FOOD SECURITY IN THE COVID-19 PANDEMIC: AN IMPACT ON THE WORLD DIET

Objetivo: este estudo constitui uma revisão integrativa sobre a insegurança alimentar durante a pandemia, desenvolvida a partir da seleção sistemática na literatura científica que atualmente faz a observação e o monitoramento da COVID-19 e sua relação com a fome no Brasil e no mundo. Métodos: A coleta de dados foi realizada no período de 12 de abril de 2020 a 12 de abril de 2021, sendo as buscas bibliográficas realizadas a partir dos dados obtidos pelos sites e documentos oficiais publicados pela OMS/WHO, ONU, OPAS, MS, IBGE e Agência Nacional de Saúde. Resultados e Discussão: para a ONU, a pandemia da COVID-19 pode provocar catástrofes de proporções inimagináveis, dobrando o número de famintos no mundo, podendo chegar a 265 milhões. No Brasil metade da população teve algum grau de insegurança alimentar em 2020, sendo que a crise causada pelo coronavírus poderá gerar uma situação de insegurança alimentar para 40 milhões de pessoas na América Latina e no Caribe, provocando muita fome em várias regiões do mundo. Conclusão: A Pandemia deixou evidente a necessidade urgente da adoção de medidas coordenadas a nível mundial, nacional e local para prevenir a crise humanitária e alimentar iminente, que ameaça os grupos em maior situação de vulnerabilidade. O momento é construção e fortalecimento de iniciativas voltadas à proteção social, assegurando o pleno acesso à alimentação saudável e adequada.Objective: this study constitutes an integrative review on food insecurity during the pandemic, developed from the systematic selection in the scientific literature that currently observes and monitors COVID-19 and its relationship with hunger in Brazil and in the world. Methods: Data collection was carried out from April 12, 2020 to April 12, 2021, and bibliographic searches were carried out based on data obtained from official websites and documents published by WHO/WHO, UN, PAHO, MS, IBGE and the National Health Agency. Results and Discussion: for the UN, the COVID-19 pandemic can cause catastrophes of unimaginable proportions, doubling the number of hungry people in the world, reaching 265 million. In Brazil, half of the population had some degree of food insecurity in 2020, and the crisis caused by the coronavirus could create a situation of food insecurity for 40 million people in Latin America and the Caribbean, causing great hunger in several regions of the world. Conclusion: Pandemic highlighted the urgent need to adopt coordinated measures at global, national and local levels to prevent the impending humanitarian and food crisis, which threatens the most vulnerable groups. The moment is to build and strengthen initiatives aimed at social protection, ensuring full access to healthy and adequate food

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P <.01), mainly due to a 0.5-serving/d greater intake of fruits and of vegetables in the BALANCE group. Primary end point events occurred in 236 participants (18.8%) in the BALANCE group and in 207 participants (16.4%) in the control group (hazard ratio, 1.15; 95% CI 0.95-1.38; P =.15). Secondary end points did not differ between groups after follow-up. Conclusions: The BALANCE Program only slightly improved adherence to a healthy diet in patients with established CVD and had no significant effect on the incidence of cardiovascular events or death. © 2019 The Author