[Evaluation indicators of Food and Nutritional Insecurity and associated factors: systematic review]

COVID-19 Pandemic and Food Insecurity among Pregnant Women in an Important City of the Amazon Region: A Study of the Years 2021 and 2022

INTRODUCTION

Food insecurity (FI) experienced during pregnancy represents a relevant public health problem, as it negatively affects maternal and child health.

OBJECTIVE

To investigate the prevalence of FI among pregnant women during the COVID-19 pandemic and determine associated factors.

METHODS

A cross-sectional study was carried out in the period from 2021 to 2022, with a representative sample of 423 women resulting from a sample calculation based on the average (2912 births) that occurred in the years 2016 to 2020 in the only maternity hospital in the municipality. After analyzing the medical records, interviews were carried out with the postpartum women using a standardized questionnaire and the Brazilian Food Insecurity Scale. Poisson regression with robust variance was used to calculate prevalence ratios and 95% confidence intervals to measure associations.

RESULTS

FI was observed in 57.0% of cases and was associated with age under 20 years (PR = 1.52; 95% CI 1.29; 1.79), receipt of government assistance (PR = 1.31; 95% CI 1.10; 1.55), loss of family employment (PR = 1.40; 95% CI 1.20; 1.64), greater number of residents (PR = 1.17; 95% CI 1.00; 1.37), and prenatal care in a public institution (PR = 1.53; 95% CI 1.04; 2.26).

CONCLUSION

There was a high prevalence of FI cases, associated with socioeconomic, demographic, and prenatal care characteristics during the COVID-19 pandemic.

Gender, skin color, and household composition explain inequities in household food insecurity in Brazil

It is well known that female-headed households (FHHs) are more likely to experience food insecurity (FI) than male-headed households (MHHs), however there is a dearth of evidence on how gender intersects with other social determinants of FI. Thus, this paper investigated changes in the prevalence of household FI in Brazil from 2004 to 2018 by the intersection of gender, race/skin color and marital status of the household reference person. Data from three cross-sectional nationally representative surveys that assessed the status of FI using the Brazilian Household Food Insecurity Measurement Scale were analyzed (N2004 = 107,731; N2013 = 115,108, N2018 = 57,204). Multinomial logistic regression models were used to examine the relationship between profiles of gender, race/skin color, marital status of the head of the household with household FI stratified by the presence of children <5 years of age. Over time, FHHs had a higher prevalence of mild and moderate/severe FI than did households headed by men. Food security prevalence increased from 2004 to 2013 and decreased between 2013 and 2018 for households headed by men and women. In 2018, households headed by black/brown single mothers with children < 5 years of age were at the highest FI risk. The probability of reporting moderate/severe FI in these households were 4.17 times higher (95% CI [2.96-5.90]) than for households headed by married white men. The presence of children in the household was associated with a higher probability of moderate/severe FI, especially for households headed by black/brown individuals regardless of the reference person's gender. The results suggest that gender inequities combined with darker skin color and the presence of children at home potentiate the risk of moderate/severe FI. Policy makers need to consider the principles of intersectionality when investing in codesigning, implementing, evaluating, and scaling up evidence-based programs to reduce FI.

Food Insecurity and Micronutrient Deficiency in Adults: A Systematic Review and Meta-Analysis

Food insecurity is a public health problem as it affects a wide array of individuals in the population. It can be characterized by food deprivation, lack of essential nutrition, lack of dietary education, lack of adequate storage conditions, poor absorption, and poor overall nutrition. The relationship between food insecurity and micronutrient deficiency requires more effort to deepen and discuss the relationship. This systematic review aimed to evaluate the association between food insecurity and micronutrient deficiency in adults. The research was conducted according to PRISMA using the Medline/Pubmed, Lilacs/BVS, Embase, Web of Science, and Cinahl databases. Studies carried out with male and female adults were included, which investigated the correlation or association between food insecurity and the nutritional status of micronutrients. There were no publication year, country, or language restrictions. A total of 1148 articles were found, and 18 of these were included, carried out mainly on the American continent and with women. The most evaluated micronutrients were iron and vitamin A. Food insecurity was associated with nutrient deficiency in 89% (n = 16) of the studies. As a result of the meta-analysis, it was observed that there is a greater chance of anemia and low levels of ferritin among food insecure individuals. It is concluded that food insecurity is associated with micronutrient deficiency. Understanding these problems allows the creation of public policies capable of contributing to changes. Protocol registration: This review was registered on the PROSPERO-International Prospective Register of Systematic Reviews database-CRD42021257443.

Chronic diseases and emotional disorders are associated with low perception of quality of life in food insecurity/security

Understanding individual perception of Quality of Life (QoL) can help combat social and health inequalities. We aimed to identify factors associated with Low Perceived Quality of Life (LPQoL) in 295 adults and older adults with food security and food insecurity, in the city of Natal, Brazil. A cross-sectional study was conducted from June to December 2019, with collection of data on socioeconomic demographic status, lifestyle information, non-communicable diseases (NCDs) and risk factors, emotional disorders, food (in) security and quality of life. To assess food insecurity, the Brazilian Scale of Food Insecurity—EBIA was used, and the WHOQOL-Bref questionnaire was used to assess quality of life. Poisson's Regression was used to verify associations between variables and LPQoL, stratifying the sample into food secure (FS) and food insecure (FI) groups. In the FI group, being overweight, older adult, having no partner, drinking alcoholic beverages twice a week or more, and not having daily availability of water were associated with LPQoL, and in the FS group, having diabetes, monthly family income in the 1st and 2nd tertiles, and never having studied was associated with LPQoL. Reporting emotional disorders and sleeping &lt; 7 h/day were associated with LPQoL in both FI and FS groups. LPQoL was associated with the occurrence of NCDs and risk factors, and emotional disorders, regardless of the food security measure. However, the lack of adequate access to water highlights the social vulnerability of the FI group.

Food Insecurity Reduces the Chance of Following a Nutrient-Dense Dietary Pattern by Brazilian Adults: Insights from a Nationwide Cross-Sectional Survey

Dietary patterns derived by data-driven techniques are still scarce in the food security context and may be a useful tool to inform policymakers to promote adequate and healthy diets for vulnerable populations. We investigated the association between food security status and dietary patterns among 28,127 Brazilian adults using data from the 2017–2018 Household Budget Survey. Food security status was measured by the Brazilian Food Insecurity Scale. Food items reported in two 24 h dietary recalls were combined into food groups. Dietary patterns were derived from exploratory factor analysis, and participants were grouped according to their factor scores by K-means cluster analysis. Multiple logistic regression models were fitted to investigate the association between food security status and clusters of adherence to dietary patterns. Four dietary patterns were derived: ‘Brazilian breakfast style’ (cluster 3), ‘Brazilian Traditional staple foods’ (cluster 2), ‘Beverages, ready-to-eat and convenience foods’ (cluster 4), and ‘Fruits, vegetables, and whole grains’ (cluster 1). After adjustments, food insecurity was inversely associated with adherence to the ‘Fruits vegetables, and whole grains’ pattern (OR = 0.75, 95% CI: 0.63–0.89). Findings suggest food insecurity negatively impact the adoption of a nutrient-dense dietary pattern and highlight the critical role of policy actions in a scenario of increasing food insecurity.

Fatores demográficos e socioambientais associados à insegurança alimentar domiciliar nos diferentes territórios da cidade de Salvador, Bahia, Brasil

O objetivo deste estudo foi apresentar a prevalência da insegurança alimentar domiciliar em diferentes territórios da cidade de Salvador, Bahia, Brasil, e analisar fatores demográficos e socioambientais a ela associados. Os dados utilizados são de uma pesquisa maior denominada Qualidade do Ambiente Urbano de Salvador - QUALISalvador, realizada entre 2018 e 2020 em Salvador. A insegurança alimentar foi avaliada por meio da Escala Brasileira de Insegurança Alimentar. Foram analisados 15.171 domicílios. Modelos de regressão logística multinominal foram utilizados para analisar a associação de variáveis demográficas e socioambientais com insegurança alimentar leve (IAL) e moderada ou grave (IAMG), para Salvador e macrozonas. Salvador apresentou 40,96% de insegurança alimentar. Nas macrozonas, as prevalências se diferenciaram: Orla Atlântica (25,8%), Área Urbana Consolidada (33%), Subúrbio (45,7%) e Miolo (47,9%). Todos os fatores analisados apresentaram associação com IAL e/ou IAMG no modelo para Salvador, entre eles estão o responsável pelo domicílio ter escolaridade ≤ 4 anos (IAL: OR = 2,00; IC95%: 1.61-2,47/IAMG: OR = 4,94; IC95%: 3,83-6,35), renda familiar per capita de até 1/2 salário mínimo (IAL: OR = 2,62; IC95%: 2,37-2,93/IAMG: OR = 4,03; IC95%: 3,53-4,60), percepção sobre a qualidade do ambiente urbano como ruim (IAL: OR = 1,57; IC95%: 1,36-1,81/IAMG: OR = 2,03; IC95%: 1,73-2,38), com maior prevalência de insegurança alimentar em cenários de pior situação sociodemográfica. Na macrozona Miolo todos os fatores também se mantiveram associados à insegurança alimentar. Assim, os fatores de vulnerabilidade social estão associados à insegurança alimentar na capital e macrozonas, mas apresentam-se de formas especificas segundo características de cada território.