Hunger and brain health risk factors among US high school students

The relationship between hunger and brain health remains understudied in adolescence. This study examines the relationship between experienced hunger attributable to inadequate food at home and health and behavioral factors relevant to brain health in a nationally representative US high school student sample.

We pooled 2017-2019 Youth Risk Behavior Survey (YRBS) data across 16 states (N=74,152 high school students). Hunger resulting from inadequate food at home -hereafter termed hunger- was assessed by asking students how often they went hungry in the past month due to inadequate food at home, with response options: "always," "most of the time," "sometimes", "rarely", or "never". Outcomes were seven health and behavioral factors relevant to brain health - concussion, depression, inadequate sleep, low physical activity, low fruit intake, low vegetable intake, and sugary drink consumption. Logistic regression models estimated odds ratios and predicted probabilities for each outcome associated with hunger. Models adjusted for age group, sex, race/ethnicity, and survey year.

Overall, 13% of students experienced hunger "sometimes", "most of the time", or "always". The majority of students were aged 15 years or older (62%), male (51%), and identified as non-Hispanic White (48%). In adjusted models, compared to students who "never" experienced hunger, those experiencing it "always" had higher odds of concussion (OR=3.44, 95%CI: 2.52-4.68), depression (OR=3.66, 95%CI: 2.74-4.88), and sugary drink consumption (OR=2.88, 95%CI: 2.10-3.96), and lower odds of low vegetable intake (OR=0.47, 95%CI: 0.33-0.68). Trend tests revealed significant associations between hunger and concussion, depression, inadequate sleep, low fruit intake, and sugary drink consumption, with higher predicted probabilities for most outcomes with greater experience of hunger.

Adolescent hunger is linked to multiple health and behavioral factors relevant to brain health, highlighting the need for early interventions. Addressing adolescent food insecurity may help them achieve and maintain optimal brain health.