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

Background: The COVID-19 pandemic has revealed the fragility of the global food system, sending shockwaves across countries\u27 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\u27s food consumption scores indicating dietary diversity varied across regions. It decreased in the Middle East and North Africa (MENA) countries, including Lebanon (p \u3c 0.001) and increased in the Gulf Cooperation Council countries including Bahrain (p = 0.003), Egypt (p \u3c 0.001) and United Arab Emirates (p = 0.013). A decline in the household\u27s dietary diversity was observed in Australia (p \u3c 0.001), in South Africa including Uganda (p \u3c 0.001), in Europe including Belgium (p \u3c 0.001), Denmark (p = 0.002), Finland (p \u3c 0.001) and Netherland (p = 0.027) and in South America including Ecuador (p \u3c 0.001), Brazil (p \u3c 0.001), Mexico (p \u3c 0.0001) and Peru (p \u3c 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 \u3c 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

An Evaluation of the COVID-19 Pandemic and Perceived Social Distancing Policies in Relation to Planning, Selecting, and Preparing Healthy Meals: An Observational Study in 38 Countries Worldwide

Objectives: To examine changes in planning, selecting, and preparing healthy foods in relation to personal factors (time, money, stress) and social distancing policies during the COVID-19 crisis. Methods: Using cross-sectional online surveys collected in 38 countries worldwide in April-June 2020 (N = 37,207, Mage 36.7 SD 14.8, 77% women), we compared changes in food literacy behaviors to changes in personal factors and social distancing policies, using hierarchical multiple regression analyses controlling for sociodemographic variables. Results: Increases in planning (4.7 SD 1.3, 4.9 SD 1.3), selecting (3.6 SD 1.7, 3.7 SD 1.7), and preparing (4.6 SD 1.2, 4.7 SD 1.3) healthy foods were found for women and men, and positively related to perceived time availability and stay-at-home policies. Psychological distress was a barrier for women, and an enabler for men. Financial stress was a barrier and enabler depending on various sociodemographic variables (all p < 0.01). Conclusion: Stay-at-home policies and feelings of having more time during COVID-19 seem to have improved food literacy. Stress and other social distancing policies relate to food literacy in more complex ways, highlighting the necessity of a health equity lens. Copyright 2021 De Backer, Teunissen, Cuykx, Decorte, Pabian, Gerritsen, Matthys, Al Sabbah, Van Royen and the Corona Cooking Survey Study Group.This research was funded by the Research Foundation Flanders (G047518N) and Flanders Innovation and Entrepreneurship (HBC.2018.0397). These funding sources had no role in the design of the study, the analysis and interpretation of the data or the writing of, nor the decision to publish the manuscript.Scopu

Exploring Australian women&rsquo;s level of nutrition knowledge during pregnancy: a cross-sectional study

Khlood Bookari,1 Heather Yeatman,1 Moira Williamson2,3 1School of Health and Society, Faculty of Social Sciences, 2School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 3School of Nursing and Midwifery, Higher Education Division, Central Queensland University, Noosaville, QLD, Australia Background: The Australian Guide to Healthy Eating (AGHE) for pregnancy provides a number of food- and nutrition-related recommendations to assist pregnant women in optimizing their dietary behavior. However, there are limited data demonstrating pregnant women&rsquo;s knowledge of the AGHE recommendations. This study investigated Australian pregnant women&rsquo;s knowledge of the AGHE and related dietary recommendations for maintaining a healthy pregnancy. The variations in nutrition knowledge were compared with demographic characteristics. Methods: A cross-sectional study assessed eight different nutrition knowledge domains and the demographic characteristics of pregnant women. Four hundred women across Australia completed a multidimensional online survey based on validated and existing measures. Results: More than half of the pregnant women surveyed (65%) were not familiar with the AGHE recommendations. The basic recommendations to eat more fruit, vegetables, bread, and cereals but less meat were poorly understood. An in-depth investigation of knowledge of nutrition information revealed misconceptions in a range of areas, including standard serving size, nutrients content of certain foods, energy density of fat, and the importance of key nutrients in pregnancy. Univariate analysis revealed significant demographic variation in nutrition knowledge scores. Multiple regression analysis confirmed the significant independent effects on respondents&rsquo; nutrition knowledge score (P&lt;0.000) of the education level, income, age, stage of pregnancy, language, and having a health/nutrition qualification. The model indicated that independent variables explained 33% (adjusted R2) of the variance found between respondents&rsquo; knowledge scores. Conclusion: Australian pregnant women&rsquo;s knowledge regarding AGHE for pregnancy and other key dietary recommendations is poor and varies significantly with their demographic profile. The setting of dietary guidelines is not sufficient to ensure improvement in their nutrition knowledge. It is essential that women receive support to achieve optimal and healthy diets during pregnancy. Keywords: Australian Guide to Healthy Eating for pregnancy, nutrition knowledge, pregnancy, healt

Informing nutrition care in the antenatal period: Pregnant women's experiences and need for support

This study aimed to provide insights into Australian women's experiences in gaining nutrition information during pregnancy. Individual semistructured telephone interviews were conducted with 17 pregnant (across all trimesters) and 9 postpartum women in five Australian states. Data were transcribed and analysed using inductive thematic analysis. Women valued nutrition information, actively sought it, and passively received it mainly from three sources: healthcare providers (HCPs), media, and their social networks. Women reported HCPs as highest for reliability but they had limited time and indifferent approaches. Various media were easily and most frequently accessed but were less reliable. Social networks were considered to be the least reliable and least accessed. Women reported becoming overwhelmed and confused. This in turn influenced their decisions (pragmatic/rational) and their eating behaviours ("overdo it," "loosen it," "ignore it," and "positive response"). Individual and environmental barriers impacted their application of knowledge to dietary practice. Women wanted more constructive and interactive engagement with their HCPs. This study identified the need to establish and maintain mutually respectful environments where women feel able to raise issues with their HCPs throughout their pregnancies and where they are confident that the information they receive will be accurate and meet their needs. © 2017 Khlood Bookari et al

Corrigendum to “Australian Pregnant Women’s Awareness of Gestational Weight Gain and Dietary Guidelines: Opportunity for Action”

In the article titled “Australian Pregnant Women’s Awareness of Gestational Weight Gain and Dietary Guidelines: Opportunity for Action” [1], there was an error and missing reference in the first paragraph of Section “2.1. Survey Development,” where [2] should be added to the article as [44] and cited in the following statement “The survey instrument was derived from a multidimensional survey that assessed women’s dietary adherence to AGHE, attitude,motivation for dietary change and knowledge of AGHE during pregnancy, and other recommendations for staying healthy and active during pregnancy, including the IOM guidelines for GWG and its management [44].”Meanwhile, the number of survey items should be 109 instead of 95 in the statement “Thesurvey also included demographic questions on women’s education, stage of pregnancy, age, marital status, income, language, and self-reported prepregnancy BMI. The multidimensional survey included 95 items and was developed using existing [24] and validated surveys [16, 23, 25] and newly created questions appropriate to the purpose of this study.” Additionally, [36] was incomplete. It should be corrected as “36. Australian Health Ministers’ Advisory Council. ‘Clinical practice guidelines: Antenatal care—module 2,’ Australian Government Department of Health and Ageing: Canberra, 2014.

Corrigendum to “Australian Pregnant Women’s Awareness of Gestational Weight Gain and Dietary Guidelines: Opportunity for Action”

In the article titled “Australian Pregnant Women’s Awareness of Gestational Weight Gain and Dietary Guidelines: Opportunity for Action” [1], there was an error and missing reference in the first paragraph of Section “2.1. Survey Development,” where [2] should be added to the article as [44] and cited in the following statement “The survey instrument was derived from a multidimensional survey that assessed women’s dietary adherence to AGHE, attitude,motivation for dietary change and knowledge of AGHE during pregnancy, and other recommendations for staying healthy and active during pregnancy, including the IOM guidelines for GWG and its management [44].”Meanwhile, the number of survey items should be 109 instead of 95 in the statement “Thesurvey also included demographic questions on women’s education, stage of pregnancy, age, marital status, income, language, and self-reported prepregnancy BMI. The multidimensional survey included 95 items and was developed using existing [24] and validated surveys [16, 23, 25] and newly created questions appropriate to the purpose of this study.” Additionally, [36] was incomplete. It should be corrected as “36. Australian Health Ministers’ Advisory Council. ‘Clinical practice guidelines: Antenatal care—module 2,’ Australian Government Department of Health and Ageing: Canberra, 2014.

Exploring Australian women's level of nutrition knowledge during pregnancy: A cross-sectional study

The Australian Guide to Healthy Eating (AGHE) for pregnancy provides a number of food- and nutrition-related recommendations to assist pregnant women in optimizing their dietary behavior. However, there are limited data demonstrating pregnant women’s knowledge of the AGHE recommendations. This study investigated Australian pregnant women’s knowledge of the AGHE and related dietary recommendations for maintaining a healthy pregnancy. The variations in nutrition knowledge were compared with demographic characteristics

Australian pregnant women’s awareness of gestational weight gain and dietary guidelines : opportunity for action

Excessive gestational weight gain (GWG) can negatively impact on maternal and foetal health. Guidelines based on Institute of Medicine (IOM) encourage managing GWG by following healthy eating recommendations and increasing physical activity. This study investigated pregnant women’s knowledge of their optimal GWG and recommended dietary approaches for GWG management. Method. English-speaking pregnant women were recruited from five hospitals in New South Wales (Australia) and an online link. Prepregnancy Body Mass Index (BMI) was calculated from self-reported height and prepregnancy weight. Participants identified their recommended GWG. A survey assessed practical dietary knowledge and asked about broad dietary recommendations to prevent excessive GWG. Chi square and logistic regression analyses were used. Results. ̧‘ = 326 pregnantwomen completed the surveys; 49% entered pregnancy overweight (25.2%) or obese (23.6%); and knowledge of recommended GWG was lacking. Prepregnancy BMI was a significant predictor of GWG recommendation knowledge (̧‘ƒ < 0.000). Pregnant women were highly knowledgeable about broad dietary recommendations but had poor knowledge of detailed recommendations. Conclusions. Limited knowledge of IOM’s GWG guidelines and of specific dietary recommendations for pregnancy should be addressed by health care providers and education initiatives to assist the high number of women who enter pregnancy overweight or obese

Falling short of dietary guidelines: What do Australian pregnant women really know?: A cross sectional study

Background: Maternal diets are not consistent with dietary guidance and this may affect the health of the mother and their infants. Nutrition knowledge and motivation may be important factors. Aims: To assess pregnant women's diets in relation to consistency with the Australian Guidelines for Healthy Eating (AGHE); factors influencing women's adherence to the recommendations; and women's attitudes towards pregnancy-specific nutrition information. Methods: A cross-sectional study using convenience sampling was undertaken at five hospitals in New South Wales (Australia) and through an online link (October 2012 to July 2013). N = 388 pregnant women completed the survey. Categorical data were analysed using Chi square and logistic regression with significance set at P < 0.05. Findings: Most participants were highly motivated to adopt a healthy diet, believed they were trying to do so and that knowing about nutrition in pregnancy was highly important. Reported dietary intakes were poor. No pregnant women met the recommended food intakes for all five food groups. Poor knowledge of these recommendations was evident. Knowledge of selected recommendations (for Fruit, Vegetables, and Breads and Cereals) increased the likelihood of those food' consumption 8 (95% confidence interval [CI], 2.3 - 27.7), 9.1 (95% CI, 2.6 - 31.3) and 6.8 (95% CI 3.4 - 13.7) times respectively. Conclusion: Pregnant women had high levels of motivation and confidence in their ability to achieve a healthy diet and understand dietary recommendations, but actually demonstrated poor knowledge and poor adherence to the guidelines. Mistaken or false beliefs may be a barrier to effective nutrition education strategies

Exploring pregnant women's current level of nutrition knowledge, attitudes, and readiness for dietary change during pregnancy

Dietary behaviours of pregnant women are important as adverse maternal and infant health outcomes have been linked with poor maternal nutrition