The impact of COVID-19 on diet quality, food security and nutrition in low and middle income countries: A systematic review of the evidence.
The impact of COVID-19 on diet quality, food security and nutrition in low and middle income countries: A systematic review of the evidence.
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DOI：
10.1016/j.clnu.2021.08.015
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发表时间：
2022-12
期刊：
影响因子：
--
通讯作者：
Roberfroid D
中科院分区：
文献类型：
--
作者：
Picchioni F;Goulao LF;Roberfroid D
当前冠状病毒（COVID-19）在全球大流行，以及为减少其传播而采取的措施，威胁着低收入和中等收入国家（LMIC）人口的营养状况。记录 COVID-19 如何影响饮食、营养和粮食安全有助于为缓解干预措施和政策提出循证建议。我们进行了系统的文献综述。结构化检索策略已应用于 MEDLINE (Pubmed®)、EMBASE®、Scopus® 和 Web of Science®。通过筛选参与监测 COVID-19 大流行对营养和粮食安全影响的预设机构名单来检索灰色文献。第一次搜索于 2020 年 8 月 20 日完成，并于 2020 年 11 月中旬和 2021 年 1 月中旬更新。所有研究步骤均按照 PRISMA 声明中的建议进行描述。在确定的 2085 篇参考文献中，包含了 35 篇初步研究。尽管研究存在异质性，但研究一致证明了 COVID-19 大流行和相关遏制措施对饮食质量和粮食不安全产生了不利影响。 COVID-19 对粮食和营养结果的主要直接影响之一是其对就业、创收活动和相关购买力的影响。其他影响渠道，例如食物的实际获取、供应和可负担性，提供了不同的情况，并通过二元且通常简单化的问题进行评估。 COVID-19对粮食系统和饮食的影响表现出不同的强度、持续时间和不同的形式。造成国家之间和国家内部这些差异的因素包括：1) 国家 COVID-19 限制措施和政策的时机、持续时间和严格程度，以减轻其不利影响； 2) 针对国内和国际遏制措施的具体食品价值链反应； 3）限制措施对不同群体的影响因性别、年龄、社会经济地位和就业条件而异。面对 COVID-19 大流行，较短的价值链和传统的小农农场在某种程度上更具弹性。此外，这一流行病的影响对妇女、社会经济地位较低的个人、非正规工人和依赖日薪的年轻人尤其不利。最后，政府为遏制病毒并减轻大流行的破坏性影响采取了不同的应对措施。事实证明，现有且运作良好的社会保护计划和公共粮食分配可以缓冲对粮食不安全的不利影响。但社会安全网本身无法发挥作用，需要进行更广泛的粮食系统干预和投资，以支持可持续和包容性粮食系统，全面实现粮食和营养安全。当前的经济和健康危机影响了饮食质量和粮食安全。这引发了人们对营养丰富的健康饮食的获取和负担能力及其健康影响的长期影响的担忧。妇女和社会经济地位较低的个人可能面临粮食不安全的风险最大。社会安全网可以有效地保护他们，必须立即实施。我们主张改进数据收集，以识别弱势群体并衡量干预措施如何成功地保护他们。
The current global pandemic of Coronavirus (COVID-19), and measures adopted to reduce its spread, threaten the nutritional status of populations in Low- and middle-income countries (LMICs). Documenting how the COVID-19 affects diets, nutrition and food security can help generating evidence-informed recommendations for mitigating interventions and policies. We carried out a systematic literature review. A structured search strategy was applied in MEDLINE (Pubmed®), EMBASE®, Scopus® and Web of Science®. Grey literature was retrieved by screening a pre-set list of institutions involved in monitoring the impact of the COVID-19 pandemic on nutrition and food security. The first search was done on 20th August 2020, and updated in mid-November 2020 and mid-January 2021. All research steps were described as recommended in the PRISMA statement. Out of the 2085 references identified, thirty-five primary studies were included. In spite of their heterogeneity, studies converge to demonstrate a detrimental effect of COVID-19 pandemic and associated containment measures on diet quality and food insecurity. One of the major direct effects of COVID-19 on food and nutrition outcomes has been through its impact on employment, income generating activities and associated purchasing power. Other channels of impact, such as physical access, availability and affordability of food provided a heterogeneous picture and were assessed via binary and often simplistic questions. The impacts of COVID-19 on food systems and diets manifested with various intensity degrees, duration and in different forms. Factors contributing to these variations between and within countries were: 1) timing, duration and stringency of national COVID-19 restriction measures and policies to mitigate their adverse impacts; 2) context specific food value chain responses to domestic and international containment measures; 3) differentiated impacts of restriction measures on different groups, along lines of gender, age, socio-economic status and employment conditions. Shorter value chains and traditional smallholder farms were somewhat more resilient in the face of COVID-19 pandemic. Additionally, the impact of the pandemic has been particularly adverse on women, individuals with a low socio-economic status, informal workers and young adults that relied on daily wages. Finally, there were heterogeneous government responses to curb the virus and to mitigate the damaging effects of the pandemic. It has been demonstrated that existing and well-functioning social protection programmes and public distribution of food can buffer the adverse effects on food insecurity. But social safety nets cannot be effective on their own and there is a need for broader food systems interventions and investments to support sustainable and inclusive food systems to holistically achieve food and nutrition security. The current economic and heath crisis impacted diet quality and food security. This raises concerns about long term impacts on access to and affordability of nutrient-rich, healthy diets and their health implications. Women and individuals with a low socio-economic are likely to be the most at risk of food insecurity. Social safety nets can be effective to protect them and must be urgently implemented. We advocate for improved data collection to identify vulnerable groups and measure how interventions are successful in protecting them.
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