Background:
•Food insecurity (FI) is a critical public health challenge in the United States, affecting nearly one in four Latino adults in the United States1 and is associated with adverse mental and cognitive health outcomes.2
•Chronic stress from FI may trigger inflammation and gut dysbiosis, disrupting the gut–brain axis and affecting neural circuitry related to cognition and mood.3 Conversely, food security (FS) — reliable access to sufficient, nutritious food — may serve as a protective factor for both cognitive and mental health outcomes.
•Proposed Biological Pathways:
▸Chronic stress and inflammation: Persistent food insecurity activates the hypothalamic-pituitary-adrenal (HPA) axis, elevating cortisol and promoting pro-inflammatory cytokine release that can damage neural tissue over time.4
▸Gut dysbiosis and the gut–brain axis: Poor dietary quality associated with food insecurity disrupts the gut microbiome, impairing bidirectional communication between the gut and brain and negatively influencing mood regulation and cognition.3
▸Nutrient deficiencies: Inadequate intake of key micronutrients (e.g., B vitamins, omega-3 fatty acids, zinc) is associated with both depressive symptoms and accelerated cognitive decline.5,6
Study Aim:
To examine the associations between food security (FS), depressive symptoms, and cognitive function among Latino families participating in the community-based Skills-based Educational strategies for Reduction of Vascular Events in Orange County
(SERVE OC) study.
Methods:
•Baseline data from the Skills Based Education strategies for Reduction of Vascular Events in Orange County (SERVE OC) RCT were used (Grant: P50MD017366).
•Baseline data from 131 randomized Latino families comprising 290 adults were used.
•Family-level FS was self-reported and categorized as low versus high/marginal security.
•Cognitive function was measured with the Montreal Cognitive Assessment (MoCA) 8.3 in English and Spanish, adjusted for education.
•Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depressive Scale (CES-D-10).
•Descriptive statistics and t-tests were used to examine differences in depression and cognition across FS levels among participants with non-missing data.
•Linear regressions assessed the relationship between FS, cognitive function and depressive symptoms adjusting for key demographic factors age, sex, and education (≤8 grade or >8 grade)
Results:
•Among respondents with FS data (N=290), 68.2% were female, with a mean age of 46.18 (SD=13.26) years.
•87 (65.91%) families, representing 65.86% of all study participants reported low FS.
•Participants with low FS had significantly higher mean depressive symptoms (9.54 vs 6.01, p<0.05) and lower mean MoCA scores (21.90 vs. 22.66, p=0.17).
•After adjusting for select demographic factors, family FS status was not significantly associated with MoCA score (β = 0.82, p = 0.12), however low FS remained significantly associated with lower depression scores (β = −3.37, p<0.001).
Conclusion:
Key Findings:
•Low food security was significantly and independently associated with greater depressive symptoms in Latino adults, even after controlling for key sociodemographic factors
•A similar trend was observed for cognitive function (MoCA), but the association did not reach statistical significance after adjustment.
Implications for Policy & Practice:
•Findings underscore the need to recognize food insecurity as a critical social determinant of mental and brain health, particularly within underserved Latino communities where both food insecurity, depression, and cognitive decline are highly prevalent.
•Routine food security screening should be integrated into primary care, behavioral health, and community-based settings serving Latino adults and families, enabling early identification and referral to food assistance programs.
•Community-based programs that improve food access and nutritional quality may serve a dual protective role, simultaneously reducing depression risk and supporting long-term cognitive health in Latino communities.
Limitations & Future Directions
•The cross-sectional design precludes causal inference; future longitudinal studies are needed to examine temporal ordering and potential causal pathways between food insecurity, depression, and cognitive decline.
•Larger samples will be needed to detect cognitive effects of food insecurity with greater precision, and to explore whether these associations differ by sex, nativity, or acculturation level.
Acknowledgements:
This research was conducted under the supervision of SERVE OC principal investigator Dr. Bernadette Boden-Albala. We would like to thank Dr. Boden-Albala for her support and guidance. Additionally, we would like to thank Dr. Jeffrey Wing and Dr. Matthew Landry for their statistical and subject matter expertise. We would like to acknowledge the NIMHD (Grant number P50MD017366) for their support of SERVE OC and the UC END Disparities P50 grant. Finally, we would like to thank all of our staff, study partners, community health workers and participants without whom none of this would have been accomplished.
