MENTAL HEALTH AND FOOD INSECURITY
CONDITIONS & DISORDERS
Food insecurity is a serious issue across the UK and adults and children alike are living without secured access to food.1 Not having access to food, or worrying about having food to eat, can impact on mental health. This article will explore the relationship between food insecurity, nutrition and mental health. Food insecurity has different degrees of severity,1 ranging from mild insecurity, which is categorised as worrying about having food to eat, all the way up to severe food insecurity, which involves experiencing hunger due to not having enough food to eat.1 Depression and anxiety are two of the most common mental health problems, with surveys showing that 19.7% of adults display symptoms2 and research has been carried out linking mental health conditions and nutrition.3 Food insecurity is continuing to rise in the UK, with more families struggling to afford food.1 This can result in families skipping meals, or reducing the amount of food that they eat and even relying on emergency food provisions from food banks.1 All these things will impact on the nutritional wellbeing of individuals, as, often, cheaper foods are likely to be more processed and contain less fresh produce.4 FOOD BANKS
Understandably, when individuals are struggling to afford food, their focus is on cost and not on the nutritional value of the food they are buying. For those who might choose to use a food bank, nutritional value of items will depend on what’s given to them. Food banks rely on donations and their parcels are designed to provide enough food for three days.6 Parcels will often contain a mixture of tinned foods, cupboard staples such as rice, and long-life products such as UHT milk.6 They can also include non-food items such as toiletries.6 The Trussell Trust, providing a network of food banks in the UK, released a nutritional analysis report in April 2018, with information on their
emergency food parcels, to determine if they met the nutritional guidelines.7 The report compared the nutrition of a hypothetical food parcel developed from the Trussell Trust’s national ‘pick list’ against food parcels collected from five London food banks.7 The report found that, generally, the food parcels exceeded the nutritional requirements for three days, with the exception of vitamins D and E. The food parcels were high in sugar and salt, exceeding the current UK recommendations. However, removing items such as fruit juice from the parcel to combat this, resulted in a decrease in other vitamins and minerals, such as vitamin C. High levels of salt were not due to any one particular food provided in the parcel, but the report suggested that this is likely to fall in future, as food manufacturers begin to decrease salt in their foods in line with ongoing UK initiatives.7 It was acknowledged too, that there was a lack of fresh fruit and vegetables in the food parcels, but including fresh produce would carry its own problems, such as risk of spoilage and requiring people to have access to refrigeration. Although these food parcels provide an important source of nutrition for individuals in crisis, the Trussell Trust’s report acknowledged that there were areas which could be improved.7 There are also numerous food banks that are operated outside of the Trussell Trust, which may not have the same nutritional offerings as their own food parcels.
Emma Berry Associate Nutritionist (Registered) Emma is working in Research and Development and is enjoying writing freelance nutrition articles.
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THE LINKS BETWEEN NUTRITION AND MENTAL HEALTH
It is well established that nutrition and mental health are linked, with food www.NHDmag.com May 2019 - Issue 144
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CONDITIONS & DISORDERS insecurity having a powerful impact. The Trussell Trust released a report on Disability, Health and Hunger in January 2018,5 highlighting that 89% of food banks surveyed reported mental health issues amongst people who had been referred to them. Although not all individuals who are food insecure will use food banks, this report does provide strong evidence that food banks should provide mental health support or advice to those in need. Many food banks are already providing this.5 Research has suggested that nutrition and diet can play a role in preventing or reducing mental health symptoms.3 It is clear too, that a diet with more processed foods can increase the risk of mental health symptoms.3 Although the relationship between nutrition, food and mental health is complex and requires further research, the links are important to understand. There are strong emotional ties to food and our choices are not related to nutrition alone. Many individuals eat emotionally for comfort when upset, often choosing processed foods high in sugar or fat.8 It would be interesting to investigate whether some individuals choose processed foods as a result of already coping with mental health symptoms. They may choose certain foods for a number of other reasons, not just emotional comfort. This could perhaps be a cycle, whereby one of these things leads to the other. This may be increased in individuals who are food insecure, as they may not have the choice to eat fresh foods due to cost, or may have limited storage facilities available to them. Instead, they may be purchasing processed foods, or receiving food parcels that may contain processed foods. As previously stated, many individuals who are food insecure will suffer from mental health symptoms.5 Children and young adults who have suffered from food insecurity are more likely to be at risk of obesity,9 mental health symptoms and chronic health conditions.10 Therefore, reducing food insecurity could have a massive impact on our current population’s health and also on the health of our population in the future. REDUCING FOOD INSECURITY
There are many challenges when it comes to reducing food insecurity, improving access to affordable nutritious foods and providing 18
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appropriate support for mental health symptoms. If we were to reduce food insecurity then more individuals should have access to nutritious foods and there may be less individuals with mental health symptoms as a result of being food insecure. There are a number of ways that we could work towards these goals, but resources are needed to support change. Until recently, the UK government has resisted measuring food insecurity, unlike other countries; instead, organisations like the Food Foundation have provided reports.1 However, a measure of food insecurity is due to be introduced in the UK,11 which will hopefully be the start of a government-led programme to reduce food insecurity in this country. MENTAL HEALTH SEVICES
Whereas food insecurity has still to be tackled across the UK, there have been significant campaigns to reduce mental health stigma and improve awareness of mental health symptoms. These campaigns are extremely important to encourage individuals to get help if they need it, without worrying about the risk of discrimination. Although individuals who use food banks should have access to support if they need it, not all individuals who are food insecure use food banks. Having free, accessible mental health services and support is extremely important for this group (and the population as a whole). Mental health services can be accessed through the NHS, but also via a number of charities such as Mind UK, Samaritans and the Mental Health Foundation. These services are vital in ensuring that a range of services are accessible and provide support for people in need. CONCLUSION
There is a lot of excellent work going on to improve food insecurity, improve access to nutritious foods and provide appropriate support for mental health needs. A lot of this work comes from the voluntary sector, but, hopefully, with an increasing amount of support from the government, this work will continue to grow, resulting in a larger impact. This would improve the lives and experiences of those in substantial need.