Hunger and Psychobehavioural Problems Among Adolescents in the Association of Southeast Asian Nations (ASEAN) Member Countries

Background: The prevalence of undernourishment or hunger is 9.6% in the association of southeast asian nations (ASEAN). Objectives: The purpose of this study was to examine the prevalence of hunger and its psychobehavioural correlates among adolescents in ASEAN member countries, including Cambodia, Indonesia, Malaysia, Myanmar, Thailand, Philippines, and Vietnam. Methods: The analysis was based on a cross sectional survey of 30 197 school-aged children (13 - 15 years) from 7 ASEAN countries participating in the global school-based student health survey (GSHS) during 2007 - 2013. Results: Regarding the overall prevalence of hunger, 56.9% of the subjects experienced hunger over the past month (rarely to always), while 4.2% were hungry most of the time or always (high hunger status). The prevalence of high hunger status ranged from 0.9% in Vietnam to 7.9% in Cambodia. In the adjusted multivariate logistic regression analysis, increased frequency of hunger in the past month was associated with psychological distress (loneliness, OR: 2.96, CI: 2.16 - 4.04; suicidal ideation, OR: 1.51, CI: 1.13 - 2.03; anxiety, OR: 3.42, CI: 2.54 - 4.62), substance use (tobacco use, OR: 1.90, CI: 1.34 - 2.41; alcohol use, OR: 1.76, CI: 1.32 - 2.35), behavioural problems (truancy, OR: 2.54, CI: 1.94 - 3.32; bully victimization, OR: 2.31, CI: 1.77 - 3.01; involvement in physical fights, OR: 2.57, CI: 1.97 - 3.35), and serious injury in the past year (OR: 2.61, CI: 2.00 - 3.41). Conclusions: In order to improve psychobehavioural health among adolescents in ASEAN member countries, the possible contribution of hunger or food insecurity should be taken into account.