Call for Emergency Action to Restore Dietary Diversity and Protect Global Food Systems in Times of COVID-19 and Beyond: Results From a Cross-sectional Study in 38 Countries

Maha Hoteit*, Reem Hoteit, Ayoub Aljawaldeh, Kathleen Van Royen, Sara Pabian, Paulien Decorte, Isabelle Cuykx, Lauranna Teunissen, Charlotte De Backer, Ina Bergheim, Raphaela Staltner, Amanda Devine, Ros Sambell, Ruth Wallace, Sabika Salem Allehdan, Tariq Abdulkarim Alalwan, Mariam Ahamad Al-Mannai, Gaëlle Ouvrein, Karolien Poels, Heidi VandeboschKatrien Maldoy, Christophe Matthys, Tim Smits, Jules Vrinten, Ann DeSmet, Nelleke Teughels, Maggie Geuens, Iris Vermeir, Viktor Proesmans, Liselot Hudders, Marcia Dutra De Barcellos, Cristina Ostermann, Ana Luiza Brock, Cynthia Favieiro, Rafaela Trizotto, Isadora Stangherlin, Anthonieta Looman Mafra, Marco Antônio Correa Varella, Jaroslava Varella Valentova, Maryanne L. Fisher, Melanie MacEacheron, Katherine White, Rishad Habib, David S. Dobson, Berta Schnettler, Ligia Orellana, Edgardo Miranda-Zapata, Angela Wen-Yu Chang, Wen Jiao, Matthew Tingchi Liu, Klaus G. Grunert, Rikke Nyland Christensen, Lucia A. Reisch, Meike Janssen, Victoria Abril-Ulloa, Lorena Encalada, Iman Kamel, Annukka Vainio, Mari Niva, Laura Salmivaara, Johanna Mäkelä, Kaisa Torkkeli, Robert Mai, Pamela Kerschke Risch, Efthymios Altsitsiadis, Angelos Stamos, Andreas Antronikidis, Maeve Henchion, Sinead McCarthy, Mary McCarthy, Alessandra Micalizzi, Peter J. Schulz, Manuela Farinosi, Hidenori Komatsu, Nobuyuki Tanaka, Hiromi Kubota, Reema Tayyem, Narmeen J. Al-Awwad, Nahla Al-Bayyari, Mohammed O. Ibrahim, Fadwa Hammouh, Somaia Dashti, Basma Dashti, Dhuha Alkharaif, Amani Alshatti, Maryam Al Mazedi, Rania Mansour, Elissa Naim, Hussein Mortada, Yareni Yunuen Gutierrez Gomez, Kelly Geyskens, Caroline Goukens, Rajshri Roy, Victoria Egli, Lisa Te Morenga, Mostafa Waly, Radwan Qasrawi, Motasem Hamdan, Rania Abu Sier, Diala Abu Al Halawa, Hazem Agha, María Reyna Liria Domínguez, Lita Palomares, Grażyna Wąsowicz, Hiba Bawadi, Reema Tayyem, Manal Othman, Jaafar Pakari, Allam Abu Farha, Rasha Abu-El-Ruz, Dacinia Crina Petrescu, Ruxandra Malina Petrescu Mag, Felix Arion, Stefan Cristian Vesa, Majid M. Alkhalaf, Khlood Bookari, Jamila Arrish, Zackaria Rahim, Roy Kheng, Yandisa Ngqangashe, Zandile June-Rose Mchiza, Marcela Gonzalez-Gross, Lisset Pantoja-Arévalo, Eva Gesteiro, Yolanda Ríos, Peter Yiga, Patrick Ogwok, Denis Ocen, Michael Bamuwamye, Haleama Al Sabbah, Zainab Taha, Leila Cheikh Ismail, Ayesha Aldhaheri, Elisa Pineda, Marisa Miraldo, Dawn Liu Holford, Hilde Van den Bulck

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Abstract

Background:The COVID-19 pandemic has revealed the fragility of the global food system, sending shockwaves across countries' societies and economy. This has presented formidable challenges to sustaining a healthy and resilient lifestyle. The objective of this study is to examine the food consumption patterns and assess diet diversity indicators, primarily focusing on the food consumption score (FCS), among households in 38 countries both before and during the first wave of the COVID-19 pandemic.

Methods: A cross-sectional study with 37 207 participants (mean age: 36.70 ± 14.79, with 77 % women) was conducted in 38 countries through an online survey administered between April and June 2020. The study utilized a pre-tested food frequency questionnaire to explore food consumption patterns both before and during the COVID-19 periods. Additionally, the study computed Food Consumption Score (FCS) as a proxy indicator for assessing the dietary diversity of households.

Findings: This quantification of global, regional and national dietary diversity across 38 countries showed an increment in the consumption of all food groups but a drop in the intake of vegetables and in the dietary diversity. The household's food consumption scores indicating dietary diversity varied across regions. It decreased in the Middle East and North Africa (MENA) countries, including Lebanon (p < 0.001) and increased in the Gulf Cooperation Council countries including Bahrain (p = 0.003), Egypt (p < 0.001) and United Arab Emirates (p = 0.013). A decline in the household's dietary diversity was observed in Australia (p < 0.001), in South Africa including Uganda (p < 0.001), in Europe including Belgium (p < 0.001), Denmark (p = 0.002), Finland (p < 0.001) and Netherland (p = 0.027) and in South America including Ecuador (p < 0.001), Brazil (p < 0.001), Mexico (p < 0.0001) and Peru (p < 0.001). Middle and older ages [OR = 1.2; 95 % CI = [1.125–1.426] [OR = 2.5; 95 % CI = [1.951–3.064], being a woman [OR = 1.2; 95 % CI = [1.117–1.367], having a high education (p < 0.001), and showing amelioration in food-related behaviors [OR = 1.4; 95 % CI = [1.292–1.709] were all linked to having a higher dietary diversity.

Conclusion: The minor to moderate changes in food consumption patterns observed across the 38 countries within relatively short time frames could become lasting, leading to a significant and prolonged reduction in dietary diversity, as demonstrated by our findings.
Original languageEnglish
Article numbere21585
JournalHeliyon
Volume9
Issue number11
Number of pages12
ISSN2405-8440
DOIs
Publication statusPublished - Nov 2023

Keywords

  • COVID-19
  • Pandemics
  • Food consumption pattern
  • Dietary diversity
  • Food consumption score
  • Food-related behaviors

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