Association between childhood hunger and depression or anxiety in later life: Insights from two case-control studies

Childhood hunger has been found to decelerate the risk of depression and anxiety, which have been reported to influence each other. However, the roles of depression and anxiety in the relationship between childhood hunger and these conditions has not been fully examined. Childhood hunger may increase the risk of depression through anxiety, while it may also increase the risk of anxiety through depression.

Two case-control studies were conducted using data from the 2017-2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Depression and anxiety were assessed by using the 10-item Center for Epidemiological Research Depression Scale (CESD-10) and the Generalized Anxiety Disorder 7-item scale (GAD-7). Logistic regression, subgroup and interaction analyses evaluated the associations, while the KHB method estimated the bidirectional mediating effects of anxiety and depression.

A total of 8866 participants were involved in data analysis. After adjusting confounders, logistic regressions and subgroup analyses indicated significant associations between childhood hunger and depression (aOR:1.190, 95 % CI:1.076-1.315, p < 0.001), and the interaction effects of subgroups were significant including residence of birth, father had steady job, father received school education, and mother received school education (p < 0.001). Similarly, childhood hunger and anxiety are significantly associated (aOR:1.309, 95 % CI:1.118-1.534, p < 0.001), particularly in sex, father received school education, mother received school education (p < 0.05). Anxiety partially mediates the relationship between childhood hunger and depression, while depression also partially mediates the relationship between childhood hunger and anxiety.

Our findings suggest that childhood hunger is associated with both depression and anxiety, with each playing a partial mediating role in the relationship between childhood hunger and the other condition, highlighting the importance of addressing early-life hunger to prevent long-term mental health issues.