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Vaiciurgis VT, Clancy AK, Charlton KE, Stefoska-Needham A, Beck EJ. Supporting the nutrition-related health and well-being of people experiencing socio-economic disadvantage: Findings from a national survey. J Hum Nutr Diet 2024; 37:1349-1360. [PMID: 38990152 DOI: 10.1111/jhn.13340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/28/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND People experiencing socio-economic disadvantage face significantly higher rates of diet-related health inequities. This study aimed to explore barriers, opportunities and potential solutions in providing food and nutrition services to people experiencing socio-economic disadvantage from the perspective of services providers. The present study is part of a broad co-design model to improve service provision for people experiencing socio-economic disadvantage. METHODS A cross-sectional online survey involving 33 open and closed-ended questions was distributed to Australian governmental and non-governmental organisations providing nutrition-related support to people experiencing socio-economic disadvantage aged 16 years and over. Data were analysed using frequency distributions and conceptual content analyses. RESULTS Sixty-eight responses were analysed. Services are predominantly offered by charitable organisations (90%), funded through private donations (66%) and reliant on volunteers (100%). Barriers to supporting clients' nutrition needs include financial constraints, limited community engagement, understaffing, insufficient resources and knowledge gaps. Opportunities and solutions for enhancing support include increasing government funding, advocacy initiatives, stronger community collaboration and more holistic, customised services. Proposed recommendations include establishing purpose-built facilities or wrap-around services to expand access to health services, life skills, training and educational programs. CONCLUSIONS Services face challenges including volunteer reliance, limited resources and inadequate government support, hindering food provision. Client barriers include transportation costs and lack of social support. With dedicated financial support, services can offer comprehensive assistance, including community spaces, staffing, health and social services and training. Community partnerships can maximise funding impact. Solutions must address overall well-being and broader social determinants such as income inequality and housing.
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Affiliation(s)
- Verena T Vaiciurgis
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Annabel K Clancy
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Karen E Charlton
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Anita Stefoska-Needham
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Eleanor J Beck
- School of Health Sciences, University of New South Wales, Kensington, NSW, Australia
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Ma E, Wagatsuma Y. Editorial: Nutrition in vulnerable groups. Front Nutr 2024; 11:1448870. [PMID: 39309140 PMCID: PMC11412871 DOI: 10.3389/fnut.2024.1448870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 08/28/2024] [Indexed: 09/25/2024] Open
Affiliation(s)
- Enbo Ma
- Health Promotion Center, Fukushima Medical University, Fukushima, Japan
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yukiko Wagatsuma
- Department of Clinical Trials and Clinical Epidemiology, University of Tsukuba Faculty of Medicine, Ibaraki, Japan
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Vaiciurgis VT, Clancy AK, O'Reilly G, Beck EJ. Perceived nutrition needs of people experiencing disadvantage in utilizing support services: An Australian case study. Food Sci Nutr 2024; 12:4133-4142. [PMID: 38873481 PMCID: PMC11167159 DOI: 10.1002/fsn3.4072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 02/14/2024] [Accepted: 02/23/2024] [Indexed: 06/15/2024] Open
Abstract
Individuals experiencing socio-economic disadvantage face higher rates of food insecurity and health disparities. This study explored the perceptions, attitudes, and knowledge of individuals providing nutrition services, and users of these services, to identify nutrition needs and inform potential strategies for addressing diet-related health inequities. Semi-structured interviews were conducted utilizing a phenomenological approach to explore lived experiences, beliefs, and perceptions influencing nutrition-related health. Key themes were derived by consensus among researchers using inductive thematic analysis. Twenty-two interviews were completed, which identified five themes. "Budgetary Constraints" was found to have a pervasive impact on all nutrition-related services. Secondly, diverse "Individual Clientele" was found to influence three overlapping themes pertaining to opportunities and limitations for "Knowledge and Skills," "Services, Resources and Staff," and the "Systems and Food Environment." Budgets directly impact the availability of services, resources, food provision, sustainability, and educational opportunities for staff, volunteers and service users. A live-in environment offers a platform to implement and evaluate targeted interventions to inform and enhance nutrition-related support services. Future interventions should address individual and systemic influences, prioritizing client-informed, cost-effective, sustainable capacity building for clients and staff. Recommendations for systemic and environmental influences include formalized staff training, peer-mentoring systems, and increasing client autonomy. This has the potential to improve food security for residents following their transition into independent living. Charitable system limitations underscore the need for broader systemic change, informed policymaking, and government intervention to effectively address the root causes of food insecurity and diet-related health inequities.
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Affiliation(s)
- Verena T. Vaiciurgis
- School of Medical, Indigenous and Health SciencesUniversity of WollongongWollongongNew South WalesAustralia
- Illawarra Health & Medical Research InstituteWollongongNew South WalesAustralia
| | - Annabel K. Clancy
- School of Medical, Indigenous and Health SciencesUniversity of WollongongWollongongNew South WalesAustralia
- Illawarra Health & Medical Research InstituteWollongongNew South WalesAustralia
| | - Grace O'Reilly
- School of Medical, Indigenous and Health SciencesUniversity of WollongongWollongongNew South WalesAustralia
- Illawarra Health & Medical Research InstituteWollongongNew South WalesAustralia
| | - Eleanor J. Beck
- School of Medical, Indigenous and Health SciencesUniversity of WollongongWollongongNew South WalesAustralia
- Illawarra Health & Medical Research InstituteWollongongNew South WalesAustralia
- School of Health SciencesUniversity of New South WalesKensingtonNew South WalesAustralia
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4
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Grammatikopoulou MG, Vassilakou T. Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances. CHILDREN (BASEL, SWITZERLAND) 2024; 11:430. [PMID: 38671646 PMCID: PMC11049479 DOI: 10.3390/children11040430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 03/24/2024] [Indexed: 04/28/2024]
Abstract
Nutrition is a modifiable factor of paramount importance for the prevention and attainment of health and the development of youngsters [...].
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Affiliation(s)
- Maria G. Grammatikopoulou
- Immunonutrition and Clinical Nutrition Unit, Department of Rheumatology and Clinical Immunology, Medical School, University of Thessaly, Biopolis Campus, GR-43100 Larissa, Greece
| | - Tonia Vassilakou
- Department of Public Health Policy, School of Public Health, University of West Attica, GR-11521 Athens, Greece
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Barth-Jaeggi T, Speich C, Havugimana C, Bayisenge F, Kimenju S, Omondi W, Pasha SF, Islam S, van Zutphen-Küffer KG, van den Berg S, Barjolle D, Pannatier M, Prytherch H. Nutrition transition, double burden of malnutrition, and urbanization patterns in secondary cities of Bangladesh, Kenya and Rwanda. BMC Nutr 2023; 9:125. [PMID: 37925425 PMCID: PMC10625300 DOI: 10.1186/s40795-023-00782-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 10/13/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND By 2050, approximately 68% of the global population will live in cities, but nutrition data on urban populations of low- and middle-income countries are scarce. Fast growing secondary cities, combining characteristics and hurdles of urban and rural settings, are hotspots for the double burden of malnutrition. The Nutrition in City Ecosystems (NICE) project focuses on 6 secondary cities in Bangladesh, Kenya and Rwanda, to improve health and nutrition, and reduce poverty. To assess the baseline situation and guide future interventions, food insecurity, dietary diversity, nutrition status, and food production and purchasing patterns were explored. METHODS In a cross-sectional study design, data were collected from urban and peri-urban households of Dinajpur and Rangpur in Bangladesh, Bungoma and Busia in Kenya, and Rubavu and Rusizi in Rwanda. Approximately 1200 households, in neighborhoods prone to malnutrition, were involved from April to June 2021. We assessed Household Food Insecurity Access Score (HFIAS), both current and before COVID-19, Household Dietary Diversity Score (HDDS), Minimum Dietary Diversity for Women (MDD-W), anthropometric measurements, household and socioeconomic information, and questions related to food production and consumer behavior. Further we collected secondary data on low birthweight and anemia during pregnancy. RESULTS All cities experienced a substantial increase in food insecurity during the COVID-19 pandemic. Stunting rates in children under 5 years varied among the cities and ranged from 7.8% in Busia to 46.6% in Rubavu, while half of adult women were overweight (between 42.1% in Rusizi and 55.8% in Bungoma). Furthermore, many women did not consume an adequately diverse diet (MDD-W < 5 for 29.3% in Bangladesh, 47.5% in Kenya, and 67.0% in Rwanda), however many of the urban and peri-urban households were engaged in farming (58-78%). CONCLUSIONS The double burden of malnutrition is high in secondary cities and the COVID-19 pandemic has exacerbated levels of food insecurity. Demand for, and access to, an affordable healthy diverse diet that comprises local, nutritious, and agroecologically produced foods present a pathway for overcoming the complex challenges of malnutrition.
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Affiliation(s)
- Tanja Barth-Jaeggi
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Cornelia Speich
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | | | | | | | | | | | | | | | | | | | - Marnie Pannatier
- Syngenta Foundation for Sustainable Agriculture, Basel, Switzerland
| | - Helen Prytherch
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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6
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Dewi NU, Khomsan A, Dwiriani CM, Riyadi H, Ekayanti I, Hartini DA, Bohari B, Aiman U, Nurulfuadi, Fadjriyah RN. The combination of nutrition education at school and home visits to improve adolescents' nutritional literacy and diet quality in food-insecure households in post-disaster area (De-Nulit study): A study protocol of cluster randomized controlled trial (CRCT). Contemp Clin Trials Commun 2023; 35:101185. [PMID: 37529067 PMCID: PMC10387559 DOI: 10.1016/j.conctc.2023.101185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 06/28/2023] [Accepted: 07/02/2023] [Indexed: 08/03/2023] Open
Abstract
Nutrition education is selected as a method which often used to change eating behaviour, yet, the effectiveness of this method in adolescents who live in household with food insecurity status is rarely investigated. The purpose of this study was to assess the impact of a combination of nutritional education held at school and home visits for increasing the nutritional literacy and its effect on the quality of adolescent diet, so that the result can be used as a strategy to improve nutritional literacy dan diet quality in those adolescents who live in food-insecure households in post-disaster areas. The De-Nulit Study is a Cluster Randomized Controlled Trial (CRCT) with an intervention from a combination of nutritional education given at school and home visits conducted for three months for adolescents who live in food-insecure households with ages ranging from 15 to 17 years old. A randomization sampling was carried out at four schools located the nearest locations which were affected heavily by the major natural disasters in 2018. The nutritional education intervention groups in schools were given in eight sessions, whereas home visits with an interview approach for students with a motivational interview approach were carried out four times. The control group will receive leaflets three times a month for three months, and each group will receive a food stamp $ 7.6 per month for three months. The trial research has been recorded in Thai Clinical Trials Registry (TCTR) with identification number of TCTR 20220203003 issued on 03 February 2022.
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Affiliation(s)
- Nikmah Utami Dewi
- Department of Nutrition, Faculty of Public Health, University of Tadulako, Indonesia
| | - Ali Khomsan
- Department of Community Nutrition, Faculty of Human Ecology, IPB University, Indonesia
| | - Cesilia Meti Dwiriani
- Department of Community Nutrition, Faculty of Human Ecology, IPB University, Indonesia
| | - Hadi Riyadi
- Department of Community Nutrition, Faculty of Human Ecology, IPB University, Indonesia
| | - Ikeu Ekayanti
- Department of Community Nutrition, Faculty of Human Ecology, IPB University, Indonesia
| | - Diah Ayu Hartini
- Department of Nutrition, Health Polytechnic of Palu, Palu, Indonesia
| | - Bohari Bohari
- Department of Nutrition, Faculty of Medicine, Sultan Ageng Tirtayasa University, City of Serang, Indonesia
| | - Ummu Aiman
- Department of Nutrition, Faculty of Public Health, University of Tadulako, Indonesia
| | - Nurulfuadi
- Department of Nutrition, Faculty of Public Health, University of Tadulako, Indonesia
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Pascall MA, DeAngelo K, Richards J, Arensberg MB. Role and Importance of Functional Food Packaging in Specialized Products for Vulnerable Populations: Implications for Innovation and Policy Development for Sustainability. Foods 2022; 11:foods11193043. [PMID: 36230119 PMCID: PMC9564204 DOI: 10.3390/foods11193043] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/14/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
Specialized products can be needed to help meet the nutrition requirements of vulnerable populations, including infants and young children, those who are ill, and older adults. Laws and regulations delineate distinct categories for such products including medical foods or formulated liquid diets, foods for special dietary use (FSDUs), infant formulas, and natural health products (NHPs). Yet, the literature is limited regarding the role and importance of functional and sustainable packaging for specialized products. This perspective review describes these unique product categories and the role of packaging as well as regulatory considerations. Furthermore, reviewed are how waste reduction strategies and emerging legislative/regulatory policies in the United States and Canada may not adequately address the functional packaging requirements for specialized products. The paper concludes by offering perspectives for emerging innovations and policy development for sustainability.
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Affiliation(s)
- Melvin A. Pascall
- Department of Food Science and Technology, The Ohio State University, Columbus, OH 43210, USA
| | - Kris DeAngelo
- Institute for Food Laws and Regulations, Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA
- College of Law, Michigan State University, East Lansing, MI 48824, USA
| | - Julie Richards
- Abbott Nutrition Division of Abbott, Columbus, OH 43219, USA
- Correspondence:
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8
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Pal J, Sethi D, Taywade M, Pal R. Role of Nutrition and Diet during COVID-19 pandemic: A narrative review. J Family Med Prim Care 2022; 11:4942-4948. [PMID: 36505552 PMCID: PMC9731022 DOI: 10.4103/jfmpc.jfmpc_1311_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/11/2021] [Accepted: 10/16/2021] [Indexed: 12/15/2022] Open
Abstract
COVID-19 has impacted mankind drastically; whether it be physical and mental health, global economy, or social disruption, everyone has sustained losses. To prevent the spread, strict containment measures and stay at home guidelines were issued by officials. Due to this, an unanticipated and rapid change has occurred in the daily routine and lifestyle of the people. Physical distancing and quarantine measures strongly impacted people's lives, their eating habits and everyday ablutions. A comprehensive search of recent literature related to nutrition and diet during the pandemic was undertaken using electronic databases like MEDLINE, PubMed, Google Scholar, and ResearchGate. This review deals with the effects of COVID-19 on malnutrition, the foods that help in boosting the immune system, and on specific, vulnerable, age groups. Although there are various health concerns that has come up during the pandemic, through this review, we investigate some aspects related to nutrition as the recovery of every individual who was affected by COVID-19 was influenced by their nutritional intake.
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Affiliation(s)
- Jagriti Pal
- College of Nursing, All India Institute of Medical Science, Bhubaneswar, Odisha, India
| | - Divya Sethi
- College of Nursing, All India Institute of Medical Science, Bhubaneswar, Odisha, India
| | - Manish Taywade
- Department of Community Medicine and Family Medicine, All India Institute of Medical Science, Bhubaneswar, Odisha, India,Address for correspondence: Dr. Manish Taywade, Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar - 751 019, Odisha, India. E-mail:
| | - Rajni Pal
- College of Nursing, All India Institute of Medical Science, Bhubaneswar, Odisha, India
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Vaiciurgis VT, Charlton KE, Clancy AK, Beck EJ. Nutrition programmes for individuals living with disadvantage in supported residential settings: a scoping review. Public Health Nutr 2022; 25:2625-2636. [PMID: 35470791 PMCID: PMC9991776 DOI: 10.1017/s1368980022000969] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 03/30/2022] [Accepted: 04/19/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Health inequities such as chronic disease are significantly higher among individuals living with disadvantage compared with the general population and many are reported to be attributable to preventable dietary risk factors. This study provides an overview of the current nutrition interventions for individuals living with extreme disadvantage, in supported residential settings, to develop insights into the development and implementation of policies and practices to promote long-term nutritional health and well-being. DESIGN A scoping review searched Scopus, ProQuest, CINAHL Plus, MEDLINE, and Web of Science databases using the terms 'resident', 'nutrition', 'disadvantage', 'intervention' and their synonyms, with particular emphasis on interventions in residential settings. SETTING Residential services providing nutrition provision and support. PARTICIPANTS People experiencing extreme disadvantage. RESULTS From 5262 articles, seven were included in final synthesis. Most interventions focused on building food literacy knowledge and skills. Study designs and outcome measures varied; however, all reported descriptive improvements in behaviour and motivation. In addition to food literacy, it was suggested that interventions need to address behaviour and motivations, programme sustainability, long-term social, physical and economic barriers and provide support for participants during transition into independent living. Socio-economic issues remain key barriers to long-term health and well-being. CONCLUSIONS In addition to food literacy education, future research and interventions should consider utilising an academic-community partnership, addressing nutrition-related mental health challenges, motivation and behaviour change and a phased approach to improve support for individuals transitioning into independent living.
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Affiliation(s)
- Verena T Vaiciurgis
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW2522, Australia
- Illawarra Health & Medical Research Institute, Wollongong, NSW2522, Australia
| | - Karen E Charlton
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW2522, Australia
- Illawarra Health & Medical Research Institute, Wollongong, NSW2522, Australia
| | - Annabel K Clancy
- Illawarra Health & Medical Research Institute, Wollongong, NSW2522, Australia
| | - Eleanor J Beck
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW2522, Australia
- Illawarra Health & Medical Research Institute, Wollongong, NSW2522, Australia
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Marshall AI, Lasco G, Phaiyarom M, Pangkariya N, Leuangvilay P, Sinam P, Suphanchaimat R, Julchoo S, Kunpeuk W, Zhang Y. Evidence on Child Nutrition Recommendations and Challenges in Crisis Settings: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126637. [PMID: 34203109 PMCID: PMC8296440 DOI: 10.3390/ijerph18126637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/15/2021] [Accepted: 06/18/2021] [Indexed: 11/21/2022]
Abstract
Adequate child nutrition is critical to child development, yet child malnutrition is prevalent in crisis settings. However, the intersection of malnutrition and disasters is sparse. This study reviews existing evidence on nutrition responses and outcomes for infants and young children during times of crisis. The scoping review was conducted via two approaches: a systematic search and a purposive search. For the systematic search, two key online databases, PubMed and Science Direct, were utilized. In total, data from 32 studies were extracted and included in the data extraction form. Additionally, seven guidelines and policy documents were included, based on relevance to this study. Overall, the existing evidence demonstrates the negative impacts of crises on nutritional status, diet intake, anthropometric failure, and long-term child development. On the other hand, crisis-related interventions positively affected nutrition-related knowledge and practices. Further studies should be carried out to explore the sustainability of the interventions and the success of existing guidelines. Since this study focuses only on nutrition among children under three, further studies should likewise consider an extended age range from three to five years.
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Affiliation(s)
- Aniqa Islam Marshall
- International Health Policy Program, Ministry of Public Health, Nonthaburi 1100, Thailand; (A.I.M.); (N.P.); (P.S.); (R.S.); (S.J.); (W.K.)
| | - Gideon Lasco
- Department of Anthropology, University of the Philippines Diliman, Quezon City 1107, Philippines;
- Development Studies Program, Ateneo de Manila University, Diliman, Quezon City 1106, Philippines
- Equity Initiative, Bangkok 10110, Thailand; (P.L.); (Y.Z.)
| | - Mathudara Phaiyarom
- International Health Policy Program, Ministry of Public Health, Nonthaburi 1100, Thailand; (A.I.M.); (N.P.); (P.S.); (R.S.); (S.J.); (W.K.)
- Correspondence:
| | - Nattanicha Pangkariya
- International Health Policy Program, Ministry of Public Health, Nonthaburi 1100, Thailand; (A.I.M.); (N.P.); (P.S.); (R.S.); (S.J.); (W.K.)
| | | | - Pigunkaew Sinam
- International Health Policy Program, Ministry of Public Health, Nonthaburi 1100, Thailand; (A.I.M.); (N.P.); (P.S.); (R.S.); (S.J.); (W.K.)
| | - Rapeepong Suphanchaimat
- International Health Policy Program, Ministry of Public Health, Nonthaburi 1100, Thailand; (A.I.M.); (N.P.); (P.S.); (R.S.); (S.J.); (W.K.)
- Equity Initiative, Bangkok 10110, Thailand; (P.L.); (Y.Z.)
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Sataporn Julchoo
- International Health Policy Program, Ministry of Public Health, Nonthaburi 1100, Thailand; (A.I.M.); (N.P.); (P.S.); (R.S.); (S.J.); (W.K.)
| | - Watinee Kunpeuk
- International Health Policy Program, Ministry of Public Health, Nonthaburi 1100, Thailand; (A.I.M.); (N.P.); (P.S.); (R.S.); (S.J.); (W.K.)
| | - Yunting Zhang
- Equity Initiative, Bangkok 10110, Thailand; (P.L.); (Y.Z.)
- Child Health Advocacy Institute, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
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Spolidoro GCI, Azzolino D, Shamir R, Cesari M, Agostoni C. Joint Effort towards Preventing Nutritional Deficiencies at the Extremes of Life during COVID-19. Nutrients 2021; 13:1616. [PMID: 34065864 PMCID: PMC8150599 DOI: 10.3390/nu13051616] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/10/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023] Open
Abstract
The COVID-19 (Coronavirus disease 2019) pandemic is posing a threat to communities and healthcare systems worldwide. Malnutrition, in all its forms, may negatively impact the susceptibility and severity of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection in both children and older adults. Both undernutrition and obesity have been evoked as conditions associated with a higher susceptibility to the infection and poor prognosis. In turn, the COVID-19 infection may worsen the nutritional status through highly catabolic conditions, exposing individuals to the risk of malnutrition, muscle wasting, and nutritional deficiencies. Accordingly, the relationship between malnutrition and COVID-19 is likely to be bidirectional. Furthermore, the modification of nutritional behaviors and physical activity, required to limit the spread of the virus, are posing a challenge to health at both the extremes of life. Thus far, even the most advanced healthcare systems have failed to address the alarming consequences of malnutrition posed by this pandemic. If not properly addressed, we may run the risk that new and old generations will experience the consequences of COVID-19 related malnutrition.
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Affiliation(s)
- Giulia C. I. Spolidoro
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (G.C.I.S.); (D.A.); (M.C.)
| | - Domenico Azzolino
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (G.C.I.S.); (D.A.); (M.C.)
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy
| | - Raanan Shamir
- Nutrition and Liver Diseases, Schneider Children’s Medical Center of Israel, Sackler Faculty of Medicine, Institute of Gastroenterology, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (G.C.I.S.); (D.A.); (M.C.)
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (G.C.I.S.); (D.A.); (M.C.)
- Pediatric Intermediate Care Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Malnutrition and Food Insecurity Might Pose a Double Burden for Older Adults. Nutrients 2020; 12:nu12082407. [PMID: 32796746 PMCID: PMC7468760 DOI: 10.3390/nu12082407] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/04/2020] [Accepted: 08/07/2020] [Indexed: 12/12/2022] Open
Abstract
Although food insecurity has been associated with a disadvantageous socioeconomic status, especially in older adults, its association with comorbidities is less clear. The scope of the present cross-sectional study was to assess the prevalence of food insecurity among older adults and evaluate the association between food insecurity, malnutrition, chronic disease, multimorbidity and healthcare utilization. A total of 121 older adults (mean (standard deviation) age: 72.6 (8.1)) were recruited from a Primary Care Health Center from 10 August 2019 to 10 September 2019. Food insecurity and malnutrition status were assessed by the Household Food Insecurity Access Scale and Mini Nutritional Assessment tool, respectively. Recorded variables included financial, family data and comorbidities. The prevalence of food insecurity in the sample reached 50.4%, with men and older adults malnourished or at risk for malnutrition, exhibiting high risk for food insecurity. Multimorbidity, frequency of health care utilization and medication adherence were not associated with food insecurity, possibly due to the free health services and remunerated medications offered by the Greek government. However, male gender and malnutrition risk were significant predictors of food insecurity in the multiple logistic analyses. This study highlights the need for mainstreaming food insecurity assessment among older adults with comorbidities, especially those at risk for malnutrition.
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