Table 2.

Data extraction of longitudinal US studies that examine the relationship between food insecurity (FI) and emotional well-being

				Measures		Prevalence at baseline
Study	Study time points	Data set	Sample and demographics	FI	Emotional well-being	FI	Emotional well-being	Outcomes
Effect of emotional well-being on food insecurity
Hanson and Olson (2012)( 16 )	T1: 1999 T2: 2003	Rural Low-income Families: Monitoring their Well-being and Functioning in the Context of Welfare Reform	Parents, n 225 % Female=NA Mean age=30·6 years Race/ethnicity=33·8 % non-white Mean income/household poverty=NA	Eighteen-item USDA HFSSM	Twenty-item CES-D scale: never, one year or two years at risk for depression	51·1 %	NA	Length of depression was significantly associated with persistent FI, but not discontinuous FI ∙ Discontinuous FI: ° 1 year at risk for depression (FI OR=1·03; P>0·05) ° 2 years at risk for depression (FI OR=1·17; P>0·05) ∙ Persistent FI: ° 1 year at risk for depression (FI OR=1·57; P>0·05) ° 2 years at risk for depression (FI OR=4·28; P<0·05)
Hernandez et al. (2013)( 18 )	T1: 2001–2003 (3 years) T2: 2003–2005 (5 years)	Fragile Families and Child Well-Being Study and In-Home Longitudinal Study of Preschool Age Children	n 1690 % Female=100 Mean age=28·4 (sd 6·0) years Race/ethnicity=26 % white, 44 % black, 26 % Hispanic, 3 % other race Mean income/household poverty=36 % at <100 % FPL, 25 % between 100 and 199 % FPL, 39 % at >200 % FPL	Eighteen-item USDA HFSSM	Composite International Diagnostic Interview Short Form for Depression	15 %	% depressed	∙ Mothers’ depression was significantly associated with subsequent FI (aOR=2·03, 95 % CI 1·45, 2·84; P<0·001) ° After adding intimate partner violence into the model, the relationship remained significant (aOR=1·97, 95 % CI 1·41, 2·76; P<0·001) ° Depression fully mediated the relationship between intimate partner violence and FI (Sobel test=2·89; P<0·01)
Garg et al. (2015)( 17 )	T1: 2001–2002 (9 months) T2: 2003 (24 months)	Early Childhood Longitudinal Study, Birth Cohort	n 2917 % Female=100 Mean age=25·5 (sd 5·8) years Race/ethnicity=37·5 % NH white, 22·5 % NH black, 34·8 % Hispanic, 2·1 % Asian/Pacific Islander NH, 3·1 % other Mean income/household poverty=52·4 % at <100 % poverty threshold, 24·2 % between 100 and <130 % poverty threshold, 23·3 % between 130 and <185 % poverty threshold	Eighteen-item USDA HFSSM	Twelve-item CES-D scale	NA	16·1 % maternal depression	∙ Mothers’ depression was significantly associated with subsequent FI (aOR†=1·50, 95 % CI 1·06, 2·12) ° WIC participation modified relationship (P=0·005). Depressed mothers who received WIC at baseline were significantly more likely to report FI at follow-up (aOR=1·59, 95 % CI 1·15, 2·21). Depressed mothers who did not receive WIC were significantly less likely to report FI at follow-up (aOR=0·20, 95 % CI 0·04, 0·93) ° SNAP did not significantly modify the relationship between maternal depression and FI (P=0·55)
Effect of food insecurity on emotional well-being
Kim and Frongillo (2007)( 20 )	T1: 1995–1996 T2: 1998 T3: 2000 T4: 2002	Health and Retirement Study (HRS), Asset and Health Dynamics among the Oldest Old (AHEAD)	HRS: Elders, n 9481 % Female=47·7 % Mean age=60·8 (sd 4·2) years Race/ethnicity=81·2 % white, 18·8 % non-white Mean income/household poverty=$US 52 602 (sd 74 783) AHEAD: Elders, n 6354 % Female=59·9 Mean age=79·6 (sd 5·8) years Race/ethnicity=87·4 % white, 12·6 % non-white Mean income/household poverty=$US 27 760 (sd 40 088)	Two-item USDA HFSSM Module	Eight-item CES-D scale	HRS: 8·4 % AHEAD: 6·7 %	HRS: 26·0 % depressed AHEAD: 21·0 % depressed	∙ In lagged models, among HRS participants but not AHEAD participants, FI elders reported a greater change in depression scores than previous food secure elders: ° HRS (aβ †=0·16; P=0·013) ° AHEAD (aβ †=0·15; P=0·185) ∙ No significant associations were observed in differences models: ° HRS (aβ †=0·11; P=0·384) ° AHEAD (aβ †=0·05; P=0·802)
Zaslow et al. (2009)( 19 )	T1: 2001–2002 (9 months) T2: 2003–2004 (24 months)	Early Childhood Longitudinal Study-Birth Cohort	n 8944 % Female=48·9 Mean age=child: 24·4 (sd 2·5) months Race/ethnicity=child: 43·1 % white, 15·9 % black, 20·2 % Hispanic, 20·9 % other Mean income/household poverty=25·8 % had <1:00 poverty ratio	Eighteen-item USDA HFSSM	Children: Toddler Attachment Sort (TAS)-45 Mothers: Twenty-item CES-D scale	12·5 %	Toddler social and emotional well-being (TAS): 38·7 % Maternal depression: 5·1 (sd 11·7) %	∙ FI was significantly related to subsequent maternal depression (aβ †=0·183; P<0·001), which was related to positive parenting practices (aβ †=−0·031; P<0·05) ° Maternal depression was not significantly related to toddler emotional well-being (aβ †=0·002; P>0·05) ° Positive parenting practice was related to toddler emotional well-being (aβ †=−0·045; P<0·05)
Huang et al. (2010)( 22 )	1997 (children ages 3–12 years) and 2002	Child Development Supplement to the Panel Study of Income Dynamics	n 416 Child: % female=54·69 Child: mean age=7·46 (sd 2·87) years Child: race/ethnicity: 29·89 % AA HoH: % female=56·76 HoH: mean age=36·91 (sd 7·05) years Mean income/household poverty=$US 24 480 (sd 14 670)	Eighteen-item USDA HFSSM	Child: Thirty-two-item Behavior Problem Index Parent stress: Seven-item index on caregivers’ perceptions on feelings and perceptions of caring for the child Parenting distress: Six-item psychological distress scale	1·66 (sd 2·48)	Child internalizing behaviours: 2·40 (sd 2·43) Child externalizing behaviours: 5·22 (sd 3·52) Parental stress: 1·95 (sd 0·64) Parental distress: 4·33 (sd 4·05)	∙ In lagged models, FI was not independently related to subsequent child internalizing (β=0·17; P>0·10) or externalizing behaviours (β=0·22; P<0·10)
Zilanawala and Pilkauskas (2012)(15)	T1: 2001–2003 (3 years) T2: 2003–2005 (5 years)	Fragile Families and Child Well-Being Study	n 2825 % Female=100 Mothers’ mean age=25·51 years Race/ethnicity=16·9 % white, 50·1 % black, 29·9 % Hispanic Mean income/household poverty=income:needs ratio 1·69 (sd 1·54)	In the past 12 months, did you receive free food or meals? Subsequent analysis utilized eighteen-item USDA HFSSM	Child Behavior and Adaptive Social Behavior Inventory	12 %	17·5 % (depression) 6·5 % (anxiety)	∙ Food hardship at age 3 was not significantly related to child outcomes at age 5: ° Externalizing behaviours (β=0·16, se=0·08; P>0·05) ° Internalizing behaviours (β=0·15, se=0·09; P>0·05) ° Positive behaviours (β=−0·02, se=0·07; P>0·05) ∙ One wave of food hardship (at age either 3 or 5) was associated with both externalizing and internalizing behaviours at age 5: ° Externalizing behaviours (β=0·24, se=0·07; P<0·01) ° Internalizing behaviours (β=0·25, se=0·08; P<0·01), ° Positive behaviours (β=0·08, se=−0·02; P>0·05) ∙ Experiencing two waves of food hardship (at age either 3 or 5) was not associated with any child outcomes at age 5. Only 4 % of participants reported two waves of food hardship: ° Externalizing behaviours (β=0·15, se=0·13; P>0·05) ° Internalizing behaviours (β=0·14, se=0·20; P>0·05) ° Positive behaviours (β=−0·16, se=0·12; P>0·05)
Laraia et al. (2015)( 21 )	T1: 24–29 weeks’ gestation T2: 3 months postpartum T3: 12 months postpartum during 2000–2006	Pregnancy, Infection, and Nutrition Study	n 526 % Female=100 Mean age*=30·05 years Race/ethnicity*=88·0 % other and white, 12·0 % black Mean income/household poverty*=442·5 poverty index	Eighteen-item USDA HFSSM at baseline Six-item USDA HFS screener at 12-months postpartum	Ten-item Perceived Stress Scale (PSS)	4·7 %	NA	∙ In unadjusted models, marginal food security and FI during pregnancy were significantly related to mean PSS scores at 3 and 12 months postpartum: ° Marginal food security (mean PSS at 3 months, 18·21 (sd 6·15), P<0·001; mean PSS at 12 months, 19·03 (sd 6·15), P<0·001) ° FI (mean PSS at 3 months, 17·80 (sd 6·70), P<0·001; mean PSS at 12 months, 17·90 (sd 7·40), P<0·001) ∙ In adjusted models, marginal food security but not FI during pregnancy was related to PSS scores at 3 and 12 months postpartum: ° Marginal food security (PSS at 3 months, aβ †=4·3, 95 % CI 2·12, 6·49; PSS at 12 months, aβ †=5·86, 95 % CI 3·54, 8·19) ° FI (PSS at 3 months, aβ †=4·3, 95 % CI 2·12, 6·49; PSS at 12 months, aβ †=3·67, 95 % CI 0·94, 6·41)
Bidirectional effect of food insecurity and emotional-well-being
Huddleston-Casas et al. (2008)( 23 )	T1: 2000 T2: 2001 T3: 2002	Rural Families Speak	n 184; 413 with imputation % Female=100 % Mean age=30·1 years Race/ethnicity=‘majority’ were NH white Mean income/household poverty=$US 14 826	Eighteen-item USDA HFSSM	Twenty-item CES-D scale	NA	NA	∙ Significant, simultaneous relationships between FI and depression were observed in imputed models: ° T1 FI→T2 depression: non-imputed standardized estimate=0·077; P=0·132; imputed standardized estimate=0·082; P=0·023 ° T1 depression→T2 FI: non-imputed standardized estimate=0·212; P<0·001; imputed standardized estimate=0·193; P<0·001
Lent et al. (2009)( 24 )	T1: 2000 T2: 2001 T3: 2002	Rural Families Speak	n 29 % Female=100 Mean age=29·3 years Race/ethnicity=87·9 % NH white Mean income/household poverty=‘very low incomes’	Eighteen-item USDA HFSSM	Twenty-item CES-D scale SF-36 mental component summary (MCS)	58·6 %	51·7 % high depressive symptoms	∙ Unhealthy CES-D scores at T2 were significantly associated with FI at T3 (P=0·009) ∙ Unhealthy MCS scores at T2 were significantly correlated with FI at T3 (P=0·01) ∙ Association between FI and depressive symptoms at T3, adjusting for T1 depression, was not significant (P=0·619) ∙ FI at T2 was not associated with T3 depressive symptoms (data not shown)
Doudna et al. (2015)( 25 )	Panel 1: T1: 1999–2001 T2: 2000–2002 Panel 2: T1: 2001–2002 T2: 2003 Panel 3: T1: 2004–2005 T2: 2005–2006	Rural Families Speak	n 314 % Female=100 % Mean age=~30 years Race/ethnicity=61·3 % NH white Mean income/household poverty=NA	Eighteen-item USDA HFSSM	Twenty-item CES-D scale	Mean FI score=3·6 (sd 3·86)	Mean depression score=17·35 (sd 11·47)	∙ FI at T1 was significantly related to depressive symptoms at T2 (B=0·636, se=0·153, β=0·221; P<0·001) ∙ Depressive symptoms at T1 were significantly related to FI at T2 (B=0·036, se=0·016, β=0·116; P=0·027) ∙ Knowledge of community resources did not serve as a protective mechanism in these relationships: ° Those with high levels of knowledge showed a significant relationship between FI at T1 and depressive symptoms at T2 (β=0·221; P=0·005) and depressive symptoms at T1 and FI at T2 (β=0·191; P=0·024) ° No differences were observed among those with low levels of knowledge
Palar et al. (2015)( 26 )	T1: 2007 T2: 2010	Research to Access to Care in the Homeless (REACH) cohort	HIV-infected homeless people in San Francisco, n 346 % Female=28·6 Mean age=NA Race/ethnicity=43·0 % AA, 37·6 % white, 7·2 % Latino, 12·1 % other Mean income/household poverty=NA	Household Food Insecurity Access Scale	Beck Depression Inventory version II	6·1 % mild FI 18·2 % moderate FI 31·2 % severe FI	NA	∙ FI was related to higher depression scores and greater odds of depression later, after adjusting for baseline depression (mild FI, aβ=0·29, P>0·05; moderate FI, aβ=0·77, P<0·01; severe FI, aβ=1·97, P<0·001) ∙ In lagged models, only severe FI was associated with depression (mild FI, aβ=0·33, P>0·05; moderate FI, aβ=0·06, P>0·05; severe FI, aβ=1·22, P<0·001) ∙ Moderate FI and severe FI were associated with greater odds of depression (mild FI, aOR†=1·41, 95 % CI 0·99, 2·02, P>0·05; moderate FI, aOR†=1·34, 95 % CI 1·01, 1·78, P<0·05; severe FI, aOR†=1·64, 95 % CI 1·26, 2·13, P<0·001)

NA, not available; FPL, federal poverty level; NH, non-Hispanic; AA, African American; HoH, head of household; USDA, US Department of Agriculture; HFSSM, Household Food Security Survey Module; HFS, Household Food Security; CES-D, Center for Epidemiologic Studies Depression; SF-36,36-Item Short Form Survey; aOR, adjusted odds ratio; WIC, Special Supplemental Nutrition Program for Women, Infants, and Children; SNAP, Supplemental Nutrition Assistance Program; aβ, adjusted β coefficient.

^*Calculated from weighted averages.

^†Adjusted estimate: indicates if models controlled for sociodemographics and/or other confounders.