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Explore the relationship between water insecurity and food security and their covariates in Mexican households.
Design:
A cross-sectional study with nationally representative data from the National Health and Nutrition Survey-Continuous 2021 (in Spanish, ENSANUT-Continua 2021), collected data from 12,619 households.
Setting:
Water insecurity was measured using the Household Water Insecurity Experiences (HWISE) Scale in Spanish and adapted to the Mexican context. Food security was measured using the Latin American and Caribbean Food Security Scale (ELCSA). A generalized path model was used to produce two simultaneous logistical regression equations--of water insecurity (WI, HWISE ≥12) and moderate-to-severe food insecurity (FI)—to understand key covariates as well as the contribution of WI to FI.
Participants:
The head of the household, an adult of >18 years of age, consented to participate in the survey.
Results:
Households experiencing WI were more likely to experience moderate to severe FI (OR=2.35; 95%CI: 2.02-2.72). The odds of WI were lower in households with medium (OR=0.74; 95%CI: 0.61-0.9) to high (OR=0.45; 95%CI: 0.37-0.55) asset scores. Water insecurity also depended on the region of Mexico. FI is more prevalent in Indigenous people (OR=1.29; 95%CI: 1.05-1.59) and rural households (OR=0.42; 95%CI: 1.16-1.73). Notably, wealth and household size did not contribute directly to FI but did so indirectly through the mediating factor of WI.
Conclusions:
Our study shows that there are structural factors that form part of the varied determinants of water insecurity, which in turn is closely linked to food insecurity.
Food insecurity remains a global issue, particularly in developing countries like Ethiopia. Thus, this study focused on identifying factors contributing to food insecurity and the strategies used to cope with it among agrarian and pastoralist communities of South Ari and Benatsemay Woreda, respectively. A facility-based qualitative study was carried out in Southern Ethiopia. Participants were selected using a purposefully targeting health extension workers, health centre directors, woreda programme experts, district health managers, and pregnant women staying in maternity waiting homes. The selection process included one health facility from each district, focusing on those with the highest number of pregnant women in maternity waiting homes. A total of 17 participants were involved in in-depth interviews, and 2 focus group discussions were conducted with 27 pregnant women, continuing until data saturation was achieved. Field notes were taken, and sessions were voice recorded. Participants in both in-depth interviews and focus group discussions frequently identified several causes of food insecurity in the community, such as food shortages, climate change, rising prices of agricultural products, inadequate agricultural technology, scarcity of farmland, and income constraints. Tailored intervention is highly demanding to implement policies to stabilise food supply chains and mitigate food shortages in both agrarian and pastoralist areas, invest in modern agricultural technologies to boost productivity, encourage the adoption of climate-smart agricultural practices to help farmers adapt to changing weather patterns, optimise the productive use of available farmland, promote income-generating activities, and diversify livelihoods to alleviate income constraints and improve food security.
Free school meals (FSM) are a crucial form of support for families. This study aimed to investigate whether the FSM allowance can provide what is perceived to be, healthy, sustainable, and satisfying food.
Design:
A mixed methods study incorporating co-production, citizen science and participatory approaches was conducted. Citizen scientists were given a daily budget equivalent to the FSM allowance and asked to purchase a ‘tasty, healthy and sustainable’ school lunch for a week. Alongside keeping records of available and purchased foods, young people engaged in focus groups to capture information on perceptions of food offered and FSM allowance adequacy.
Setting:
Secondary schools in Yorkshire, UK.
Participants:
Citizen scientists (n=42) aged 11-15 years across seven schools.
Results:
Obstacles were faced in obtaining sustainable and healthful meals when restricted to an FSM allowance. Reasons included restrictions in what could be purchased due to costs, limitations in the use of allowances that restricted breaktime purchases leading to hunger, inadequate portion sizes, systemic barriers like hurried lunch breaks that encourage “grab and go” options, and broken water fountains that led students to purchase bottled drinks. Findings were reinforced by descriptive food record data.
Conclusions:
Our findings suggest that schools would benefit from national policies to address the lack of funding, infrastructure issues and capacity to support optimal provision of food to those on FSM as well as provide greater flexibility in how pupils use their allowance. Young people verified these findings, which they presented to policy-makers at a parliamentary event.
Despite the recognised links between food insecurity and parenting, few studies have evaluated the perceived impacts of livelihood or food security interventions on parental practices, intra-household functioning, adolescent behaviour and psychosocial outcomes in HIV-affected households in sub-Saharan Africa.
Aims
The study aimed to understand the perceived effects of food security on parenting practices and how this was experienced by both adolescent girls (aged 13–19 years) and their caregivers in rural Kenya.
Method
We conducted semi-structured, individual interviews with 62 caregiver–adolescent dyads who were participants in the adolescent Shamba Maisha (NCT03741634), a sub-study of adolescent girls and caregivers with a household member participating in the Shamba Maisha agricultural and finance intervention trial (NCT01548599). Data were analysed following the principles of thematic analysis.
Results
Compared to control households, the Shamba Maisha intervention households had improved food security and strengthened economic security, which, in turn, improved parenting practices. Intervention households described changes in parenting experiences, including decreased parental stress, reduced absenteeism and harsh parenting and improved caregiver– adolescent relationships. These positive caregiving practices, in turn, contributed to improved mental health and fewer behavioural problems among adolescent girls. Changes in the control households were less noticeable.
Conclusion
These findings demonstrate how an income-generating agricultural intervention may improve food security and positively affect parenting practices, intra-household dynamics and adolescent psychosocial well-being and behaviour. Further research is needed to explore how to harness the social benefits of agricultural interventions to best address the critical intersections among food insecurity, parenting practices and adolescent mental health.
The COVID-19 pandemic has presented multifaceted challenges globally, impacting adolescent health. Among these, food security and nutrition are intertwined closely with mental health outcomes. In Indonesia, with its diverse socio-economic landscape, these interconnections may have been exacerbated by the pandemic. This study investigated the relationship between food security, nutrition and adolescent mental health in Indonesia during COVID-19. Longitudinal data were collected from 511 adolescent boys and girls in 2021–2022 in Gunungkidul district, Yogyakarta. Food security was measured using the Household Food Insecurity Access Scale (HFIAS), and the validated Kessler-10 Psychological Distress Scale (K10) was used to measure adolescent depression. Multivariate linear regression and linear mixed-effects regression were employed to explore associations between these variables, while adjusting for sex, age, pubertal status and household income. Overall, food insecurity score was positively associated with depressive symptoms (β: 0·72, 95 % CI 0·52, 0·92), while BMI z-score was inversely associated (β: −0·31, 95 % CI 0·68, −0·03). We found an increase in strength of association between food insecurity and depressive symptoms over time (moderately food-insecure: β: 1·36 (95 % CI −0·10, 2·83) to 4·63 (95 % CI 2·17, 7·09); severely food-insecure: β: 1·89 (95 % CI 0·36, 3·41) to 3·30 (95 % CI 1·50, 5·10). Enhancing food access, improving nutritional status and providing mental health support are crucial components of adolescent health.
To investigate the association between food insecurity (FI) and diet quality in private sector service workers.
Design:
Data were collected via electronic questionnaires (2019) and the national register data (2018–2019). FI was measured using the Household Food Insecurity Access Scale (HFIAS) and diet quality using an FFQ and a modified Healthy Food Intake Index (mHFII). The associations between HFIAS and mHFII were studied using ANOVA and ordinal regression analysis.
Setting:
Cross-sectional survey and register data for all municipalities in Finland in 2018–2019.
Participants:
Individuals (n 6435) belonging to the Finnish Service Union United. The members are predominantly women and work mainly in retail trade, tourism, restaurant and leisure services, property maintenance and security services.
Results:
Overall diet quality, measured by mHFII, was significantly lower in those experiencing severe FI than in those who were food secure (8·0 v. 9·1). Additionally, those with severe FI were less likely to have higher (more optimal) scores in sugar-sweetened beverages (OR: 0·67), fibre-rich grains (OR: 0·79), vegetables (OR: 0·54), fruits and berries (OR: 0·61), vegetable oil (OR: 0·80), fish (OR: 0·65), milk (OR: 0·89) and nuts and seeds (OR: 0·66) than food-secure participants. Severe FI was associated with higher odds for less frequent consumption of red and processed meat (OR: 1·15, a higher score represents less frequent consumption).
Conclusions:
Severe FI was linked to both lower overall diet quality and suboptimal consumption of several food groups. Individuals experiencing severe FI may be predisposed to accumulating dietary risk factors for chronic diseases.
School-based interventions encouraging children to replace sugar-sweetened beverages with water show promise for reducing child overweight. However, students with child food insecurity (CFI) may not respond to nutrition interventions like children who are food-secure.
Design:
The Water First cluster-randomised trial found that school water access and promotion prevented child overweight and increased water intake. This secondary analysis used mixed-effects regression to evaluate the interaction between the Water First intervention and food insecurity, measured using the Child Food Security Assessment, on child weight status (anthropometric measurements) and dietary intake (student 24-h recalls, beverage intake surveys).
Setting:
Eighteen elementary schools (serving ≥ 50 % children from low-income households), in which drinking water had not been previously promoted, in the San Francisco Bay Area.
Participants:
Students in fourth-grade classes (n 1056).
Results:
Food insecurity interacted with the intervention. Among students with no CFI, the intervention group had a lower prevalence of obesity from baseline to 7 months (–0·04, CI –0·08, 0·01) compared with no CFI controls (0·01, CI –0·01, 0·04) (P = 0·04). Among students with high CFI, the intervention group had a pronounced increase in the volume of water consumed between baseline and 7 months (86·2 %, CI 21·7, 185·0 %) compared with high CFI controls (–13·6 %, CI –45·3, 36·6 %) (P = 0·02).
Conclusions:
Addressing food insecurity in the design of water promotion interventions may enhance the benefit to children, reducing the prevalence of obesity.
More than 5 million children in the United States experience food insecurity (FI), yet little guidance exists regarding screening for FI. A prediction model of FI could be useful for healthcare systems and practices working to identify and address children with FI. Our objective was to predict FI using demographic, geographic, medical, and historic unmet health-related social needs data available within most electronic health records.
Methods:
This was a retrospective longitudinal cohort study of children evaluated in an academic pediatric primary care clinic and screened at least once for FI between January 2017 and August 2021. American Community Survey Data provided additional insight into neighborhood-level information such as home ownership and poverty level. Household FI was screened using two validated questions. Various combinations of predictor variables and modeling approaches, including logistic regression, random forest, and gradient-boosted machine, were used to build and validate prediction models.
Results:
A total of 25,214 encounters from 8521 unique patients were included, with FI present in 3820 (15%) encounters. Logistic regression with a 12-month look-back using census block group neighborhood variables showed the best performance in the test set (C-statistic 0.70, positive predictive value 0.92), had superior C-statistics to both random forest (0.65, p < 0.01) and gradient boosted machine (0.68, p = 0.01), and showed the best calibration. Results were nearly unchanged when coding missing data as a category.
Conclusions:
Although our models could predict FI, further work is needed to develop a more robust prediction model for pediatric FI.
There has been limited focus placed on exploring food insecurity within the UK-ex-Armed Forces population. The present study aims to build on initial work by investigating the prevalence and associated factors of food insecurity within UK veterans and their families and their current health status. 881 veterans (or a family member) who previously served in the Royal Navy and Royal Marines, Army and the Royal Air Force completed an online survey to explore health status, food insecurity and receipt of benefits. In total, 16.9% of survey respondents were part of food-insecure households, with 12% of these also experiencing some element of hunger. Working age, non-officer rank at the time of service discharge, not being married, living in rented accommodation, having at least one medical condition and in receipt of other benefits were significant risk factors associated with food insecurity. Understanding the specific risk factors associated with food insecurity is vital to develop personalised interventions and policies, such as income support programmes and affordable housing initiatives. However, more work is needed to further explore the factors associated with food insecurity, particularly in the long term.
This study aimed to assess hemoglobin concentration and its association with oral contraceptive (OC) use, food insecurity (FI) and dietary iron availability (DIA) in adult women of reproductive age (20–44 years). This is a population-based cross-sectional study that analysed 505 women living in favelas and urban communities in a capital city in northeastern Brazil. Hemoglobin concentration was determined using capillary blood samples. FI and DIA were assessed using the Brazilian Food Insecurity Scale and the 24-h food recall, respectively. Association analysis was carried out using logistic regression. A directed acyclic graph (DAG) was designed to illustrate the causal paths between hemoglobin concentration and DIA. A significance level of 5 % was adopted. Low hemoglobin concentrations (11·2 g/dl: (1·79)) and a high prevalence of anaemia (64·0 %) were observed; 28·7 % used OC (28·7 %) and 76·4 % were in FI. An average energetic intake of 1495 kcal/d (482·0) and 0·46 mg/d (0·27) of DIA were also observed. In the DAG-guided multivariable analysis, it was observed that hemoglobin concentrations ≥ 12 mg/dl were directly associated with higher DIA (OR: 1·67; 95 % CI (1. 08, 2·59)) and OC use (OR: 1·67; 95 % CI (1·10, 2·55)) and inversely associated with mild FI (OR: 0·60; 95 % CI (0·37, 0·96)) or severe FI (OR: 0·37; 95 % CI: (0·18, 0·76)). Women taking OC and with a higher DIA were less likely to have low hemoglobin concentrations, while those in the context of FI were in the opposite situation.
This research validated an Arabic version of the Psychological General Well-being Index-Short version (PGWB-S) and examined the relationship between perceived psychological well-being, and food insecurity, academic achievement, and other risk factors in a sample of university students in Amman, Jordan, during COVID-19. A cross-sectional study was conducted in two phases. Phase 1 translated and validated the Arabic copy of the PGWB-S in 122 students from the University of Jordan. In Phase 2, 414 students completed the demographic questionnaire, Arabic versions of the PGWB-S, the Ryff Psychological Well-being Scale, and the Individual Food Insecurity Experience Scale. The participants had a mean PGWB-S score of 15.82 ± 0.34, and 41.3% had a mean score below 15. Psychological well-being was better in students younger than 21 and/or who had a GPA ≥3.0, were of normal weight or overweight, physically inactive, and food secure, did not drink coffee or smoke, as well as in those whose neighbourhood contained grocery stores and/or public transportation (P < 0.05). In conclusion, during the pandemic, perceived mental well-being was moderate in a Jordanian sample of university students. Perceived psychological well-being was also positively associated with food security and academic performance. These findings suggest that improving food security and academic achievement may contribute to enhanced psychological well-being among university students. Therefore, higher education institutions with the help of the government are encouraged to facilitate the provision of mental health care services to students, mainly post the coronavirus, which according to our knowledge is limited.
Households with children accessing food aid in high-income countries are often food insecure. We aimed to review the evidence on food aid interventions in households with children and impact on food insecurity, diet quality and mental health.
Design:
A systematic search was conducted using Web of Science, MEDLINE, CINAHL and PsycINFO. Articles published from January 2008 to July 2022 including cross-sectional, cohort and interventional studies in high-income countries were eligible.
Setting:
Food aid is defined as the use of interventions providing free food items by community and/or charitable organisations.
Participants:
Two-parent, lone parent or households with a primary caregiver with at least one child ≤ 18 years.
Results:
From a total of 10 394 articles, nine were included. Food banks, mobile pantry combined with a free meal for children, backpack provision during school term and food parcel home delivery interventions were evaluated. Food bank models offering additional support such as community programmes, health and social services, cooking classes and free meals for children, client-choice-based models and programmes providing convenient access were associated with improved food security and diet quality (increased intake of wholegrains, fruit and vegetables). One study reported an improvement in mental health and food bank access at the end of 18 months but not at earlier timepoints and one study reported no change in parents’ mental health.
Conclusions:
Accessing food aid was linked to improved diet quality and reduced food insecurity in some studies. Allowing clients to choose food items and providing support services were most effective.
To characterise the association between risk of poor glycaemic control and self-reported and area-level food insecurity among adult patients with type 2 diabetes.
Design:
We performed a retrospective, observational analysis of cross-sectional data routinely collected within a health system. Logistic regressions estimated the association between glycaemic control and the dual effect of self-reported and area-level measures of food insecurity.
Setting:
The health system included a network of ambulatory primary and speciality care sites and hospitals in Bronx County, NY.
Participants:
Patients diagnosed with type 2 diabetes who completed a health-related social need (HRSN) assessment between April 2018 and December 2019.
Results:
5500 patients with type 2 diabetes were assessed for HRSN with 7·1 % reporting an unmet food need. Patients with self-reported food needs demonstrated higher odds of having poor glycaemic control compared with those without food needs (adjusted OR (aOR): 1·59, 95 % CI: 1·26, 2·00). However, there was no conclusive evidence that area-level food insecurity alone was a significant predictor of glycaemic control (aOR: 1·15, 95 % CI: 0·96, 1·39). Patients with self-reported food needs residing in food-secure (aOR: 1·83, 95 % CI: 1·22, 2·74) and food-insecure (aOR: 1·72, 95 % CI: 1·25, 2·37) areas showed higher odds of poor glycaemic control than those without self-reported food needs residing in food-secure areas.
Conclusions:
These findings highlight the importance of utilising patient- and area-level social needs data to identify individuals for targeted interventions with increased risk of adverse health outcomes.
The COVID-19 pandemic and subsequent policy response to mitigate disease spread had far-reaching impacts on health and social well-being. In response, the Supplemental Nutrition Assistance Program (SNAP) underwent several pandemic-era modifications, including a 15 % monthly benefit increase on January 1, 2021. Research documenting the health effects of these SNAP modifications among low-income households and minoritized groups who were most impacted by the economic fallout during the first years of the pandemic is lacking. We aimed to estimate the health effects of the 15 % SNAP benefit increase in January 2021, among SNAP-eligible US households.
Design:
We estimated the effects of the SNAP increase on food insufficiency, mental health, and financial well-being using a rigorous quasi-experimental difference-in-differences (DID) analysis.
Setting:
August 19, 2020, to March 29, 2021.
Participants:
Participants were drawn from the national US Census Bureau Household Pulse Survey waves 13–27 (n 44 477).
Results:
Compared with SNAP-eligible non-recipients, SNAP-eligible recipients experienced decreased food insufficiency (–1·9 percentage points (pp); 95 % CI –3·7, –0·1) and anxiety symptoms (–0·09; 95 % CI –0·17, –0·01), and less difficulty paying for other household expenses (–3·2 pp; 95 % CI –4·9, –1·5) after the SNAP benefit increase. Results were robust to alternative specifications.
Conclusions:
Expansions of federal nutrition programmes have the potential to improve health and financial well-being. This study provides timely evidence to inform comprehensive safety net nutrition policies during future economic crises and public health preparedness response plans.
College student food insecurity (FI) is a public health concern. Programming and policies to support students have expanded but utilisation is often limited. The aim of this study was to summarise the barriers to accessing college FI programming guided by the social ecological model (SEM) framework. A scoping review of peer-reviewed literature included an electronic search conducted in MEDLINE, ERIC, and PubMed databases, with a secondary search in Google Scholar. Of the 138 articles identified, 18 articles met eligibility criteria and were included. Articles primarily encompassed organisational (17/18) level barriers, followed by individual (15/18), relationship (15/18), community (9/18), and policy (6/18) levels. Individual barriers included seven themes: Knowledge of Process, Awareness, Limited Time or Schedules, Personal Transportation, Internal Stigma, Perception of Need, and Type of Student. Four relationship barriers were identified: External Stigma, Comparing Need, Limited Availability Causes Negative Perceptions, and Staff. Ten barrier themes comprised the organisational level: Application Process, Operational Process, Location, Hours of Operation, Food Quality, Food Quantity, Food Desirability or Variety of Food, Marketing Materials, Awareness of the Program, and COVID-19 Restrictions. Two barrier themes were identified at the community level, Public Transportation and Awareness of SNAP, while one barrier theme, SNAP Eligibility and Process, encompassed the policy level. Higher education stakeholders should seek to overcome these barriers to the use of food programmes as a means to address the issue of college FI. This review offers recommendations to overcome these barriers at each SEM level.
To identify (1) who experiences food insecurity of differing severity and (2) who uses food banks in England, Wales and Northern Ireland; (3) whether the same groups experience food insecurity and use food banks; and (4) to explore country- and region-level differences in food insecurity and food bank use.
Design:
This pooled cross-sectional study analysed the characteristics of adults experiencing food insecurity of differing severity using generalised ordinal logistic regression models and the characteristics of adults using food banks using logistic regression models, using data from three waves of the Food and You 2 surveys, 2021–2023.
Setting:
England, Wales and Northern Ireland.
Participants:
18 557 adults.
Results:
20·8 % of respondents experienced food insecurity in the past 12 months, and 3·6 % had used a food bank. Food insecurity was associated with income, working status, respondent age, family type, ethnicity, country, long-term health conditions, food hypersensitivity, urban-rural status and area-level deprivation. Severe food insecurity was concentrated among respondents with long-term health conditions and food hypersensitivities. Food bank use was more prevalent among food insecure respondents and unemployed and low-income respondents. Neither outcome showed clear geographical variation. Certain groups experienced an elevated likelihood of food insecurity but did not report correspondingly greater food bank use.
Conclusions:
Food insecurity is unevenly distributed, and its nutrition and health-related consequences demonstrate that food insecurity will intensify health inequalities. The divergence between the scale of food insecurity and food bank use strengthens calls for adequate policy responses.
The prevalence of food insecurity in Cyprus and the socio-demographic factors that are related to this public health problem are unknown. Data used in this cross-sectional study were collected between 1 June 2022 and 21 May 2023 using a self-reported method. Food insecurity was evaluated using the Greek version of Adult Food Security Survey Module. The data regarding socio-demographic and socio-economic characteristics along with body weight and height measurements were collected through self-administered questionnaire. A representative sample of n=1255 adults, ≥18 years old living in the five different districts of the Republic of Cyprus, was recruited. Prevalence of food insecurity in Cypriot population was 12.6%. Prevalence was higher in females, in older adults, in adults living in Paphos, in individuals who were separated, divorced, or widowed, in retired people, in people living with children, and in people with low income and education. Based on multivariable analysis, income was the strongest socio-demographic factor independently associated with food security (€ 6,500–€ 19,500: AOR: 0.49, 95% CI 0.28, 0.86 and >€ 19,500: AOR: 0.15, 95% CI 0.73, 0.31). Food insecurity is a global problem that need further examination. The association between food insecurity and socio-demographic characteristics needs to be highlighted in order for each country to develop specific public health policies (e.g. financial support to low income people) to decrease food insecurity and improve people’s overall health and quality of life.
Social determinants of health (SDoH), such as food and financial insecurity and food assistance, are potentially modifiable factors that may influence breastfeeding initiation and duration. Knowledge gaps exist regarding the relationship between these SDoH and infant feeding practices. We explored the relationships of food and financial insecurity and food assistance with the continuation of breastfeeding at four months postpartum among mothers and whether race and ethnicity modified these associations.
Design:
Mothers retrospectively reported food and financial insecurity and receipt of food assistance (e.g. Women, Infants and Children and Supplemental Nutrition Assistance Program) during pregnancy with their first child and infant feeding practices (exclusive/mostly breastfeeding v. exclusive/mostly formula feeding) following the birth of their first child. Sociodemographic-adjusted modified Poisson regressions estimated prevalence ratios and 95 % CI.
Setting:
Minneapolis-St. Paul, Minnesota.
Participants:
Mothers who participated in the Life-course Experiences And Pregnancy study (LEAP) (n 486).
Results:
Ten percent of mothers reported food insecurity, 43 % financial insecurity and 22 % food assistance during their pregnancies. At four months postpartum, 63 % exclusively/mostly breastfed and 37 % exclusively/mostly formula-fed. We found a lower adjusted prevalence of breastfeeding at four months postpartum for mothers who reported experiencing food insecurity (0·65; 0·43–0·98) and receiving food assistance (0·66; 0·94–0·88) relative to those who did not. For financial insecurity (aPR 0·92; 0·78, 1·08), adjusted estimates showed little evidence of an association.
Conclusions:
We found a lower level of breastfeeding among mothers experiencing food insecurity and using food assistance. Resources to support longer breastfeeding duration for mothers are needed. Moreover, facilitators, barriers and mechanisms of breastfeeding initiation and duration must be identified.
Suicidal behaviours among students pose a significant public health concern, with mental health problems being well-established risk factors. However, the association between food insecurity (FIS) and suicidal behaviours remains understudied, particularly in Bangladesh. This study aimed to investigate the relationship between FIS and suicidal behaviours among Bangladeshi university students.
Design:
A cross-sectional survey using convenience sampling was conducted between August 2022 and September 2022. Information related to socio-demographics, mental health problems, FIS and related events and suicidal behaviours were collected. Chi-squared tests and multivariable logistic regression models, both unadjusted and adjusted, were employed to examine the relationship between FIS and suicidal behaviour.
Setting:
Six public universities in Bangladesh.
Participants:
This study included 1480 students from diverse academic disciplines.
Results:
A substantial proportion of respondents experienced FIS, with 75·5 % reporting low or very low food security. Students experiencing FIS had a significantly higher prevalence of suicidal ideation, plans and attempts compared with food-secure students (18·6 % v. 2·8 %, 8·7 % v. 0·8 % and 5·4 % v. 0·3 %, respectively; all P < 0·001). In addition, students who have personal debt and participate in food assistance programmes had a higher risk of suicidal behaviours.
Conclusions:
This study highlights the association between FIS and suicidal behaviours among university students. Targeted mental health screening, evaluation and interventions within universities may be crucial for addressing the needs of high-risk students facing FIS.