An overview of food insecurity during the global COVID-19 outbreak: transformative change and priorities for the Middle East

Abstract The consequences of COVID-19 on the economy and agriculture have raised many concerns about global food security, especially in Middle Eastern countries, where unsustainable farming practices are widespread. Regarding the unprecedented crisis of the COVID-19 pandemic and the importance of early implementation of prevention programs, it is essential to understand better its potential impacts on various food security dimensions and indicators in these countries. In this scoping review, research databases were searched using a search strategy and keywords developed in collaboration with librarians. The review includes community trials and observational studies in all population groups. Two researchers separately conducted the literature search, study selection, and data extraction. A narrative synthesis was implemented to summarize the findings. The impacts of COVID-19 on three of four dimensions of food security through the food and nutrition system were identified: availability, accessibility, and stability. Disruption of financial exchanges, transportation, and closing of stores led to reduced production, processing, and distribution sub-systems. Rising unemployment, quitting some quarantined jobs, increasing medical healthcare costs, and increasing food basket prices in the consumption sub-system lead to lower access to required energy and nutrients, especially in the lower-income groups. Increased micronutrient deficiency and decreased immunity levels, increased overweight, obesity and non-communicable diseases would also occur. The current review results predict the effect of COVID-19 on food security, especially in vulnerable populations, and develop effective interventions. This review provides information for policymakers to better understand the factors influencing the implementation of these interventions and inform decision-making to improve food security. PROSPERO identifier: CRD42020185843

Adherence to the Mediterranean diet and the risk of lung cancer: A systematic review and dose-response meta-analysis of observational studies

Context: The literature supports the protective role of the Mediterranean diet (MD) in the prevention of some types of cancer, such as colorectal and liver cancer. The link between the MD and lung cancer, however, is still unclear. Objective: The aim of this systematic review and meta-analysis was to investigate the association between the MD and risk of lung cancer. Data Sources: Electronic databases (PubMed, Scopus, Embase, and Web of Science) were searched up to May 2021. Study Selection: Case-control and cohort studies reporting the association between intake of the MD and risk of lung cancer and with accessible full texts published in English were included. Review articles, laboratory and animal studies, abstracts, letters to the editor, and studies lacking sufficient data were excluded. Data Extraction: The risk ratio (RR) was extracted from eligible studies, and meta-analysis was performed to calculate the pooled RR of the included studies. Results: Nine studies (8 cohort, 1 case-control) were included in the meta-analysis. High adherence to the MD was associated with a lower likelihood of lung cancer compared with low adherence (RR = 0.84; 95%CI, 0.77-0.91; I2 = 52%, heterogeneity P = 0.03). Dose-response analysis showed that a 2-score increment in MD adherence was associated with a 6% lower risk of lung cancer (RR = 0.94; 95%CI, 0.91-0.96; nonlinearity P = 0.97). Subgroup analyses showed a protective association between MD adherence and risk of lung cancer among former smokers (n = 3 studies) (RR = 0.81; 95%CI, 0.74-0.89), but no significant association was observed for never smokers (n = 3 studies) (RR = 0.78; 95%CI, 0.29-2.07) or current smokers (n = 3 studies) (RR = 0.82; 95%CI, 0.58-1.16). In addition, an inverse association between the MD and lung cancer was observed in both males (RR = 0.84; 95%CI, 0.74-0.96) and females (RR = 0.87; 95%CI, 0.77-0.98). Conclusions: High adherence to the MD is associated with a lower risk of lung cancer, especially in former smokers. Systematic Review Registration: PROSPERO registration no. CRD42019146460