{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T07:55:44Z","timestamp":1781596544739,"version":"3.54.5"},"reference-count":50,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T00:00:00Z","timestamp":1676937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Little is known about the relationship between food insecurity and sleep problems in low\u2010 and middle\u2010income countries, while the mediators of this association are largely unknown. Therefore, we investigated the association between food insecurity and insomnia\u2010related symptoms in six low\u2010 and middle\u2010income countries (i.e., China, Ghana, India, Mexico, Russia, South Africa), and the potential mediators of this relationship. Cross\u2010sectional, nationally representative data from the Study on Global AGEing and Adult Health (2007\u20132010) were analysed. Past 12\u2010month food insecurity was assessed with two questions on the frequency of eating less, and on hunger owing to a lack of food. Insomnia\u2010related symptoms referred to severe or extreme sleep problems in the past 30\u2009days. Multivariable logistic regression and mediation analysis were conducted. Data on 42,489 adults aged \u226518\u2009years were analysed (mean [standard deviation] age 43.8 [14.4]\u00a0years; 50.1% females). The prevalence of any food insecurity and insomnia\u2010related symptoms was 11.9% and 4.4%, respectively. After adjustment, compared with no food insecurity, moderate (odds ratio\u00a0=\u00a01.53, 95% confidence interval\u00a0=\u00a01.11\u20132.10) and severe food insecurity (odds ratio\u00a0=\u00a02.35, 95% confidence interval\u00a0=\u00a01.56\u20133.55) were significantly associated with insomnia\u2010related symptoms. Anxiety, perceived stress, and depression mediated 27.7%, 13.5%, and 12.5% of the relationship between any food insecurity and insomnia\u2010related symptoms, respectively (total percentage\u00a0=\u00a043.3%). Food insecurity was positively associated with insomnia\u2010related symptoms in adults from six low\u2010 and middle\u2010income countries. Anxiety, perceived stress, and depression explained a substantial proportion of this relationship. Addressing food insecurity itself or the identified potential mediators among people with food insecurity may lead to a reduction in sleep problems among adults in low\u2010 and middle\u2010income countries, pending confirmation with longitudinal studies.<\/jats:p>","DOI":"10.1111\/jsr.13852","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T16:43:32Z","timestamp":1676997812000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Food insecurity and insomnia\u2010related symptoms among adults from low\u2010 and middle\u2010income countries"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1071-1239","authenticated-orcid":false,"given":"Louis","family":"Jacob","sequence":"first","affiliation":[{"name":"Research and Development Unit Parc Sanitari Sant Joan de D\u00e9u, CIBERSAM, ISCIII  Barcelona Spain"},{"name":"Department of Physical Medicine and Rehabilitation Lariboisi\u00e8re\u2010Fernand Widal Hospital, AP\u2010HP, University Paris Cit\u00e9  Paris France"},{"name":"Faculty of Medicine University of Versailles Saint\u2010Quentin\u2010en\u2010Yvelines  Montigny\u2010le\u2010Bretonneux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5340-9833","authenticated-orcid":false,"given":"Lee","family":"Smith","sequence":"additional","affiliation":[{"name":"Centre for Health, Performance, and Wellbeing Anglia Ruskin University  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2124-7227","authenticated-orcid":false,"given":"Karel","family":"Kostev","sequence":"additional","affiliation":[{"name":"University Clinic of Marburg  Marburg 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