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 (<i>β</i>: 0·72, 95 % CI 0·52, 0·92), while BMI <i>z</i>-score was inversely associated (<i>β</i>: -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: <i>β</i>: 1·36 (95 % CI -0·10, 2·83) to 4·63 (95 % CI 2·17, 7·09); severely food-insecure: <i>β</i>: 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.