The Health Effects of Food Insecurity
Food security is crucial to the health of the world’s population. Consequently, a lack of food security is associated with various adverse health effects. Our discussion introduces the physical and psychosocial health effects that can occur as a result of food insecurity.
Physical health effects
Food insecurity is associated with poor general health and increased likelihood of illness. The major physical health effects of food insecurity seen globally are the consequences of hunger and malnutrition. As stated in our introductory discussion, hunger and malnutrition are strongly associated with food security. All people who suffer from hunger are food-insecure. Hunger is the uncomfortable sensation resulting from inadequate food consumption. This physical manifestation of hunger is due to undernutrition, where the body is deficient in adequate nutrients as food consumption is not sufficient to provide them. Undernutrition is a type of malnutrition, which describes the physical conditions that occur when there is an imbalance in certain nutrients. These can be macronutrients, such as energy and protein, or vitamins and minerals, also known as micronutrients. The other type of malnutrition is overnutrition, which is defined as an excess in nutrient intake.
Macronutrient or caloric undernutrition due to food insecurity is of major concern, particularly in developing countries. As shown in the below figure, undernutrition can affect every stage of life and have consequences for subsequent generations. Mothers who suffer chronic undernutrition due to prolonged food insecurity are more likely to give birth to low birthweight babies. Underweight in infancy is associated with higher infant mortality and impaired mental and physical development. Continued food insecurity during childhood contributes to reduced mental and physical capacity, the latter of which manifests as wasting and stunting, or short stature. These physical signs are a direct result of inadequate caloric and micronutrient intake, which impair normal growth in childhood. Kwashiorkor and marasmus describe the most severe states of protein-energy undernutrition. Both conditions are characterised by wasting, however, kwashiorkor presents with associated swelling. The poor physical effects of undernutrition experienced in childhood and adolescence may continue into adulthood if food security does not improve.
Even if a person’s diet meets their caloric requirements, adequate micronutrient intake is not guaranteed. In contrast to the obvious physical signs of macronutrient undernutrition, micronutrient undernutrition only manifests physically in states of severe deficiency. Hence, micronutrient undernutrition is often termed hidden hunger. Dietary deficiencies in vitamin A and the minerals zinc and iron due to food insecurity are significant contributors to the global disease burden. Vitamin A deficiency is associated with maternal mortality, and is the leading cause of preventable blindness in children in developing countries. Zinc, along with vitamin A, is central to the immune response to infectious diseases. Deficiencies in these compromise the immune system, resulting in increased risk of infections, including diarrhoeal diseases, pneumonia, malaria, and tuberculosis, especially in children. Inadequate iron intake can lead to anaemia, associated with impaired cognitive development and cerebral damage in children, which can have profound effects through to adulthood.
In developed countries, the major physical health effect of food insecurity is overnutrition. This is largely due to consumption of calorie-rich, energy-dense foods with low nutritional content, which manifests physically as overweight and obesity. Consumption of such foods often occurs in a feast or famine cycle, a coping strategy employed by food-insecure people that is associated with higher risk of obesity, particularly in food-insecure women. The feast or famine cycle is characterised by overeating when food becomes affordable and readily available in order to compensate for periods of famine, such as skipped meals. Obesity is associated with significantly increased risk of many chronic diseases, including hypertension, cardiovascular disease, stroke, cancer, and diabetes. Overweight and obesity due to food insecurity is becoming increasingly common in developing countries, often coexisting with undernutrition in a phenomenon known as the double burden of malnutrition.
Psychosocial health effects
Food insecurity has profound health effects beyond the physical. The psychosocial effects on children are of particular concern, as these can have consequences in adulthood. In developing countries, children suffering from undernutrition are more likely to receive less schooling, and instead may be sent to work as a coping strategy to help increase the food security of their household. Low educational attainment is linked to reduced work capacity and lower earnings over the lifetime, potentially perpetuating food insecurity in subsequent generations. Food-insecure children in both developed and developing countries who do attend school have been found to have reduced academic performance, learning difficulties, and slower progress, which can lead to poorer employment and health outcomes in adulthood. In children in developed countries, food insecurity has also been found to be associated with behavioural problems such as aggression and attention deficit disorder, and mental illnesses including anxiety and depression.
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