Food insecurity and adverse childhood experiences: a systematic review

Michael F. Royer, Chinedum O. Ojinnaka, Xing Zhang, Anthony G. Thornton, Kimberly Blackhorse, Meg Bruening

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Context: Food insecurity (FI) and adverse childhood experiences (ACEs) disproportionally affect vulnerable populations and are key social determinants of health that predict nutrition-related outcomes. It is critical to understand how FI and ACEs are interrelated so prevention studies can be designed to better promote health equity. Objective: A systematic literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to determine the association between FI and ACEs. Data Sources: Google Scholar, PubMed, and Scopus databases were used to find articles relevant to the study. Inclusion criteria included quantitative, qualitative, or mixed-methods studies of humans, using an experimental or observational research design to examine the relationship between FI and ACEs using the validated ACEs measure in its entirety. Data Extraction: Studies were assessed for study design, data set, population descriptions, and results of the association between FI and ACEs. Additionally, all included studies were assessed for bias and validity. Data Analysis: A total of 10 articles were included in the systematic review. Of those articles, 9 were reports on cross-sectional studies, and 1 reported on a longitudinal study; however, all 10 studies used a retrospective approach. Six studies were conducted using secondary data. Results reported in all 10 articles indicated a significant positive association between FI and ACEs. Evidence indicated greater odds of FI among individuals with high ACE scores, with most studies indicating a dose-response or a threshold effect of higher ACEs being associated with more severe FI. Conclusions: FI and ACEs are consistently related. Prevention study interventions should be designed to address FI and problems stemming from ACEs. Filling knowledge gaps regarding the relationship between ACEs and FI is critical for designing nutrition interventions that promote food security, prevent the occurrence of ACEs, and improve health outcomes among vulnerable populations with high ACEs.

Original languageEnglish (US)
Pages (from-to)2089-2099
Number of pages11
JournalNutrition Reviews
Issue number10
StatePublished - Oct 1 2022


  • adverse childhood experiences
  • food insecurity
  • hunger
  • systematic review
  • trauma

ASJC Scopus subject areas

  • General Medicine


Dive into the research topics of 'Food insecurity and adverse childhood experiences: a systematic review'. Together they form a unique fingerprint.

Cite this