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.

Pollen Diet Diversity does not Affect Gut Bacterial Communities or Melanization in a Social and Solitary Bee Species

Pollinators face many stressors, including reduced floral diversity. A low-diversity diet can impair organisms' ability to cope with additional stressors, such as pathogens, by altering the gut microbiome and/or immune function, but these effects are understudied for most pollinators. We investigated the impact of pollen diet diversity on two ecologically and economically important generalist pollinators, the social bumble bee (Bombus impatiens) and the solitary alfalfa leafcutter bee (Megachile rotundata). We experimentally tested the effect of one-, two-, or three-species pollen diets on gut bacterial communities in both species, and the melanization immune response in B. impatiens. Pollen diets included dandelion (Taraxacum officinale), staghorn sumac (Rhus typhina), and hawthorn (Crataegus sp.) alone, each pair-wise combination, or a mix of all three species. We fed bees their diet for 7 days and then dissected out guts and sequenced 16S rRNA gene amplicons to characterize gut bacterial communities. To assess melanization in B. impatiens, we inserted microfilament implants into the bee abdomen and measured melanin deposition on the implant. We found that pollen diet did not influence gut bacterial communities in M. rotundata. In B. impatiens, pollen diet composition, but not diversity, affected gut bacterial richness in older, but not newly-emerged bees. Pollen diet did not affect the melanization response in B. impatiens. Our results suggest that even a monofloral, low-quality pollen diet such as dandelion can support diverse gut bacterial communities in captive-reared adults of these bee species. These findings shed light on the effects of reduced diet diversity on bee health.

Effect of dietary diversity on incident of disability in community-dwelling older adults with sarcopenia: A 40-month follow-up longitudinal study

BACKGROUND

Sarcopenia is a clinical issue in older adults that leads to serious adverse health outcomes, including disability. The present study investigated whether dietary diversity affects the incidence of disability in older adults with sarcopenia.

METHOD

Participants were 759 Japanese older adults with sarcopenia (mean age 77.2 ± 6.0 years; 44.4 % men) who were aged ≥65 years at the time of the examination. Sarcopenia was diagnosed according to the recommendations of the European Working Group on Sarcopenia in Older People 2. Dietary diversity was assessed using a diet variety score. This diet variety score assessed the one-week consumption frequency of ten food groups, according to the following responses: "eat almost every day" (1 point), or "not eaten almost daily" (0 points). Older adults with a diet variety score of 3 or more points were defined as having high dietary diversity. Incident disability was certified by long-term care insurance (mean follow-up duration 32 months).

RESULTS

The cumulative disability incidence rates in the older adults with low dietary diversity and high dietary diversity were 23.3 % and 16.9 %, respectively. Cox proportional hazards regression analysis revealed high dietary diversity was associated with a lower risk of incident disability in older adults with sarcopenia (hazard ratio 0.66, 95 % confidence interval 0.47-0.92; p = 0.015), after adjusting for covariates.

CONCLUSIONS

This longitudinal study revealed that high dietary diversity is associated with a lower risk of incident disability among sarcopenic Japanese older adults.

Assessing the performance of national sentinel food lists at subnational levels in six countries

OBJECTIVE

To assess how well national sentinel lists of the most frequently consumed foods in each food group capture data at subnational levels to measure minimum diet diversity (MDD).

DESIGN

We analysed data from seven surveys with 24-h open dietary recalls to evaluate: (1) the percentage of reported foods that were included in each sentinel food list; (2) whether these lists captured consumption of some food groups better than others and (3) differences between estimates of dietary diversity calculated from all food items mentioned in the open 24-h recall v. only food items included in the sentinel lists.

SETTING

Seven subnational areas: Bangladesh (2), Benin, Colombia, Kenya, Malawi and Nepal.

PARTICIPANTS

8094 women 15-49 years; 4588 children 6-23 months.

RESULTS

National sentinel food lists captured most foods reportedly consumed by women (84 %) and children (86 %). Food groups with the highest variability were 'other fruits' and 'other vegetables.' MDD calculated from the sentinel list was, on average, 6·5 (women) and 4·1 (children) percentage points lower than when calculated from open 24-h recalls, with a statistically significant difference in most subnational areas.

CONCLUSION

National sentinel food lists can provide reliable data at subnational levels for most food groups, with some variability by country and sub-region. Assessing the accuracy of national sentinel food lists, especially for fruits and vegetables, before using them at the subnational level could avoid potentially underestimating dietary diversity and provide more accurate local information for programmes, policy and research.

Immunonutrition: Diet Diversity, Gut Microbiome and Prevention of Allergic Diseases

Allergic diseases are increasing both in morbidity and mortality. Genetic, environmental, and dietary factors may all be involved in this increase. Nutrition during pregnancy, breastfeeding, and early life may play a particularly important role in preventing allergic diseases. Based on current systematic reviews, the intake of specific nutrients has failed to prevent allergic disease. Prevention strategies have shifted their focus to the overall diet which can be described using diet diversity. Infant and maternal diet diversity in pregnancy has been associated with reduced allergy outcomes in childhood. Overall, diet also seems to have a marked effect on the microbiome compared to single foods. Factors that may negate the allergy-preventative effect of overall diet diversity include the addition of emulsifiers, advanced glycation end-product content, and overuse of commercial baby foods. There is a need to perform randomized controlled trials using overall dietary intake to support international food allergy guidelines. These studies should ideally be conducted by multi-professional teams.

Diet change and sustainability in Indigenous areas: characteristics, drivers, and impacts of diet change in Gunayala, Panama

Many Indigenous communities around the world have been experiencing rapid and profound diet changes. This case report uses a Sustainability Science lens to understand the characteristics of diet change in Indigenous Gunas communities of Panama, as well as its drivers and sustainability impacts. We use primary information collected through interviews with 30 experts and 232 household surveys in three Gunas islands  characterised by different levels of development, western influence, and cultural erosion. We observe a rapid westernization of diets that has been mainly driven by closer interaction with tourists and the Panamanian society, as well as broader development processes. However, this diet change has a series of intersecting sustainability impacts related to food security, health, and socio-cultural and environmental change. It is necessary to understand the intersection of these phenomena when designing programs and interventions that seek to prevent or mitigate negative diet changes in Gunayala, and other  Indigenous contexts more broadly.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11625-023-01325-0.

Impact of the COVID-19 lockdown on household diet diversity in rural Bihar, India: a longitudinal survey

BACKGROUND

The COVID-19 pandemic disrupted livelihoods and diets across the world. This study aimed to assess changes in household diet diversity and food consumption between the pre-COVID-19 period (December 2019-January 2020) and during the lockdown (March-May 2020), and to identify the socio-economic characteristics that determine these changes in rural Bihar, India.

METHODS

Households that had provided their phone numbers in the pre-COVID-19 household survey (n = 1797) were contacted for interviews during the lockdown telephonic survey in a longitudinal survey in two districts (Gaya and Nalanda) in Bihar. In total, 939 households were interviewed. Using data on food consumption from both surveys, 876 households were included in the analysis. Food and Agriculture Organization's household diet diversity score (HDDS) was used to compare diet diversity between the pre-COVID-19 period and during the lockdown. Logistic regression was used to identify factors affecting household diet diversity and food consumption in the study households.

RESULTS

Low diet diversity increased from 51.6% (95% CI 48.3-54.9) to 75.8% (95% CI 73.0-78.6) from the pre-COVID-19 to the lockdown period. Reduced food consumption was reported across all foods with nearly a quarter of the households reporting reduced consumption of fruits (27%), pulses (25%) and cereals (21%). Nearly 60% and above reported stopping consumption of nutrient-rich foods such as chicken, fish and eggs although the population was predominantly non-vegetarian. Logistic regression analysis revealed that taking a loan from neighbours/relatives (OR = 1.8; 95% CI 1.3-2.5) and belonging to lower social groups (OR = 1.8; 95% CI 1.1-2.9) increased odds of low HDDS. While those possessing ration cards had lower odds of reduced consumption of all food items, it was not associated with stopping consumption of any food item. In an unadjusted analysis, receipt of cash transfer during lockdown was also not associated with diet diversity (OR = 1.2; 95% CI 0.9-1.7).

CONCLUSIONS

COVID-19 has impacted the consumption of nutrient-rich foods among already low-income rural households in India. Maintaining diet diversity among socio-economically vulnerable households during periods when food consumption is most threatened by shocks such as COVID-19 would need sustained government support in terms of social protection coverage and benefit transfers in rural communities.

Determinants of complementary feeding practices among children aged 6-24 months in urban slums of Pune, Maharashtra, in India

BACKGROUND

Inequalities in child feeding practices are evident in urban slums in developing nations. Our study identified the determinants of complementary feeding (CF) practices in the informal settings of Pune, India, a district close to the business capital of India.

METHODS

Employing a cross-sectional study design, 1066 mother-children dyads were surveyed. Five indicators defined by the WHO were used to study complementary feeding practices. Determinants of complementary feeding practices were identified using multivariate analyses.

RESULTS

Timely initiation of CF was reported by 42%. Minimum acceptable diet (MAD), minimum meal frequency (MMF), and Diet Diversity Score > 4 were achieved by 14.9%, 76.5%, and 16.4%, respectively. Continued breastfeeding (CBF) at 2 years, and feeding processed foods were practiced by 94% and 50%, respectively. Among the maternal characteristics, a mother's age > 30 years at pregnancy was less likely to achieve DD [AOR: 0.195 (CI 0.047-0.809)] and MAD [AOR: 0.231 (CI 0.056-0.960)]. Mothers with lower education were less likely to meet MMF [AOR: 0.302 (0.113-0.807)], MAD [AOR: 0.505 (CI 0.295-0.867)] and to introduce formula feeds (FF) [AOR: 0.417 (0.193- 0.899)]. Among obstetric characteristics, birth spacing < 33 months was less likely to achieve DD [AOR: 0.594 (CI 0.365-0.965)] and CBF [AOR: 0.562 (CI: 0.322-0.982)]. Receiving IYCF counseling only during postnatal care hindered the timely initiation of CF [AOR: 0.638 (0.415-0.981)]. Very Low Birth Weight increased the odds of achieving DD [AOR: 2.384 (1.007-5.644)] and MAD [AOR: 2.588(CI: 1.054-6.352)], while low birth weight increased the odds of children being introduced to processed foods [AOR: 1.370 (CI: 1.056-1.776)]. Concerning socio-economic status, being above the poverty line increased the odds of achieving MMF, [AOR: 1.851 (1.005-3.407)]. Other backward castes showed higher odds of achieving MAD [AOR: 2.191 (1.208-3.973)] and undisclosed caste in our study setting decreased the odds of FF [AOR: 0.339 (0.170-0.677)]. Bottle feeding interfered with MMF [AOR: 0.440 (0.317-0.611)] and CBF [AOR: 0.153 (0.105-0.224)].

CONCLUSION

Investing in maternal education and IYCF counseling during both ANC and PNC to provide nutritious complementary foods alongside addressing poverty should be a national priority to prevent the double burden of undernutrition at an early age in informal settings.

Child undernutrition and associated factors among children 6-23 months old in largely food insecure areas of rural Ethiopia

Child malnutrition is the leading public health problem in Sub-Saharan Africa, resulting in poor health and economic losses. Ethiopia has one of the highest child undernutrition rates in the world that occurs to multifaceted factors, including food insecurity. Thus, we performed a cross-sectional study to assess the prevalence and risk factors for child undernutrition in largely food insecure areas of Ethiopia. Data were collected from 354 mother-child pairs from the Siraro district. Both bivariate and multivariate logistic regression was used for statistical analysis. Variables with a P-value of <0⋅05 in multivariate analysis were used to detect statistical significance at a 95 % confidence level. About 67 % of households are food insecure. The prevalence of stunting wasting and underweight were 42⋅7, 9⋅9 and 27⋅7 %, respectively. Female gender, higher age of the child (12-23 months v. 6-11 months), living in a household with five or more siblings, not getting therapeutic zinc supplement at least once, inadequate diet diversity, lack of growth monitoring service, and maternal own income increases the likelihood of child undernutrition. It can be concluded that child undernutrition is a severe public health problem in the study area. Improving primary healthcare services related to zinc supplementation, growth monitoring and promotion, and improving infant and child feeding practices can be considered as a strategy to address the problem.

Socio-economic and socio-demographic determinants of diet diversity among rural pregnant women from Pune, India

Background

Diet diversity signifies the nutrient adequacy of an individual and thus has gained widespread significance in recent times. In developing countries achieving maximum diet diversity, especially among pregnant women from rural areas is challenging although of great importance. However, to do so understanding the primary factors associated with diet diversity is important. This paper, therefore, assessed the socio-demographic and socio-economic determinants of diet diversity among rural pregnant women in India.

Methods

The study consisted of a community-based prospective cohort of n = 204 pregnant women attending primary healthcare centers (PHC) across 14 villages in Mulshi Taluka, Pune, Maharashtra, India. The data was collected using a structured questionnaire through a one-to-one interview method.

Results

The prevalence of low, medium and high diet diversity was 56.4%, 33.3%, and 10.3% respectively. Minimum diversity in the diet was achieved among 73.5% of pregnant women. The mean diet diversity score (DDS) was 3.6 ± 1.3 with starchy staples being (100%) of commonly consumed foods. Young (< 20 years) women (OR = 5.2; CI:1.9- 13.8), housewives (OR = 3; CI:1.4–6.7), husbands working as skilled laborers (OR = 2.5; CI:1.2–5.5) were at significant risk of having low diet diversity scores. Whereas, those living in a joint family (OR = 0.3; CI:0.1–0.6), not owning a house (OR = 0.5; CI:0.2–0.9), and having a poor income (OR = 1.9; CI: 0.9- 3.7) were less likely to have low diet diversity.

Conclusion

Socio-economic and demographic factors (maternal age, mother's occupation, and husband's occupation) influenced the diet diversity among pregnant women. Monotonous diets are commonly seen in developing countries, especially in rural areas which can be a risk factor for poor nutrient adequacy and health of pregnant women. Policies and programs about these determinants of diet diversity should be enacted to replace the poor quality diets to ensure improved diet diversity and nutrient adequacy.

Does a school snack make a difference? An evaluation of the World Food Programme emergency school feeding programme in Lebanon among Lebanese and Syrian refugee children

OBJECTIVE

To investigate the effects of providing a daily healthy school snack on children's nutritional, social and educational outcomes and explore stakeholders' perceptions of an emergency school feeding programme (SFP).

DESIGN

Convergence triangulation mixed-methods study design. Associations were examined between receiving the school feeding intervention and children's outcomes using multivariable regression models. Quantitative data were complemented with interviews and focus group discussions with parents and staff.

SETTING

In vulnerable communities in Lebanon, the World Food Programme has implemented an emergency SFP targeting Lebanese (attending morning sessions) and Syrian refugee children (attending afternoon sessions) in public schools.

PARTICIPANTS

Children from ten intervention schools (morning n 403; afternoon n 379) and ten matched control schools (morning n 399; afternoon n 401), as well as twenty-nine parents and twenty-two school staff members.

RESULTS

Diet diversity was higher in intervention schools as compared with control with a significantly higher consumption of dairy products, nuts and fruit in both sessions. Child-reported food insecurity experience was lower in children attending the afternoon session of intervention v. control schools. The SFP intervention was associated with higher school engagement and sense of school community in the morning session only. While the SFP was significantly associated with higher attendance for children in afternoon sessions only, it was significantly associated with school retention of children in both sessions.

CONCLUSIONS

A daily healthy snack potentially acts as an incentive to improve children's nutritional outcomes, school engagement, sense of belonging, equality between students and improvement in children's attendance and retention in public schools.

COVID-19 and women's nutrition security: panel data evidence from rural India

In response to the COVID-19 pandemic, India implemented a stringent nationwide lockdown. Although food value chains and allied activities were exempted from the lockdown, there were widespread disruptions in food access and availability. Using two panel-datasets, we distinguish the pandemic's impact on non-staples versus staples in relation to household food availability and women's diet diversity at the national, state, and district levels in four economically backward districts of Uttar Pradesh (Maharajganj), Bihar (Munger), and Odisha (Kandhamal and Kalahandi). Both the primary and secondary data indicate a decline in household food expenditures and women's dietary diversity in May 2020 compared to May 2019, particularly for non-staples like meats, eggs, vegetables and fruits. This occurred despite special PDS, direct benefit transfer, and ration from aanganwadis rations reaching 80%, 50%, and 30% of surveyed households, respectively. While national and state-level expenditures recovered to the pre-lockdown levels by June 2020, the district-level expenditures did not recover. Our findings contribute to the growing body of evidence of women's disproportionate vulnerability to economic shocks, the impact of a staple grain focused safety net program, and restricted markets on the access and availability of diverse nutritious foods. This paper makes a case for policy reforms towards PDS diversification to include nutrition-rich foods and market reforms to remove supply-side bottlenecks and expansion of direct benefit transfers for healthy food access. We also highlight the importance of gender-responsive safety nets and their increased coverage for improving intrahousehold nutritional disadvantages.

Crop diversity is associated with higher child diet diversity in Ethiopia, particularly among low-income households, but not in Vietnam

OBJECTIVES

To examine associations of household crop diversity with school-aged child dietary diversity in Vietnam and Ethiopia and mechanisms underlying these associations.

DESIGN

We created a child diet diversity score (DDS) using data on seven food groups consumed in the last 24 h. Generalised estimating equations were used to model associations of household-level crop diversity, measured as a count of crop species richness (CSR) and of plant crop nutritional functional richness (CNFR), with DDS. We examined effect modification by household wealth and subsistence orientation, and mediation by the farm's market orientation.

SETTING

Two survey years of longitudinal data from the Young Lives cohort.

PARTICIPANTS

Children (aged 5 years in 2006 and 8 years in 2009) from rural farming households in Ethiopia (n 1012) and Vietnam (n 1083).

RESULTS

There was a small, positive association between household CNFR and DDS in Ethiopia (CNFR-DDS, β = 0·13; (95 % CI 0·07, 0·19)), but not in Vietnam. Associations of crop diversity and child diet diversity were strongest among poor households in Ethiopia and among subsistence-oriented households in Vietnam. Agricultural earnings positively mediated the crop diversity-diet diversity association in Ethiopia.

DISCUSSION

Children from households that are poorer and those that rely more on their own agricultural production for food may benefit most from increased crop diversity.

Infant and young child feeding practices in Ethiopia: analysis of socioeconomic disparities based on nationally representative data

BACKGROUND

Undernutrition among children is a priority area of public health concern in Ethiopia. The purpose of this study was to examine disparities in Infant and Young Child Feeding (IYCF) practices among children 6-23 months.

METHOD

Data were drawn from the 2016 Ethiopian Demographic and Health Surveys (EDHS). A total of 3240 children aged 6-23 months were used for the present analysis. The outcome variable was IYCF practice score (ranging 0-7) which was constructed based on the linear and combined effects of four sets of variables: breastfeeding, avoidance of bottle feeding, diet diversity score and minimum feeding frequency. IYCF practice score was further recoded into three categories. Proportional odds regression was used to assess the determinants of IYCF category.

RESULTS

The proportional odds regression analysis showed that IYCF scores significantly decreased by 5% (Adjusted Odds Ratio (AOR) = 0.95; 95% CI: 0.93-0.97) for every unit increase in the child's age. Households with fathers of primary and secondary and above level education were 1.37 times (95% CI: 1.14-1.66) and 1.67 times (95% CI: 1.26-2.23) more likely to be in the high IYCF category than in the poor IYCF category. The likelihood of being in the high IYCF practice category decreased for non-working mothers by 30% (AOR = 0.70; 95% CI: 0.59-0.83) compared to those working in gainful employment. The chance of being in the high IYCF practice category decreased by 29% for households with no access to radio (AOR = 0.71; 95% CI: 0.59-0.85). Those with medium and rich/richer wealth category were 1.54 times (95% CI: 1.22-1.94) and 1.40 times (95% CI: 1.11-1.75) more likely to belong to high IYCF practice category than being in poor IYCF category. For every unit increase in health service utilization, the chance of falling in higher IYCF category increases by 1.15 times (95% CI: 1.08-1.23). The chance of falling in higher IYCF practice category decreases for rural residents by 37% (AOR = 0.63; 95% CI: 0.47-0.84) compared to those residing in urban areas.

CONCLUSION

For a child, the first two years is the time span during which linear faltering of growth is most prevalent and the period when the process of becoming stunted is almost complete. This study recommends improving access to women for gainful employment, provision of economic support to poor rural women, education and promotion of nutrition messages using most accessible media and boosting the positive role of fathers in child feeding practices.

Food insecurity, diet quality and body composition: data from the Healthy Life Trajectories Initiative (HeLTI) pilot survey in urban Soweto, South Africa

OBJECTIVE

To determine whether food security, diet diversity and diet quality are associated with anthropometric measurements and body composition among women of reproductive age. The association between food security and anaemia prevalence was also tested.

DESIGN

Secondary analysis of cross-sectional data from the Healthy Life Trajectories Initiative (HeLTI) study. Food security and dietary data were collected by an interviewer-administered questionnaire. Hb levels were measured using a HemoCue, and anaemia was classified as an altitude-adjusted haemoglobin level < 12·5 g/dl. Body size and composition were assessed using anthropometry and dual-energy x-ray absorptiometry.

SETTING

The urban township of Soweto, Johannesburg, South Africa.

PARTICIPANTS

Non-pregnant women aged 18-25 years (n 1534).

RESULTS

Almost half of the women were overweight or obese (44 %), and 9 % were underweight. Almost a third of women were anaemic (30 %). The prevalence rates of anaemia and food insecurity were similar across BMI categories. Food insecure women had the least diverse diets, and food security was negatively associated with diet quality (food security category v. diet quality score: B = -0·35, 95 % CI -0·70, -0·01, P = 0·049). Significant univariate associations were observed between food security and total lean mass. However, there were no associations between food security and body size or composition variables in multivariate models.

CONCLUSIONS

Our data indicate that food security is an important determinant of diet quality in this urban-poor, highly transitioned setting. Interventions to improve maternal and child nutrition should recognise both food security and the food environment as critical elements within their developmental phases.

A Consensus Approach to the Primary Prevention of Food Allergy Through Nutrition: Guidance from the American Academy of Allergy, Asthma, and Immunology; American College of Allergy, Asthma, and Immunology; and the Canadian Society for Allergy and Clinical Immunology

Recently published data from high-impact randomized controlled trials indicate the strong potential of strategies to prevent the development of food allergy in high-risk individuals, but guidance in the United States at present is limited to a policy for only the prevention of peanut allergy, despite other data being available and several other countries advocating early egg and peanut introduction. Eczema is considered the highest risk factor for developing IgE-mediated food allergy, but children without risk factors still develop food allergy. To prevent peanut and/or egg allergy, both peanut and egg should be introduced around 6 months of life, but not before 4 months. Screening before introduction is not required, but may be preferred by some families. Other allergens should be introduced around this time as well. Upon introducing complementary foods, infants should be fed a diverse diet, because this may help foster prevention of food allergy. There is no protective benefit from the use of hydrolyzed formula in the first year of life against food allergy or food sensitization. Maternal exclusion of common allergens during pregnancy and/or lactation as a means to prevent food allergy is not recommended. Although exclusive breast-feeding is universally recommended for all mothers, there is no specific association between exclusive breast-feeding and the primary prevention of any specific food allergy.

Food insecurity and depression among low-income adults in the USA: does diet diversity play a role? Findings from the 2013-2014 National Health and Nutrition Examination Survey

OBJECTIVE

Food insecurity is associated with a greater risk of depression among low-income adults in the USA. Members of food-insecure households have lower diet diversity than their food-secure counterparts. This study examined whether diet diversity moderates the association between food insecurity and depression.

DESIGN

Multiple logistic regression was conducted to examine independent associations between food insecurity and depression, between diet diversity and depression, and the moderating effect of diet diversity in the food insecurity-depression link.

SETTING

Cross-sectional data from the National Health and Nutrition Examination Survey (2013-2014).

PARTICIPANTS

2636 low-income adults aged 18 years and older.

RESULTS

There was a positive association between food insecurity and depression among low-income adults. Diet diversity was not associated with depression. Diet diversity had a moderating effect on the association between food insecurity and depression among low-income adults.

CONCLUSIONS

Food insecurity is independently associated with depression among low-income adults in the USA. However, this association differs across levels of diet diversity. Longitudinal studies are needed to confirm the role diet diversity may play in the pathway between food insecurity and depression.

Demonstration gardens improve agricultural production, food security and preschool child diets in subsistence farming communities in Panama

OBJECTIVES

To explore impacts of a demonstration garden-based agricultural intervention on agricultural knowledge, practices and production, food security and preschool child diet diversity of subsistence farming households.

DESIGN

Observational study of households new to the intervention or participating for 1 or 5 years. Variables measured were agricultural techniques learned from the intervention and used, agricultural production, household food insecurity (FIS) and child diet diversity (DDS), over one agricultural cycle (during land preparation, growing and harvest months).

SETTING

Fifteen rural subsistence farming communities in Panama.

PARTICIPANTS

Households participating in intervention (n 237) with minimum one preschool child.

RESULTS

After 1 year, participants had more learned and applied techniques, more staple crops produced and lower FIS and higher DDS during land preparation and growing months compared with those new to the intervention. After 5 years, participants grew more maize, chickens and types of crops and had higher DDS during growing months and, where demonstration gardens persisted, used more learned techniques and children ate more vitamin A-rich foods. Variables associated with DDS varied seasonally: during land preparation, higher DDS was associated with higher household durable asset-based wealth; during growing months, with greater diversity of vegetables planted and lower FIS; during harvest, with older caregivers, caregivers working less in agriculture, more diverse crops and receiving food from demonstration gardens.

CONCLUSIONS

The intervention improved food production, food security and diets. Sustained demonstration gardens were important for continued use of new agricultural techniques and improved diets.

Diet diversity score and healthy eating index in relation to diet quality and socio-demographic factors: results from a cross-sectional national dietary survey of Swedish adolescents

Objective:

Groups with low socio-economic status have less healthy diets and higher prevalence of non-communicable diseases. Using the latest Swedish national dietary survey data, we developed a healthy eating index and a diet diversity score with the aim to explore associations between the scores and socio-demographic factors.

Design:

Cross-sectional national dietary survey. A web-based retrospective registration of food and beverages during 2 d was used to assess dietary intake. This information was used to construct the Swedish Healthy Eating Index for Adolescents 2015 (SHEIA15) and the Riksmaten Adolescents Diet Diversity Score (RADDS). The scores were based on the latest Swedish dietary guidelines from 2015. Intakes of food and nutrients across the scores were examined. Mixed-effects multilevel models were used to assess associations between the scores and household education, sex, school grade, weight status and school municipality.

Setting:

School-based survey in Sweden.

Participants:

2905 adolescents in grades 5, 8 and 11, 56 % girls.

Results:

High scores on SHEIA15 and RADDS were associated with higher intake of vegetables, fish and several nutrients, and lower intake of sugar-sweetened beverages and red meat. Boys and participants in households with lower education level scored lower on both indices. Individuals with overweight/obesity scored lower on RADDS.

Conclusions:

The newly developed indices can be used to identify healthy eating patterns among Swedish adolescents. Both indices show that boys and adolescents from households with lower education level have poorer dietary habits. Lower diet diversity was related to overweight/obesity, but the overall healthy eating index was not.

EAACI position paper on diet diversity in pregnancy, infancy and childhood: Novel concepts and implications for studies in allergy and asthma

To fully understand the role of diet diversity on allergy outcomes and to set standards for conducting research in this field, the European Academy of Allergy and Clinical Immunology Task Force on Diet and Immunomodulation has systematically explored the association between diet diversity and allergy outcomes. In addition, a detailed narrative review of information on diet quality and diet patterns as they pertain to allergic outcomes is presented. Overall, we recommend that infants of any risk category for allergic disease should have a diverse diet, given no evidence of harm and some potential association of benefit in the prevention of particular allergic outcomes. In order to harmonize methods for future data collection and reporting, the task force members propose relevant definitions and important factors for consideration, when measuring diet diversity in the context of allergy. Consensus was achieved on practice points through the Delphi method. It is hoped that the definitions and considerations described herein will also enable better comparison of future studies and improve mechanistic studies and pathway analysis to understand how diet diversity modulates allergic outcomes.

Different Measures of Diet Diversity During Infancy and the Association with Childhood Food Allergy in a UK Birth Cohort Study

BACKGROUND

Diet diversity (DD) during infancy may prevent food allergies (FA), possibly by exposing the gastrointestinal microbiota to diverse foods and nutrients.

OBJECTIVE

To investigate the association between 4 different measures of DD during infancy and development of FA over the first decade of life.

METHODS

A birth cohort born between 2001 and 2002 were followed prospectively, providing information on sociodemographic, environmental, and dietary exposures. Information on age of introduction of a range of foods and food allergens was collected during infancy. Children were assessed for FA at 1, 2, 3, and 10 years. DD was defined using 4 measures in the first year of life: the World Health Organization definition of minimum DD at 6 months, as food diversity (FD) and fruit and vegetable diversity (FVD) at 3, 6, and 9 months, and as food allergen diversity (FAD) at 3, 6, 9, and 12 months.

RESULTS

A total of 969 pregnant women were recruited at 12-week gestation. A total of 900, 858, 891, and 827 offspring were assessed at 1, 2, 3, and 10 years. Univariate analysis showed that World Health Organization DD (P = .0047), FD (P = .0009), FAD (P = .0048), and FVD (P = .0174) at 6 months and FD (P = .0392), FAD (P = .0233), and FVD (.0163) at 9 months significantly reduced the odds of FA over the first decade of life. DD measures at 3 months were not associated with FA, but only 33% of the cohort had solid foods introduced by this age.

CONCLUSION

Increased infant DD, as measured by 4 different methods, decreased the likelihood of developing FA.

Food consumption, meat cooking methods and diet diversity and the risk of bladder cancer

BACKGROUND

Since food metabolites are eliminated by the urinary tract, several studies have investigated the association between diet and bladder cancer risk. Recently, the World Cancer Research Fund International/American Institute for Cancer Research (WCRF/AICR) suggested a potential beneficial effect of some foods (mainly vegetables, fruit, and milk) in the development of bladder cancer. We investigated the association between food groups and bladder cancer risk, seeking insights into food diversity as well as meat cooking methods.

METHODS

Data were derived from an Italian multicentre case-control study, conducted between 2003 and 2014, including 690 bladder cancer cases and 665 frequency-matched controls. Odds ratios (ORs) and the corresponding 95% confidence intervals (95%CIs) for various dietary aspects were estimated by unconditional logistic regression models adjusted for energy intake and the major known risk factors for bladder cancer.

RESULTS

Comparing the highest versus the lowest quartiles, consumption of vegetables (OR = 0.62; 95%CI: 0.44-0.88) and milk/yogurt (OR = 0.62; 95%CI: 0.44-0.87) reduced the risk of bladder cancer. Conversely, consumption of meat increased bladder cancer risk with an OR of 1.57 (95%CI: 1.07-2.31), particularly when the meat was stewed (OR = 1.47; 95%CI: 1.03-2.09) or roasted (OR = 1.41; 95%CI: 1.00-1.99). There was a suggestion that a diversified diet reduced the risk of bladder cancer, but this was not significant.

CONCLUSIONS

Our study consolidates the role of diet in bladder cancer aetiology, showing a reduced risk for vegetable and milk/yogurt consumption and an increased risk for meat consumption, especially when the meat is stewed or roasted.

A sequential, exploratory, mixed-methods approach for development and validation of a context-specific knowledge, attitude and practice questionnaire on micronutrients for literate mothers of school-age children

OBJECTIVE

To develop and validate a context-specific comprehensive knowledge, attitude and practice (KAP) questionnaire for literate mothers on factors affecting micronutrient status of 6-10-year-old children.

DESIGN

Sequential exploratory mixed-methods study using focus group discussions (FGD) and psychometric validation.

SETTING

Seven randomly selected villages with &gt;500 households with three to five family members each, in Ghatkesar sub-district, Medchal district, Telangana state, India.ParticipantsLiterate mothers from middle-income households with at least one child (6-10 years) for FGD (n 44), for testing the internal consistency (n 80) and for test-retest reliability (n 30).

RESULTS

The themes for FGD were diet diversity, micronutrients, cooking and eating practices, national programmes and sunlight exposure. Knowledge among caregivers about sources of micronutrients, deficiency symptoms, cooking/eating practices was low, while attitude towards diet diversity and sunlight was good. Non-availability of fruits and vegetables was a barrier to diet diversity. About 72 % of the questions from the item pool were based on FGD. After content validity, 125 items were selected for the questionnaire which, upon psychometric validation, was reduced to an eighty-eight-item questionnaire with difficulty index of 0·10-0·91, discrimination index of 0·09-0·68, Cronbach's α of 0·78 (reliability of knowledge and attitude) and 0·50 (practice). A Bland-Altman plot showed good agreement between test and retest scores.

CONCLUSIONS

The questionnaire developed and validated using a sequential exploratory mixed-methods approach can be used for assessing KAP on micronutrients and factors affecting consumption of diverse diets in rural Indian households.

Refining the ecological brain: Strong relation between the ventromedial prefrontal cortex and feeding ecology in five primate species

To survive in complex and seasonal environments, primates are thought to rely upon cognitive capacities such as decision-making and episodic memory, which enable them to plan their daily foraging path. According to the Ecological Brain hypothesis, feeding ecology has driven the expansion of the brain to support the corresponding development of cognitive skills. Recent works in cognitive neurosciences indicate that cognitive operations such as decision-making or subjective evaluation (which are contextual and dependent upon episodic memory), relied critically upon a small part of the frontal lobe, often referred to as the ventromedial prefrontal cortex (VMPFC). Several authors suggested that this area might be important for foraging, but this has never been tested. In the present study, we quantified the relation between the size of the VMPFC (along with other cerebral measures: the whole brain, the gyrus rectus and the somatosensory cortex) and key socio-ecological variables in five primate species (Macaca mulatta, Macaca fuscata, Gorilla gorilla, Pan troglodytes and Homo sapiens). We hypothesized that the size of the VMPFC would be greater in primates with a large dietary spectrum and complex foraging strategies. We also hypothesized that the impact of feeding ecology would be stronger on this specific region than on other regions (somatosensory cortex) or on more global cerebral measures (e.g., whole brain). In line with these hypotheses, we found that all cerebral measures were more strongly related to feeding ecology than group size, a proxy for social complexity. As expected, the VMPFC volume is more precisely related to feeding ecology than the whole brain, and appears to be critically related to dietary quality. Thus, combining a comparative approach with predictions coming both from behavioral ecology and cognitive neurosciences, our study provides evidence that feeding ecology played a key role in the development of specific cognitive skills, which rely upon the expansion of a specific cortical area.

Speed breeding orphan crops

This review explores how speed breeding protocols that hasten plant growth and development could be applied to shorten breeding cycles and accelerate research activities in orphan crops. There is a growing need for the agri-food sector to sustainably produce larger quantities of higher-quality food, feed and fuel using fewer resources, within the context of changing agroclimatic conditions. Meeting this challenge will require the accelerated development and dissemination of improved plant varieties and substantial improvement of agricultural practices. Speed breeding protocols that shorten plant generation times can hasten breeding and research to help fulfil the ever-increasing demands. Global agri-food systems rely on a relatively small number of plant species; however, there are calls to widen the scope of globally important crops to include orphan crops, which are currently grown and used by the world's poorest people or marketed as niche products for affluent consumers. Orphan crops can supply global diets with key nutrients, support economic development in the world's poorest regions, and bolster the resilience of the global agri-food sector to biotic and abiotic stresses. Little research effort has been invested in orphan crops, with farmers growing landraces that are sourced and traded through poorly structured market systems. Efforts are underway to develop breeding resources and techniques to improve orphan crops. Here, we highlight the current efforts and opportunities to speed breed orphan crops and discuss alternative approaches to deploy speed breeding in the less-resourced regions of the world. Speed breeding is a tool that, when used together with other multidisciplinary R&D approaches, can contribute to the rapid creation of new crop varieties, agricultural practices and products, supporting the production and utilisation of orphan crops at a commercial scale.

Deforestation and child diet diversity: A geospatial analysis of 15 Sub-Saharan African countries

Deforestation worldwide could have important consequences for diet quality and human nutrition given the numerous ecosystem services that are provided by forests and biodiverse landscapes. Yet, empirical research assessing the links between deforestation and diets is lacking. In this study, we examined the association between deforestation and diet diversity among children using geolocated Demographic and Health Survey data for 33,777 children across 15 countries of sub-Saharan Africa coupled with remotely-sensed data on forest cover loss. Deforestation was negatively associated with diet diversity (regression coefficient (95% CI): - 0.47 (- 0.76, - 0.18)), as well as recent consumption of legumes and nuts, flesh foods, and fruits and vegetables among children aged 6 months to 24 months. Regionally, these trends were statistically significant only in the West Africa region. This hypothesis-generating research adds to the growing body of evidence that forests and forest-based ecosystems are associated with diet quality and nutrition and provides support for future studies that examine mechanisms linking forest loss and human nutrition.

Economic analysis of the link between diet quality and health: Evidence from Kosovo

We analyse the link between diet diversity, (which is a proxy of diet quality) and health outcomes measured by body-mass index (BMI) in a representative sample of Kosovar adults using household expenditure micro-data. Building on a household model of health production we devise a two-stage empirical strategy to estimate the determinants of diet diversity and its effect on BMI. Economic factors and demographic characteristics play an important role in the choice of balanced diets. Results from the BMI analysis support the hypothesis that diet diversity is associated with optimal BMI. One standard deviation increase in diet diversity leads to 2.3% increase in BMI of the underweight individuals and to 1.5% reduction in BMI of the obese individuals. The findings have important implications for food security policies aiming at enhancing the public health in Kosovo.

The effectiveness of fish feeding behaviour in mirroring trawling-induced patterns

The ability to observe and predict trawling-induced patterns at spatial and temporal scales that are relevant to inform realistic management strategies is a challenge which scientists have consistently faced in recent decades. Here, we use fish feeding behaviour, a biological trait easily impaired by trawling disturbance, to depict alterations in fish condition (i.e. individual fitness) and feeding opportunities. The benthivorous fish Mullus barbatus barbatus was selected as a model species. The observed trends of responses to trawling in prey species confirmed the effectiveness of a non-trawled zone in sustaining higher levels of diet diversity (e.g. quantity and quality of ingested prey) and fish condition values (e.g. morphometric and physiological Condition Index). Changes observed in fish prey selection confirmed the role of trawling disturbance in modifying the local soft bottoms community, producing alterations of prey availability that trigger shifts in fish diet. Trawling-induced feeding patterns, mirrored through stomach contents, can positively or negatively affect fish condition, the main driver of population dynamics in maintaining carrying capacity levels. Due to the widespread socio-economic value of the red mullet fishery, and the current exploitation status, evidence gathered by the proposed bottom-up trait based approach might inform future trawling adaptation strategies, and tailor spatial conservation measures supporting an Ecosystem-Based Fisheries Management.

Microbiome symbionts and diet diversity incur costs on the immune system of insect larvae

Communities of symbiotic microorganisms that colonize the gastrointestinal tract play an important role in food digestion and protection against opportunistic microbes. Diet diversity increases the number of symbionts in the intestines, a benefit that is considered to impose no cost for the host organism. However, less is known about the possible immunological investments that hosts have to make in order to control the infections caused by symbiont populations that increase because of diet diversity. Using taxonomical composition analysis of the 16S rRNA V3 region, we show that enterococci are the dominating group of bacteria in the midgut of the larvae of the greater wax moth (Galleria mellonella). We found that the number of colony-forming units of enterococci and expressions of certain immunity-related antimicrobial peptide (AMP) genes such as Gallerimycin, Gloverin, 6-tox, Cecropin-D and Galiomicin increased in response to a more diverse diet, which in turn decreased the encapsulation response of the larvae. Treatment with antibiotics significantly lowered the expression of all AMP genes. Diet and antibiotic treatment interaction did not affect the expression of Gloverin and Galiomicin AMP genes, but significantly influenced the expression of Gallerimycin, 6-tox and Cecropin-D Taken together, our results suggest that diet diversity influences microbiome diversity and AMP gene expression, ultimately affecting an organism's capacity to mount an immune response. Elevated basal levels of immunity-related genes (Gloverin and Galiomicin) might act as a prophylactic against opportunistic infections and as a mechanism that controls the gut symbionts. This would indicate that a diverse diet imposes higher immunity costs on organisms.

Household food insecurity and diet diversity after the major 2010 landslide disaster in Eastern Uganda: a cross-sectional survey

In 2010, a landslide in Bududa, Eastern Uganda, killed about 350 people and nearly 1000 affected households were resettled in Kiryandongo, Western Uganda. A cross-sectional survey assessed household food insecurity and diet diversity among 1078 affected and controls. In Bududa, the affected had a lower adjusted mean score of food insecurity than controls - 9·2 (se 0·4) v. 12·3 (se 0·4) (P<0·01)--but higher diet diversity score (DDS) - 7·1 (se 0·1) v. 5·9 (se 0·1) (P<0·01). On controlling for disaster and covariates, recipients of relief food had higher food insecurity - 12·0 (se 0·6) v. 10·4 (se 0·3) (P=0·02)--whereas farmers had higher DDS - 6·6 (se 0·2) v. 5·6 (se 0·3) (P<0·01). Household size increased the likelihood of food insecurity (OR 1·15; 95% CI 1·00, 1·32; P<0·05) but reduced DDS (OR 0·93; 95% CI 0·87, <1·00; P=0·04). Low DDS was more likely in disaster affected (OR 4·22; 95% CI 2·65, 6·72; P<0·01) and farmers (OR 2·52; 95% CI 1·37, 4·64; P<0·01). In Kiryandongo, affected households had higher food insecurity - 12·3 (se 0·8) v. 2·6 (se 0·8) (P<0·01)--but lower DDS - 5·8 (se 0·3) v. 7·0 (se 0·3) (P=0·02). The latter reduced with increased age (OR 0·99; 95% CI 0·97, 1·00; P<0·05), lowest education (OR 0·54; 95% CI 0·31, 0·93; P=0·03), farmers (OR 0·59; 95 % CI 0·35, 0·98; P=0·04) and asset ownership (OR 0·56; 95% CI 0·39, 0·81; P<0·01). Addressing social protection could mitigate food insecurity.

The interactive association of dietary diversity scores and breast-feeding status with weight and length in Filipino infants aged 6-24 months

OBJECTIVE

To assess how breast-feeding and dietary diversity relate to infant length-for-age Z-score (LAZ) and weight-for-age Z-score (WAZ).

DESIGN

Breast-feeding, dietary and anthropometric data from the Cebu Longitudinal Health and Nutrition Survey were analysed using sex-stratified fixed-effects longitudinal regression models. A dietary diversity score (DDS) based on seven food groups was classified as low (<4) or high (≥ 4). The complementary feeding patterns were: (i) non-breast-fed with low DDS (referent); (ii) breast-fed with low DDS; (iii) non-breast-fed with high DDS; and (iv) breast-fed with high DDS (optimal). Interactions between age, energy intake and complementary feeding patterns were included.

SETTING

Philippines.

SUBJECTS

Infants (n 2822) measured bimonthly from 6 to 24 months.

RESULTS

Breast-feeding (regardless of DDS) was significantly associated with higher LAZ (until 24 months) and WAZ (until 20 months). For example, at 6 months, breast-fed boys with low DDS were 0.246 (95% CI 0.191, 0.302) sd longer and 0.523 (95% CI 0.451, 0.594) sd heavier than the referent group. There was no significant difference in size between breast-fed infants with high v. low DDS. Similarly, high DDS conferred no advantage in LAZ or WAZ among non-breast-fed infants. There were modest correlations between the 7-point DDS and nutrient intakes but these correlations were substantially attenuated after energy adjustment. We elucidated several interactions between sex, age, energy intake and complementary feeding patterns.

CONCLUSIONS

These results demonstrate the importance of prolonged breast-feeding up to 24 months. The DDS provided qualitative information on infant diets but did not confer a significant advantage in LAZ or WAZ.

The dynamics of food, alcohol and cigarette consumption in Russia during transition

This paper presents evidence on the impact of individual as well as regional characteristics on the dynamics of fat, protein, alcohol and cigarette consumption, and on the diversity of the diet in Russia between 1994 and 2005. All those aspects of nutritional behavior are important inputs to the production of health. A dynamic panel data model is used to estimate demand functions for fat, protein, alcohol, cigarettes and diversity of the diet. The results suggest the existence of strong habits in drinking and smoking, and the absence of habits in fat and protein consumption. We also found evidence of habit formation for food diversity. Comparing nutritional behavior of younger and older consumers, we find significant differences in the demand for fat and cigarettes. Older consumers seem to be more persistent in their drinking and smoking behavior. Similarly, men show higher habit persistence for alcohol and cigarette consumption. The results also suggest that among individual determinants, especially education, income and employment have statistically significant impacts on consumption behavior. Regarding the macroeconomic variables, economic growth is negatively related to protein consumption, while regional unemployment rate is negatively affecting the demand for protein and food diversity. Finally, Russian consumers react to the price changes of alcohol, cigarettes, fat and protein as suggested by theory. Consumer demand for food diversity responds negatively to price changes of alcohol and cigarettes, but positively to the price of fat.