Processes
                Aging
                Medicine and Health Sciences
                Physiology
                Physiological Processes
                Aging
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Mood Disorders
                Depression
                People and Places
                Geographical Locations
                Africa
                Ghana
                Biology and Life Sciences
                Nutrition
                Diet
                Alcohol Consumption
                Medicine and Health Sciences
                Nutrition
                Diet
                Alcohol Consumption
                Custom metadata
                Upon another contact with the Ethics Committee of the Lingnan University, the data for this paper has currently been released to me and made freely available for public access and use without any institutional restrictions. In this regard, I have the authority to display the data freely without contacting the copyright holders for registration and access. I would be able to submit the data to the journal's website upon acceptance of the paper

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                Uncategorized

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