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Food insecurity and insomnia-related symptoms among adults from low- and middle-income countries

 Louis Jacob  ;  Lee Smith  ;  Karel Kostev  ;  Hans Oh  ;  Razak M Gyasi  ;  Guillermo F López Sánchez  ;  Tae-Jin Song  ;  Mark A Tully  ;  Josep Maria Haro  ;  Dong Keon Yon  ;  Jae Il Shin  ;  Ai Koyanagi 
 JOURNAL OF SLEEP RESEARCH, Vol.32(4) : e13852, 2023-08 
Journal Title
Issue Date
Adolescent ; Adult ; Aging ; Cross-Sectional Studies ; Developing Countries ; Female ; Humans ; Logistic Models ; Male ; Prevalence ; Sleep Initiation and Maintenance Disorders* / epidemiolo
epidemiology ; food insecurity ; insomnia-related symptoms ; low- and middle-income countries ; sleep problems
Little is known about the relationship between food insecurity and sleep problems in low- and middle-income countries, while the mediators of this association are largely unknown. Therefore, we investigated the association between food insecurity and insomnia-related symptoms in six low- and middle-income countries (i.e., China, Ghana, India, Mexico, Russia, South Africa), and the potential mediators of this relationship. Cross-sectional, nationally representative data from the Study on Global AGEing and Adult Health (2007-2010) were analysed. Past 12-month food insecurity was assessed with two questions on the frequency of eating less, and on hunger owing to a lack of food. Insomnia-related symptoms referred to severe or extreme sleep problems in the past 30 days. Multivariable logistic regression and mediation analysis were conducted. Data on 42,489 adults aged >= 18 years were analysed (mean [standard deviation] age 43.8 [14.4] years; 50.1% females). The prevalence of any food insecurity and insomnia-related symptoms was 11.9% and 4.4%, respectively. After adjustment, compared with no food insecurity, moderate (odds ratio = 1.53, 95% confidence interval = 1.11-2.10) and severe food insecurity (odds ratio = 2.35, 95% confidence interval = 1.56-3.55) were significantly associated with insomnia-related symptoms. Anxiety, perceived stress, and depression mediated 27.7%, 13.5%, and 12.5% of the relationship between any food insecurity and insomnia-related symptoms, respectively (total percentage = 43.3%). Food insecurity was positively associated with insomnia-related symptoms in adults from six low- and middle-income countries. Anxiety, perceived stress, and depression explained a substantial proportion of this relationship. Addressing food insecurity itself or the identified potential mediators among people with food insecurity may lead to a reduction in sleep problems among adults in low- and middle-income countries, pending confirmation with longitudinal studies.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Shin, Jae Il(신재일) ORCID logo https://orcid.org/0000-0003-2326-1820
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