By Syreen Goulmamine, MPH, Science Programs Manager
Food security refers to the capacity for all people to consistently have physical and economic access to sufficient and quality food that meets their dietary needs and preferences. While many definitions for food insecurity exist across the world due to differences in data tracking and context, in the United States, food insecurity is defined as a household-level economic and social condition of limited or uncertain access to adequate food. Food insecurity encompasses issues related to access, quality, and variety of diet. Due to economic inequities, caregiving responsibilities, and broader social determinants of health, women are disproportionately impacted by food insecurity. Globally, women face higher levels of food insecurity compared to men, with an estimated 822.3 million adult women worldwide being moderately or severely food insecure.
Malnutrition, a consequence of food insecurity, refers to a deficiency, excess, or imbalance in a person’s intake of energy and nutrients. Food insecurity interacts with women’s biological mechanisms in distinct ways, shaping health outcomes differently across the lifespan. These biological vulnerabilities are compounded by social and economic determinants that magnify the impact of inadequate nutrition. From adolescence through menopause, these intertwined disparities reveal why addressing food insecurity is not only a matter of nutrition, but also of equity and lifelong health.
The Biology of Food Insecurity in Women
Food insecurity can affect women’s health not only through inadequate nutrient intake but also at the cellular and molecular level, leading to higher long-term health risks. Biological sex differences in hormones, chromosomes, and body composition play key roles in nutrition requirements, metabolic processes, and disease susceptibility. When women face obstacles in meeting their nutritional needs, these differences can put additional stress on the body.
Malnutrition can compromise immune function, triggering chronic and systematic inflammation that contributes to the development of diseases and conditions. At the cellular level, a lack of nutrients can trigger the overproduction of reactive oxygen species (ROS), a group of molecules derived from molecular oxygen, that can damage DNA and activate pathways that lead to inflammation and tissue damage. Over time, this can contribute to health issues that distinctly affect women, such as polycystic ovary syndrome (PCOS), cardiovascular disease (CVD), Alzheimer’s disease, and infertility.
Low levels of antioxidants and micronutrients in the body can also increase metabolic stress, which raises the risk of type 2 diabetes and other chronic illnesses. Insulin sensitivity, which is the way the body responds to insulin, also shapes how women metabolize nutrients. When the system is disrupted, it can lead to insulin resistance. Data suggests that undernutrition can aid in the development of insulin resistance. For women in particular, long-term exposure to malnutrition can destroy beta cell function, raising the risk of insulin resistance and type 2 diabetes. Taken together, these mechanisms highlight how food insecurity interacts with biology to create unique challenges for women’s health.
Impacts of Food Insecurity Across the Lifespan
Adolescence & Early Reproductive Years
Food insecurity during adolescence and early adulthood can have lasting implications for reproductive and mental health. In rodent studies, females that had experienced food insecurity in their adolescence later exhibited greater weight gain, increased fat mass, and higher liver fat accumulation when fed a high-fat diet in adulthood as compared to males. They also had issues with learning and memory, showing lasting impacts on brain function. Among young women with PCOS, a pilot study found that limited access to nutritious foods contributed to poorer diet quality and increased insulin resistance, further exacerbating PCOS symptoms and raising long-term risks. The chronic stress of food insecurity can also worsen anxiety and depression in women, particularly through adolescence and earlier adult years.
Iron deficiency, which affects one in five U.S. women and is common among those with heavy menstrual bleeding, can lead to anemia, fatigue, and pregnancy complications. During pregnancy and postpartum, food insecurity has been linked to gestational diabetes, excessive weight gain, and maternal depression. Animal studies further suggest that early malnutrition may trigger sex-specific epigenetic reprogramming and influence mental health outcomes during pregnancy.
Midlife & Menopause
National data show that women in their midlife (ages 40-65) experiencing food insecurity are more likely to develop poorer mental health than men. Several studies show that food-insecure women and adults above the age of 30 have a higher prevalence of obesity as compared to other subgroups. The odds of being overweight are 2.5 times higher in women between the ages of 45-59 as compared to women between the ages of 20-34. Nutritional inadequacies also threaten bone health. Notably, women account for 80% of osteoporosis cases in the United States, underscoring the consequences of poor nutrition. Calcium and vitamin D deficiencies, already common among women, are strongly associated with increased risk of fractures and osteoporosis. Nutrient deficiencies due to lifestyle factors including diet can also influence the strength, frequency, and tolerability of menopausal symptoms. These deficiencies can also increase postmenopausal women’s vulnerability to comorbidities such as metabolic diseases, osteoporosis, obesity, cancer, Alzheimer’s disease, dementia, and depression. Insulin resistance risk is also further exacerbated during menopause. While estrogen provides some protection against insulin resistance during reproductive years, its decline after menopause increases women’s risk for type 2 diabetes, highlighting the burden food insecurity poses on women going through this life stage.
With women comprising more than 61% of individuals living in poverty ages 65 and older, women become more at risk for the impacts of food insecurity on their health as they age. Addressing food insecurity for women means not only improving access to healthy foods but also tackling the broader social and economic inequalities that shape women’s health across their lives.
Moving Forward
This World Food Day on October 16 is an optimal time to highlight food insecurity as a critical women’s health issue. Women experience food insecurity in unique and disproportionate ways, shaped not only by social and economic inequities but also by biological mechanisms that influence health outcomes across the lifespan. Integrating women’s health research into policies that govern distribution and access to nutrition education and services would ensure that food assistance programs align with biological and social realities. Expanding access to culturally relevant and nutritious foods can improve both dietary quality and program engagement, especially for women in underserved communities.
But these solutions cannot stop with food alone. Addressing structural inequities, such as childcare barriers, unstable housing, and wage disparities, can help create the conditions that allow women to achieve both food security and better overall health. Tackling the challenges of food security will require holistic solutions that integrate basic research, clinical care, and policy.