Association of Food Insecurity with Nutrient Intake and Depression among Korean and US Adults: Data from the 2014 Korea and the 2013-2014 US National Health and Nutrition Examination Surveys

Abstract

The purpose of this study is to understand the current status of food insecurity in Korea and the US and to compare the relationship of food insecurity with nutrient intake and depression. Data from the 2014 Korea and the 2013-2014 US National Health and Nutrition Examination Surveys were analyzed, and a total of 3102 Korean and 3234 American adults aged 20-64 years were included. Study subjects were classified into three groups according to degree of food insecurity assessed by the 18-item Household Food Security Survey Module: food secure (FS), mildly food insecure (FI 1), and moderately-to-severely food insecure (FI 2) groups. Energy and nutrient intake were assessed using a 24-h dietary recall. Depression was measured using the Patient Health Questionnaire-9 (PHQ-9) screener. The prevalence of food insecurity was 17.2% in Korea and 26.4% in the US. In both countries, the people in the FI 2 group had lower incomes and education levels and were mostly single. Energy and nutrient intake differed by food insecurity status. In both Korea and the US, adults with moderate-to-severe food insecurity (FI 2) consumed fewer proteins, fiber, potassium, and vitamin C. Additionally, the FI 2 groups had higher proportions of people not meeting the Dietary Reference Intake for protein, potassium, niacin, and vitamin C than the FS groups in Korea and the US. FI 2 people were three times more likely to be depressed than FS group; this difference was stronger in Korea than the US. We found that the prevalence of food insecurity was higher in the US than in Korea, and food insecurity was associated with reduced nutrient intake and increased odds of depression in both Korean and US adults. Therefore, food insecurity is an important public health issue at both the individual and national levels. Continuous monitoring and new intervention activities to promote food security are needed.

Keywords: KNHANES; NHANES; adult; depression; food insecurity; nutrient intake.

Figure 1

Prevalence of food insecurity in the 2014 Korea National Health and Nutrition Examination Survey (KNHANES) and 2013–2014 US National Health and Nutrition Examination Survey (NHANES) according to food insecurity status. The study subjects were divided into three groups according to their food insecurity status: (1) food secure group (FS), (2) mildly food insecure group (FI 1), (3) moderately-to-severely food insecure group (FI 2).

Figure 2

Prevalence of population not meeting the Dietary Reference Intake according to food insecurity status in the Korean adults. The study subjects were divided into three groups according to their food insecurity status: (1) food secure group (FS), (2) mildly food insecure group (FI 1), (3) moderately-to-severely food insecure group (FI 2); p-value was obtained from the Chi-square test (* p < 0.05, *** p < 0.001); KNHANES: Korea National Health and Nutrition Examination Survey.

Figure 3

Prevalence of population not meeting the Dietary Reference Intake according to food insecurity status in the US adults. The study subjects were divided into three groups according to the food insecurity status: (1) food secure group (FS), (2) mildly food insecure group (FI 1), (3) moderately-to-severely food insecure group (FI 2); p-value was obtained from the Chi-square test (* p < 0.05, ** p < 0.01, *** p < 0.001); NHANES: National Health and Nutrition Examination Survey.