Food insecurity measurement and prevalence estimates during the COVID-19 pandemic in a repeated cross-sectional survey in Mexico

Food insecurity, eating behaviour, and relative weight change among young adults in the aftermath of the COVID-19 lockdown

This study aims to investigate the association between food insecurity, eating behaviour and relative weight change among Malaysian young adults in the aftermath of the pandemic-led lockdown. Socio-demographics, body height, and body weight were self-reported by the young adults. Food security was assessed using the 8-item validated Food Insecurity Experience Scale (FIES), while the Three-Factor Eating Questionnaire-Revised 18-item (TFEQ-R18) was adopted to evaluate the eating behaviour of young adults. Of the 447, 45.9% maintained the same body weight as before the pandemic-led lockdown. While almost half of the young adults (47.2%) were food secure, about one-fourth (24.8%) suffered moderate-to-severe food insecurity. Meanwhile, the standardised raw scores for all the eating behaviour subscales were in the ascending order of cognitive restraint (49.37 ± 18.60) < uncontrolled eating (50.61 ± 20.37) < emotional eating (50.68 ± 24.50). The findings of the Sobel test indicated that the mediation effects of eating behaviour were not statistically significant (p > 0.05), suggesting that eating behaviour (cognitive restraint, uncontrolled eating and emotional eating) did not mediate the relationship between moderate-to-severe food insecurity and relative weight change. Health promotion interventions such as introducing food assistance programs, offering incentives for nutritious food purchases, and re-emphasising healthy eating are essential to rectify food insecurity and disordered eating among Malaysians.

Predictors of persistent moderate and severe food insecurity in a longitudinal survey in Mexico during the COVID-19 pandemic

Background

Household food insecurity (HFI) increased in Latin America by 9% between 2019 and 2020. Scant evidence shows who was unable to recover from the COVID-19 pandemic. Our aim was to use a Machine Learning (ML) approach to identify consistent and influential predictors of persistent moderate or severe HFI over 2 years.

Methods

We use a three-wave longitudinal telephone survey with a probabilistic sample representative of the Mexican population. With a response rate of 51.3 and 60.8% for the second and third waves, the final sample size consisted of 1,074 individuals. The primary outcome was persistent HFI, i.e., respondents who reported moderate or severe HFI in 2021 and 2022. Twelve income-related predictors were measured in 2020, including baseline HFI. We employed 6 supervised ML algorithms to cross-validate findings in models, examined its precision with 4 standard performance indicators to assess precision, and used SHAP values (Shapley Additive exPlanations) to identify influential predictors in each model.

Results

Prevalence of persistent moderate/severe HFI in 2021 and 2022 was 8.8%. Models with only a HFI 2020 baseline measure were used as a reference for comparisons; they had an accuracy of 0.79, a Cohen's Kappa of 0.57, a sensitivity of 0.68, and a specificity of 0.88. When HFI was substituted by the suite of socioeconomic indicators, accuracy ranged from 0.70 to 0.84, Cohen's Kappa from 0.40 to 0.67, sensitivity from 0.86 to 0.90, and specificity from 0.75 to 0.82. The best performing models included baseline HFI and socioeconomic indicators; they had an accuracy between 0.81 and 0.92, a Cohen's Kappa between 0.61 and 0.85, a sensitivity from 0.74 to 0.95, and a specificity from 0.85 to 0.92. Influential and consistent predictors across the algorithms were baseline HFI, socioeconomic status (SES), adoption of financial coping strategies, and receiving government support.

Discussion

Persistent HFI can be a relevant indicator to identify households that are less responsive to food security policies. These households should be prioritized for innovative government support and monitored to assess changes. Forecasting systems of HFI can be improved with longitudinal designs including baseline measures of HFI and socioeconomic predictors.

A surge in food insecurity during the COVID-19 pandemic in a cohort in Mexico City

BACKGROUND

The COVID-19 pandemic has not only caused tremendous loss of life and health but has also greatly disrupted the world economy. The impact of this disruption has been especially harsh in urban settings of developing countries. We estimated the impact of the pandemic on the occurrence of food insecurity in a cohort of women living in Mexico City, and the socioeconomic characteristics associated with food insecurity severity.

METHODS

We analyzed data longitudinally from 685 women in the Mexico City-based ELEMENT cohort. Food insecurity at the household level was gathered using the Latin American and Caribbean Food Security Scale and measured in-person during 2015 to 2019 before the pandemic and by telephone during 2020-2021, in the midst of the pandemic. Fluctuations in the average of food insecurity as a function of calendar time were modeled using kernel-weighted local polynomial regression. Fixed and random-effects ordinal logistic regression models of food insecurity were fitted, with timing of data collection (pre-pandemic vs. during pandemic) as the main predictor.

RESULTS

Food insecurity (at any level) increased from 41.6% during the pre-pandemic period to 53.8% in the pandemic stage. This increase was higher in the combined severe-moderate food insecurity levels: from 1.6% pre-pandemic to 16.8% during the pandemic. The odds of severe food insecurity were 3.4 times higher during the pandemic relative to pre-pandemic levels (p<0.01). Socioeconomic status quintile (Q) was significantly related to food insecurity (Q2 OR = 0.35 p<0.1, Q3 OR = 0.48 p = 0.014, Q4 OR = 0.24 p<0.01, and Q5 OR = 0.17 p<0.01), as well as lack of access to social security (OR = 1.69, p = 0.01), and schooling (OR = 0.37, p<0.01).

CONCLUSIONS

Food insecurity increased in Mexico City households in the ELEMENT cohort as a result of the COVID-19 pandemic. These results contribute to the body of evidence suggesting that governments should implement well-designed, focalized programs in the context of economic crisis such as the one caused by COVID-19 to prevent families from the expected adverse health and well-being consequences associated to food insecurity, especially for the most vulnerable.

Changes in Food and Beverage Purchases Associated With the Coronavirus Disease Pandemic in Mexico

BACKGROUND

Public policies to contain the spread of coronavirus disease in Mexico could have had an effect on food purchase patterns.

OBJECTIVE

The objective of the study was to assess changes in the quantity of food and beverages purchased and proportion spent on food consumed away from home during the coronavirus disease pandemic in Mexican households.

DESIGN

This study is a secondary analysis of cross-sectional data from the National Household Income and Expenditure Survey 2014-2020.

PARTICIPANTS/SETTING

The study included 234,631 households with information on food and beverages purchases from 2014 to 2020.

MAIN OUTCOME MEASURES

Food and beverage purchases were classified into six categories: basic, nonbasic energy-dense foods, prepared food for consumption at home, water, milk, and sugar-sweetened beverages. In the National Household Income and Expenditure Survey 2014-2020, expenditures on food and beverages consumed away from home are not classified into any specific items but represents more than 10% of food and beverage expenditures; therefore, the analyses included the proportion of food and beverage expenditures spent on food consumed away from home.

STATISTICAL ANALYSES PERFORMED

A two-part model was used to evaluate changes in the quantity of food purchased and the proportion spent away from home during the coronavirus disease pandemic in 2020 compared with 2018, adjusting for socio-demographic variables, gross domestic product and previous survey rounds. Results are presented at the national level, by income quintile and by place of residence.

RESULTS

Purchases of basic food increased by 17 g/capita/day at the national level and 22.4 g/capita/day in urban areas (P < 0.001). Purchases of nonbasic energy-dense foods decreased both at the national level (-4.2 g/capita/day; P < 0.001) and by place of residence (-4.8 g/capita/day; P < 0.001 in urban areas and -2.5 g/capita/day; P = 0.001 in rural settings). Purchases of prepared food increased 16 g/capita/day (P < 0.001). In rural areas, purchases of sugar-sweetened beverages increased 7.2 mL/per capita/day (P < 0.001). For the lowest income quintile purchases of processed meat increased 2.4 g/capita/day (P < 0.001). The proportion spent on food consumed away from home decreased by -44.9% (P < 0.001).

CONCLUSIONS

Results of this study show that during the coronavirus disease lockdown there was an increase in basic and prepared food purchases, whereas purchases of nonbasic energy-dense foods and the proportion spent on food consumed away from home decreased. However, findings showed an increase in sugar-sweetened beverages purchases among rural dwellers and an increase in purchases of processed meat among the lowest income quintile. Various factors such as income reductions, unemployment, mobility restrictions, or increases in prices may have led the observed changes. Future research should be conducted to analyze these potential pathways.

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.

Socio-demographic, migratory and health-related determinants of food insecurity among Venezuelan migrants in Peru

OBJECTIVE

To evaluate the factors associated with food insecurity (FI) among Venezuelan migrants residing in Peru. Secondarily, to evaluate the psychometric properties of the Food Insecurity Experience Scale (FIES).

DESIGN

A cross-sectional study based on secondary data analysis of the 2022 Venezuelan Population Residing in Peru Survey (ENPOVE-2022, from the Spanish acronym) was conducted. FI was measured with the FIES, whose properties were tested using the Rasch model. Multinomial logistic regression was performed to estimate relative prevalence ratios with their corresponding 95 % confidence intervals.

SETTING

This survey was conducted in February and March 2022 in the eight cities most populated by Venezuelan migrants and refugees in Peru.

PARTICIPANTS

Venezuelan migrants and refugees over the age of 18 years living in Peru.

RESULTS

A total of 7727 participants were included. Rasch reliability was adequate (0·73). The prevalence of mild, moderate and severe FI was 36·71 %, 31·14 % and 10·48 %, respectively. Being aged 25-34 and 35-44 years, unemployed, uninsured, having no formal education or secondary, illegal status, living in a dwelling with 2-4 and more than 4 people, presenting one or more than one chronic disease, residing in Peru for 0-6 months and perceived discrimination were associated with a higher probability of moderate FI. Furthermore, having secondary education, being unemployed, uninsured, never married, illegal, residing in Tumbes, presenting one or more than one chronic disease and perceived discrimination were significantly associated with severe FI.

CONCLUSION

Four out of ten Venezuelan migrants residing in Peru presented moderate to severe FI. The FIES showed adequate psychometric properties. Differences in the socio-demographic, health and migratory factors associated with FI levels were found. Inter-sectoral and multi-sectoral interventions are needed and should be focused on addressing the determinants of FI.

Late-life food insecurity and cognition: exploring timing, duration, and mechanisms among older Mexican adults

BACKGROUND

Food insecurity (FI) remains a global public health problem. FI is more prevalent in low-and middle-income countries than high-income countries. FI is related with worse cognitive outcomes including cognitive function, cognitive decline, and cognitive impairment. Few studies have sought to identify how patterns of FI relate with cognitive function in old age and the potential mechanisms underlying this association.

METHODS

Data from the 2015 and 2018 waves of the Mexican Health and Aging Study (n = 9,654, age 50+) were used in this study. Reports of FI in 2015 and 2018 were combined to create four patterns of FI groups: "persistently food secure", "became food secure", "became food insecure", and "persistently food insecure". Linear regression was used to estimate associations between patterns of FI and cognitive task performance. The mediating roles of depressive symptoms, body mass index, and chronic conditions were tested using Karlson, Holm, and Breen methodology.

RESULTS

Approximately half of the sample were persistently food secure, 17% became food secure, 14% became FI, and 15% experienced persistent FI. When adjusting for demographic/socioeconomic confounders, persistent FI related with worse Verbal Learning, Verbal Recall, Visual Scanning, and Verbal Fluency performance compared to the persistently food secure. Becoming FI related with worse Verbal Learning, Visual Scanning, and Verbal Fluency. Mediation analyses provided support for depressive symptoms mediating associations between FI and poorer cognition, where 48% of the association between persistent FI and worse Verbal Recall performance was attributed to higher depressive symptoms. Becoming food secure was not associated with cognitive performance compared to the persistently food secure.

CONCLUSIONS

FI may represent an important modifiable risk factor for poorer cognitive outcomes among older adults. Public health efforts should focus on providing stable food access to older adults, especially those living in poverty.

A systematic review of the direct and indirect COVID-19's impact on food security and its dimensions: pre-and post-comparative analysis

BACKGROUND

Since its emergence, the COVID-19 pandemic has compromised the food security both directly by impacting food supply chain and indirectly by overwhelming the individual health and/or personal financial situation. The overarching aim of the current study is to assess aspects of the food security crisis that have arisen due to COVID-19 and to identify which, if any, food security dimensions were specifically compromised.

METHODS

Primary research articles were initially identified through four online databases (Scopus, PubMed, Google Scholar, and Web of Science), with the references of each paper then also reviewed for additional article. The food security status of individuals and the wider community, both before and after the emergence of COVID-19, were examined.

RESULTS

Of the 2,057 studies initially identified, a total of ten were included in the final review. The included studies confirmed that COVID-19 had substantially impacted food security, with individuals, households and the wider community experiencing food insecurity. Nine of the included studies aruged that the food accessibility dimension was the most compromised.

CONCLUSION

To address the identified direct and indirect food security issues associated with COVID-19, it is proposed that a combination of prevention practices and proactive food security activities is required. Integrating food security interventions, supporting and facilitating food security resilience, and conducting further studies on the food security of COVID-19 are also recommended.

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.

Perceptions of food environments in the school and at home during Covid-19: An online cross-sectional study of parents, teachers and experts from Latin America

BACKGROUND

The high prevalence of overweight and obesity in children from Latin America (LA) have been related to obesogenic food environments. Besides, the negative effects of the Covid-19 pandemic should also be considered. The objective of this research was to describe and compare the perceptions of parents, teachers, and experts in LA of food environments at home and school that favor healthy habits in schoolchildren in pre Covid-19 stage and during the pandemic.

METHODS

This study used a survey self-reporting regarding conditions at home and the school favoring healthy habits, for three profiles: parents, primary school teachers, and experts. A fisher exact test was used to establish the difference between the response categories between countries and profiles. Logistic regression models were used to determine the probability of response in the levels of importance adjusted for sex and nationality.

RESULTS

Information from 954 questionnaires was reported: 48.4% experts, 32.0% teachers, and 19.6% parents. There were differences in the perception of food environments at school between profiles (p<0.001). In multivariate logistic regression models, experts and teachers were 20% more likely to give greater importance to elements of the food environment at school compared to parents (p<0.001).

CONCLUSIONS

Our findings showed that parents were less likely to perceive important elements of the school food environment compared to experts and teachers. Interventions are required to improve healthy eating environments that consider children's interpersonal mediators.

Prevalence of food insecurity and its association with depressive and anxiety symptoms in older adults during the COVID-19 pandemic in Mexico: A secondary analysis of ENCOVID-19 survey

Introduction

COVID-19 infection has caused high rates of morbi-mortality in older adults (OAs). In addition, conditions such as depression, anxiety, unemployment, and poverty frequently contribute to this population being at higher risk of food insecurity (FI) during the COVID-19 pandemic.

Objective

This study aimed to analyze the prevalence of FI and its association with depressive and anxiety symptoms in Mexican OAs during the COVID-19 pandemic.

Methods

This study involved a secondary analysis of the National Survey on the Effects of COVID-19 on the Wellbeing of Mexican Households (ENCOVID-19), a series of cross-sectional telephone surveys conducted between April and October 2020. The OA subsample was 1,065. FI was measured by using the Latin American and Caribbean Food Security Scale (ELCSA), and depression and anxiety symptoms were measured by using the Depression Scale of the Center for Epidemiological Studies (CESD-7) and the Generalized Anxiety Disorder Scale (GAD-2), respectively. Socioeconomic status (SES), occupation, schooling, and pension were also evaluated. ANOVA was used to compare the variables between the different FI groups, and logistic regression was used to analyze the risk between FI and the anxiety and depression variables.

Results

The mean age of the participants was 67.31 ± 6.4 years, and FI was classified as mild, moderate, and severe, with prevalences of 38.6, 15.04, and 8.16%, respectively. Overall, 28.01% of the OAs presented symptoms of anxiety and 39.09% of depression. In the comparison between groups, a higher prevalence of depressive symptoms was observed with a higher degree of FI, with 65.75% in moderate-to-severe, 10.39% in mild, and 9.40% without FI, p ≤ 0.000. Regarding anxiety symptoms, 48% of the OAs showed moderate-to-severe, 30.05% showed mild, and 15.38% were without FI, p ≤ 0.000. Using multiple logistic regression, an OR of 5.50 (95% CI 2.74–11.04) was observed for depressive symptoms when moderate-to-severe FI is present. In the case of the risk of anxiety symptoms, it was significant in all degrees of FI, in mild (OR = 2.43, 95% CI 1.66–3.59) and in moderate-to-severe (OR = 5.32, 95% CI 3.45–8.19).

Conclusion

There is a high prevalence of FI in Mexican OAs during the COVID-19 pandemic. FI increases the risk of other conditions such as depression and anxiety. It is important to design and implement programs aimed at OAs with these conditions to reduce or prevent FI.

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.

Household food insecurity before and during COVID-19 pandemic and its association with perceived stress: population-based studies

The growing prevalence of food insecurity observed in the last years, has been favored by the COVID-19 pandemic, leading to mental health issues, such as stress. We aim to analyze the prevalence of household food insecurity before and during the COVID-19 pandemic and its association with perceived stress. We analyzed data from two population-based studies conducted in 2019 and 2020-2021 in the municipality of Criciúma, State of Santa Catarina, Southern Brazil. Food insecurity and perceived stress were assessed with the Brazilian Food Insecurity Scale and the Perceived Stress Scale. The covariables were sex, age, skin color, schooling level, income, job status, marital status, household crowding, overweight, and diet quality. Crude and adjusted associations between food insecurity and perceived stress were assessed using Poisson regression. A total of 1,683 adult individuals were assessed. Prevalence of food insecurity was 25.8% in 2019, decreasing to 21.6% in 2020. Prevalence of perceived stress was about 38% for both years. Before the pandemic, food insecurity increased the prevalence of perceived stress by 29% (PR = 1.29; 95%CI: 1.02; 1.63), but no association was found during COVID-19. We found a worrying prevalence of food insecurity before and after de pandemic, nonetheless food insecurity and perceived stress were associated only in 2019. An assessment of these aspects after COVID-19 is needed to ensure basic life rights for all.

Prevalence and Severity of Food Insecurity Before and During the Coronavirus Disease 2019 Pandemic Among Adults and Youth in Australia, Canada, Chile, Mexico, the United Kingdom, and the United States

BACKGROUND

Disruptions from the coronavirus disease 2019 (COVID-19) pandemic potentially exacerbated food insecurity among adults and youth.

OBJECTIVES

The objective was to examine changes in the prevalence and severity of food insecurity among adults and youth from before (2019) to during (2020) the pandemic in multiple countries.

METHODS

Repeated cross-sectional data were collected among adults aged 18-100 y (n = 63,278) in 5 countries in November to December in 2018-2020 and among youth aged 10-17 y (n = 23,107) in 6 countries in November to December in 2019 and 2020. Food insecurity in the past year was captured using the Household Food Security Survey Module and the Child Food Insecurity Experiences Scale. Changes in the prevalence and severity of food insecurity were examined using logistic and generalized logit regression models, respectively. Models included age, gender, racial-ethnic identity, and other sociodemographic characteristics associated with food insecurity to adjust for possible sample differences across waves. Models were weighted to reflect each country's population.

RESULTS

Adults [adjusted OR (AOR): 1.15; 95% CI: 1.02, 1.31] and youth (AOR: 1.43; 95% CI: 1.19, 1.71) in Mexico were more likely to live in food-insecure households in 2020 compared to 2019. Adults in Australia (AOR: 0.81; 95% CI: 0.72, 0.92) and Canada (AOR: 0.87; 95% CI: 0.77, 0.99) were less likely to live in food-insecure households in 2020. Trends in severity aligned with changes in prevalence, with some exceptions. Youth in Australia (AOR: 2.24; 95% CI: 1.65, 3.02) and the United States (AOR: 1.39; 95% CI: 1.04, 1.86) were more likely to have many compared with no experiences of food insecurity in 2020 compared to 2019. There was no evidence of change among adults and youth in the remaining countries.

CONCLUSIONS

Except for Mexico, few changes in food insecurity among adults and youth were observed from before to during the COVID-19 pandemic. Action is needed to support households at risk of food insecurity. J Nutr 20XX;xx:xx-xx.

The impact of COVID-19 on diet quality, food security and nutrition in low and middle income countries: A systematic review of the evidence

BACKGROUND & AIMS

The current global pandemic of Coronavirus (COVID-19), and measures adopted to reduce its spread, threaten the nutritional status of populations in Low- and middle-income countries (LMICs). Documenting how the COVID-19 affects diets, nutrition and food security can help generating evidence-informed recommendations for mitigating interventions and policies.

METHODS

We carried out a systematic literature review. A structured search strategy was applied in MEDLINE (Pubmed®), EMBASE®, Scopus® and Web of Science®. Grey literature was retrieved by screening a pre-set list of institutions involved in monitoring the impact of the COVID-19 pandemic on nutrition and food security. The first search was done on 20th August 2020, and updated in mid-November 2020 and mid-January 2021. All research steps were described as recommended in the PRISMA statement.

RESULTS

Out of the 2085 references identified, thirty-five primary studies were included. In spite of their heterogeneity, studies converge to demonstrate a detrimental effect of COVID-19 pandemic and associated containment measures on diet quality and food insecurity. One of the major direct effects of COVID-19 on food and nutrition outcomes has been through its impact on employment, income generating activities and associated purchasing power. Other channels of impact, such as physical access, availability and affordability of food provided a heterogeneous picture and were assessed via binary and often simplistic questions. The impacts of COVID-19 on food systems and diets manifested with various intensity degrees, duration and in different forms. Factors contributing to these variations between and within countries were: 1) timing, duration and stringency of national COVID-19 restriction measures and policies to mitigate their adverse impacts; 2) context specific food value chain responses to domestic and international containment measures; 3) differentiated impacts of restriction measures on different groups, along lines of gender, age, socio-economic status and employment conditions. Shorter value chains and traditional smallholder farms were somewhat more resilient in the face of COVID-19 pandemic. Additionally, the impact of the pandemic has been particularly adverse on women, individuals with a low socio-economic status, informal workers and young adults that relied on daily wages. Finally, there were heterogeneous government responses to curb the virus and to mitigate the damaging effects of the pandemic. It has been demonstrated that existing and well-functioning social protection programmes and public distribution of food can buffer the adverse effects on food insecurity. But social safety nets cannot be effective on their own and there is a need for broader food systems interventions and investments to support sustainable and inclusive food systems to holistically achieve food and nutrition security.

CONCLUSION

The current economic and heath crisis impacted diet quality and food security. This raises concerns about long term impacts on access to and affordability of nutrient-rich, healthy diets and their health implications. Women and individuals with a low socio-economic are likely to be the most at risk of food insecurity. Social safety nets can be effective to protect them and must be urgently implemented. We advocate for improved data collection to identify vulnerable groups and measure how interventions are successful in protecting them.

Self-efficacy and Social Settings Matter for Fostering Healthy Eating in Mexican Schoolchildren

OBJECTIVE

To identify differences in schoolchildren's self-efficacy for eating behaviors across social settings and self-efficacy sources favoring healthy and unhealthy eating.

DESIGN

A cross-sectional, mixed-methods study using self-efficacy and demographic surveys, focus groups, and school environment semistructured observations.

SETTING

Morelos, Mexico, Cuernavaca City school district, public elementary schools in the National School Lunch Program.

PARTICIPANTS AND RECRUITMENT

We studied 274 fifth- and sixth-grade children from 8 elementary schools during the 2016-2017 school year.

VARIABLES MEASURED

Children's self-efficacy for healthy and unhealthy eating across 3 settings (school cafeteria, recess, and home). Children's perceptions about sources of self-efficacy, which favor their healthy or unhealthy eating (performance accomplishments, behavior modeling, verbal persuasion, and emotional or physiological states). Sociodemographic information was obtained from parents.

ANALYSIS

We performed a variance components analysis with school and students within schools as random effects with paired t tests (quantitative data) and content analysis on the basis of the Social Cognitive Theory (qualitative data).

RESULTS

Schoolchildren's self-efficacy for healthy eating differed across social settings, being greater in the school cafeteria than at recess or home, except for drinking water. On average, self-efficacy for unhealthy eating was lower in the cafeteria than in other studied settings. Performance achievements and behavior modeling were key sources of self-efficacy for healthy and unhealthy eating.

CONCLUSION AND IMPLICATIONS

Sources of self-efficacy and social settings matter to understanding schoolchildren's healthy and unhealthy eating. Future interventions might consider developing collective efficacy among the school community and boosting children's participation in home meal planning. Further research could explore locus of control and other intrapersonal dimensions influencing self-efficacy.

The Impact of the COVID-19 Pandemic on the Food Security of UK Adults Aged 20-65 Years (COVID-19 Food Security and Dietary Assessment Study)

The first UK lockdown greatly impacted the food security status of UK adults. This study set out to establish if food procurement was adapted differently for different income groups and if this impacted dietary intakes disproportionately. Adults (n = 515) aged 20-65 years participated in an online survey with 56 completing a 3-4 day diet diary. Food availability was a significant factor in the experience of food insecurity. Similar proportions of food secure and food insecure adapted food spend during lockdown, spending similar amounts. Food insecure (n = 85, 18.3%) had a 10.5% lower income and the money spent on food required a greater proportion of income. Access to food was the biggest driver of food insecurity but monetary constraint was a factor for the lowest income group. The relative risk of food insecurity increased by 0.07-fold for every 1% increase in the proportion of income spent on food above 10%. Micronutrient intakes were low compared to the reference nutrient intake (RNI) for most females, with riboflavin being 36% lower in food insecure groups (p = 0.03), whilst vitamin B12 was 56% lower (p = 0.057) and iodine 53.6% lower (p = 0.257) these were not significant. Coping strategies adopted by food insecure groups included altering the quantity and variety of fruit and vegetables which may have contributed to the differences in micronutrients.

Prevalence and factors associated with food insecurity in eight high-altitude cities in Peru during the second wave of the COVID-19 pandemic: a retrospective, cross-sectional study

Background

Food insecurity has increased during the COVID-19 pandemic, affecting an estimated 260 million people. However, little evidence is available on how pandemic-related characteristics influence food security in a high-altitude population. The objective of this study was to assess factors associated with food insecurity in high-altitude Peruvian cities during the second epidemic wave of COVID-19.

Methods

A retrospective, cross-sectional study was conducted in eight Peruvian cities over 1,500 m above sea level. An online survey measuring food security, presence of anxiety & depressive symptoms, sleep quality, post-traumatic stress disorder (PTSD), resilience, and sociodemographic characteristics was disseminated through social networks between December 2020 and February 2021. Generalized linear models were used to identify an association between the study variables.

Results

Of 700 participants, the median age was 23 years, and more than half were female (56.7%). The prevalence of food insecurity was 37.1%. Anxiety symptoms, depressive symptoms, and PTSD were present in 72.7%, 64.1%, and 15% of respondents, respectively. The prevalence of food insecurity was higher in people with fair (PR: 1.60, 95% CI: 1.23–2.07) and very bad perception of their health (PR: 4.06, 95% CI: 2.63–6.26), individuals seeking mental health support (PR: 1.42, 95% CI: 1.25–1.62), and in those who lost their job due to the pandemic (PR: 1.82, 95% CI: 1.62–2.04). Having moderate (PR: 1.52, 95% CI: 1.26–1.83) and moderate to severe depressive symptoms (PR: 1.58, 95% CI: 1.11–2.27) also increased the prevalence of food insecurity.

Conclusion

During the pandemic, the prevalence of food insecurity has increased in the Peruvian high-altitude population, revealing the need for preventive strategies. Identification of pandemic-related characteristics that influence food insecurity can guide interventions in at-risk individuals and reduce the long-term impact of this problem on overall health and quality of life.

Eating habits of children and adolescents during the COVID-19 era: A systematic review

The COVID19 pandemic has affected all aspects of people's lives. Eating habit plays a crucial role in children and adolescents' physical and mental development and the impacts might last until adulthood. This systematic review aimed to summarize a comprehensive and updated overview of eating habits changes due to COVID19 confinements among children and adolescents. A systematic literature search was performed in three databases for all the English studies published from the start of the confinements until April 2022. Two researchers screened articles independently and included observational studies which evaluated children's and adolescents' eating habits before and during confinements. The quality of the included studies was assessed by Newcastle-Ottawa Quality Assessment checklists for cross-sectional and cohort studies. Among 2,436 studies, 39 final full-text articles were included. The total participants of this systematic review consist of 157,900 children and adolescents. Seven categories were identified: daily eating patterns, junk food, beverage, fruits and vegetables, milk and dairy, protein-rich foods, and legumes and cereals. In summary, most of the included studies reported a significant increase in consumption of home-cooked meals, amount of food, snack, french fries, sweets, fruits, vegetables, legumes, bread, and bakery products. On the other hand, studies demonstrated significantly lower intake of fast food and soft drink. The studies reported controversial results about breakfast consumption, sugar-added drinks, caffeinated drinks, milk and dairy products, protein-rich foods (including meat, fish, egg and chicken, and poultry), rice, and cereal. Changes in children's and adolescents' eating habits during the COVID-19 era were both positive and negative, for example, a decrease in fast food, fruit, and vegetable consumption vs. an increase in snacking and sweet consumption. Both changes have significant short-term and long-term impacts on population health. This study could provide us with insight into the changes in eating habits in children and adolescents in the COVID-19 era which we can use to limit the negative consequences on health.

Greenhouse Gas Emission: Perception during the COVID-19 Pandemic

The period 2020/2021 was an unprecedented and historic time for industrial, economic, and societal activities all over the world with great challenges to human health, the ecosystems, and other aspects of human endeavors owing to the COVID-19 or SARS-CoV-2 (CV-19) pandemic which is now a topical aspect of research interest. Despite the negative impacts of the CV-19 pandemic, there are also positive reports during the CV-19 pandemic such as the reduction of gas flare, reduction in the burning of fossil fuels from automobile exhaust and a reduction in the other ensuing factors of greenhouse gases emissions (which is one of the major drives for global warming and climate change as well as other environmental effluences). Hence, this brief perspective review study is centered on greenhouse gas (GHG) emission. The study employs a methodical approach to analyze some already available research studies from existing publications and databases on GHG emission using the perception during the CV-19 pandemic. The specific findings from this review show that, from the meteorological perspective, the global response to the catastrophe ensuing from the CV-19 pandemic has a great influence on the reduction of GHGs, the reduction in the burning of fossil fuels from automobiles and industrial devices, and the reduction in the other ensuing factors of GHG emission. Hence, it will not be far from the truth to conclude that there is a possible positive connection between the CV-19 pandemic and GHG emissions. The study has a direct impact on the environment owing to the negative and positive environmental consequences of the CV-19 pandemic. Suggestions and recommendations in the form of future prospects of GHG emission vis-à-vis global warming and climate change are also discussed. Furthermore, suggestions on how to improve food security and agriculture during a pandemic such as the CV-19 outbreak period are highlighted.

Association of sociodemographic and lifestyle factors with dietary patterns among men and women living in Mexico City: A cross-sectional study

Background

Diet is one of the leading risk factors for non-communicable diseases and is related to sociodemographic and lifestyle factors, including sex. These associations vary across populations. We aimed to investigate which factors are associated with dietary patterns among adults living in Mexico City by sex.

Methods

We used data from the Mexico City Diabetes Representative Study, a cross-sectional, multistage, stratified, and cluster-sampled survey in Mexico City (n = 1,142; 413 men and 729 women). Dietary information was collected using a semi-quantitative food frequency questionnaire. Foods and beverages were categorized into 23 food groups to identify dietary patterns by cluster analysis. Sociodemographic and lifestyle variables included were self-reported through standardized questionnaires. We assessed the association of sociodemographic and lifestyle factors with dietary patterns through a multinomial logistic model stratified by sex.

Results

We identified three dietary patterns: basic, prudent, and fast food. Among men and women, higher school attainment was associated with a lower relative probability of having a basic rather than prudent dietary pattern (women: RRR = 0.8, 95% CI: 0.8, 0.9; men: RRR = 0.8, 95% CI: 0.7, 0.9). Divorced or separated men (RRR = 3.8, 95% CI: 1.3, 11.2) and those living with a partner (RRR = 2.6, 95% CI: 1.1, 6.1) had a higher relative probability of consuming a fast food dietary pattern than the prudent one, compared to single men. Men living with a partner (RRR = 3.0, 95% CI: 1.1, 8.6) or working long shifts (RRR = 3.8, 95% CI: 1.3, 11.1) had a higher probability of consuming a basic pattern rather than a prudent one compared to peers. Among women, those with high SES had a lower probability of consuming the "basic" pattern rather than the "prudent" pattern compared to those with low SES. No lifestyle factors were associated to dietary patterns.

Conclusions

Men living in Mexico City with lower education, age, non-single, and working long hours (i.e., more than the established by the law), and women with lower age, education, and socioeconomic level are prone to adhere to unhealthy diets. These associations are likely to be driven by gender roles.

Suicide after and during the COVID-19 pandemic in Mexico City

Objectives:

Prior research has indicated that no increase in suicides occurred immediately following the declaration of the COVID-19 emergency in Mexico City. Here we examine longer-term overall suicide trends and trends according to basic demographic groups.

Methods:

We used interrupted time-series analysis to model trends in monthly suicides before COVID-19 (January 1, 2010 to March 31, 2020), comparing the expected number of suicides both overall and according to age and sex with the observed number of suicides for the remainder of 2020 (April 1, 2020 to December 31, 2020).

Results:

There was an overall increase in suicides during the first 9 months of the pandemic, with a rate ratio of 2.07 (1.86-2.31). The increase began in the early months of the pandemic and remained stable and high after June 2020. Men and women, younger people (< 45) and older people (≥ 45) were affected. The increase was especially high among older women (RR = 3.33; 2.04-5.15).

Conclusions:

The increase in suicides in Mexico City is worrying and highlights the need to strengthen economic development, mental health, and well-being programs. Suicides among older women should be closely monitored. There is an urgent need to expand primary health care services to include robust suicide prevention and treatment options.

COVID-19 market disruptions and food security: Evidence from households in rural Liberia and Malawi

We use data collected from panel phone surveys to document the changes in food security of households in rural Liberia and Malawi during the market disruptions associated with the COVID-19 lockdowns in 2020. We use two distinct empirical approaches in our analysis: (a) an event study around the date of the lockdowns (March to July 2020), and (b) a difference-in-differences analysis comparing the lockdown period in 2020 to the same months in 2021, in order to attempt to control for seasonality. In both countries, market activity was severely disrupted and we observe declines in expenditures. However, we find no evidence of declines in food security.

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.

Diet and food insecurity among mothers, infants, and young children in Peru before and during COVID‐19: A panel survey

The COVID‐19 pandemic may impact diet and nutrition through increased household food insecurity, lack of access to health services, and poorer quality diets. The primary aim of this study is to assess the impact of the pandemic on dietary outcomes of mothers and their infants and young children (IYC) in low‐income urban areas of Peru. We conducted a panel study, with one survey prepandemic (n = 244) and one survey 9 months after the onset of COVID‐19 (n = 254). We assessed breastfeeding and complementary feeding indicators and maternal dietary diversity in both surveys. During COVID‐19, we assessed household food insecurity experience and economic impacts of the pandemic on livelihoods; receipt of financial or food assistance, and uptake of health services. Almost all respondents (98.0%) reported adverse economic impacts due to the pandemic and 46.9% of households were at risk of moderate or severe household food insecurity. The proportion of households receiving government food assistance nearly doubled between the two surveys (36.5%–59.5%). Dietary indicators, however, did not worsen in mothers or IYC. Positive changes included an increase in exclusive breastfeeding <6 months (24.2%–39.0%, p < 0.008) and a decrease in sweet food consumption by IYC (33.1%–18.1%, p = 0.001) and mothers (34.0%–14.6%, p < 0.001). The prevalence of sugar‐sweetened beverage consumption remained high in both mothers (97%) and IYC (78%). In sum, we found dietary indicators had not significantly worsened 9 months into the COVID‐19 pandemic. However, several indicators remain suboptimal and should be targeted in future interventions.

Almost all respondents (98.0%) reported negative economic impacts on their households from the pandemic.

During the pandemic, almost half of households (46.9%) were at risk of moderate or severe household food insecurity.

During the pandemic, 66.9% of households received cash transfers, and 59.4% received food assistance from the government.

Nine months into the pandemic, positive changes included an increased prevalence of exclusive breastfeeding <6 months, a decreased proportion of mothers and infants and young children (IYC) consuming sweet foods, and stable dietary indicators for IYC and women.

Consumption of sugar‐sweetened beverages and unhealthy foods remained high across the two time periods for mothers and IYC and should be targeted in future interventions.

COVID-19's impacts on incomes and food consumption in urban and rural areas are surprisingly similar: Evidence from five African countries

African governments imposed mobility restrictions to suppress the spread of COVID-19. Many observers feared these measures would dramatically decrease incomes and increase food insecurity and anticipated that urban households would be much more impacted than rural ones. We use rural and urban survey data from 4000 households across five African countries to assess the pandemic's effect on incomes and food consumption. We find that a large share of the population saw incomes drop between March and July 2020. But these decreases were 43–63% smaller than predictions and early estimates, and highly correlated with the severity of restrictions. The income and food consumption impacts of the COVID-19 shock were widespread over both rural and urban areas. Policy making during a pandemic should recognize that restrictive measures will affect rural and urban, farming and non-farming, and richer and poorer households.

Self-Reported Impacts of the COVID-19 Pandemic on Diet-Related Behaviors and Food Security in 5 Countries: Results from the International Food Policy Study 2020

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has impacted many aspects of daily life, including dietary intake; however, few studies have reported its impacts on dietary behaviors and food security across multiple countries.

OBJECTIVES

We examined self-reported impacts of COVID-19 on food behaviors, food security, and overall diet healthfulness in 5 countries.

METHODS

Adults aged 18-100 years (n = 20,554) in Australia, Canada, Mexico, the United Kingdom, and the United States completed an online survey in November and December 2020 as part of the International Food Policy Study, an annual, repeat cross-sectional survey. Survey measures assessed perceived impacts of the COVID-19 pandemic on eating food prepared away from home, having food delivered from a restaurant, and buying groceries online, as well as perceived food security and overall diet healthfulness. Regression models examined associations between each outcome and sociodemographic correlates.

RESULTS

Across all countries, 62% of respondents reported eating less food prepared away from home due to the pandemic, while 11% reported eating more. Some participants reported having less food delivered from a restaurant (35%) and buying fewer groceries online (17%), while other respondents reported more of each (19% and 25%, respectively). An average of 39% reported impacts on their food security, and 27% reported healthful changes to their overall diet. The largest changes for all outcomes were observed in Mexico. Participants who were younger, ethnic minorities, or had lower income adequacy tended to be more likely to report food-related changes in either direction; however, these relationships were often less pronounced among respondents in Mexico.

CONCLUSIONS

Respondents reported important changes in how they sourced their food during the pandemic, with trends suggesting shifts towards less food prepared away from home and more healthful diets overall. However, changes in diet and food behaviors occurred in both healthful and less healthful directions, suggesting that dietary responses to the pandemic were highly variable.

COVID-19 Impact on Household Food Security in Urban and Peri-Urban Areas of Hyderabad, India

This paper investigates the impact of the COVID-19 pandemic on food security and on coping-strategies in urban and peri-urban areas of the Hyderabad, India. Household survey data were collected before (October 2018) and during (January 2021) the onset of the pandemic. Results from logistic regression with the standarized Food Insecurity Expecience Scale (FIES) as dependent variable reveal that close to 40% of the households surveyed experienced a deterioration in food security status during the pandemic. In particular, we find that food security is closely related to the sector of employment in which the primary income- earning member of a household is engaged. To mitigate the impact of the pandemic on their food security, our sampled households adopted a variety of consumption-smoothing strategies including availing credit from both formal and informal sources, and liquidating their savings. Compared to households with severe or moderate level of food insecurity, households facing a mild level of food insecurity relied on stored food as a strategy to smoothen consumption in response to the income shock imparted by the pandemic. In addition, the results indicate that urban households, who adopted similar coping strategies as those adopted by peri-urban households, tended to be more food-insecure. Finally, the duration of unemployment experienced during the pandemic significantly influenced the status of household food security. These findings can inform the formulation of immediate and medium-term policy responses, including social protection policies conductive to mitigating the impacts of the COVID-19 pandemic and ameliorating the governance of urban food security during unexpected events and shocks.

Food Insecurity in Central-Eastern Europe: Does Gender Matter?

Food insecurity (FI) remains a challenge not only in less-developed countries but also worldwide. The literature indicates higher rates of FI for women than men in some regions of the world. Thus, the main objective of this cross-sectional study was to assess differences in experiencing FI according to gender in Central-Eastern Europe—a region that has been little researched in terms of FI. The study analyzes individual-level data on FI from the Gallup World Poll (GWP) for the years 2018–2019, obtained under a license from the Food and Agriculture Organization (FAO). Dataset encompasses representative samples of individuals aged 15 and above for each studied country. Apart from bivariate analysis, the ordered logistic regression, the generalized ordered logistic regression and multinomial logistic regression models were used. It was found that women experienced mild FI more often than men. However, gender differences with respect to moderate or severe FI were not confirmed. Moreover, the significant associations of all severity levels of FI with education, employment status, social capital, social network, age, marital status, household composition and income were observed. The research findings can be used to inform policy and to design targeted assistance programs for those in need.

Unhealthy Dieting During the COVID-19 Pandemic: An Opinion Regarding the Harmful Effects on Brain Health

Since 2020, the world has been suffering from a pandemic that has affected thousands of people regardless of socio-economic conditions, forcing the population to adopt different strategies to prevent and control the advance of the disease, one of which is social distancing. Even though social distancing is a safe strategy to reduce the spread of COVID-19, it is also the cause of a rising sedentary behavior. This behavior develops an excess of fat tissue that leads to metabolic and inflammatory disruption related to chronic diseases and mental health disorders, such as anxiety, depression, and sleep issues. Furthermore, the adoption of dietary patterns involving the consumption of ultra-processed foods, higher in fats and sugars, and the reduction of fresh and healthy foods may play a role in the progress of the disease. In this perspective, we will discuss how an unhealthy diet can affect brain function and, consequently, be a risk factor for mental health diseases.

Food Insecurity across the Life-Course and Cognitive Function among Older Mexican Adults

BACKGROUND

Food insecurity remains a global public health problem. Experiencing food insecurity is related to poorer cognitive function among older adults. However, few studies have examined how food insecurity, experienced over the life-course, relates to cognitive function among older adults in Mexico.

METHODS

Data came from the 2015 Mexican Health and Aging Study (n = 11,507 adults aged 50 and over). Early- and late-life food insecurity were ascertained by self-report. We evaluated how both measures of food insecurity related to the performance of multiple cognitive tasks (Verbal Learning, Verbal Recall, Visual Scanning, and Verbal Fluency), while controlling for key health and sociodemographic confounders using linear regression.

RESULTS

In descriptive analyses, respondents who experienced food insecurity in either early or late life performed significantly worse on all cognitive tasks when compared to the food secure. In models adjusted for health and sociodemographic confounders, early-life food insecurity predicted worse Verbal Learning performance and late-life food insecurity was associated with poorer Visual Scanning performance.

CONCLUSIONS

Food insecurity was related to poorer cognitive function in a nationally representative sample of older adults in Mexico. However, results suggested that the significance of effects depended on cognitive task and when in the life-course food insecurity was experienced.

Prevalence of Household Food Insecurity in Ethiopia during the COVID-19 pandemic: Evidence from panel data

The COVID-19 pandemic is a global problem that confronted the economy and household food security of many countries. This study aimed to analyze the determinants of a household's food insecurity status in the era of the COVID-19 pandemic in Ethiopia. A panel data of 2,410 households in a six-round High-Frequency Phone Survey were retrieved from the World Bank database. The product of the corresponding pairwise severity weight and household responses to each coping strategy was summed up to get the individual's Coping Strategy Index. The Random Effect Model (REM) for panel data analysis was used to identify factors associated with household-related food insecurity during the COVID-19 pandemic. The descriptive statistics result shows that 18.63% and 11.08% of rural households and 56.55% and 38.13% of urban residents were food secure in the first and sixth rounds, respectively. On the contrary, 3.65% and 3.2% of rural households and 6.8% and 7.18% of urban households experienced severe food insecurity from the first to the sixth round, respectively. Most households have maintained their food security in urban areas than rural residents. However, the number of food secure households was gradually reduced from Round-1 to Round-6. Besides, REM output indicates that access to financial services, farm income, wage employment, income from property, investment, and savings, and NGO assistance negatively affected household's food insecurity. Whereas government support showed a positive association with households' food insecurity. Based on the findings, we recommend that households should adopt the behavior of enhancing and diversifying their sources of income, and the government also emphasize the establishment of national social security services by taking experience from NGOs’ emergency response mechanisms.

Factors Associated With Dietary Quality During Initial and Later Stages of the COVID-19 Pandemic in Mexico

Background: The COVID-19 pandemic disrupted the global economy and modified lifestyles. The aim of our study was to identify factors associated with dietary quality, and their frequency, in Mexican adults at the initial and later stages of the pandemic.

Methods: Two online surveys were conducted between June and July 2020 (n = 3,131) and between November and December 2020 (n = 1,703 including non-participants from 1st round). A diet quality score was estimated using a short instrument to measure the consumption of several healthy/unhealthy food items. Linear regression models were used to identify the association between pandemic related factors and the diet quality score, adjusted by sociodemographic characteristics. The 2nd round was weighted to represent the 1st round.

Results: During the 1st and 2nd rounds only ~12% of the sample perceived that their intake of healthy food decreased, relative to before the pandemic; ~20% perceived that their intake of unhealthy foods increased. Diet quality remained similar between the 1st and 2nd round. The following factors were negatively associated with diet quality: Eating food prepared away-from-home; going out to work ≥4 times/week; decreased time for food preparation; decreased interest in eating healthy; eating more due to anxiety, depression, or boredom; food insecurity; and stockpiling junk food. Purchasing food using a mixed modality of both in-store and home delivery was positively associated with diet quality. With the exception of eating more due to anxiety (reported by 47% of participants), all these factors were reported by a minority of participants during the first round (≤15%). During the 2nd round, there was an increase in the frequency of participants who reported eating food prepared away-from-home, going out to work ≥4 times/week, having less time to prepare food, being more interested in eating healthfully, and a decrease in participants eating more due to anxiety, depression or boredom, or stockpiling junk food.

Conclusions: Most participants perceived that their dietary intake improved during both initial and later stages of the pandemic. This might be related to factors associated with higher dietary quality, such as not going out to work, eating homemade food, and online grocery shopping.

Breastfeeding media coverage and beliefs during the COVID-19 pandemic in Mexico: implications for breastfeeding equity

BACKGROUND

Because breastfeeding offers short- and long- term health benefits to mothers and children, breastfeeding promotion and support is a public health priority. Evidence shows that SARS-CoV-2 is not likely to be transmitted via breastmilk. Moreover, antibodies against SARS-CoV-2 are thought to be contained in breastmilk of mothers with history of COVID-19 infection or vaccination. WHO recommends direct breastfeeding as the preferred infant feeding option during the COVID-19 pandemic, even among women with COVID-19; but conflicting practices have been adopted, which could widen existing inequities in breastfeeding. This study aims to describe how information about breastfeeding was communicated in Mexican media during the pandemic and assess Mexican adults' beliefs regarding breastfeeding among mothers infected with COVID-19.

METHODS

We conducted a retrospective content analysis of media coverage on breastfeeding in Mexico between March 1 and September 24, 2020, excluding advertisements. For the content analysis, we performed both a sentiment analysis and an analysis based on strengths, weaknesses, opportunities, and threats (SWOT) for breastfeeding promotion. Additionally, we conducted a descriptive analysis of nationally representative data on adults' beliefs about breastfeeding from the July 2020 round of the ENCOVID-19 survey in Mexico and stratified the results by gender, age, and socioeconomic status.

RESULTS

A total of 1014 publications on breastfeeding were identified on the internet and television and in newspapers and magazines. Most information was published during World Breastfeeding Week, celebrated in August. The sentiment analysis showed that 57.2% of all information was classified as positive. The SWOT analysis indicated that most information focused on current actions, messages, policies, or programs that enable breastfeeding (i.e., strengths) or those not currently in place but that may enable breastfeeding (i.e., opportunities) for breastfeeding promotion. However, ENCOVID-19 survey results showed that 67.3% of adults living in households with children under 3 years of age believe that mothers with COVID-19 should not breastfeed, and 19.8% do not know whether these mothers should breastfeed. These beliefs showed differences both by gender and by socioeconomic status.

CONCLUSIONS

While the Mexican government endorsed the recommendation on breastfeeding during the COVID-19 pandemic, communication was sporadic, inconstant and unequal across types of media. There was a widespread notion that mothers with COVID-19 should not breastfeed and due to differences on beliefs by socioeconomic status, health inequities could be exacerbated by increasing the risk of poorer breastfeeding practices and preventing vulnerable groups from reaping the short and long-term benefits of breastfeeding.

The association between COVID-19 related food insecurity and weight promoting eating behaviours: The mediating role of distress and eating to cope

Food insecurity (a lack of stable access to nutritious food) is reliably associated with higher BMI, although the underlying mechanisms are unclear. Past research indicates that this relationship may, in part, be explained by the distress of being food insecure and using food as a coping mechanism. While previous work has focused on long-term food insecurity, the first COVID-19 national lockdown presented a unique opportunity to establish if the same relationships existed for individuals experiencing pandemic related food insecurity. Adults in the United Kingdom (N = 211) were recruited three months after the first UK lockdown via social media. They completed questionnaires on COVID-19 related food insecurity, physical stress, psychological distress, eating to cope, drinking to cope, diet quality, and changes in weight promoting eating behaviours (e.g. consuming larger portions, increased snacking) since the start of the lockdown. A structural equation model revealed that food insecurity was indirectly associated with changes in weight promoting eating behaviours. As predicted, the more instances of pandemic related food insecurity, the more distress individuals reported. Distress was then associated with eating as a way of coping, which in turn was associated with increases in weight promoting eating behaviours. Food insecurity was also indirectly associated with diet quality, but this was via distress only. These results reflect similar pathways observed in individuals reporting chronic food insecurity and strengthens the evidence that distress and eating to cope are generic mediators of food insecurity and eating behaviour.

Is COVID-19 a threat or an opportunity for healthy eating? An exploration of the factors that moderate the impact of the pandemic on eating habits in Uruguay

In May 2020, Uruguay was one of the few Latin American countries that had managed to control the outbreak of COVID-19 without mandatory curfews or quarantines. However, several social distancing measures created a major disruption in different aspects of the daily life of Uruguayan citizens. In this context, the objectives of the present work were i) to identify changes in eating habits perceived by Uruguayan citizens as a consequence of the COVID-19 pandemic, and ii) to explore factors associated with different perceived changes on eating habits. A cross-sectional online study was conducted with 891 participants, recruited using an advertisement on Facebook and Instagram. Fifty-one percent of the participants indicated that their eating habits had changed since the detection of the first cases of COVID-19 in Uruguay. Large heterogeneity in the categorization of the changes existed: 45% of the participants regarded the changes as positive, 32% as negative and 23% as neither positive nor negative. A multinomial logistic regression analysis was used to study the influence of explanatory variables in the likelihood of belonging to groups who reported different changes in eating habits (no changes, positive, negative, or neither positive nor negative changes). Household income and reliance on instrumental and emotional support increased the likelihood of reporting positive changes in eating habits, whereas negative changes were associated with a reduction in household income due to COVID-19 and the coping strategies self-distraction and self-blaming. Insights for policy making to reinforce positive effects and minimize threats to healthy eating are discussed.

Global assessment of the impacts of COVID-19 on food security

In this paper we present the first global assessments of COVID-19's impacts on food systems and their actors, focusing specifically on the food security and nutritional status of those affected in low and middle-income countries. The assessment covers 62 countries and is based on the analysis of 337 documents published in English, French, Spanish and Portuguese. The review confirms the magnitude and the severity of an unprecedented crisis that has spread worldwide and has spared only a few. The analysis shows that the dimension of food security that has been most affected is accessibility, with reasonably solid evidence suggesting that both financial and physical access to food have been disrupted. In contrast, there is no clear evidence that the availability of food has been affected. Overall, data suggests that food systems resisted and adapted to the disruption of the pandemic. This resilience came, however, at great costs, with the majority of the systems' actors having to cope with severe disruptions in their activities. In contrast, grocery stores and supermarkets made billions of dollars in profits in 2020.

A Multi-Site Analysis of the Prevalence of Food Insecurity in the United States, before and during the COVID-19 Pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic profoundly affected food systems including food security. Understanding how the COVID-19 pandemic impacted food security is important to provide support and identify long-term impacts and needs.

OBJECTIVE

The National Food Access and COVID research Team (NFACT) was formed to assess food security over different US study sites throughout the pandemic, using common instruments and measurements. This study presents results from 18 study sites across 15 states and nationally over the first year of the COVID-19 pandemic.

METHODS

A validated survey instrument was developed and implemented in whole or part through an online survey of adults across the sites throughout the first year of the pandemic, representing 22 separate surveys. Sampling methods for each study site were convenience, representative, or high-risk targeted. Food security was measured using the USDA 6-item module. Food security prevalence was analyzed using ANOVA by sampling method to assess statistically significant differences.

RESULTS

Respondents (n = 27,168) indicate higher prevalence of food insecurity (low or very low food security) since the COVID-19 pandemic, compared with before the pandemic. In nearly all study sites, there is a higher prevalence of food insecurity among Black, Indigenous, and People of Color (BIPOC), households with children, and those with job disruptions. The findings demonstrate lingering food insecurity, with high prevalence over time in sites with repeat cross-sectional surveys. There are no statistically significant differences between convenience and representative surveys, but a statistically higher prevalence of food insecurity among high-risk compared with convenience surveys.

CONCLUSIONS

This comprehensive study demonstrates a higher prevalence of food insecurity in the first year of the COVID-19 pandemic. These impacts were prevalent for certain demographic groups, and most pronounced for surveys targeting high-risk populations. Results especially document the continued high levels of food insecurity, as well as the variability in estimates due to the survey implementation method.

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.

Household food insecurity before and during the COVID-19 pandemic in Chile

Objectives

To compare food insecurity (FI) in Chile before and during the COVID-19 pandemic according to different household types and vulnerability indicators.

Study design

Longitudinal study based on two population-based surveys in Chile (CASEN 2017 and COVID 2020).

Methods

Descriptive analysis and multinomial regression models for FI through the Food Insecurity Experience Scale (FIES).

Results

FI levels increased significantly (P < 0.001) between 2017 (30%) and 2020 (49%). There was increased FI in all households, but especially in those with economically dependent persons (i.e. children, adolescents and older adults). Household vulnerability indicators showed a statistically significant relationship with FI both before and during the pandemic. The pandemic has resulted in new population groups experiencing FI.

Conclusions

The COVID-19 pandemic has led to a significant increase in FI, which has also been seen in new population groups.

Effects of the COVID-19 Pandemic on Food Security and Agriculture in Iran: A Survey

The consequences of COVID-19 on the economy and agriculture have raised many concerns about global food security, especially in developing countries. Given that food security is a critical component that is affected by global crises, beside the limited studies carried out on the macro-impacts of COVID-19 on food security in Iran, this paper is an attempt to address the dynamic impacts of COVID-19 on food security along with economic and environmental challenges in Iran. For this purpose, a survey was conducted with the hypothesis that COVID-19 has not affected food security in Iran. To address this fundamental hypothesis, we applied the systematic review method to obtain the evidence. Various evidences, including indices and statistics, were collected from national databases, scientific reports, field observations, and interviews. Preliminary results revealed that COVID-19 exerts its effects on the economy, agriculture, and food security of Iran through six major mechanisms, corresponding to a 30% decrease in the purchasing power parity in 2020 beside a significant increase in food prices compared to 2019. On the other hand, the expanding environmental constraints in Iran reduce the capacity of the agricultural sector to play a crucial role in the economy and ensure food security, and in this regard, COVID-19 forces the national programs and budget to combat rising ecological limitations. Accordingly, our study rejects the hypothesis that COVID-19 has not affected food security in Iran.

Profiles of Food Insecurity: Similarities and Differences across Selected CEE Countries

Food security (FS) is influenced by primarily financial but also sociodemographic factors. Identification of correlates of food insecurity (FI) is a crucial issue in the context of achieving sustainable development goals. The aims of the study were: (1) to recognize FI in the selected Central and Eastern European (CEE) countries, (2) to examine common socioeconomic and demographic characteristics for FI. The analysis used the set of eight-item FI indicators adopted by the Food and Agriculture Organization, applying the Gallup World Poll survey data from 2017 to 2019. Multinomial logistic regressions were used to examine FI at mild and moderate or severe levels compared with FS. Differences in the profiles of FI were observed in analyzed countries: Poland, Lithuania and Slovakia. Lithuanians experienced the lowest FS, and Slovaks the highest. The FI status was associated with education, gender, age, household composition and income. It was found that the impact of these factors was not the same in the examined countries. Differences in profiles of FI in CEE countries indicate the need to analyze the problem individually for each country. Identifying groups particularly vulnerable to FI may allow appropriate targeting of instruments counteracting FI and adapt them to people with different characteristics.

Impact of COVID-19 on child malnutrition, obesity in women and household food insecurity in underserved urban settlements in Sri Lanka: a prospective follow-up study

OBJECTIVES

To determine changes and factors associated with child malnutrition, obesity in women and household food insecurity before and after the first wave of COVID-19 pandemic.

DESIGN

A prospective follow-up study.

SETTING

In 2019, the baseline Urban Health and Nutrition Study 2019 (UHNS-2019) was conducted in 603 households, which were selected randomly from 30 clusters to represent underserved urban settlements in Colombo. In the present study, 35 % of households from the UHNS-2019 cohort were randomly selected for repeat interviews, 1 year after the baseline study and 6 months after COVID-19 pandemic in Sri Lanka. Height/length and weight of children and women were re-measured, household food insecurity was reassessed, and associated factors were gathered through interviewer-administered questionnaires. Differences in measurements at baseline and follow-up studies were compared.

PARTICIPANTS

A total of 207 households, comprising 127 women and 109 children were included.

RESULTS

The current prevalence of children with wasting and overweight was higher in the follow-up study than at baseline UHNS-2019 (18·3 % v. 13·7 %; P = 0·26 and 8·3 % v. 3·7 %; P = 0·12, respectively). There was a decrease in prevalence of child stunting (14·7 % v. 11·9 %; P = 0·37). A change was not observed in overall obesity in women, which was about 30·7 %. Repeated lockdown was associated with a significant reduction in food security from 57 % in UHNS-2019 to 30 % in the current study (P < 0·001).

CONCLUSIONS

There was an increase in wasting and overweight among children while women had a persistent high prevalence of obesity. This population needs suitable interventions to improve nutrition status of children and women to minimise susceptibility to COVID-19.

COVID-19 Disrupted Provision and Utilization of Health and Nutrition Services in Uttar Pradesh, India: Insights from Service Providers, Household Phone Surveys, and Administrative Data

BACKGROUND

The coronavirus (COVID-19) pandemic may substantially affect health systems, but little primary evidence is available on disruption of health and nutrition services.

OBJECTIVES

This study aimed to 1) determine the extent of disruption in provision and utilization of health and nutrition services induced by the pandemic in Uttar Pradesh, India; and 2) identify how adaptations were made to restore service provision in response to the pandemic.

METHODS

We conducted longitudinal surveys with frontline workers (FLWs, n = 313) and mothers of children <2 y old (n = 659) in December 2019 (in-person) and July 2020 (by phone). We also interviewed block-level managers and obtained administrative data. We examined changes in service provision and utilization using Wilcoxon matched-pairs signed-rank tests.

RESULTS

Compared with prepandemic, service provision reduced substantially during lockdown (83-98 percentage points, pp), except for home visits and take-home rations (∼30%). Most FLWs (68%-90%) restored service provision in July 2020, except for immunization and hot cooked meals (<10%). Administrative data showed similar patterns of disruption and restoration. FLW fears, increased workload, inadequate personal protective equipment (PPE), and manpower shortages challenged service provision. Key adaptations made to provide services were delivering services to beneficiary homes (∼40%-90%), social distancing (80%), and using PPE (40%-50%) and telephones for communication (∼20%). On the demand side, service utilization reduced substantially (40-80 pp) during the lockdown, but about half of mothers received home visits and food supplementation. Utilization for most services did not improve after the lockdown, bearing the challenges of limited travel (30%), nonavailability of services (26%), and fear of catching the virus when leaving the house (22%) or meeting service providers (14%).

CONCLUSIONS

COVID-19 disrupted the provision and use of health and nutrition services in Uttar Pradesh, India, despite adaptations to restore services. Strengthening logistical support, capacity enhancement, performance management, and demand creation are needed to improve service provision and utilization during and post-COVID-19.

Time to Scale-up Research Collaborations to Address the Global Impact of COVID-19 - A Commentary

Objective

In this commentary, we suggest that the unprecedented global impact of the COVID-19 pandemic provides a compelling reason for researchers to stretch beyond usual limits and find new ways to engage in global collaborations.

Methods

We point to data that have emerged on the mental health and economic consequences of the pandemic to illustrate the extent to which these common issues cross national borders. There is high likelihood that these burdens will continue to persist long after the pandemic is declared "over."

Results

We urge researchers, particularly those from countries with higher income economies, to share resources to increase international collaborative research efforts. We present a case study of an ongoing project and offer some lessons learned for individual investigators.

Conclusion

Global problems require global solutions. The COVID-19 pandemic is a global crisis that should prompt researchers to engage in science and research across national borders.

Breastfeeding Media Coverage and Beliefs During the COVID-19 Pandemic in Mexico: Implications for Breastfeeding Equity

BACKGROUND

Breastfeeding offers short- and long- term health benefits to mothers and children and constitutes a priority for public health. Evidence shows that SARS-CoV-2 is not likely to be transmitted via breastmilk. Moreover, antibodies against SARS-CoV-2 are presumably contained in breastmilk of mothers with history of COVID-19 infection or vaccination. Direct breastfeeding is the preferred infant feeding option during the pandemic, but conflicting practices have been adopted, which could widen existing disparities in breastfeeding. This study aims to describe how was information about breastfeeding communicated in Mexican media during the pandemic and assess Mexican adults' beliefs regarding breastfeeding among mothers infected with COVID-19.

METHODS

A retrospective content analysis of media coverage on breastfeeding in Mexico between March 1 and September 24, 2020, excluding advertisements, was done. For the content analysis, both a sentiment analysis and an analysis based on strengths, weaknesses, opportunities and threats for breastfeeding promotion were performed. Also, we incorporated a descriptive analysis from the July 2020 wave of the ENCOVID-19 survey, which included questions on beliefs about breastfeeding. This information was stratified by gender, age, and socioeconomic status.

RESULTS

1014 publications on breastfeeding were identified in internet, newspapers, TV, and magazines. Most information was published during World Breastfeeding Week, celebrated in August. Based on the sentiment analysis, 57.2% of all information was classified as positive, and based on the SWOT analysis, most information was classified either as strengths or opportunities for breastfeeding promotion. However, the ENCOVID-19 data showed that 67.3% of people living in households with children under 3 years of age believe that mothers with COVID-19 should not breastfeed, and 19.8% stated that they simply didn't know. These beliefs showed differences both by gender and by socioeconomic status.

CONCLUSIONS

While the Mexican government endorsed the recommendations on breastfeeding during the COVID-19 pandemic, communication of those messages was sporadic, inconstant and unequal across types of media. Moreover, there were also negative messages for breastfeeding circulating on the media. There continues to be a widespread notion that mothers with COVID-19 should not breastfeed and, due to differences on beliefs by socioeconomic status, health inequities could be exacerbated.

Food Security and COVID-19: A Systematic Review of the First-Year Experience

For decades, global food security has not been able to address the structural problem of economic access to food, resulting in a recent increase in the number of undernourished people from 2014. In addition, the FAO estimates that the number of undernourished people drastically increased by 82–132 million people in 2020 due to the COVID-19 pandemic. To alleviate this dramatic growth in food insecurity, it is necessary to understand the nature of the increase in the number of malnourished during the pandemic. In order to address this, we gathered and synthesized food-security-related empirical results from the first year of the pandemic in a systematic review. The vast majority (78%) of the 51 included articles reported household food insecurity has increased (access, utilization) and/or disruption to food production (availability) was a result of households having persistently low income and not having an adequate amount of savings. These households could not afford the same quality and/or quantity of food, and a demand shortfall immediately appeared on the producer side. Producers thus had to deal not only with the direct consequences of government measures (disruption in labor flow, lack of demand of the catering sector, etc.) but also with a decline in consumption from low-income households. We conclude that the factor that most negatively affects food security during the COVID-19 pandemic is the same as the deepest structural problem of global food security: low income. Therefore, we argue that there is no need for new global food security objectives, but there is a need for an even stronger emphasis on poverty reduction and raising the wages of low-income households. This structural adjustment is the most fundamental step to recover from the COVID-19 food crises, and to avoid possible future food security crises.

Impact of COVID-19 on household food insecurity and interlinkages with child feeding practices and coping strategies in Uttar Pradesh, India: a longitudinal community-based study

OBJECTIVES

The COVID-19 pandemic has profound negative impacts on people's lives, but little is known on its effect on household food insecurity (HFI) in poor setting resources. This study assessed changes in HFI during the pandemic and examined the interlinkages between HFI with child feeding practices and coping strategies.

DESIGN

A longitudinal survey in December 2019 (in-person) and August 2020 (by phone).

SETTING

Community-based individuals from 26 blocks in 2 districts in Uttar Pradesh, India.

PARTICIPANTS

Mothers with children <2 years (n=569).

MAIN OUTCOMES AND ANALYSES

We measured HFI by using the HFI Access Scale and examined the changes in HFI during the pandemic using the Wilcoxon matched-pairs signed-rank tests. We then assessed child feeding practices and coping strategies by HFI status using multivariable regression models.

RESULTS

HFI increased sharply from 21% in December 2019 to 80% in August 2020, with 62% households changing the status from food secure to insecure over this period. Children in newly or consistently food-insecure households were less likely to consume a diverse diet (adjusted OR, AOR 0.57, 95% CI 0.34 to 0.95 and AOR 0.51, 95% CI 0.23 to 1.12, respectively) compared with those in food-secure households. Households with consistent food insecurity were more likely to engage in coping strategies such as reducing other essential non-food expenditures (AOR 2.2, 95% CI 1.09 to 4.24), borrowing money to buy food (AOR 4.3, 95% CI 2.31 to 7.95) or selling jewellery (AOR 5.0, 95% CI 1.74 to 14.27) to obtain foods. Similar findings were observed for newly food-insecure households.

CONCLUSIONS

The COVID-19 pandemic and its lockdown measures posed a significant risk to HFI which in turn had implications for child feeding practices and coping strategies. Our findings highlight the need for further investment in targeted social protection strategies and safety nets as part of multisectoral solutions to improve HFI during and after COVID-19.