Effect of Covid-19 on food security: A cross-sectional survey

Food insecurity and its contributing determinants among rural households in the south-western region of Bangladesh, 2021: A cross-sectional study

Introduction

The onset of the COVID-19 pandemic has disrupted food access, resulting in substantial consequences for food insecurity and contributing to adverse individual and public health outcomes. To comprehensively evaluate these challenges and grasp their implications for food security, this study aimed to evaluate the contributing determinants of food insecurity among rural households in the southwestern region of Bangladesh.

Study design

A cross-sectional study was conducted using a validated questionnaire in selected 310 rural household respondents from the southwestern region of Bangladesh.

Methods

Household food insecurity status was the outcome variable for the analysis. Multinomial logistic regression analysis was used to explore and predict risk factors correlated with food insecurity among southwestern Bangladeshi households.

Results

We found that 59 % and 27.5 % of households were suffering from moderate food insecurity and severe food insecurity, respectively. The multinomial regression model revealed that respondents residing in Kusthia (RRR = 5.56 CI:2.67-8.4 and RRR = 6.65, CI:3.37-9.22) aged between 30 and 40 years (RRR = 2.32, 95 % CI:1.84-3.77 and RRR = 1.87, 95 % CI:1.48-3.97) and 40-50 years (RRR = 1.86 95 % CI:1.46-3.82 and RRR = 1.95, 95 % CI:1.75-3.26) were significantly associated with mild-to-moderate and severe food insecurity. Respondents with a monthly family income of <58.96 USD (3.38 times and 2.18 times), had ≥5 family members (2.68 times and 1.89 times), and had poor income during the pandemic (4.25 times and 2.75 times) more likely to be moderate and severe food insecure.

Conclusion

The results emphasized that during the COVID-19 lockdown in Bangladesh, rural households faced diverse levels of food insecurity, ranging from moderate to severe. It suggests that efforts to raise awareness and implement support strategies for those at higher risk should not only focus on income but also consider additional factors such as family size, adults aged 30-40 years, and occupation.

Adherence to the Gluten-Free Diet Role as a Mediating and Moderating of the Relationship between Food Insecurity and Health-Related Quality of Life in Adults with Celiac Disease: Cross-Sectional Study

This cross-sectional study aimed to estimate the relationship between food insecurity (FI) and health-related quality of life (HRQoL) in patients with celiac disease (CD) and assess whether this relationship is mediated or moderated by adherence to the gluten-free diet (GFD). The results of 1162 samples of patients diagnosed with CD showed that 8.3% of individuals who have a combined score of less than 13 exhibited excellent or very good adherence to the GFD. Furthermore, moderate and fair to poor adherence to the GFD was demonstrated, respectively and 71.9% of the patients had poor HRQoL levels. A significant and moderate positive correlation between FI and GFD adherence (r = 0.489) was found, indicating that 24% of the variance in FI is shared with GFD adherence. The patients' gender, marital status, and monthly income made statistically significant contributions to the prediction (p < 0.05). Females had significantly lower HRQoL scores than males (B = -4.619, 95% CL: -6.08, -3.16) after holding all other variables constant. In conclusion, FI is mediated by GFD adherence to HRQoL. Moreover, a significant total effect relation was found between HRQoL and both FI and GFD adherence, suggesting that lowering symptoms and complications associated with CD may reduce the impact of FI on HRQoL.

Consumption of Meats and Fish in Poland during the COVID-19 Lockdown Period

The COVID-19 pandemic and related restrictions have significantly impacted the quality of life of society in many countries in various aspects. The purpose of this study was to examine how the COVID-19 pandemic affected the consumption of meat and fish in society in Poland as well as the factors that determined these changes. The cross-sectional study was conducted using an original online questionnaire between 8th and 18th of April 2020. The subjects were selected randomly. The target population were adults living in Poland. The inclusion criterion for the study was the age of at least 18 years and consent to selfless participation in the study. Communication via social media such as Facebook or Instagram was used to enroll more participants from different socio-demographic subgroups. The questionnaire was divided into two parts-the first part contained questions about sex, age, body mass, body height, residence, level of education, and occupation, and the second part consisted of specific questions about the consumption frequency of different kinds of meat during the COVID-19 lockdown period (in comparison to the time before the pandemic). A total of 3888 people took part in the study including 84.54% women, with an average age of 30.17 ± 9.22 years. The frequency of poultry consumption increased, while for pork, beef, ham and other meat products as well as fish and seafood it declined. The factors that influenced the change in dietary patterns during the lockdown related to the COVID-19 pandemic included age, body mass index, gender, place of residence, and type of work performed. However, no relationship was found between the change in meat and fish consumption during the pandemic and the level of education and form of employment during the pandemic.

Trends in Sugar From Packaged Foods and Beverages Purchased by US Households Between 2002 and 2020

BACKGROUND

Excess sugar consumption is a public health concern in the United States. How sugar purchases have changed over time, whether there are disparities across subpopulations, and the contribution of various food groups are unclear.

OBJECTIVE

To assess trends in sugar from packaged foods and beverages purchased by US households between 2002 and 2020.

DESIGN

This is an open cohort study.

PARTICIPANTS/SETTING

We obtained data from the NielsenIQ U.S. Homescan Consumer Panel, which collects data on household purchases of all consumer packaged goods in 52 metropolitan and 24 non-metropolitan markets across the United States. We assessed data on food and beverage purchases for 1,163,447 household-years.

MAIN OUTCOME MEASURES

The primary outcomes are the total sugar in grams purchased per capita per day and percentage of calories from sugar, by sociodemographic group.

STATISTICAL ANALYSES PERFORMED

We used linear regression to estimate trends in total grams of sugar per capita per day, percentage of calories from sugar, and percentage of total sugar purchases by food or beverage group. We estimated means for select years and tested for significance compared with 2002 and with the previous timepoint and calculated the overall P-value for the linear trend using time series regression.

RESULTS

Total sugar purchases decreased over the study period, both in absolute terms (-37.2 g/capita/day; 95% confidence interval [CI], -38.7, -35.6) and as a percentage of total calories purchased (-5.3 percentage points; 95% CI, -5.5, -5.2). Sugar purchases declined for all sociodemographic groups, but disparities have persisted or widened, particularly among individuals who are non-Hispanic Black, low-income, and with lower educational attainment. Beverages' contributions to sugar purchases decreased 8.1 percentage points (95% CI, -8.4, -7.8).

CONCLUSION

In the United States, purchases of sugar declined, but disparities by socioeconomic status and race or ethnicity persisted or widened. Policies to further reduce sugar consumption and the burden of diet-related disparities are needed.

Factores socioeconómicos asociados por nivel de inseguridad alimentaria en adultos mexicanos con diabetes mellitus durante la pandemia de la COVID-19

OBJETIVOS

estimar la prevalencia de la inseguridad alimentaria e identificar los factores socioeconómicos asociados en adultos mexicanos con diabetes mellitus, durante la pandemia de la COVID-19.

MÉTODOS

estudio transversal, análisis secundario de los datos de la Encuesta Nacional de Salud y Nutrición 2020 sobre la COVID-19. Se estudió a 1 232 individuos que representan a 9 569 330 adultos con diabetes mellitus. La inseguridad alimentaria se midió utilizando la Escala Latinoamericana y Caribeña de Seguridad Alimentaria adaptada para México. Se realizó un modelo de regresión logístico binario para cada nivel de inseguridad alimentaria. Se calcularon razón de momios e intervalos de confianza al 95 %. Un valor de p < 0.05 fue estadísticamente significativo.

RESULTADOS

el 64.8 % presentó inseguridad alimentaria: 40.7 % leve, 14.2 % moderada y 9.9 % severa. Los factores asociados a inseguridad alimentaria leve fueron: nivel socioeconómico muy bajo (RM 2.6), pérdida del empleo de algún miembro del hogar (RM 2.0) y reducción de gastos en alimentación (RM 5.0); para inseguridad moderada la RM fue de 7.7, 3.4 y 18.6 y en severa la RM 7.1, 3.0 y 46.7, respectivamente.

CONCLUSIONES

la COVID-19 ha tenido efectos inmediatos en la inseguridad alimentaria de la población de adultos mexicanos con diabetes mellitus. Identificar los factores socioeconómicos asociados es prioritario para llevar a cabo políticas públicas que permitan redirigir los recursos y cubrir necesidades básicas como la alimentación.

Food insecurity and water management shocks in Saudi Arabia: Bayesian VAR analysis

The existing conditions of domestic agricultural production and the resulting products will not be able to fruitfully address the increasing food demand due to the limited fertile land and water resources in Saudi Arabia. Moreover, the escalating threat of a hotter climate, the deterioration in precipitation, and harsh droughts in Saudi Arabia have reduced the predictability of water management efficiency and resulted in the exhaustion of water bodies and serious degradation of ecosystems that have directly affected agricultural systems and indirectly, food security. This study also aims to assess the impact of water efficiency on food insecurity in Saudi Arabia. The study applied the Bayesian Vector Autoregressive (BVAR) model for the reference period for the data extended from 2000-2020. Likewise, we used both impulse response functions (IRFs) and forecasting variance error decomposition (FVED) through 1000 Monte Carlo simulations according to the BVAR model to examine both the response of food insecurity to the shocks on water management efficiency used for various purposes and the decomposition of error variance in food insecurity. The results show that food insecurity was not observed throughout this study. The results of the BVAR analysis indicate that in the short run, the coefficients of water use efficiency are significant based on the Food Insecurity Multidimensional Index (FIMI). Also, the BVAR model provides a better forecast with an interdependence on water use efficiency for agricultural purposes and FIMI. Moreover, the results obtained from IRFs have shown a significant effect of water efficiency on FIMI. Water use efficiency for agriculture and industrial purposes reduces food insecurity while increasing water for services use increases food insecurity. Water use efficiency is the key factor affecting food insecurity in the short run. The results reveal that the water use efficiency shocks will decrease food insecurity. The shocks experienced by food insecurity can be predicted as self-shock over a span of ten years. Emphasis is given to the task of water management that may support food security in Saudi Arabia through implementing and enhancing the water use efficiency as an integral part of achieving the SDGs in Saudi Arabia.

Regional Agriculture and Food Systems Amid the COVID-19 Pandemic: The Case of the Near East and North Africa Region

The COVID-19 pandemic affected agri-food systems worldwide. However, while the impacts differed from one country/region to another, the scholarly literature seems to focus on developed countries in the Global North. Consequently, this review scrutinizes the literature on the pandemic's impacts in the Near East and North Africa (NENA) region. A search on the Web of Science in March 2023 generated 334 documents, of which 151 were eligible for inclusion in the systematic review. According to the bibliometric analysis, the most active nations are Saudi Arabia, Egypt, Jordan, the United Arab Emirates, and Lebanon. In general, the coverage of studies is better in the Gulf region than in the less developed countries of North Africa and those suffering from wars (cf. Libya, Syria, and Yemen). Studies generally focus on crop production and the downstream food chain (cf. distribution and consumption). While the pandemic influenced every pillar of food security, this research concentrates on access and utilization. Meanwhile, the lion's share of the literature deals with the pandemic's socio-economic effects, especially those linked to food (in)security and health. The pandemic, which laid bare the agri-food system vulnerabilities, should be seized to foster the transition towards more resilient agri-food systems in the NENA region.

Call for emergency action to restore dietary diversity and protect global food systems in times of COVID-19 and beyond: Results from a cross-sectional study in 38 countries

Background

The COVID-19 pandemic has revealed the fragility of the global food system, sending shockwaves across countries' societies and economy. This has presented formidable challenges to sustaining a healthy and resilient lifestyle. The objective of this study is to examine the food consumption patterns and assess diet diversity indicators, primarily focusing on the food consumption score (FCS), among households in 38 countries both before and during the first wave of the COVID-19 pandemic.

Methods

A cross-sectional study with 37 207 participants (mean age: 36.70 ± 14.79, with 77 % women) was conducted in 38 countries through an online survey administered between April and June 2020. The study utilized a pre-tested food frequency questionnaire to explore food consumption patterns both before and during the COVID-19 periods. Additionally, the study computed Food Consumption Score (FCS) as a proxy indicator for assessing the dietary diversity of households.

Findings

This quantification of global, regional and national dietary diversity across 38 countries showed an increment in the consumption of all food groups but a drop in the intake of vegetables and in the dietary diversity. The household's food consumption scores indicating dietary diversity varied across regions. It decreased in the Middle East and North Africa (MENA) countries, including Lebanon (p < 0.001) and increased in the Gulf Cooperation Council countries including Bahrain (p = 0.003), Egypt (p < 0.001) and United Arab Emirates (p = 0.013). A decline in the household's dietary diversity was observed in Australia (p < 0.001), in South Africa including Uganda (p < 0.001), in Europe including Belgium (p < 0.001), Denmark (p = 0.002), Finland (p < 0.001) and Netherland (p = 0.027) and in South America including Ecuador (p < 0.001), Brazil (p < 0.001), Mexico (p < 0.0001) and Peru (p < 0.001). Middle and older ages [OR = 1.2; 95 % CI = [1.125-1.426] [OR = 2.5; 95 % CI = [1.951-3.064], being a woman [OR = 1.2; 95 % CI = [1.117-1.367], having a high education (p < 0.001), and showing amelioration in food-related behaviors [OR = 1.4; 95 % CI = [1.292-1.709] were all linked to having a higher dietary diversity.

Conclusion

The minor to moderate changes in food consumption patterns observed across the 38 countries within relatively short time frames could become lasting, leading to a significant and prolonged reduction in dietary diversity, as demonstrated by our findings.

Household food security access and dietary diversity amidst COVID-19 pandemic in rural Nepal; an evidence from rapid assessment

BACKGROUND

The COVID-19 pandemic led to surging concerns about food insecurity status throughout the world. In response to global and national concerns on food and nutrition security, this study aimed to examine the prevalence and determining factors of household food insecurity and dietary diversity among people from selected rural municipalities of Lalitpur district, Nepal.

METHODS

A community-based cross-sectional study was conducted among 432 households. Pretested structured questionnaires were used to collect socio-demographic characteristics of the participants, household income; influence of COVID-19 on their income and livelihood, household's access to food and dietary diversity. Food insecurity was measured using the Household Food Insecurity Access Scale (HFIAS) and the Household Dietary Diversity Score (HDDS). A multivariable analysis was done using binary logistic regression model following a bivariate analysis to assess the association between the dependent and independent variables.

RESULTS

More than one-third (36%) of the households reported some form of food insecurity. The overall mean score for Household Dietary Diversity Score (HDDS) was 6.0 (±1.1). Multivariable logistic regression analysis showed that participants aged 41-64 years (aOR = 0.35, 95% CI: 0.21-0.59), those over 64 years (aOR = 0.22, 95% CI: 0.07-0.66), as well as those in service occupation (aOR = 0.22, 95% CI: 0.06-0.77) were associated with lower odds of HFIAS. Conversely, Participants belonging to a disadvantaged ethnic group (aOR = 2.73, 95% CI: 1.23-6.07), having no education (aOR = 3.70, 95% CI: 1.16-11.71) or primary education (aOR = 3.67, 95% CI: 1.23-9.89), and those suffering from chronic illness (aOR = 3.12, 95% CI: 1.53-6.35) were associated with higher odds of HFIAS. As for HDDS, participants aged 41-64 years (aOR = 0.48, 95% CI: 0.28-0.83) were associated with lower odds of HDDS, while participants having no education (aOR = 10.05, 95% CI: 4.05-24.01) were associated with significantly higher odds of HDDS.

CONCLUSION

Owing to the pandemic, our study showed a substantial prevalence of food insecurity among diverse community residing in rural outskirts of Kathmandu Valley, particularly among disadvantaged ethnic group and people with lower level of education. Interventions targeting these particular groups may help in improving HFIAS and HDDS among them during emergencies.

Exacerbation of household food insecurity among low-income families in Hong Kong during the COVID-19 pandemic

AIM

The economic depression and reduced physical mobility associated with COVID-19 potentially affected the food security status of the poor. This study aimed to assess the possible worsening of perceived food insecurity among low-income families in Hong Kong.

METHODS

Families either receiving government subsidies or living in a subdivided flat referred by local non-governmental organisations were invited to participate in a telephone survey. Food security status before (by recalling) and during the pandemic were assessed using Household Food Insecurity Access Scale. Chi-square analysis and ANOVA were used to test the difference between the percentage of participants who responded affirmatively to survey questions and various categories of food insecurity. Paired t-test was used to examine the reported change in food insecurity score before and during the COVID-19 pandemic. Association between socio-demographic factors and change in food insecurity score was then assessed by multiple linear regression using backward stepwise elimination.

RESULTS

Findings from the 212 households revealed that, for all nine questions concerning food insecurity, there was a significantly higher percentage of affirmative responses during versus before the pandemic. The proportion of food-secure households dropped from 16.5% to 7.1% amidst the pandemic. By contrast, households with severe food insecurity increased from 19.3% to 33.5%. Regression analysis showed that those households who were living in subdivided flats and with high monthly housing expenses, were likely to experience an exacerbation of food insecurity. Meanwhile, households with divorced parents (probably due to consistent social subsidy) and high household incomes, showed resilience toward food insecurity. Concurrently, about one fifth of children in these households had an experience of starvation for a whole day due to financial constraints.

CONCLUSION

The exacerbation of food insecurity among low-income families during the COVID-19 pandemic necessitates timely assessments and the implementation of appropriate measures to prevent them from experiencing physiological harm. These initiatives can be guided by the identified at-risk socio-economic characteristics in the present study.

Effectiveness of orange almond potato cookie vs. orange potato cookie supplementation on nutritional wellbeing of the Indonesian stunted preschool-aged children during COVID-19 pandemic

Background

Preschool-aged children who experience stunting due to insufficient consumption of macro- and micronutrients exhibit weakened immune systems, rendering them susceptible to contracting COVID-19 during the ongoing epidemic. Therefore, it is imperative to implement interventions aimed at enhancing the nutritional status of preschool-aged children by providing them with nutrient-rich food supplements as a preventive measure against illness transmission. The objective of the study was to evaluate the impact of incorporating potato almond orange cookies into the diet on the nutritional status of preschool-aged children who are experiencing stunting.

Methods

A non-randomized pre-post intervention study was done on 42 individuals aged 12-58 months during 4 weeks. The intervention group was provided with almond potato cookies, while the control group was given orange potato cookies. During the study period, educational sessions on balanced nutrition in preschool-aged children with stunting and COVID-19 were provided to the mothers of both groups. The data analysis involved conducting univariate and bivariate analyses, namely utilizing the independent t-test.

Results

The intervention group exhibited the most significant enhancements in -for-Age Z-score. The mean -for-Age Z-score of the intervention group increased by 0.51 (from -3.15 to -2.64), whereas the control group saw a smaller gain of 0.25 (from -2.69 to -2.44). This increase was influenced by the mother's age; mother's education; father's occupation; family size; good sanitation facilities; healthy home environment; and fat, calcium, and zinc intake from the cookies (p < 0.05). From the perspective of knowledge about balanced nutrition and COVID-19, there was no significant difference in the -for-Age Z-score in the intervention group.

Conclusion

The ingestion of orange almond potato cookies has the potential to enhance the nutritional wellbeing of children in the preschool age group who are experiencing stunted growth.

COVID-19 and food security risk in Nkambe Cameroon: perceptions, drivers and household response measures

This study focuses on COVID-19 and food security risk, capturing perceptions, drivers and household response measures. Using a mixed research design, the researchers investigated food security risk in Nkambe Cameroon during peak periods of COVID-19. Data were collected through a structured questionnaire distributed to 400 respondents and key informant interviews, and it was analysed using both descriptive and inferential statistics. Results showed significant differences in the food security dynamics among COVID-19-infected and non-infected households (19% and 33%, respectively, p = 0.002), with non-infected households being more food secure than COVID-19-infected ones. Significant positive effects between variables, like age of respondent, household size, level of education and food security of affected households were identified. The regression model explains 82.8% of the food security determinants in the midst of COVID-19's peak period. Both COVID-19-infected and non-infected households responded to food insecurity through food rationing and consumption frequency rationing, instead of reducing food consumption frequency. The researchers recommend increasing the efficacy of safety nets and other social assistance programmes in the face of shocks by targeting households most vulnerable to COVID-19-induced food insecurity. Expanding this research agenda to other study sites with a gender lense can provide insights for food security policies post COVID-19.

The correlations between food security, diet quality and weight change among working women of reproductive age during the endemic phase of COVID-19

Aim

This cross-sectional study aims to investigate the correlations between food security, diet quality and weight change among working women during the endemic phase of COVID-19 in the Klang Valley of Malaysia.

Methods

Working women aged 18-49 years were required to self-report their socio-demographics and pre-pandemic body weight (body weight during February 2020). Body height and current body weight were measured using a SECA stadiometer and TANITA weighing scale. Food security was assessed using the Food Insecurity Experience Scale (FIES); the diet quality was determined with the Diet Quality Questionnaire (DQQ) for Malaysia.

Results

The prevalence of moderate-to-severe food insecurity was 19.9%. It is noted that 64.3% of working women gained weight throughout the pandemic, with an average weight gain of 4.36 ± 3.19 kg. Concerning diet quality, the majority (82.5%) achieved the Minimum Dietary Diversity for Women (MDD-W). Findings from linear regression revealed that food security was not significantly correlated with weight change. However, working women who failed to achieve the MDD-W gained, on average, 1.853 kg more than those who did (p = 0.040). On the other hand, no significant correlation was observed between food security status and diet quality in weight change of working women.

Conclusion

The current study shall provide an impetus to develop intervention strategies for promoting healthy eating among working women.

Moderate-to-severe food insecurity is positively correlated with the risk of eating disorders in the aftermath of the COVID-19 pandemic

Background

The COVID-19 pandemic may have worsened food insecurity and altered the eating behaviour of young adults. Therefore, this cross-sectional study aims to investigate the correlation between moderate-to-severe food insecurity and the risk of eating disorders among young urbanists in Malaysia after the pandemic-led lockdown.

Methods

The food security status and the risk of eating disorders were assessed using the validated Food Insecurity Experience Scale (FIES) and Eating Attitude Test (EAT-26), respectively.

Results

Among the 208 young urbanists, approximately one-third (30.8%) were moderate-to-severe food insecure and about one-fifth (18.8%) were at risk of eating disorders after the nationwide lockdown. With the adjustment of gender, the binary logistic regression analysis revealed that moderate-to-severe food insecure individuals were 2.279 times (P = 0.030, 95% CI = 1.084-4.791) more likely to engage in disordered eating in the aftermath of the COVID-19 pandemic. The findings of partial correlation further indicated that moderate-to-severe food insecurity was positively correlated (r_partial = 0.156, P = 0.024) with bulimia and food preoccupation after the outbreak.

Conclusions

Governments and non-governmental organizations must work closely to develop effective policies to address food insecurity and disordered eating behaviour among young urbanists - after the pandemic.

Covid-19 related factors to food security and dietary diversity among urban households in western Oromia, Ethiopia

Background

This study aims to assess factors associated with food security and dietary diversity among poor urban households of western Oromia, Ethiopia, after the outbreak of the Covid-19 pandemic.

Method

A cross-sectional, community-based study was conducted in May to June 2021 with 361 poor urban households in the Horo Guduru Wollega zone, western Oromia, Ethiopia. A pre-tested structured questionnaire was used to collect primary data. Twenty-four hour reminder points were used to assess household dietary diversity, and household food security was assessed using the Household Food Insecurity Access Scale tool. Data were evaluated using the statistical software SPSS version 25.0.

Results

This study showed a prevalence of food insecurity in households of 59.6%. The mean and standard deviation of household dietary diversity values were 4.19 ± 1.844. Family size (AOR = 8.5; 95% CI:3.295-21.92), monthly income (AOR = 3.52; 95% CI; 1.771-6.986), dietary diversity (AOR = 8.5; 95% CI; 3.92-18.59), knowledge (AOR = 3.0, 95% CI = 1.08-)8.347), attitude (AOR = 8.35, 95% CI:3.112-22.39) and practices against Covid-19 (AOR = 2.12; 95% CI:1.299-11.4) were factors significantly associated with food insecurity. Variables like educational status (AOR = 3.46; 95% CI:1.44-8.312), increased family size after the Covid-19 pandemic (AOR = 2.26; 95% CI:1.02-5.04), food security (AOR = 6.7; 95% CI:4.01-19.01), knowledge (AOR = 3.96; 95% CI:1.57-10.0), attitude (AOR = 3.9; 95% CI:1.75-8.82) and practices toward coronavirus (AOR = 2.23; 95% CI:2.18-23.95) were predictors significantly associated with dietary diversity.

Conclusion

This study concluded that family size, monthly income, and dietary diversity were factors contributed to household food security. On the other hand, variables such as educational status, family size, and food security were highly relevant factors for dietary diversity after the outbreak of the Covid-19 pandemic. Knowledge, attitudes, and practices were also variables related to both household food security and dietary diversity. Therefore, immediate interventions such as nutrition-specific interventions can be suggested to address food insecurity and problems of inadequate food intake in poor urban households. In addition, governmental and non-governmental organizations should raise awareness and policies to support those at higher risk by developing affordable, sustainable and targeted social protection systems that ensure food security and adequate dietary intake at the household level.

Prevalence of dietary supplement use and knowledge, attitudes, practice (KAP) and associated factors in student population: A cross-sectional study

Dietary supplements (DSs) intake has been increasing worldwide despite no consensus evidence for the efficacy and safety of disease prevention, control, or treatment in nutrient-replete populations. This study aimed to determine the prevalence of DSs use, knowledge, attitude, and practice (KAP) and associated factors among university students in Jordan. A national cross-sectional study was carried over across universities in Jordan. Participants completed a valid and reliable online questionnaire (Cronbach's alpha = 0.802 and correlation coefficients between 0.72 and 0.26). Univariate analyses were used to determine the relationship between variables. Multivariable regression was carried out to identify significant factors contributing DSs usage. A total of 448 university students completed the study (73.7% females). More than half of the students used DSs (60.9%), with single-nutrient ingredient supplements being the most commonly used type. The primary motivators were maintaining health and most students reported no side effects associated with consumption. The results revealed poor knowledge, a negative attitude towards DSs usage among all participants, even non-users, and high-risk practices among the DSs users. Normal weight and overweight individuals were more likely to use DSs (OR:2.88, 95%CI:1.61-5.16, OR:1.95, 95%CI:1.01-3.79, respectively). Low and medium-family income categories were more likely to use DSs than those in the high-income category (OR: 0.04, 95%CI: 0.02-0.07, OR: 0.06, 95CI:0.03-0.11, respectively). Undergraduate students were more likely to use DSs than postgraduate students (OR:5.56, 95%CI:3.19-9.69). In this study, a high prevalence of DSs use was highlighted. The results suggest that nutrition education is required to improve awareness of DSs and to promote safe practices.

Impact of SARS-CoV-2 Pandemic on food Security in Patients With chronic Kidney Disease

OBJECTIVE

The present study aims to determine the degree of Food Insecurity (FI) in adult patients with CKD during the COVID-19 pandemic, as well as the association between FI and food consumption.

METHODS

A cross-sectional study was conducted on patients with chronic kidney disease (CKD), with and without substitutive treatment, and older than 18 years of age. Food security was measured using the Mexican Food Security Scale (MFSS). Sociodemographic data and a food frequency questionnaire were obtained. Multinomial logistic regression was performed using the 4 categories of food security (food security as reference); principal component analysis was also performed to assess the relationship between food consumption patterns and sociodemographic characteristics.

RESULTS

The prevalence of FI in patients with CKD was 71.6%, the most prevalent degree of FI was moderate. As FI increased, a greater amount of beans, eggs, sweets/desserts, soft drinks, and artificial juices (P < .001) was consumed. The risk factors of FI were diabetes, hypertension, unpaid occupation, living in the country's capital, having children at home, or a decrease in income due to the pandemic. Four main components were identified that were associated with the different degrees of FI.

CONCLUSION

The present study allowed us to conclude that more than 70% of CKD patients in the study cohort had some type of FI, which makes it difficult to adhere to treatment and may increase the risk of advanced CKD. A less healthy food pattern is associated with greater FI.

COVID-19: Lessons on malnutrition, nutritional care and public health from the ESPEN-WHO Europe call for papers

With prolonged pandemic conditions, and emerging evidence but persisting low awareness of the importance of nutritional derangements, ESPEN has promoted in close collaboration with World Health Organization-Europe a call for papers on all aspects relating COVID-19 and nutrition as well as nutritional care, in the Society Journals Clinical Nutrition and Clinical Nutrition ESPEN. Although more COVID-related papers are being submitted and continue to be evaluated, ESPEN and WHO present the current editorial to summarize the many published findings supporting major interactions between nutritional status and COVID-19. These include 1) high risk of developing the disease and high risk of severe disease in the presence of pre-existing undernutrition (malnutrition) including micronutrient deficiencies; 2) high risk of developing malnutrition during the course of COVID-19, with substantial impact on long-term sequelae and risk of long COVID; 3) persons with obesity are also prone to develop or worsen malnutrition and its negative consequences during the course of COVID-19; 4) malnutrition screening and implementation of nutritional care may improve disease outcomes; 5) social and public health determinants contribute to the interaction between nutritional status and COVID-19, including negative impact of lockdown and social limitations on nutrition quality and nutritional status. We believe the evidence supports the need to consider COVID-19 as (also) a case of malnutrition-enhanced disease and disease-related malnutrition, with added risk for persons both with and without obesity. Similarities with many other disease conditions further support recommendations to implement standard nutritional screening and care in COVID-19 patients, and they underscore the relevance of appropriate nutritional and lifestyle prevention policies to limit infection risk and mitigate the negative health impact of acute pandemic bouts.

Link between structural risk factors for adverse impacts of COVID-19 and food insecurity in developed and developing countries

COVID-19 has had serious consequences for world food security; lockdowns and social distancing have led to changes in global food value chains, primarily affecting the poorest of the planet. The aim of this research is to analyse the relationship between food insecurity and the structural risk factors for adverse impacts of COVID-19. To that end, 12 contingency tables are constructed to identify the association between the pillars of the food insecurity index and the INFORM COVID-19 Risk Index. We use the Gamma coefficient as a measure of association. In addition, this paper proposes a synthetic index produced by applying the TOPSIS method, using the pillars of the two aforementioned indices (criteria) to establish a ranking of 112 countries (alternatives) ordered from highest to lowest risk faced in the key year of the pandemic, 2020. The results show that the two problems are connected, indicating to international organizations that countries with worse food insecurity will suffer more serious consequences from extreme situations such as the one experienced during the pandemic. The ranking established directs international organizations' attention to countries such as Haiti, Zambia and Burundi, highlighting their greater need for an injection of financial aid than other emerging economies. Conversely, Switzerland is the country with the lowest combined risk.

Food insecurity associated with self-reported mental health outcomes in Peruvian households during the COVID-19 pandemic

Background

The global pandemic of COVID-19 and the social distancing efforts implemented worldwide to limit its spread have disrupted the economy, increased food insecurity, and mental health problems.

Objectives

The aim of this study was to determine the association between food insecurity and mental health outcomes (stress, depression, and anxiety) in Peruvian households during the COVID-19 pandemic.

Materials and methods

A cross-sectional investigation was conducted with 525 participants of both sexes (68% women), over 18 years of age and from the three geographic regions of Peru: Coast (54.9%), Highlands (28.4%), and Jungle (16.8%). The data were collected during the year 2021, between July 6 and September 22 through a self-administered online survey designed to assess socio-demographic, socioeconomic, food insecurity, and mental health outcomes (depression, anxiety, and stress).

Results

The majority of households (71.4%) experienced some degree of food insecurity. Mild food insecurity was the most frequent, affecting 49.1%, followed by moderate 15.4%, and severe 6.9%. Regarding mental health outcomes, 24.8% manifested depression, 26.7% anxiety, and 15.3% stress. With respect to the association between the level of food insecurity and anxiety, this was highly significant (p < 0.01). Households with mild, moderate and severe food insecurity are 2.04, 4.5, and 10.44 times, respectively, more likely to have moderate-severe anxiety. On the other hand, the mild food insecurity was not associated with moderate-severe depression. In contrast, households with moderate and severe food insecurity are 2.8 and 5.7 times, respectively, more likely to have moderate-severe depression. Finally, households with moderate food insecurity are 5.9 times more likely to have moderate-severe stress, and households with severe food insecurity are 8.5 times more likely to have moderate-severe stress, both having a highly significant association (p < 0.01).

Conclusion

In conclusion, during the second wave of the COVID-19 pandemic in Peru, household food insecurity was independently associated with worse mental health outcomes. Monitoring of both food insecurity and mental health will be important as the COVID-19 pandemic continues.

The Diet Quality of Food-Insecure Australian Adults-A Nationally Representative Cross-Sectional Analysis

Poor diet quality exacerbates risks for acute and chronic conditions. People experiencing food insecurity have an increased likelihood of lower diet quality; however, this has not been investigated in the Australian context. The aim of this cross-sectional study was to examine whether the diet quality of Australian adults differed according to their household food security status. Data were analysed from a nationally representative sample (≥19 years; n = 9115) collected as part of the National Nutrition and Physical Activity Survey 2011-12. Household food security status and socio-demographic and health characteristics were assessed using data from an 18-module health interview. A 24 h dietary recall was used to estimate food and nutrient intakes and to calculate the Dietary Guidelines Index (DGI). DGI is a food-based score (0 to 130) that assesses adherence to the 2013 Australian Dietary Guidelines. Survey-weighted linear regression models, adjusted for age and sex, were used to examine diet quality (total DGI and component scores), and total energy and nutrient intake by food security status. Adults from food-insecure households had a mean total DGI score 3.5 points lower (95% CI -5.57, -1.46) than food-secure adults (p = 0.001). Adults from households experiencing food insecurity, when compared to those who were food-secure, had several lower DGI component scores including for dietary variety (1.6 vs. 2.3, p = 0.009), fruit (3.8 vs. 5.0, p = 0.001) and vegetables (3.7 vs. 4.4, p = 0.010). Adults from food-insecure households consumed on average more carbohydrates (45.6 vs. 43.3, p = 0.004) and total sugar (21.8 vs. 19.0, p = 0.003) as a percentage of daily energy and less protein (18.5 vs. 17.2, p = 0.004), mono-unsaturated fats (11.2 vs. 11.8, p = 0.026) as a percentage of daily energy, and fibre (20.1 vs. 23.0, p = 0.003), than food-secure adults. Sub-optimal diet may be one of the contributing factors to, or outcomes of, poorer health in food-insecure populations. Food security interventions are required to better address nutrition in food-insecure households and should be tailored to the health and socio-demographic characteristics of this population.

Empirical analysis on the impact of the COVID-19 pandemic on food insecurity in South Africa

The study sought to ascertain the changes in the food insecurity status of households during the COVID-19 pandemic. The study made use of secondary data obtained from the 5 Waves of the National Income Dynamics Study-Coronavirus Rapid Mobile Survey (NIDS-CRAM). Descriptive statistics, food insecurity index and independent sample t-test were used to compare the mean differences in the food insecurity statuses of the households over the 5 Waves. The study found that there was an increase in food insecurity as the COVID-19 progressed from Wave 1 to 5. Significant differences at the 1% level were observed between Wave 5 and Wave 1 as well as between Wave 5 and Wave 3. The study concludes that there was food security in the initial progression of the COVID-19 pandemic which deteriorated. The study recommends a reconsideration of the scrapping of the top ups on the social grants. This will likely tighten the dire economic situation the households find themselves in. There is need to expand the social safety nets to accommodate the vulnerable in society. Short and localised value chains should be promoted to improve food accessibility during times of crisis.

Food insecurity and its determinants in a vulnerable area of Santiago, Chile

This study aims to identify the determinants associated to food insecurity in a group of households composed of schoolchildren and their mothers/caregivers, who lived in a low-to-medium community development index area of the city of Santiago, Chile with a high presence of migrant population. The non-probabilistic and convenience sample was made up of 646 people, who answered a series of surveys with the aim of characterizing this group in sociodemographic terms (sex, age, number of inhabitants in the household, place of food purchase, conditional or non-conditional state transfer program beneficiary status, persons in charge of purchasing food for the household, mothers/caregivers education level and basic knowledge of food and nutrition). To assess moderate-to-severe food insecurity and severe food insecurity, the Food Insecurity Experience Scale-FIES was applied between September and October 2021. Logistic regression analysis were used to carry out multivariate analyses, with the use of stepwise back-and-forward strategies for the selected variables and defining p &lt; 0.05. These models were adjusted per number of inhabitants in the household. The results indicate that 25.4% of households presented moderate-to-severe food insecurity, and 6.4% severe food insecurity experience. The variables that presented significant odds of risk to food insecurity were being a migrant, low maternal education level, low performance on basic knowledge in nutrition and when the father was responsible for food purchases. Several public policies have been implemented in Chile during the most recent decades aimed at increasing access to healthier foods and the implementation of healthier food environments. Despite this, there are still social and economic health determinants that contribute to the risk of odds insecurity for the most vulnerable groups in the country, thus putting at risk the fulfillment of the human right to adequate food at risk.

Impacts of the Pandemic, Animal Source Food Retailers' and Consumers' Knowledge and Attitudes toward COVID-19, and Their Food Safety Practices in Chiang Mai, Thailand

The COVID-19 pandemic affected the food supply chain, retailers, and consumers owing to infection awareness. This study evaluated the impacts COVID-19 on ASF retailers' businesses and consumers' livelihoods, as well as their knowledge toward the disease, attitudes, and food safety practices to prevent infections. The study includes a cross-sectional component that was conducted in urban/peri-urban (U/PU) and rural areas in Chiang Mai province. In another part of the study, a structured questionnaire was developed for animal source food (ASF) retailers and consumers, with three primary parts for data analysis: general information, COVID-19 impacts, and knowledge, attitudes, and practices (KAP) assessment. Data corresponding to three periods of interest (before the COVID-19 outbreak, during partial lockdown, and present) were gathered and analyzed. In this study, 155 retailers and 150 consumers participated, of which the majority of the respondents were female (70.3% and 82.7%, respectively) with average ages of 47.4 and 44.9 years, respectively. The most noticeable effect of COVID-19 was a decline in income for retailers and consumers. The KAP scores of consumers in both areas were not significantly different, whereas the retailer attitudes toward COVID-19 prevention and food safety practices scored more highly in rural areas than in U/PU. During the partial lockdown, food safety practices significantly improved relative to the time preceding the outbreak, and these practices have remained constant to the present day. The results revealed that gender, age group, business type, and type of ASF retailers were associated with the KAP of the retailers, whereas gender, age group, education, number of family members, and occupation were associated with the KAP of the consumers. Our findings provide in-depth information about the effects of COVID-19 on ASF retailers and consumers, as well as their KAP regarding the outbreak and food safety, which may serve as support in developing policies for improved health and food safety.

Factors Associated with Food Insecurity in Latin America and the Caribbean Countries: A Cross-Sectional Analysis of 13 Countries

It is estimated that Latin America and the Caribbean (LAC) is the region with the second highest figures for food insecurity (FI) globally, with a prevalence of 40.9% in the entire region. This cross-sectional study analyzes the household factors associated with FI across 13 LAC countries. We used data from the first round of high-frequency phone surveys, conducted by the World Bank. Approximately 4 out of 10 people in LAC experienced FI during the first phase of the COVID-19 pandemic. FI was positively associated with the number of individuals aged from 5 to 18 years, the number of men, the illness, accident, or death of an income-earning household member, and health expenditure due to COVID-19 or other illnesses, as well as the increase in food prices, reduced family income, and job loss by a member of the household. On the other hand, households located in capital cities and those with more bedrooms were less likely to have experienced FI. The design of social policies must focus on the economic deficiencies experienced by the LAC population, with unemployment, reduced income, and high food costs being the main factors that must be addressed to ensure adequate nutrition.

Increased prevalence and severity of psychiatric illness in hospitalized youth during COVID-19

BACKGROUND AND OBJECTIVES

Previous studies have demonstrated an increase in mental health emergencies among youth seen in ambulatory and emergency room settings during the COVID-19 pandemic. This study investigates rates of mental health-related consultation and markers of illness severity since the start of the pandemic.

METHODS

We evaluated all pediatric patients admitted to a single children's hospital from March 2019 to March 2021 who received psychiatry and/or psychology consults. We report the absolute number of these patients, as well as the proportion of all study site admissions who received such consults. Severity of psychiatric illness was described in terms of LOS, disposition, and use of restraints and psychotropic medications.

RESULTS

The number and proportion of pediatric patients receiving psychiatry and/or psychology consults rose during the pandemic. Participants also became proportionally more female and older. The study population had higher odds of requiring restraints and antipsychotics during the pandemic.

CONCLUSIONS

More pediatric inpatients at the study site have required psychiatric care during the pandemic. The severity of mental illness in this population appears to have worsened based on increased utilization of as-needed psychotropic medications and restraints. These findings highlight the changes experienced by patients and providers during the pandemic and merit further study.

Association of Household Food Insecurity With Dietary Intakes and Nutrition-Related Knowledge, Attitudes, and Practices Among School-Aged Children in Gaza Strip, Palestine

Background

The present study aimed to determine the association of household food insecurity with dietary intakes and nutrition-related knowledge, attitudes, and practices (KAP) among school-aged children.

Methods

This cross-sectional study was conducted among a representative sample of school-aged children. A total of 380 children and their parents were selected from all Gaza strip governorates, using a random sampling method. The demographic and socioeconomic characteristics; the Radimer/Cornell food security scale; two non-consecutive days of 24-h dietary recall; anthropometric measurements; and the Food and Agriculture Organization KAP-questionnaire (Module 3) were employed. Statistical analysis was performed using SPSS version 25.

Results

About 71.6% of school-aged children were household food-insecure, while 28.4% were household food-secure. Significant associations were found between living area, educational level, household monthly income, weight for age and BMI for age z-scores, underweight, malnutrition status, intakes of protein, iron, vitamin D, and zinc among household food-secure, and household food-insecure. After adjustment for confounding variables, having nutrition-related adequate KAP were associated with lower odds of being food-insecure household [OR = 0.519, 95% (CI = 0.320–0.841)], [OR = 0.510, 95% CI = (0.315–0.827)], and [OR = 0.466, 95% CI = (0.285–0.763), P < 0.05 for all], respectively.

Conclusions

Low socioeconomic status, low anthropometric indices, poor dietary intakes may be associated with a high level of food-insecurity; while having nutrition-related adequate KAP may be protective against food-insecurity among school-aged children.

Lockdown Due to COVID-19 and Its Consequences on Diet, Physical Activity, Lifestyle, and Other Aspects of Daily Life Worldwide: A Narrative Review

The novel coronavirus, termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is responsible for the disease called coronavirus disease 2019 (COVID-19). Besides the important rates of mortality and morbidity directly attributed to the infection itself, many studies detected an important shift towards mostly unhealthy lifestyle patterns in previously healthy non-infected populations all around the world. Although most of the changes in lifestyle had or will have a negative impact on general population health status, some findings are encouraging. Notwithstanding that there was an obvious necessity for governments to apply national lockdowns, it is also necessary to identify and comprehend the consequences they have caused. A narrative literature review was performed, based on scientific articles and previous reviews. An accurate description of changes in eating habits and alcohol consumption, physical activity, mental health, daily routines, economic impacts, and broader effects on society is provided for each continent and different age groups through this review. The volume of selected scientific surveys encompasses approximately 400,000 persons.

Food Insecurity, Dietary Diversity, and Coping Strategies in Jordan during the COVID-19 Pandemic: A Cross-Sectional Study

The 2019 coronavirus disease (COVID-19) is an emerging respiratory infection with severe impacts on the nutritional status of the worldwide population. This cross-sectional study was conducted to assess the food insecurity, dietary diversity, and food-related coping strategies in Jordan during the pandemic using an online, self-administered questionnaire. Among the 740 adults who completed the survey, the prevalence of food security was 84.1%, whereas 2% and 13.9% were moderately and severely food-insecure, respectively. The determinants of food insecurity were educational level, monthly income, marital status, availability of health insurance, and type of residence. In addition, food insecurity was significantly higher among the participants who consumed two or fewer meals per day (p = 0.015). Moreover, an acceptable food consumption score was shown among 76.2% of the participants, and the remaining participants were at borderline (14.1%) or had poor scores (9.7%), with a significant association between food insecurity and food consumption scores (p < 0.001). The food-related coping strategies studied were significantly associated with food insecurity at both levels (p < 0.001) and were more evident in the severely food-insecure group. These findings highlight the adverse effects of COVID-19 restrictions on nutritional status, especially among food-insecure households, which might reduce food accessibility due to economic difficulties.

Taneyan Lanjang Shared Home Gardens and Sustainable Rural Livelihoods of Ethnic Madurese in Madura Island, Indonesia

The ethnic Madurese are among the top five most populous ethnic groups in Indonesia. Their traditional settlements have a special design called Taneyan Lanjang (TL). TL settlements consist of several elements, which are arranged in a specific pattern that is affected by local and Islamic culture. The gardening space of a TL settlement—here referred to as the shared home garden (SHG)—is shared by several family households. The ethnic Madurese apply traditional knowledge to manage their home gardens. This study investigated the features of TLs and SHGs, mostly in relation to cultural matters, the utilization of plants, management based on local knowledge, and their contribution to rural livelihoods. The study area consisted of the four regencies of Madura Island, Indonesia. A total of 200 TL settlements were observed, and 4 key informants and 400 respondents who were engaged in TL were questioned through in-depth interviews. The plant species cultivated in the SHGs were recorded and identified according to the database of The Plant List. In total, 108 plant species within 40 plant families were recorded. Fabaceae had the highest number of species, with 10 species (9.26%), most of which are used as food (65.7%). We identified and characterized the most important services and functions provided by SHGs to rural livelihoods that directly benefit rural communities.

Factors influencing low-income households' food insecurity in Bangladesh during the COVID-19 lockdown

BACKGROUND

The COVID-19 pandemic and countrywide lockdown could negatively impact household food insecurity among low-income households. This study aimed to investigate the prevalence of household food insecurity and its influencing factors among low-income people in Bangladesh during the lockdown of COVID-19.

METHODS

This cross-sectional study was conducted through face-to-face interviews from 500 low-income households during the countrywide COVID-19 lockdown. A pretested, structured and validated questionnaire was used to collect socioeconomic characteristics, household income conditions, and food accessibility. Household Food Insecurity Access Scale (HFIAS) and Dietary Diversity Score (DDS) were used to measure food insecurity. Multinomial logistic regression models were estimated to evaluate and predict risk factors that influence food insecurity.

RESULTS

The study found that above 67% of households was mild-to-moderate food insecure while 23% experienced severe food insecurity. Significantly, 88%, 97.4%, and 93.4% of the households had anxiety and uncertainty, inadequate quality, and inadequate quantity of food, respectively. The regression analysis revealed the age 36-50 years (RRR: 4.86; 95% CI: 2.31-7.44, RRR: 4.16; 95% CI: 2.25-6.10) and monthly income <58.3 USD (RRR: 3.04; 95% CI: 1.12-5.14, RRR: 3.26; 95% CI: 1.79-4.71) were significantly associated with food insecurity (p <0.001). Likewise, less-income (RRR: 3.87; 95% CI: 1.37-6.46, RRR: 2.99; 95% CI: 1.16-4.83), increase in food prices (RRR: 1.29; 95% CI: 0.32-2.33, RRR: 1.08; 95% CI: 0.05-1.12), and those who did not have same type of earning as before during the COVID-19 lockdown (RRR: 3.41; 95% CI: 1.33-5.62, RRR: 2.60; 95% CI: 0.99-4.24) were potential risk factor for MMFI and FI.

CONCLUSION

This study found that households become more susceptible to food insecurity during the COVID-19 pandemic and lockdown period. Based on the findings, we suggest some essential food policies and adequate food assistance to mitigate these negative consequences.

Impact of lockdown due to COVID-19 on nutrition and food security of the selected low-income households in Bangladesh

This study aims to explore the impact of COVID-19 pandemic lockdown on household food security and the nutritional status of the children and identify the risk factors associated with it. A cross-sectional study was conducted in 220 households having at least one under 5 children of Narayanganj district in Bangladesh. Household food insecurity, coping strategies and nutritional status of children were the main outcome variables. Multivariate logistic regression analysis was performed to investigate the significant determinants. A total of 93.2 % of households were food insecure, with 32.3% experiencing mild, 18.6% facing moderate, and 42.3% undergoing severe food insecurity. Forty seven percent households used high coping strategies and 93.2% of households consumed less expensive/preferable food as the common coping technique. Logistic regression analysis showed the variables significantly associated with moderate to severe food insecurity were low household income before COVID-19 (AOR = 46.07, CI: 13.68-155.10), more reduction of family income (AOR = 32.47, 95% CI: 9.29-113.41), maternal occupation as housewife (AOR = 7.73, CI: 2.59-23.07), losses of job (AOR = 4.28, CI: 1.31-13.98) and higher family members (AOR = 3.39, CI: 1.07-10.71). The prevalence of stunting, underweight and wasting in children under 5 years of age were 29.0%, 23.4% and 15.6%, respectively. Significantly the independent predictors of stunting were maternal occupation, education, age, household head occupation, child age, and the coping strategy score. Household dietary diversity score was an important independent predictor of underweight and wasting. In conclusion, social safety net initiatives for vulnerable households along with maternal education and employment should be strengthened to reduce hunger and malnutrition.

Dietary Diversity in the Eastern Mediterranean Region Before and During the COVID-19 Pandemic: Disparities, Challenges, and Mitigation Measures

The COVID-19 pandemic has revealed the Eastern Mediterranean Region's food system's fragility posing severe challenges to maintaining healthy sustainable lifestyle. The aim of this cross-sectional study (N = 13,527 household's family members, mean age: 30.3 ±11.6, 80% women) is to examine the impact of the COVID-19 pandemic on food consumption patterns and household's dietary diversity in 10 Eastern Mediterranean countries. A food frequency questionnaire was used to investigate the consumption patterns along with the calculation of the Food Consumption Score (FCS), a proxy indicator of dietary diversity. Data collected on cooking attitudes, shopping and food stock explore the community mitigation measures. In the overall population, before and during the pandemic, most food groups were consumed less or equal to 4 times per week. As evident from our findings and considering that the pandemic may be better, but it's not over, small to moderate changes in food consumption patterns in relatively short time periods can become permanent and lead to substantial poor dietary diversity over time. While it is a priority to mitigate the immediate impact, one area of great concern is the long-term effects of this pandemic on dietary patterns and dietary diversity in Eastern Mediterranean households. To conclude, the COVID-19 crisis revealed the region's unpreparedness to deal with a pandemic. While the aggressive containment strategy was essential for most countries to help prevent the spread, it came at a high nutritional cost, driving poor dietary diversity.

Food insecurity and COVID-19 risk in low- and middle-income countries

The COVID-19 pandemic prompted social distancing, workplace closures, and restrictions on mobility and trade that had cascading effects on economic activity, food prices, and employment in low- and middle-income countries. Using longitudinal data from Bangladesh, Kenya, and Nigeria covering a period from October 2020 to April 2021, the paper assesses whether knowledge of a person infected with COVID-19 is associated with food insecurity, job loss and business closures, and coping strategies to smooth consumption. The likelihood of households to experience food insecurity at the extensive and intensive margins increased among those who knew an infected person in Bangladesh and Kenya.

Households' Food Insecurity and Its Association with Demographic and Socioeconomic Factors in Gaza Strip, Palestine: A Cross-Sectional Study

Background

This sudy aimed to identify the prevalence of household's food insecurity and its association with demographic and socioeconomic factors.

Methods

A cross-sectional study was conducted in September 2021 among a representative sample of households in the Gaza strip governorates. A total of 1167 households randomly selected from all five governorates and were included in the study. The Radimer/Cornell food security scale was used to determine the prevalence and levels of household food insecurity. The household's demographic and socioeconomic characteristics were obtained using an interview-based questionnaire. Statistical analysis was performed using SPSS version 25.

Results

The overall prevalence of household's food insecurity was 71.5%. The prevalence by governorates was highest in Gaza (30.8%), followed by Khanyounis (23.0%), North-Gaza (18.6%), Middle-Area (15.2%) and Rafah (12.4%). Regarding the food insecurity levels, 333 (28.5%) of the households were food secure, 422 (36.2%) had mild food insecurity, 161 (13.8%) had moderate food insecurity, and 251 (21.5%) had severe food insecurity. Significant associations were found between governorates, monthly income, homeownership, work status with the household's food insecurity, (Crude OR [COR] = 2.02, 95% CI = [1.02–3.98], P value < 0.05), (COR = 2.00, 95% CI = [1.04–2.75], P value < 0.05), (COR = 2.36, 95% CI = [1.39–3.99], P value < 0.05), and (COR = 1.14, 95% CI = [0.66–1.97], P value < 0.05), respectively.

Conclusions

Our study demonstrates that food insecurity is highly prevalent in the Gaza strip and is associated with poor living conditions. Therefore, this high prevalence should be seriously discussed and urgently considered.

Tradeoff analysis of the pork supply and food security under the influence of African swine fever and the COVID-19 outbreak in China

China is the world's largest consumer of pork and grains. However, African swine fever (ASF) and the COVID-19 outbreak have greatly impacted the pork supply and food security in China. How can food security and the pork supply be ensured under the dual impacts of COVID-19 and ASF? This is a major problem to be urgently solved by the Chinese government. This study indicated that the main pork production and sales areas in China were separated, which reflected the spatial imbalance between the supply and demand. The total area of suitable selected sites for pig farms in China is 21.5 million ha. If only the areas with levels of high and moderate suitability are considered as potential sites for pig farms, the potential pork production can reach 56.1 million tons in China, which is slightly lower than demand. Due to the impact of the ASF epidemic, the food consumed by pigs has been reduced by 34.7 million tons. However, with increasing pork productivity in the future, the self-sufficiency rate of grains may further decline. On the premise that the quality of people's life is not affected, the diversification of meat supply channels should be realized in an orderly and sustainable way, which might alleviate the pressure on food supply. This study provides a theoretical reference for the spatiotemporal layout of the swine industry and addresses the issue of food security in China under the influence of ASF and the COVID-19 outbreak.

Mental Health-Related Emergency Department Visits Among Children During The Early COVID-19 Pandemic

Objective

To measure univariate and covariate-adjusted trends in children's mental health-related emergency department (MH-ED) use across geographically diverse areas of the U.S. during the first wave of the Coronavirus-2019 (COVID-19) pandemic.

Method

This is a retrospective, cross-sectional cohort study using electronic health records from four academic health systems, comparing percent volume change and adjusted risk of child MH-ED visits among children aged 3-17 years, matched on 36-week (3/18/19-11/25/19 vs. 3/16/20-11/22/20) and 12-week seasonal time intervals. Adjusted incidence rate ratios (IRR) were calculated using multivariate Poisson regression.

Results

Visits declined during spring-fall 2020 (n = 3892 vs. n = 5228, -25.5%) and during spring (n = 1051 vs. n = 1839, -42.8%), summer (n = 1430 vs. n = 1469, -2.6%), and fall (n = 1411 vs. n = 1920, -26.5%), compared with 2019. There were greater declines among males (28.2% vs. females -22.9%), children 6-12-year (-28.6% vs. -25.9% for 3-5 years and -22.9% for 13-17 years), and Black children (-34.8% vs. -17.7% to -24.9%). Visits also declined for developmental disorders (-17.0%) and childhood-onset disorders (e.g., attention deficit and hyperactivity disorders; -18.0%). During summer-fall 2020, suicide-related visits rose (summer +29.8%, fall +20.4%), but were not significantly elevated from 2019 when controlling for demographic shifts. In contrast, MH-ED use during spring-fall 2020 was significantly reduced for intellectual disabilities (IRR 0.62 [95% CI 0.47-0.86]), developmental disorders (IRR 0.71 [0.54-0.92]), and childhood-onset disorders (IRR 0.74 [0.56-0.97]).

Conclusions

The early pandemic brought overall declines in child MH-ED use alongside co-occurring demographic and diagnostic shifts. Children vulnerable to missed detection during instructional disruptions experienced disproportionate declines, suggesting need for future longitudinal research in this population.

Household food security during the COVID-19 pandemic in urban and semi-urban areas in Indonesia

BACKGROUND

One of the impacts of the COVID-19 pandemic was the weakening of the community's economic condition. The weak economy of the community will have an impact on household food security. This study aims to determine food security in the COVID-19 pandemic situation and the impact of the pandemic on food security in urban and semi-urban areas.

METHODS

A cross-sectional study with a total sample of 517 people who live in urban (Jakarta) and semi-urban (Depok) areas. The research data was collected online and purposively through Posyandu cadres who have access to family/community. Food security was measured using HFIAS (Household Food Insecurity Access Scale) method, while impact of COVID-19 pandemic was categorized into two categories: impacted (reduced income and laid off) and less impacted (not reduced income and laid off). Data analysis used the Chi-square test and multiple logistic regression.

RESULTS

There were 65.0% of households with various level of food insecurity during the COVID-19 pandemic. The results of the multivariate analysis showed that family income during the COVID-19 pandemic (AOR = 4.2; CI = 2.7-6.7), the type of impact of the COVID-19 pandemic, i.e., reduced income and stopped working (AOR = 2.6; CI = 1.6-4.1), and the age of the respondent (AOR = 1.7; CI = 1.1-2.5) were significantly related to household food security during the pandemic after being controlled by husband's work status. Households with lower income had 4 times higher risk to experience food insecurity compared to those with higher income. Heavily impacted households (through reduced income and stopped working) had 3 times higher risk to experience food insecurity compared to those who did not. Additionally, we found that households with younger respondent (< 31 years old) had 2 times higher risk to experience food insecurity compared to those older counterparts.

CONCLUSIONS

The COVID-19 pandemic impacted household food security in both urban and semi-urban areas through worsening employment status and income condition.

COVID-19 home isolation and food consumption patterns: Investigating the correlates of poor dietary diversity in Lebanon: a cross-sectional study

Background: The unfurling COVID-19 pandemic has uncovered the defenselessness of the Lebanese food system leading to serious implication in maintaining a healthy sustainable lifestyle.

Aim: The main purpose of this study is to examine the impact of the COVID-19 pandemic on food consumption patterns and dietary diversity of the Lebanese people.

Methods: The online survey, completed between April and June 2020, consisted of a cross-sectional study on 2282 Lebanese participants (mean age: 29.36±12.221, 80.9% women) that was part of a survey across 38 different countries conducted by De Backer, C. et al. A food frequency questionnaire was used to investigate the consumption patterns along with the calculation of the Food Consumption Score (FCS), a proxy indicator of dietary diversity. Data collected on cooking attitudes, shopping, and food stock identify the community mitigation measures.

Results: Home isolation due to COVID-19 induced an increase in the consumption of legumes and pulses (3.2%, p-value=0.001) and whole wheat groups (2.8%, p-value=0.03). In contrast, a decrease of 5.4%, 6.9%, 5.8%, 5.1%, 3.1%, 3.4% and 2.8% was observed in the consumption of fruits (p-value=0), vegetables (p-value=0), processed meats, poultry, and fish (p-value=0), other dairy products (p-value=0), sweet snacks (p-value=0.001), sugared beverages (p-value=0), fats and oils (p-value=0.001), respectively. The FCS decreased by 4.6%. As food-related behaviors, most cooking attitudes, and practices (10 out of 13) showed an amelioration during the lockdown and the proportions of food stocked have been changing since the start of the pandemic seeing higher amounts of pasta, rice or other grains, flour, and legumes/pulses stocked.

Conclusion: To conclude, the hostile home isolation strategy followed to prevent the COVID-19 spread in Lebanon, came at a high nutritional cost, driving poor dietary diversity.

Pedi-R-MAPP: The development of a nutritional awareness tool for use in remote paediatric consultations using a modified Delphi consensus

BACKGROUND & AIMS

The Remote Malnutrition Application (R-MAPP) was developed during the COVID-19 pandemic to provide support for health care professionals (HCPs) working in the community to complete remote nutritional assessments, and provide practical guidance for nutritional care. The aim of this study was to modify the R-MAPP into a version suitable for children, Pediatric Remote Malnutrition Application (Pedi-R-MAPP), and provide a structured approach to completing a nutrition focused assessment as part of a technology enabled care service (TECS) consultation.

METHODS

A ten-step process was completed: 1) permission to modify adult R-MAPP, 2) literature search to inform the Pedi-R-MAPP content, 3) Pedi-R-MAPP draft, 4) international survey of HCP practice using TECS, 5) nutrition experts invited to participate in a modified Delphi process, 6) first stakeholder meeting to agree purpose/draft of the tool, 7) round-one online survey, 8) statements with consensus removed from survey, 9) round-two online survey for statements with no consensus and 10) second stakeholder meeting with finalisation of the Pedi-R-MAPP nutrition awareness tool.

RESULTS

The international survey completed by 463 HCPs, 55% paediatricians, 38% dietitians, 7% nurses/others. When HCPs were asked to look back over the last 12 months, dietitians (n = 110) reported that 5.7 ± 10.6 out of every 10 appointments were completed in person; compared to paediatricians (n = 182) who reported 7.5 ± 7.0 out of every 10 appointments to be in person (p < 0.0001), with the remainder completed as TECS consultations. Overall, 74 articles were identified and used to develop the Pedi-R-MAPP which included colour-coded advice using a traffic light system; green, amber, red and purple. Eighteen participants agreed to participate in the Delphi consensus and completed both rounds of the modified Delphi survey. Agreement was reached at the first meeting on the purpose and draft sections of the proposed tool. In round-one of the online survey, 86% (n = 89/104) of statements reached consensus, whereas in round-two 12.5% (n = 13/104) of statements reached no consensus. At the second expert meeting, contested statements were discussed until agreement was reached and the Pedi-R-MAPP could be finalised.

CONCLUSION

The Pedi-R-MAPP nutrition awareness tool was developed using a modified Delphi consensus. This tool aims to support the technological transformation fast-tracked by the COVID-19 pandemic by providing a structured approach to completing a remote nutrition focused assessment, as well as identifying the frequency of follow up along with those children who may require in-person assessment.

Improving the safety and security of fruits and vegetables during COVID-19 pandemic with postharvest handling

The COVID-19 pandemic has damaged the world's economy during 2020-2021, reduced the purchasing power of households, partially restricted international movements and trade (including food products) and damaged horticultural production. This resulted in uncertainty in the food business and caused food supply shocks. According to some scientists, business people, and politicians, this situation is a forerunner and warning for humanity to change its lifestyle by focusing on sustainable measures to prevent natural ecosystems damage. In line with this, the present review article focused on the significant impacts of the COVID-19 pandemic on horticultural production and some prevention measures. It has been scientifically confirmed that the postharvest losses of fruits and vegetables reach around 10-15% in developed countries and about 20-40% in developing countries, higher in some specific crops. It is believed that reducing these losses can help the world fight food supply shocks during the COVID-19 pandemic and customary conditions to reduce the pressure on natural resources. Therefore, the present paper aimed to highlight some critical handling practices against food supply shocks.

Effect of COVID-19 on food security, hunger, and food crisis

COVID-19 affected the world’s socioeconomic and food security more than other infectious diseases. In many countries, food industries’ workers were moderated because of the COVID-19 pandemic, which caused food factories to reduce or slow down their production. Airline closures, national and international restrictions, and lockdowns have severely disrupted the food supply chain. These, along with structural weaknesses in the world food system such as production, distribution, access, and stability in the food chain, have exposed more people to the food crisis and acute hunger in the world. Therefore it is necessary to use proper planning by governmental organizations and charities in the field of food supply in critical situations.

Prevalence and factors associated with food insecurity in Latin America and the Caribbean during the first wave of the COVID-19 pandemic

Objective

We assessed the prevalence of food insecurity (FI) and its associated factors in Latin American and the Caribbean (LAC) early during the COVID-19 pandemic.

Methods

We performed secondary data analysis of a survey conducted by Facebook and the University of Maryland. We included adults surveyed from April to May 2020. FI was measured by concerns about having enough to eat during the following week. Sociodemographic, mental health, and COVID-19-related variables were collected. We performed generalized Poisson regressions models considering the complex sampling design. We estimated crude and adjusted prevalence ratios with their 95% confidence intervals.

Results

We included 1,324,272 adults; 50.5% were female, 42.9% were under 35 years old, 78.9% lived in a city, and 18.6% had COVID-19 symptoms. The prevalence of food insecurity in LAC was 75.7% (n = 1,016,841), with Venezuela, Nicaragua, and Haiti with 90.8%, 86.7%, and 85.5%, respectively, showing the highest prevalence. Gender, area of residence, presence of COVID-19 symptoms, and fear of getting seriously ill or that a family member gets seriously ill from COVID-19 were associated with a higher prevalence of food insecurity. In contrast, increasing age was associated with a lower prevalence.

Conclusion

The prevalence of food insecurity during the first stage of the COVID-19 pandemic in LAC was high and was associated with sociodemographic and COVID-19-related variables.

Can the Covid19 pandemic affect the achievement of the 'Zero Hunger' goal? Some preliminary reflections

The ongoing Covid19 pandemic is producing dramatic effects on the economic and social life of many countries, which in turn may further undermine people's health and well-being. This note focuses on some potential effects on the achievement of the UN Sustainable Development Goal 2 'Zero Hunger' (Target 2.1) and, specifically, on the prevalence of undernourishment. After discussing the main changes induced by the Covid19 outbreak in various dimensions of food security, as identified by the preliminary literature on the topic, the note presents the dynamic estimates (GMM) of the recent determinants of food security, measured through the prevalence of undernourishment (SDG indicator 2.1.1), using a sample of 84 developing countries observed over the period 2000-2017. Since the rate of economic growth turns out to be a relevant determinant, the analysis quantifies the potential consequences that the economic downturn caused by the pandemic may have on the short- and long-run achievements of SDG 2 if proper counterbalancing measures will not be implemented. Such consequences in the short run would consist of millions of new undernourished people, while in the long run the progress made towards the 'Zero Hunger' goal are at risk of being completely reversed in the majority of countries. The note concludes by suggesting some directions for future research.

Food insecurity and mental health of women during COVID-19: Evidence from a developing country

BACKGROUND

This study examines the association between food insecurity and mental health of women during the COVID-19 pandemic in a resource poor setting.

MATERIALS AND METHODS

Data were collected at two time-points (wave 1 and 2) from 2402 women, one per household, participating in a larger study during extended COVID-19 lockdown in the rural areas of the southwest region of Bangladesh. The primary outcome of the analyses is the association between food insecurity, measured using the Food Insecurity Experience Scale (FIES), and stress level, measured using the Perceived Stress Scale (PSS), for women during the lockdown. General awareness about COVID-19 and attitude towards prescribed preventive measures were also measured since COVID-19 health concerns could exacerbate food insecurity.

RESULTS

An individual-level evaluation of the effect of wave 2 FIES score on PSS score showed that worsening of the food security status increasing the stress level of the participants (95% CI: 1.61; 2.13; p-value: <0.001). Additionally, a significant negative association was observed between the PSS score and change in food security status between the two waves (Coefficient: -1.15, 95% CI: -1.30; -0.99, p-value: <0.001), indicating that deterioration in food security status over the pandemic period increasing the stress level. At the village level, the results showed a similar pattern. General awareness around ways coronavirus spreads was high, yet there were misperceptions at a higher level. Maintaining hand hygiene, wearing face masks outside the home, and going outside only when necessary were widely practised. Fewer respondents could maintain a 1.5-metre distance from others in the outside and maintained cough and sneeze etiquette.

CONCLUSION

The results indicate a higher stress level, a potential contributor to poor mental health, as food insecurity deteriorated. Policy initiatives in ameliorating immediate food insecurity during crises, improving long-term wellbeing, and expanding the reach of mental health support are warranted.

The water-energy-food nexus and COVID-19: Towards a systematization of impacts and responses

The COVID-19 pandemic offers an opportunity to examine the impacts of system-wide crises on key supply sectors such as water, energy and food. These sectors are becoming increasingly interlinked in environmental policy-making and with regard to achieving supply security. There is a pressing need for a systematization of impacts and responses beyond individual disruptions. This paper provides a holistic assessment of the implications of COVID-19 on the water-energy-food (WEF) nexus. First, it integrates the academic literature related to single cases and disruptions to provide a broader view of COVID-19 demand- and supply-side disruptions and immediate effects. Then, the major, long-term impact categories of medicalization/hygienization, (re)localization of production, and demand fluctuations are highlighted. These impacts result in priority cross-links such as irrigation, energy requirements for local food production, energy use for water and wastewater treatment, or water for energy use. Finally, sector-level insights on impacts and responses are provided, drawing from illustrative cases. The analysis of impacts of COVID-19 on the WEF nexus reflects heterogeneous experiences of short-term adaptations, and highlights the revaluation of the water-food-trade nexus. Revived debates on food sufficiency can benefit from green applications to minimize expected trade-offs. The current crisis also reveals some gaps in the WEF nexus debates with regard to the lack of risk-based perspectives and the need for a better consideration of spatial aspects in resource integration. Regarding resource-security issues in the WEF nexus, the COVID-19 stress test boosts debates concerning the adequacy of the production value chains (e.g., contingency and storage, diversification, and self-sufficiency) and the value of cross-border integration (e.g., trade, globalization, and aid).

The relationship between job components, neighbourhood walkability and African academics' physical activity: a post-COVID-19 context

Research to date suggests that physical activity (PA) among academics is insufficient globally. Academics in many African countries were recently required to resume work while observing social distancing protocols. Physical inactivity (PI) was, therefore, expected to increase in such academics. Interestingly, walkable neighbourhoods are resources that could discourage excessive sitting and PI in this situation. This study, therefore, assessed the moderating role of neighbourhood walkability in the relationship between core job components (i.e. on-site teaching, online teaching, research and student assessment) and PA among academics. The study adopted a cross-sectional design that utilized an online survey hosted by Google Forms to gather data. Participants were volunteer full-time academics in Nigeria, Ghana, Kenya and Tanzania. A total of 1064 surveys were analysed, with a sensitivity analysis utilized to select covariates for the ultimate hierarchical linear regression model. After controlling for the ultimate covariates (e.g. gender, education and income), PA was found to be positively associated with the job component 'research work' but negatively associated with student assessment. Neighbourhood walkability increased the positive relationship of research work with PA and reduced the negative relationship of student assessment with PA. The non-significant negative relationship between 'teaching online' and PA was made positively significant by neighbourhood walkability. We conclude that research as a job component is positively associated with PA, but online teaching is negatively associated with PA among African academics in a post-COVID-19 context.

Appraisal survey of the knowledge, attitudes, and behaviors of Jordanian society toward diet and nutrition during COVID-19 era

INTRODUCTION

This study aimed to evaluate the knowledge, attitudes, and behavior (KAB) of the Jordanian society toward nutrition and diet during the COVID-19 era.

DESIGN AND METHODS

This study is an observational, cross-sectional study using a structured, validated, reproducible, self-administered online Arabic questionnaire. KAB of the study participants was assessed via a web-based, structured, validated, reproducible Arabic questionnaire. The tool for the assessment of the KAB was composed of 33-closed-ended multi-answer questions.

RESULTS

A total of 672 people were surveyed, 70.2% were between 18 and 34, and 69.5% were females. Participants have paid little attention to the healthfulness of their diet in the last year. The majority of participant's attitudes towards using different approaches to manage weight in the next year were: eating smaller portions for weight management, tracking to maximize the amount of time of physical activity, and substituting lower-calorie foods for full-calorie alternatives. Only tenth of participants utilize the time to perform physical activity. The majority made changes to their diet and exercise, and strictly follow commitment in connection with planning for the following year.

CONCLUSIONS

Educators, legislative, food manufacturers, household heads, and policymakers are called upon to improve Jordanians' KAB on nutrition and diet. Furthermore, Jordanian nutrition and diet behavior can be invested to improve the dietary interventions designed by nutrition and dietetics professionals.

The association between core job components, physical activity, and mental health in African academics in a post-COVID-19 context

This study examined the association between core job components (i.e. teaching, research, and student assessment), physical activity (PA), and mental health in a post-COVID-19 context. An online questionnaire administered via Google Forms was used to gather data from 1064 African academics in four countries. A sensitivity analysis was applied to adjust for covariates. Data were analyzed with the hierarchical linear regression analysis. The average age of participants was 44 years. The study found that PA was positively associated with research but negatively associated with student assessment. Mental health was positively associated with onsite teaching but negatively associated with online teaching and research. PA did not predict mental health and mediate the relationship between the job components and mental health. It is concluded that PA may not increase mental health in African academics in a post-COVID-19 situation that required the resumption of work while observing social distancing protocols.