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

Facilitators and barriers to anemia prevention in the urban government childcare program for infants and young children in Peru

BACKGROUND

Anemia is a major public health problem in children under 2 years old in Peru and other low- and middle-income countries.

OBJECTIVES

We aimed to explore facilitators and barriers to anemia prevention through feeding strategies in the Cuna Mas day-care centers in urban Peru among infants and young children (IYC) aged 6-23 months.

METHODS

Qualitative research in day-care services (n = 14) in Peru. We conducted direct observations and semi-structured interviews about consumption of animal source foods (ASF) and iron supplementation with day-care staff (technical managers, nursery caregivers and 'mother guides') and caregivers of IYC. We applied a grounded approach to data analysis.

RESULTS

Cuna Mas staff facilitated ASF consumption by introducing small portions of iron-rich foods and serving organ meats in tasty stews. Staff also avoided giving carbohydrate-rich foods to IYC prior to giving organ meats. Staff facilitated giving daily iron supplement by using standardized and personalized strategies, such as using a timed reminder, praising and cheering a child or giving supplements whilst washing a child's hands and face. These strategies were also shared with primary caregivers to use at home. Some barriers reported by caregivers included difficulties in accessing and preparing specific ASF at home.

CONCLUSION

The Peruvian Cuna Mas complementary feeding program facilitated consumption of iron-rich ASF and iron supplements through a range of strategies which they then shared with caregivers for implementation at home. These institutional behavioral change initiatives could be replicated in other settings whilst considering the facilitators and barriers identified in this study.

The effect of the COVID-19 pandemic on the baby-friendly community initiative and maternal infant and young child nutrition in Kenya

BACKGROUND

The COVID-19 pandemic led to decline in access and utilization of the baby-friendly community initiative (BFCI) which is being implemented in Kenya. The impact of the pandemic on the BFCI and on maternal and child health and nutrition has not been documented. We undertook a qualitative study that assessed the effect of the COVID-19 pandemic on the baby-friendly community initiative (BFCI) activities, maternal and child health (MCH) services and maternal, infant and young child nutrition (MIYCN) practices in Kenya.

METHODS

Data on the impact of the pandemic on the BFCI activities, provision and access to MCH services and MIYCN practices were collected using key informant interviews (n = 57), in-depth interviews (n = 31), and focus group discussions (n = 15) with government officials, civil society organizations and community members in BFCI implementing and non-implementing urban and rural areas.

RESULTS

Our study found that BFCI activities, such as home visits, support group meetings and MCH services such as nutrition counselling, growth monitoring and vaccination were interrupted by the pandemic due to fear of contracting the virus, lack of personal protective equipment (PPEs) and movement restrictions. This meant that mothers did not have access to basic community and health services. Food insecurity attributed to financial difficulties resulted in coping strategies such as skipping meals and negatively affected MIYCN practices. Positive measures to prevent COVID-19 spread such as remote working enabled some mothers to adequately feed their children because they were better able to balance working and the demands of feeding young children from home.

CONCLUSION

On balance, the pandemic negatively impacted the BFCI, MCH services and MIYCN practices in Kenya. In such a context, there is a need for innovative approaches to ensure continued provision of and access to facilities and community health services in the future if the country finds itself in a similar position with the challenges of a pandemic. The pandemic revealed that remote working support policies could have the potential to improve breastfeeding and complementary feeding for working women but further evidence is needed to fully evaluate this.

Household food insecurity and nutritional status of pre-school children following relaxation of corona virus disease-2019 (COVID-19) restrictions

BACKGROUND & AIMS

Studies found a high prevalence of household food insecurity (HFI) and malnutrition and an association between them during the movement restriction period of the corona virus disease-2019 (COVID-19) pandemic. This nutritional status should have improved by now as movement restrictions, including quarantine, have been lifted. Therefore, the goal of this cross-sectional study was to determine the current prevalence of HFI and malnutrition and their associations and contributing factors among pre-school children (i.e., children under the age of 5 years) following relaxation of the COVID-19 restrictions in Jordan.

METHODS

A sample of 386 children (197 boys and 189 girls) in Irbid, Jordan, were recruited in this study following the simple random sampling method. The levels of HFI and malnutrition were assessed using the Food Insecurity Experience Scale (FIES) and the World Health Organization (WHO) growth reference values, respectively. Relevant information were managed and measurements made and employed to calculate four major anthropometric indicators for the sample children (weight for height (WHZ), height for age z-score (HAZ), weight for age z-score (WAZ) and body mass index (BMI)-for-age z-score.

RESULTS

The results of analysis pointed out that prevalence of food security among the sample children was 58.2 %, where 19.9 % of the kids were experiencing moderate food insecurity and 38.3 % were suffering from severe food insecurity. On the other hand, prevalence of malnutrition among those children was 1.81 %, where 1.55 % of the kids were emaciated and 1.26 % were severely emaciated. The results also indicated that mother's age, number of children in the family, income of the family, monthly expenses on food and beverages and the energy expenses contributed significantly (p < 0.05) to food insecurity. Moreover, the study found that HFI had negative correlations with WHZ (r = -0.272, p = 0.000), WAZ (r = -0.193, p = 0.000) and BMI-for-age z-score (r = -0.263, p = 0.000) and a positive correlation with HAZ (r = 0.041, p = 0.00).

CONCLUSIONS

The study reports high prevalence of HFI among children under the age of 5 years in Jordan, even after relaxation of the COVID-19 restrictions on mobility. However, prevalence of malnutrition among this group of the population is low. These results spotlight the continued impact of the COVID-19 crisis on the financial statuses of households.

Consumption of protect and risk food groups for non-communicable diseases among women of reproductive age in rural areas of Morogoro, Tanzania

Malnutrition has been persistently high in Tanzania, especially in the rural areas. Although some interventions have been implemented to reduce the rate of undernutrition, improvement is much slower than expected. Moreover, the prevalence of overweight and obesity among women of reproductive age has been on the increase. Changes in lifestyles specifically in eating habits may contribute to the observed increase trend in the prevalence of overweight and obesity. However, there are limited studies that have assessed diet quality for women. Hence, this study aimed to assess the consumption of protective and risk food groups for non-communicable diseases (NCDs) in rural areas of the Morogoro region, Tanzania. The cross-sectional study involved 512 randomly selected women of reproductive age in Mvomero district. All mothers or caretakers with children of age 6-23 months who resided in the area for over three months were eligible to participate. A structured questionnaire was used to collect demographic data and the Global Diet Quality Questionnaire was used to collect dietary intake data for women. A multivariate regression model was used to identify factors associated with consumption of diversified diets, NCD-protect, and NCD-risk food group scores. The results show that about 42% of the women had no formal education and about one in three women own a mobile phone. About 70% consumed vegetables while 33% consumed deep fried foods. Only 34% of the women met the minimum diet diversity (MDD-W) of five or more food groups. The mean NCD-protect score was 2.8 ± 1.4 and the NCD-risk score was 0.77 ± 0.97. Household income was positively associated with an increase in both protect scores and NCD-risk. Mobile phone ownership was positively associated with NCD-risk. Other factors such as age and self-employment in agriculture were positively associated NCD-protect while the number of children was negatively associated with NCD-protect score. Rural communities should be educated on the importance of food diversification starting from production to consumption and the need for multiple sources of income to increase purchasing power of the household while considering proper food choices to avoid the risk of NCDs. The Ministry of Agriculture and other stakeholders should support and promote production of bio-fortified crops and keeping small animals. The Ministry of Education should ensure that school children are aware of the NCD-risk foods and make available healthier food choices around the school environment.

The case for investment in nutritional interventions to prevent and reduce childhood and adolescent overweight and obesity in Peru: a modelling study

BACKGROUND

Between 2006 and 2016 the prevalence of overweight and obesity among children and adolescents aged 5-19 years in Peru increased from 22.7 to 27.0%. This investment case quantifies the economic impacts of childhood and adolescent overweight and obesity in Peru. It identifies and quantifies the potential impact of a set of new or expanded interventions that can strengthen current national efforts to prevent and reduce child and adolescent overweight and obesity.

METHODS

A deterministic Markov cohort model with a societal cost perspective estimated reductions in mortality and morbidity from implementing interventions to prevent and reduce child and adolescent overweight and obesity and the impact in savings in healthcare costs and gains in wages and productivity. Interventions identified through a review of published literature includes a school-based social marketing campaign, exclusive breastfeeding promotion and support, a healthy food and drink policy for school premises, and a 20% subsidy on fruits and vegetables for people living below the national poverty line. The return on investment (ROI) was calculated along with the estimated cost savings associated with the interventions. Analysis was conducted to test ROI sensitivity to changes in the key parameters and assumptions.

RESULTS

Between 2025 and 2092, the expected combined direct and indirect healthcare costs attributable to child and adolescent overweight and obesity in Peru are 210.6 billion USD. The direct healthcare costs are 1.8 billion USD, and the indirect costs are 208.8 billion USD. Expected savings for all interventions combined is 13.9 billion USD with a per-person savings of 12,089.8 USD. The expected ROI of the four interventions combined is 39.3 USD (30-years), 64.6 USD (50-years), and 164.1 USD (66-years) per one USD invested.

CONCLUSIONS

The overweight and obesity epidemic among children and adolescents in Peru requires wide-ranging and expanded implementation of policies to achieve long-term reductions in prevalence. This study's findings show that the four priority interventions have high ROIs and can be used to guide policy to address the complex interplay of factors that contribute to the obesogenic environment.

Impact of COVID-19 on food security and diet quality in Chilanga District, Zambia

INTRODUCTION

Food security and nutrition have been severely impacted during the COVID-19 pandemic, particularly in low- and middle-income countries (LMICs). We aimed to quantify the impacts of the pandemic on food security and diet diversity within Chilanga District in Zambia and identify target areas for high-impact social protection and safety net programs.

METHODS

We conducted a cross-sectional study in Chilanga district immediately after the Omicron variant surge in February 2022. Diet quality and food security were assessed based on a household diet questionnaire and a Minimum Dietary Diversity-Women (MDD-W) score was calculated. A paired t-test was used to determine whether there was a statistically significant change in the MDD-W score and McNemar test was used to investigate the change in food security between the pre- and peri-COVID-19 period.

RESULTS

Compared to the pre-COVID-19 period, there were increases in food prices across the board in the peri-COVID-19 period and decreased consumption of key food categories including legumes, dairy and vitamin A rich foods. Despite high rates of food insecurity, only 6.6% of surveyed households received any cash or in-kind assistance from a government agency, non-profit, or other organization in the post-COVID-19 period.

CONCLUSION

The COVID-19 pandemic had significant impacts on food security and dietary diversity in Chilanga district. This is particularly relevant in the low-income communities that we surveyed, which had pre-existing challenges with food security. Additional resources must be invested in Chilanga District and similarly affected areas to address this gap in access to food and promote national equity. Trial Registration N/A.

Food insecurity, COVID-19 and diets in Fiji - a cross-sectional survey of over 500 adults

INTRODUCTION

Food insecurity is associated with inadequate nutrition and increased rates of chronic disease. The primary aim of this study was to assess self-reported food insecurity and the perceived impact of COVID-19 on food security, in two regional districts of Central Fiji, as part of a broader program of work on strengthening and monitoring food policy interventions. The secondary aim was to explore the relationship between food insecurity and salt, sugar and fruit and vegetable intake.

METHODS

Seven hundred adults were randomly sampled from the Deuba and Waidamudamu districts of Viti Levu, Fiji. Interview administered surveys were conducted by trained research assistants with data collected electronically. Information was collected on demographics and health status, food security, the perceived impact of COVID-19 on food security, and dietary intake. Food insecurity was assessed using nine questions adapted from Fiji's 2014/5 national nutrition survey, measuring markers of food insecurity over the last 12 months. Additional questions were added to assess the perceived effect of COVID-19 on responses. To address the secondary aim, interview administered 24-hour diet recalls were conducted using Intake24 (a computerised dietary recall system) allowing the calculation of salt, sugar and fruit and vegetable intakes for each person. Weighted linear regression models were used to determine the relationship between food insecurity and salt, sugar and fruit and vegetable intake.

RESULTS

534 people participated in the survey (response rate 76%, 50.4% female, mean age 42 years). 75% (75.3%, 95% CI, 71.4 to 78.8%) of people reported experiencing food insecurity in the 12 months prior to the survey. Around one fifth of people reported running out of foods (16.8%, 13.9 to 20.2%), having to skip meals (19.3%, 16.2 to 22.9%), limiting variety of foods (19.0%, 15.9 to 22.5%), or feeling stressed due to lack of ability to meet food needs (19.5%, 16.4 to 23.0%). 67% (66.9%, 62.9 to 70.7%) reported becoming more food insecure and changing what they ate due to COVID-19. However, people also reported positive changes such as making a home garden (67.8%, 63.7 to 71.6%), growing fruit and vegetables (59.5%, 55.6 to 63.8%), or trying to eat healthier (14.7%, 12.0 to 18.0%). There were no significant associations between food insecurity and intakes of salt, sugar or fruit and vegetables.

CONCLUSION

Participants reported high levels of food insecurity, exceeding recommendations for salt and sugar intake and not meeting fruit and vegetable recommendations, and becoming more food insecure due to COVID-19. Most participants reported making home gardens and/or growing fruit and vegetables in response to the pandemic. There is an opportunity for these activities to be fostered in addressing food insecurity in Fiji, with likely relevance to the Pacific region and other Small Island Developing States who face similar food insecurity challenges.

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.

Creed‐Kanashiro H. Exploring the magnitude and drivers of the double burden of malnutrition at maternal and dyad levels in peri-urban Peru: A cross-sectional study of low-income mothers, infants and young children

Multiple forms of malnutrition coexist in Peru, especially in peri-urban areas and poor households. We investigated the magnitude of, and the contribution of, dietary and socio-demographic factors to the double burden of malnutrition (DBM) at maternal (i.e., maternal overweight/obesity with anaemia) and dyad (i.e., maternal overweight/obesity with child anaemia) levels. A cross-sectional survey was conducted among low-income mother-child (6-23 months) dyads (n = 244) from peri-urban communities in Peru. Dietary clusters and the minimum dietary diversity score (MDD) were generated for mothers and infants, respectively. A composite indicator using the maternal dietary clusters and the MDD was created to relate to dyad level DBM. Two dietary clusters were found: (i) the 'high variety (i.e., animal-source foods, fruit and vegetables), high sugary foods/beverages' (cluster 1) and (ii) the 'high potato, low fruit and vegetables, low red meat' (cluster 2). DBM prevalence among mothers and dyads was 19.9% and 36.3%, respectively. Logistic regression analyses revealed that the only socio-demographic factor positively associated with maternal DBM was maternal age (aOR/5 years: 1.35 [1.07, 1.71]). Mothers belonging to diet cluster 1 were less likely to experience the DBM (aOR = 0.52 [0.26, 1.03]), although CIs straddled the null. Socio-demographic factors positively associated with dyad level DBM included maternal age (aOR/5 years: 1.41 [1.15, 1.73]), and having ≥ two children under 5 years (aOR = 2.44 [1.23, 4.84]). Diet was not associated with dyad-level DBM. Double-duty actions that tackle the DBM are needed given that one-third of dyads and a fifth of mothers had concurrent overweight/obesity and anaemia.

Association between total available nutritional quality and food expenditure in Peruvian households, 2019-2020

Evidence points to a direct relationship between nutritional quality and food expenditure. However, food expenditure is highly susceptible to changes, and nutritional quality of household food presents limited evidence. The aim of this study was to assess the relationship between nutritional quality available and total food expenditure in Peruvian households, and whether there were differences by area (urban and rural) and between years of the COVID-19 pandemic. For this, we used Peru's National Household Survey (ENAHO) from 2019 and 2020. We assessed total food expenditure in US dollars per day, whereas household nutritional quality available was assessed based on dietary diversity and compliance with the household calorie requirements, percentage of food expenditure, and potential confounders. We used the Student's t-test, analysis of variance (ANOVA), linear regression, and the Wald test to assess the interaction effect. Households with adequate total/partial nutritional quality available by area were found to spend, on average, USD 2.00 more in urban than in rural areas and, by year, they presented 7.1% more percentage of food expenditure in 2020 than in 2019. Despite associations existing between nutritional quality available and total food expenditure by year and study area, the effect modification was only present by study area. In multivariable model, households with adequate total/partial nutritional quality available consistently presented a lower total food expenditure by year, with a lower total food expenditure in urban areas. An inverse relationship was found between nutritional quality available and total food expenditure, in contrast to the direct relationship of studies assessing dietary cost and nutritional quality. Our results reflect the nutritional deficit in the food purchases of Peruvian households.

Nutrition-Related Experiences of Women With Perinatal Depression During the COVID-19 Pandemic: A Qualitative Study

Women with perinatal depression are at a high risk for unhealthy dietary behaviors but whether the coronavirus disease 2019 (COVID-19) pandemic has exacerbated this risk is unknown. Here we report the findings of a qualitative study exploring the impact of the COVID-19 pandemic on nutrition-related experiences of women with perinatal depression. Using a qualitative descriptive approach, in-depth interviews were conducted with 18 women with a history of perinatal depression and 10 healthcare providers. A semistructured format elicited how food and nutrition-related behaviors of women with perinatal depression were affected by the COVID-19 pandemic. Thematic analysis identified 4 themes related to the COVID-19 pandemic: (1) Adaptations in shopping and cooking behaviors; (2) increases in stress and declines in respite; (3) declines in support and increases in isolation; and (4) low levels of breastfeeding guidance. Our findings confirm the importance of resilience among women with perinatal depression and future research is needed to elucidate the mechanisms connecting resilience and dietary behaviors.

Unhealthy food consumption and its associated factors among infants and young children in Gondar city, northwest Ethiopia: a community based cross sectional study

INTRODUCTION

Many low- and middle-income countries are now shifting toward diets that are higher in added sugars, unhealthy fats, salt, and refined carbohydrates. Childhood obesity and chronic diseases have all been linked to unhealthy food consumption. Despite this, the majority of Ethiopian infants and children consume unhealthy food. There is also a scarcity of evidence. Therefore, the objective of this study was to assess the prevalence of unhealthy food consumption and its associated factors among children ages 6-23 months in Gondar City, northwest Ethiopia.

METHODS

A community-based cross-sectional study was conducted from June 30 to July 21, 2022, in Gondar city. Multistage sampling was used to select 811 mother-child pairs. Food consumption was measured through a 24-hour recall. Data were entered into EpI Data 3.1 before being exported to STATA 14 for further analysis. A multivariable logistic regression analysis was employed to identify the factors associated with unhealthy food consumption. An adjusted odds ratio (AOR) with a 95% confidence interval was used to show the strength of the association, while a P-value of 0.05 was used to declare the significance of the association.

RESULTS

The percentage of children with unhealthy food consumption was 63.7% (95% CI: 60.4%, 67.2%). Maternal education [AOR = 1.89, 95% CI = 1.05, 3.69], living in an urban residence [AOR = 4.55, 95% CI = 3.61, 7.78], GMP service [AOR = 2.07, 95% CI = 1.48, 3.18], age of the child 18-23 months [AOR = 0.53, 95% CI = 0.34, 0.74], and family size of more than four [AOR = 1.22, 95% CI = 1.07, 2.78] were significantly associated with unhealthy food consumption.

CONCLUSION

In Gondar City, nearly two thirds of infants and children received unhealthy food. Maternal education, urban residence, GMP service, child age, and family size were all significant predictors of unhealthy food consumption. Thus, improving the uptake of GMP services and family planning services is critical to reducing unhealthy food consumption.

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.

Food insecurity and its socioeconomic and health determinants in pregnant women and mothers of children under 2 years of age, during the COVID-19 pandemic: A systematic review and meta-analysis

Background

The COVID-19 pandemic has reduced access to adequate food in terms of quality and quantity, especially for the most vulnerable population groups. The objective of this study was to evaluate the prevalence of Food Insecurity and its main socioeconomic and health determinants in pregnant women and mothers of children under 2 years of age, during the COVID-19 pandemic.

Methods

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021278033). The descriptors "Pregnant Woman", "Postpartum Women", "Breastfeeding Women", "COVID-19", "Food Insecurity", "Food Security" were combined in Scopus (Elsevier), Medline/PubMed (via National Library of Medicine), Embase (Elsevier), Web of Science and Science Direct independently by two researchers in September 2022. Original articles about Food Insecurity in households with pregnant women and mothers of children under 2 years of age during the COVID-19 pandemic were included. The meta-analysis of the prevalence of Food Insecurity was conducted using the RStudio software (4.0.4).

Results

The initial search resulted in 539 records, and 10 articles met the proposed criteria and were included in this review. The prevalence of Food Insecurity ranged from 11.5 to 80.3% and in the meta-analysis it was 51% (IC: 30-71) (I 2 = 100.0%). The main socioeconomic and health determinants were ethnicity, domain language, low education, low income, informal employment, unemployment, occurrence of mental disorders, domestic violence, in addition to the unavailability of food in markets and lack of transport. The inclusion of studies with data collection by telephone stands out as a limitation, due to the non-inclusion of vulnerable groups without access to this means of communication.

Conclusion

It is necessary to implement and strengthen specific public policies for the maternal and child group with the objective of protecting and strengthening the rights of women to maintain the physical and mental integrity of this group and guarantee Food Security.

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

Background

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

Objectives

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

Materials and methods

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

Results

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

Conclusion

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

Negative Effects of Chronic High Intake of Fructose on Lung Diseases

In the modern diet, excessive fructose intake (>50 g/day) had been driven by the increase, in recent decades, of the consumption of sugar-sweetened beverages. This phenomenon has dramatically increased within the Caribbean and Latin American regions. Epidemiological studies show that chronic high intake of fructose related to sugar-sweetened beverages increases the risk of developing several non-communicable diseases, such as chronic obstructive pulmonary disease and asthma, and may also contribute to the exacerbation of lung diseases, such as COVID-19. Evidence supports several mechanisms—such as dysregulation of the renin−angiotensin system, increased uric acid production, induction of aldose reductase activity, production of advanced glycation end-products, and activation of the mTORC1 pathway—that can be implicated in lung damage. This review addresses how these pathophysiologic and molecular mechanisms may explain the lung damage resulting from high intake of fructose.