About 3.8 million Californians could not afford to consistently feed themselves or their families during the Great Recession, according to a UCLA study released Monday.

Low-income families, households with children and Latinos suffered the greatest so-called food insecurity–multiple occasions in which people had to cut their food intake and experienced hunger, according to the UCLA Center for Health Policy Research.

An inability to maintain a balanced diet is associated with poor physical and mental health, including an increased risk of depression, diabetes and hypertension.

The 18-month Great Recession officially began in December 2007 and lasted until June 2009. Unemployment during the period jumped from 5 percent to 11 percent. The recession also caused a 5 percent decline in median family income between 2009-10, according to the study.

About one-in-six low-income Californians had very low food security in 2009, according to the study based on data from the California Health Interview Survey conducted by the UCLA Center for Health Policy Research. The number was double the one-in-12 who experienced periods of hunger in 2001, the researchers said.

The effects of the recession continue to linger and pose a hunger risk to low-income Californians, the study’s authors said. The state’s unemployment rate was 10.8 percent in May, three years after the official end of the recession.

“With the economy still in a slump, many families are grappling with difficult choices: do I pay the bills or buy food to feed my children?” said study co-author and UCLA health professor Gail Harrison. “In a state that is the nation’s breadbasket, it’s sad to see that so many people don’t know where their next meal is coming from.”

Researchers said the state-subsidized food assistance program known as CalFresh was an important safety net during the recession. People enrolled in CalFresh were the only low-income Californians not to experience an increase in food insecurity.

The American Recovery and Reinvestment Act of 2009 increased CalFresh benefits by 17 percent, but the subsidy increase is set to expire in 2013.

“Without the ARRA, many Californians would be in much deeper poverty,” Harrison said. “And with millions of Californians still struggling economically, 2013 is too soon to consider ending this important life-support for our poorest residents.”

The study’s authors recommended boosting enrollment in childhood nutrition programs such as free or subsidized breakfasts at school. More than half of the state’s six million public school students qualify, but only about 1 million eat breakfast at school.

The study’s authors found eating breakfast at school to be the “most effective strategy to ensure that schoolchildren have adequate nutrition to sustain them during the day.”