The increased stress brought by the pandemic has been felt at a deeper level by a growing group of Americans—those unable to put food on the table.

Food insufficiency—which describes households that don’t have enough food to eat at least once a week—increased by 25 percent in the first months of the pandemic, according to a study published in the American Journal of Preventive Medicine.

The chronic stress of food insecurity “raises levels of stress hormones like cortisol, which raises anxiety,” says Dr. Jason Nagata, one of the study’s authors, who cites this condition as “a vicious cycle you can’t get out of.”