Food insecurity and BMI are associated with depressive symptoms among adolescents in Yogyakarta province, Indonesia, during the COVID-19 pandemic: a 1-year longitudinal study.

The COVID-19 pandemic has presented multifaceted challenges globally, impacting adolescent health. Among these, food security and nutrition are intertwined closely with mental health outcomes. In Indonesia, with its diverse socio-economic landscape, these interconnections may have been exacerbated by the pandemic. This study investigated the relationship between food security, nutrition and adolescent mental health in Indonesia during COVID-19. Longitudinal data were collected from 511 adolescent boys and girls in 2021-2022 in Gunungkidul district, Yogyakarta. Food security was measured using the Household Food Insecurity Access Scale (HFIAS), and the validated Kessler-10 Psychological Distress Scale (K10) was used to measure adolescent depression. Multivariate linear regression and linear mixed-effects regression were employed to explore associations between these variables, while adjusting for sex, age, pubertal status and household income. Overall, food insecurity score was positively associated with depressive symptoms (β: 0·72, 95 % CI 0·52, 0·92), while BMI z-score was inversely associated (β: -0·31, 95 % CI 0·68, -0·03). We found an increase in strength of association between food insecurity and depressive symptoms over time (moderately food-insecure: β: 1·36 (95 % CI -0·10, 2·83) to 4·63 (95 % CI 2·17, 7·09); severely food-insecure: β: 1·89 (95 % CI 0·36, 3·41) to 3·30 (95 % CI 1·50, 5·10). Enhancing food access, improving nutritional status and providing mental health support are crucial components of adolescent health.