RESUMEN
BACKGROUND: To reduce health inequities in paediatric patients with complex diseases, our hospital developed a food security programme in 2022. The programme aims to mitigate food insecurity (FI) in paediatric patients with oncological, transplantation and congenital cardiovascular diagnoses, by providing a monthly nutritious food supply that covers up to 50% of the patient's family food intake, accompanied by social and nutritional follow-up. In this study, we aimed to assess the effect of the programme on FI and nutritional status and describe its implementation. METHOD: We conducted a before-and-after study of patients who entered the programme in a 14-month period. We used the Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA) scale score, FI level and nutritional status measures to assess the effect of the programme. We used the Wilcoxon and McNemar tests to assess changes in scores and proportions of patients with moderate and severe FI, respectively, 31.5%-14.4% (p=0.0008) and of moderate FI from 68.5% to 36.9%. RESULTS: 111 patients were included. They had a baseline median (IQR) ELCSA score=8 (7-11) that changed to 6 (4-9) (p<0.0001). Severe FI according to ELCSA changed from 31.5% to 14.4% (p<0.001) and moderate from 68.5% to 36.9% (p<0.001). We found no differences in nutritional status regarding height for age (49.5% vs 51.3%, p=0.76), weight for height (42.5% vs 59.1%, p=0.75) or body mass index for age (38% vs 46%, p=0.42) CONCLUSION: The programme reduced FI in families by improving its level to mild or moderate. Children who entered the programme maintained an appropriate nutritional status despite the considerable risk of malnutrition described for oncological paediatric patients and paediatric solid organ transplantation receptors.
Asunto(s)
Seguridad Alimentaria , Estado Nutricional , Humanos , Masculino , Femenino , Niño , Preescolar , Inseguridad Alimentaria , Lactante , Evaluación de Programas y Proyectos de Salud , Adolescente , Abastecimiento de Alimentos/estadística & datos numéricosRESUMEN
Food insecurity (FI) is a critical issue in developing countries, particularly in low-resource settings, where it can worsen women's mental health. Psychosocial factors such as low household income, limited education, multiparity, and vulnerability are linked to depressive symptoms during pregnancy. Additionally, the family environment influences parental practices, which may impact mental health. This study evaluates the association of socioeconomic factors, parental practices, FI risk, and home visit frequency with depressive symptoms in pregnant women enrolled in the Happy Child Program (Programa Criança Feliz-PCF) in the Federal District, Brazil. In this cross-sectional study, 132 pregnant women monitored by PCF from May to July 2023 were assessed using a self-administered questionnaire for socioeconomic data, the two-item Triage for Food Insecurity (TRIA) instrument for FI risk, the Scale of Parental Beliefs and Early Childhood Care Practices, and the Beck Depression Inventory-II for depressive symptoms. Most participants were multiparous (87.9%), had low income (under 200 USD/month; 80.8%), presented depressive symptoms (67.4%) and were at risk of FI (81.8%). About half demonstrated adequate parental practices (50.8%) and received four home visits per month during pregnancy (54.5%). Women who received four PCF home visits had a lower prevalence of depressive symptoms compared to those with fewer visits (PR 0.76, 95% CI 0.59-0.98). No significant association was found between FI or parental practices and depressive symptoms. These findings suggest that the PCF home-visiting program may strengthen vulnerable families, support social networks, and improve mental health during pregnancy. Additionally, the results of this study highlight the need for targeted interventions aimed at reducing food insecurity and promoting mental health during pregnancy, particularly among socially vulnerable populations. Furthermore, they reinforce the importance of expanding access to home-visiting programs as an effective strategy to improve maternal mental health and well-being, while fostering healthier prenatal environments for both mothers and their children.
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Depresión , Inseguridad Alimentaria , Visita Domiciliaria , Humanos , Femenino , Embarazo , Depresión/epidemiología , Brasil/epidemiología , Adulto , Estudios Transversales , Factores Socioeconómicos , Atención Prenatal , Adulto Joven , Mujeres Embarazadas/psicología , Encuestas y Cuestionarios , Responsabilidad Parental/psicologíaRESUMEN
This study investigated the association between head of household disability and the severity of food insecurity in Colombian households during 2017. A secondary data analysis was conducted based on 2017 Colombian National Quality of Life Survey (ECV 2017). As the independent variable, disability was assessed using questions from the Washington group, whereas the dependent variable - food insecurity - was measured by the Latin American and Caribbean Food Security Scale (ELCSA). Sociodemographic confounding variables and variables related to food insecurity were included. Association was analyzed by ordinal logistic regression, and the odds ratio (OR) was estimated with its 95% confidence intervals (95%CI). All calculations considered the complex sampling of ECV 2017. Data from 8,488 heads of household were included. A total of 9.2% of the participants had some type of disability and 41.8% reported some level of household food insecurity. Households with a head of household with some disability were 30% more likely to develop severe food insecurity compared with households with a head of household without disabilities (OR = 1.30; 95%CI: 1.07-1.59), adjusted for multiple confounding variables. In 2017, Colombian households with heads of household with disabilities were more likely to develop severe food insecurity. It is essential to implement nutritional assistance programs aimed at vulnerable populations, such as people with disabilities.
El objetivo de este estudio fue estimar la asociación entre la discapacidad del jefe de familia y la severidad de la inseguridad alimentaria de su hogar, en pobladores de Colombia, durante el 2017. Se realizó un análisis secundario de los datos de la Encuesta Nacional de Calidad de Vida del 2017 (ECV 2017) de Colombia. La variable independiente fue la discapacidad evaluada con las preguntas del grupo de Washington y la variable dependiente fue la inseguridad alimentaria medida con la Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA). Se incluyeron variables de confusión sociodemográficas y relacionadas con la inseguridad alimentaria. Para demostrar la asociación se utilizó la regresión logística ordinal y se estimaron odds ratio (OR) con sus intervalos de 95% de confianza (IC95%). En todos los cálculos se consideró el muestreo complejo de la ECV 2017. Se incluyeron los datos de 8.488 jefes de familia. El 9,2% admitió que tenía alguna discapacidad y el 41,8% refirió que su hogar presentaba algún nivel de inseguridad alimentaria. Los hogares con un jefe de familia con discapacidad tuvieron 30% más probabilidad de mayor severidad de inseguridad alimentaria, en comparación con los hogares con un jefe de familia sin discapacidad (OR = 1,30; IC95%: 1,07-1,59), ajustado por múltiples variables de confusión. En conclusión, en Colombia, durante el 2017, la discapacidad de los jefes de familia aumentó la probabilidad de mayor severidad de la inseguridad alimentaria en sus hogares. Es necesaria la creación de programas de asistencia nutricional enfocados en las poblaciones vulnerables como las personas con discapacidad.
Este estudo busca determinar a associação entre a deficiência do chefe de família e a gravidade da insegurança alimentar em domicílios colombianos durante 2017. Foi realizada uma análise secundária dos dados da Pesquisa Nacional de Qualidade de Vida de 2017 (ECV 2017) da Colômbia. A variável independente foi a deficiência, avaliada por meio de perguntas do grupo de Washington, e a variável dependente foi a insegurança alimentar, medida pela Escala de Segurança Alimentar da América Latina e do Caribe (ELCSA). Foram incluídas variáveis de confusão sociodemográficas e relacionadas à insegurança alimentar. A regressão logística ordinal foi utilizada para analisar a associação, e a razão de probabilidades (OR) foi estimada com seus intervalos de 95% de confiança (IC95%). Em todos os cálculos foi considerada a amostragem complexa da ECV 2017. Foram incluídos dados de 8.488 chefes de família. Houve 9,2% dos participantes com algum tipo de deficiência e 41,8% relataram que seu domicílio apresentava algum nível de insegurança alimentar. Os domicílios com chefe de família com deficiência tiveram 30% mais chances de desenvolver insegurança alimentar mais grave, em comparação com as famílias com chefe de família sem deficiência (OR = 1,30; IC95%: 1,07-1,59), ajustado para múltiplas variáveis de confusão. Em 2017, os domicílios colombianos com chefes de família com deficiência tiveram maior probabilidade de desenvolver insegurança alimentar grave. É necessária a implementação de programas de assistência nutricional voltados para populações vulneráveis como as pessoas com deficiência.
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Personas con Discapacidad , Composición Familiar , Inseguridad Alimentaria , Factores Socioeconómicos , Humanos , Colombia , Personas con Discapacidad/estadística & datos numéricos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Adulto Joven , Calidad de Vida , Adolescente , Encuestas y Cuestionarios , Estudios Transversales , Anciano , Abastecimiento de Alimentos/estadística & datos numéricosRESUMEN
OBJECTIVE: To analyze the association of food insecurity (FI) with chronic noncommunicable diseases (NCDs) in the Brazilian context. METHODS: The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO). The searches were conducted in LILACS and PubMed databases (September/2022). Observational studies carried out in the Brazilian population published since 2003 were included, in which: (1) the association of FI with NCDs was analyzed; and (2) the Brazilian Food Insecurity Scale was used. Studies on pregnant women and those that associated FI with cancer, sexually transmitted infections, and musculoskeletal and respiratory diseases were excluded. The studies were subjected to methodological quality assessment. RESULTS: A total of 27 cross-sectional studies were included; nine used secondary data from national surveys, and the others used primary data. An association between FI and overweight and obesity in different age groups was verified in the studies. CONCLUSION: The included articles did not produce evidence on other NCDs of interest to health in Brazil such as diabetes and high blood pressure. However, they corroborate the already-known relationship between obesity and FI. Studies on the topic, with a longitudinal design, should be encouraged.
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Inseguridad Alimentaria , Enfermedades no Transmisibles , Humanos , Brasil/epidemiología , Enfermedades no Transmisibles/epidemiología , Enfermedad Crónica/epidemiología , Obesidad/epidemiología , Femenino , Estudios Transversales , Factores de Riesgo , MasculinoRESUMEN
BACKGROUND: Food insecurity and HIV-related stigma negatively affect HIV outcomes. Few studies have examined how food security interventions affect HIV-related stigma and social support. SETTING: Two HIV clinics in the Dominican Republic. METHODS: A pilot cluster randomized controlled trial of an urban gardens and peer nutritional counseling intervention was conducted to examine outcomes of HIV-related stigmas and social support. Adult patients (≥18 years of age) with moderate or severe household food insecurity and evidence of suboptimal ART adherence and/or a detectable viral load were enrolled; standard measures of internalized and experienced stigmas and social support were collected at baseline and at 6 and 12 months. Intervention clinic participants received training and materials from agronomists for a home garden, 3-4 sessions of nutritional counseling from the clinic's peer counselor, and a garden produce cooking workshop facilitated by professional nutritionists. RESULTS: Of 109 study participants (46 intervention and 63 control), 103 (94%) completed 12-month follow-up. Difference-in-differences multivariate longitudinal linear regressions adjusting for sociodemographic factors found that intervention participants had reduced internalized stigma by 3.04 points (scale 0-32) at 12 months (P = 0.002); reduced probability of experiencing HIV-related stigma or discrimination in the past 6 months (20 percentage points at 6 months, P = 0.05 and 25 percentage points at 12 months, P = 0.02); and modestly improved social support at 12 months (1.85 points on 30-pt scale, P = 0.093). CONCLUSION: A fully powered, larger trial is needed to establish the efficacy of the intervention and assess pathways by which the intervention may improve HIV stigma and social support.
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Consejo , Inseguridad Alimentaria , Infecciones por VIH , Estigma Social , Apoyo Social , Humanos , Infecciones por VIH/psicología , Infecciones por VIH/prevención & control , Masculino , Femenino , República Dominicana , Adulto , Persona de Mediana Edad , Jardines , Grupo Paritario , Población Urbana , Proyectos PilotoRESUMEN
Background: Household food insecurity (HFI) increased in Latin America by 9% between 2019 and 2020. Scant evidence shows who was unable to recover from the COVID-19 pandemic. Our aim was to use a Machine Learning (ML) approach to identify consistent and influential predictors of persistent moderate or severe HFI over 2 years. Methods: We use a three-wave longitudinal telephone survey with a probabilistic sample representative of the Mexican population. With a response rate of 51.3 and 60.8% for the second and third waves, the final sample size consisted of 1,074 individuals. The primary outcome was persistent HFI, i.e., respondents who reported moderate or severe HFI in 2021 and 2022. Twelve income-related predictors were measured in 2020, including baseline HFI. We employed 6 supervised ML algorithms to cross-validate findings in models, examined its precision with 4 standard performance indicators to assess precision, and used SHAP values (Shapley Additive exPlanations) to identify influential predictors in each model. Results: Prevalence of persistent moderate/severe HFI in 2021 and 2022 was 8.8%. Models with only a HFI 2020 baseline measure were used as a reference for comparisons; they had an accuracy of 0.79, a Cohen's Kappa of 0.57, a sensitivity of 0.68, and a specificity of 0.88. When HFI was substituted by the suite of socioeconomic indicators, accuracy ranged from 0.70 to 0.84, Cohen's Kappa from 0.40 to 0.67, sensitivity from 0.86 to 0.90, and specificity from 0.75 to 0.82. The best performing models included baseline HFI and socioeconomic indicators; they had an accuracy between 0.81 and 0.92, a Cohen's Kappa between 0.61 and 0.85, a sensitivity from 0.74 to 0.95, and a specificity from 0.85 to 0.92. Influential and consistent predictors across the algorithms were baseline HFI, socioeconomic status (SES), adoption of financial coping strategies, and receiving government support. Discussion: Persistent HFI can be a relevant indicator to identify households that are less responsive to food security policies. These households should be prioritized for innovative government support and monitored to assess changes. Forecasting systems of HFI can be improved with longitudinal designs including baseline measures of HFI and socioeconomic predictors.
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COVID-19 , Inseguridad Alimentaria , Humanos , COVID-19/epidemiología , México/epidemiología , Estudios Longitudinales , Femenino , Masculino , Adulto , Persona de Mediana Edad , Aprendizaje Automático , Composición Familiar , Encuestas y Cuestionarios , Factores Socioeconómicos , Adulto Joven , SARS-CoV-2 , Adolescente , Pandemias , Abastecimiento de Alimentos/estadística & datos numéricosRESUMEN
OBJECTIVES: Short sleep duration has been associated with an increased risk of childhood overweight and obesity in high-income countries, but data from low- and middle-income countries are scarce. Independently, short sleep and food insecurity may increase the risk of overweight/obesity, but it is unknown whether they concurrently affect it. METHODS: We included 3350 adolescents aged 10-14 from the 2012 and 2016 Mexican National Health and Nutrition Survey. Short sleep was categorized as less than 9 hours for ages 10-12 and less than 8 hours for ages 13-14. Overweight/obesity was assessed via anthropometry. Modified Poisson regression models assessed prevalence ratios between short sleep and overweight, examining effect modification by food security status. RESULTS: 86% met sleep duration recommendations. Short sleep was associated with an increased prevalence of overweight/obesity (prevalence ratio, 1.16; 95% CI, 1.05, 1.31). Multiplicative interaction was found between low and very low food security status and short sleep: adolescents in low food secure households with short sleep had 1.38 (95% CI: 1.10, 1.75) times the prevalence of overweight/obesity compared to adequate sleepers. Very low food secure households had 1.16 (95% CI: 1.14, 1.31) times the prevalence compared to adequate sleepers. This association was not significant in fully or marginally food secure households. CONCLUSIONS: Short sleep is associated with an increased obesity risk among Mexican adolescents 10-14years, particularly in the context of low and very low food security. These findings highlight the importance of addressing both sleep hygiene and food security in strategies to reduce obesity risk.
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Inseguridad Alimentaria , Sobrepeso , Obesidad Infantil , Sueño , Humanos , Adolescente , Niño , Masculino , Femenino , México/epidemiología , Obesidad Infantil/epidemiología , Sobrepeso/epidemiología , Factores de Tiempo , Encuestas Nutricionales , Prevalencia , Factores de Riesgo , Duración del SueñoRESUMEN
BACKGROUND: The food choices of migrants are frequently limited by lack of access to sufficient and adequate food. Food insecurity (FI) during adolescence has potential negative health consequences, however the experiences of FI of adolescent in-transit migrants have seldom been reported. OBJECTIVE: To explore the experiences of FI of adolescent in-transit migrants and their ways of coping with it. METHODS: Qualitative study, with 19 semi-structured interviews with adolescents (ages 13-19 years), in shelters for migrants in Mexico in 2022-2023. We followed a reflexive thematic analysis strategy. RESULTS: Most participants had experienced FI during the journey, and responded by limiting intake, choosing food according to price, seeking temporary work or asking for food or money in the streets. We defined "solidarity through food" as a central theme that summarized participants' experiences of sharing food with other migrants, as givers or recipients. Solidarity through food was a response to FI, benefitting the more disadvantaged (e.g. young children, those who had been robbed). Despite their young age, interviewees took part in this, giving their food to others and restricting their intake to prioritize younger siblings. DISCUSSION/CONCLUSIONS: Solidarity through food was a form of generalized reciprocity, enacted not only among family members or friends, but extended to other migrants sharing the route. In further studies, it will be important to explore the role and nuances of food sharing as a practice of social exchange of responsibility and care, on adolescent migrants' health, and in their psychological and relational development into adulthood.
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Inseguridad Alimentaria , Investigación Cualitativa , Migrantes , Humanos , Adolescente , México , Femenino , Masculino , Migrantes/psicología , Adulto Joven , América Central/etnología , Adaptación Psicológica , Abastecimiento de AlimentosRESUMEN
Although food insecurity presents a decreasing trend worldwide, some regions recently observed an increase in hunger levels. Such was the case in Brazil between 2014 and 2018, during and after the great Brazilian recession, and between 2020 and 2021, during the COVID-19 pandemic. This paper describes the evolution of food insecurity in Brazil between 2004 and 2022 using Brazilian National Household Sample Survey (PNAD), Brazilian Household Budget Survey (POF) and Continuous PNAD. Households were classified in 20 types of arrangements, and the most vulnerable living arrangements between 2004 and 2018 were identified by multinomial logistic models. Overall, households headed by women (single blacks, whites or in couples) with or without children were the most prone to food insecurity. As for the evolution of food insecurity in Brazil between 2018 and 2022, logistic models were applied to estimate moderate and severe food insecurity levels among the 20 household types. Additionally, effects of the emergency aid and idiosyncrasies of the COVID-19 pandemic were estimated.
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COVID-19 , Composición Familiar , Inseguridad Alimentaria , Factores Socioeconómicos , Humanos , Brasil/epidemiología , COVID-19/epidemiología , Femenino , Masculino , Adulto , SARS-CoV-2 , Características de la Residencia , Modelos Logísticos , Pandemias , Abastecimiento de Alimentos/estadística & datos numéricos , Persona de Mediana EdadRESUMEN
This study aimed to evaluate the association between employment status and mental health, considering food insecurity as a mediator of this relation. A cross-sectional population-based study was conducted with adults (≥ 18 and < 60 years) during the COVID-19 outbreak in two cities from Southern Brazil. Employment status was categorized into working, not working, and lost job. The mental health outcomes evaluated were depressive symptoms, perceived stress, and sadness. Food insecurity was identified by the short-form version of the Brazilian Food Insecurity Scale. Adjusted analyses using Poisson regression were performed to assess the association between employment status and mental health. Mediation analysis was performed to investigate the direct and indirect effects of employment status on mental health outcomes. In total, 1,492 adults were analyzed. The not working status was associated with 53% and 74% higher odds of perceived stress and of sadness, respectively. Being dismissed during the pandemic increased the odds of depressive symptoms, perceived stress, and sadness by 68%, 123%, and 128%, respectively. Mediation analyses showed that food insecurity was an important mediator of the association between employment status and depressive symptoms and sadness, but not of perceived stress. The complexity of these results highlights economic and nutritional aspects involved in mental health outcomes.
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COVID-19 , Depresión , Empleo , Inseguridad Alimentaria , Salud Mental , Pandemias , Estrés Psicológico , Humanos , COVID-19/psicología , COVID-19/epidemiología , Brasil/epidemiología , Adulto , Femenino , Estudios Transversales , Masculino , Depresión/epidemiología , Depresión/psicología , Persona de Mediana Edad , Salud Mental/estadística & datos numéricos , Adulto Joven , Empleo/psicología , Empleo/estadística & datos numéricos , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología , Factores Socioeconómicos , SARS-CoV-2 , Desempleo/psicología , Desempleo/estadística & datos numéricos , AdolescenteRESUMEN
INTRODUCTION: Food insecurity (FI) experienced during pregnancy represents a relevant public health problem, as it negatively affects maternal and child health. OBJECTIVE: To investigate the prevalence of FI among pregnant women during the COVID-19 pandemic and determine associated factors. METHODS: A cross-sectional study was carried out in the period from 2021 to 2022, with a representative sample of 423 women resulting from a sample calculation based on the average (2912 births) that occurred in the years 2016 to 2020 in the only maternity hospital in the municipality. After analyzing the medical records, interviews were carried out with the postpartum women using a standardized questionnaire and the Brazilian Food Insecurity Scale. Poisson regression with robust variance was used to calculate prevalence ratios and 95% confidence intervals to measure associations. RESULTS: FI was observed in 57.0% of cases and was associated with age under 20 years (PR = 1.52; 95% CI 1.29; 1.79), receipt of government assistance (PR = 1.31; 95% CI 1.10; 1.55), loss of family employment (PR = 1.40; 95% CI 1.20; 1.64), greater number of residents (PR = 1.17; 95% CI 1.00; 1.37), and prenatal care in a public institution (PR = 1.53; 95% CI 1.04; 2.26). CONCLUSION: There was a high prevalence of FI cases, associated with socioeconomic, demographic, and prenatal care characteristics during the COVID-19 pandemic.
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COVID-19 , Inseguridad Alimentaria , Humanos , Femenino , COVID-19/epidemiología , Brasil/epidemiología , Embarazo , Adulto , Estudios Transversales , Adulto Joven , Mujeres Embarazadas/psicología , Prevalencia , SARS-CoV-2 , Ciudades/epidemiología , Adolescente , PandemiasRESUMEN
PURPOSE: The current research aimed to investigate the connection between food insecurity and sleep issues among Spanish adolescents aged from 12 to 17 years from the Valle de Ricote (Region of Murcia, Spain). METHODS: Data from the Eating Healthy and Daily Life Activities Study, which included a sample of 836 adolescents (55.3% girls), were analyzed. Food insecurity was evaluated using the Child Food Security Survey Module in Spanish (CFSSM-S), while sleep-related problems were evaluated using the Bedtime problems, Excessive daytime sleepiness, Awakenings during the night, Regularity and duration of sleep, and Sleep-disordered breathing (BEARS) sleep screening tool. Generalized linear models were employed to explore the association between food insecurity and sleep-related issues. RESULTS: Compared with their counterparts with food security, adolescents with food insecurity had greater probabilities of bedtime problems (24.1%, 95% confidence interval (CI) 16.9% to 33.0%, p = 0.003), excessive daytime sleepiness (36.4%, 95% CI 27.5% to 46.3%, p < 0.001), awakenings during the night (16.7%, 95% CI 10.8% to 25.1%, p = 0.004), and any sleep-related problems (68.1%, 95% CI 57.5% to 77.1%, p < 0.001). CONCLUSIONS: This study suggests that food insecurity is related to greater sleep-related problems among adolescents. Implementing strategies to mitigate food insecurity may contribute to improved sleep health among adolescents, highlighting the importance of integrated public health interventions.
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Inseguridad Alimentaria , Trastornos del Sueño-Vigilia , Humanos , Adolescente , Femenino , Masculino , España/epidemiología , Niño , Trastornos del Sueño-Vigilia/epidemiología , Sueño , Estudios Transversales , Encuestas y CuestionariosRESUMEN
AIM: To ascertain whether maternal food insecurity was associated with low birth weight of their babies. METHODS: Systematic review conducted following the items of the Preferred Reporting Items for Systematic Reviews-PRISMA, and recorded in PROSPERO. The descriptors food security, low birth weight and infant low birth weight were combined in the electronic databases: Scopus, PubMed, Cochrane Library, Latin American and Caribbean Health Sciences Literature and Google Scholar, independently by two researchers, between October 2022 and September 2023. The meta-analysis of the association between food insecurity and low birth weight was conducted. The included studies underwent quality and risk of bias assessment. RESULTS: The initial search resulted in 631 records, 12 of which met the inclusion criteria and were selected for this study. Mothers experiencing food insecurity presented 3.09 more risk of having low birth weight babies when compared to those in food security situations. CONCLUSION: Evaluating and monitoring the food and nutritional situation of pregnant women is necessary, with emphasis on the importance of prenatal care, to direct public policies that ensure food security and strengthen adequate nutritional conditions for pregnant women and their babies.
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Inseguridad Alimentaria , Recién Nacido de Bajo Peso , Humanos , Recién Nacido , Femenino , Embarazo , Factores de RiesgoRESUMEN
BACKGROUND: Tuberculosis is a leading cause of death worldwide, and food insecurity is known to negatively influence health outcomes through multiple pathways. Few studies have interrogated the relationship between food insecurity and tuberculosis outcomes, particularly independent of nutrition. METHODS: We conducted a prospective cohort study of adults initiating first-line treatment for clinically suspected or microbiologically confirmed drug-sensitive tuberculosis at a rural referral center in Haiti. We administered a baseline questionnaire, collected clinical data, and analyzed laboratory samples. We used logistic regression models to estimate the relationship between household food insecurity (Household Hunger Scale) and treatment failure or death. We accounted for exclusion of patients lost to follow-up using inverse probability of censoring weighting and adjusted for measured confounders and nutritional status using inverse probability of treatment weighting. RESULTS: We enrolled 257 participants (37% female) between May 2020 and March 2023 with a median age (interquartile range) of 35 (25-45) years. Of these, 105 (41%) had no hunger in the household, 104 (40%) had moderate hunger in the household, and 48 (19%) had severe hunger in the household. Eleven participants (4%) died, and 6 (3%) had treatment failure. After adjustment, food insecurity was significantly associated with subsequent treatment failure or death (odds ratio 5.78 [95% confidence interval, 1.20-27.8]; P = .03). CONCLUSIONS: Household food insecurity at tuberculosis treatment initiation was significantly associated with death or treatment failure after accounting for loss to follow-up, measured confounders, and nutritional status. In addition to the known importance of undernutrition, our findings indicate that food insecurity independently affects tuberculosis treatment outcomes in Haiti.
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Antituberculosos , Inseguridad Alimentaria , Población Rural , Tuberculosis , Humanos , Haití/epidemiología , Femenino , Masculino , Estudios Prospectivos , Adulto , Población Rural/estadística & datos numéricos , Persona de Mediana Edad , Tuberculosis/tratamiento farmacológico , Tuberculosis/epidemiología , Antituberculosos/uso terapéutico , Resultado del Tratamiento , Estado Nutricional , Insuficiencia del TratamientoRESUMEN
BACKGROUND: The COVID-19 pandemic has not only caused tremendous loss of life and health but has also greatly disrupted the world economy. The impact of this disruption has been especially harsh in urban settings of developing countries. We estimated the impact of the pandemic on the occurrence of food insecurity in a cohort of women living in Mexico City, and the socioeconomic characteristics associated with food insecurity severity. METHODS: We analyzed data longitudinally from 685 women in the Mexico City-based ELEMENT cohort. Food insecurity at the household level was gathered using the Latin American and Caribbean Food Security Scale and measured in-person during 2015 to 2019 before the pandemic and by telephone during 2020-2021, in the midst of the pandemic. Fluctuations in the average of food insecurity as a function of calendar time were modeled using kernel-weighted local polynomial regression. Fixed and random-effects ordinal logistic regression models of food insecurity were fitted, with timing of data collection (pre-pandemic vs. during pandemic) as the main predictor. RESULTS: Food insecurity (at any level) increased from 41.6% during the pre-pandemic period to 53.8% in the pandemic stage. This increase was higher in the combined severe-moderate food insecurity levels: from 1.6% pre-pandemic to 16.8% during the pandemic. The odds of severe food insecurity were 3.4 times higher during the pandemic relative to pre-pandemic levels (p<0.01). Socioeconomic status quintile (Q) was significantly related to food insecurity (Q2 OR = 0.35 p<0.1, Q3 OR = 0.48 p = 0.014, Q4 OR = 0.24 p<0.01, and Q5 OR = 0.17 p<0.01), as well as lack of access to social security (OR = 1.69, p = 0.01), and schooling (OR = 0.37, p<0.01). CONCLUSIONS: Food insecurity increased in Mexico City households in the ELEMENT cohort as a result of the COVID-19 pandemic. These results contribute to the body of evidence suggesting that governments should implement well-designed, focalized programs in the context of economic crisis such as the one caused by COVID-19 to prevent families from the expected adverse health and well-being consequences associated to food insecurity, especially for the most vulnerable.
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COVID-19 , Inseguridad Alimentaria , Pandemias , Humanos , COVID-19/epidemiología , México/epidemiología , Femenino , Adulto , Factores Socioeconómicos , Persona de Mediana Edad , SARS-CoV-2/aislamiento & purificación , Estudios de Cohortes , Abastecimiento de Alimentos/estadística & datos numéricos , Estudios LongitudinalesRESUMEN
In the past five decades, global food systems have undergone a notable transition, moving from predominantly rural settings to increasingly urban and industrialized environments, largely driven by processes of globalization and supply chain integration. However, this evolution has not adequately addressed equitable access to nutritious diets and food environments, resulting in adverse health outcomes. This study delves into the spatial and non-spatial barriers that impede the adoption of healthy diets in the Noreste of Mexico, particularly focusing on the challenges associated with accessing and cultivating plant-based foods. Through an examination of suitable areas for urban agriculture and an exploration of the socio-cultural factors influencing the adoption of plant-based diets, the research focuses on interventions aimed at promoting healthier and more sustainable eating practices in Monterrey. The findings of the study reveal significant disparities in food access across the Monterrey metropolitan area, with central urban zones exhibiting superior access to fresh foods compared to suburban and peripheral regions. This inequality disproportionately affects marginalized areas characterized by higher poverty rates, exacerbating issues of food insecurity. Nevertheless, traditional dietary practices could offer promising avenues for creating culturally significant and healthier dietary transitions, even amidst the ongoing process of urbanization.
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Dieta Saludable , Abastecimiento de Alimentos , México , Humanos , Factores Socioeconómicos , Agricultura , Población Urbana , Inseguridad Alimentaria , Urbanización , Población RuralRESUMEN
INTRODUCCIÓN: La inseguridad alimentaria es una prioridad mundial que, según se ha constatado, repercute negativamente en la salud mental, aumentando los riesgos de padecer trastornos mentales comunes y enfermedades mentales graves. Los migrantes internacionales pueden enfrentarse a la inseguridad alimentaria a lo largo del ciclo migratorio, debido a una serie de factores de riesgo como las precarias condiciones de tránsito, la precariedad laboral, la presión financiera, la discriminación y la falta de disponibilidad y acceso a alimentos culturalmente relevantes, entre otros. Aunque existen varias revisiones sobre migración, inseguridad alimentaria y salud en general, no se ha realizado ninguna revisión de alcance sobre la inseguridad alimentaria entre los migrantes internacionales con especial atención a la salud mental. OBJETIVO: Investigar la evidencia sobre inseguridad alimentaria y salud mental entre los migrantes internacionales. MÉTODOS: Se realizará una búsqueda de literatura científica en inglés, español, francés, italiano y portugués publicada desde 2013 en las bases de datos Web of Science, PubMed, Medline, APA PsycArticles, Cinahl, y ASSIA, y de literatura gris en Google Scholar. Dos autores revisarán de forma independiente los títulos, resúmenes y textos completos, antes de extraer los datos de las publicaciones que cumplan los criterios de elegibilidad. Los datos extraídos se mapearán descriptivamente según categorías temáticas generales emergentes. RESULTADOS: esperados La revisión contribuirá a identificar lo que se sabe sobre la migración internacional, la inseguridad alimentaria y la salud mental, las lagunas en la literatura sobre el tema, las oportunidades para subtemas específicos de investigación, y explorar cómo la inseguridad alimentaria y la salud mental pueden estar vinculadas en la literatura existente.
INTRODUCTION: Food insecurity is a global priority that has been found to negatively impact mental health, increasing the risk of mental disorders and severe mental illness. International migrants may face food insecurity throughout their migratory cycle due to a range of risk factors, such as poor transit conditions, precarious employment, financial pressure, discrimination, and lack of availability and access to culturally relevant food, among others. Although there are multiple reviews on migration, food insecurity, and health in general, no scoping review has been conducted on food insecurity among international migrants focusing on mental health. OBJECTIVE: To investigate the available evidence on food insecurity and mental health among international migrants. METHODS: A search of scientific literature in English, Spanish, French, Italian, and Portuguese published since 2013 will be performed in the Web of Science, PubMed, Medline, APA PsycArticles, Cinahl, and ASSIA databases, including grey literature available in Google Scholar. Two authors will independently review titles, abstracts, and full texts before extracting data from publications complying with the eligibility criteria. Extracted data will be descriptively mapped according to emerging thematic categories. EXPECTED RESULTS: The review will contribute to identifying what is known about international migration, food insecurity, and mental health, gaps in the literature, opportunities for specific research subtopics, and how food insecurity and mental health can be linked in the existing literature.
Asunto(s)
Humanos , Migrantes/psicología , Migrantes/estadística & datos numéricos , Salud Mental , Inseguridad Alimentaria , Trastornos Mentales/epidemiología , Proyectos de Investigación , Literatura de Revisión como Asunto , Factores de Riesgo , Abastecimiento de AlimentosRESUMEN
This study analyzed food insecurity and associated factors in the urban area of a municipality in the Amazon River basin, Western Amazon. This is a cross-sectional population-based study conducted from August to November 2021 with 983 households selected by stratified probability sampling. A multinomial logistic regression model was used, adopting the following criteria: p-value < 20% in the bivariate analysis and p-value < 5% for the multivariate adjustment. The results of the analyses were described as odds ratio (OR) and 95% confidence interval (95%CI). The following variables were significantly associated with mild or moderate food insecurity: household water insecurity; number of residents ≥ 5 in the household; belonging to socioeconomic class D or E; having a father, mother or another as the head of the family; and having any resident as a beneficiary of the Brazilian Income Transfer Program. The analysis model for severe food insecurity showed that living with household water insecurity; belonging to socioeconomic class D or E; having a father, mother or another as the head of the family; age of the head of the family < 55 years; and family income lower that two minimum wages increased the chances of severe food insecurity when compared to those with food security. In conclusion, this study found a high prevalence of food insecurity in the Municipality of Itapiranga, State of Amazonas, North Region of Brazil, associated with social and economic vulnerability, lack of public services, and household water insecurity.
Este estudo analisa a insegurança alimentar e os fatores a ela associados na área urbana de um município na bacia hidrográfica do Rio Amazonas, Amazônia Ocidental. Trata-se de pesquisa transversal, de base populacional, realizada de agosto a novembro de 2021, com 983 domicílios selecionados por amostragem probabilística estratificada. Empregou-se o modelo de regressão logística multinomial, adotando-se os seguintes critérios: valor de p < 20% na análise bivariada e valor de p < 5% para o ajuste multivariado. Os resultados das análises foram descritos como odds ratios (OR) e intervalo de 95% de confiança (IC95%). Foram significantemente associadas à insegurança alimentar leve ou moderada as seguintes variáveis: insegurança hídrica domiciliar, número de moradores ≥ 5 no domicílio, pertencer à classe socioeconômica D ou E, ter pai, mãe ou outro, como chefe da família e ter algum morador beneficiário do Programa Bolsa Família. No modelo de análise para a insegurança alimentar grave constatou-se que viver em insegurança hídrica domiciliar, pertencer à classe socioeconômica D ou E, ter pai, mãe ou outro chefe da família, e tendo este menos que 55 anos, e renda familiar menor que dois salários mínimos aumentaram as chances de insegurança alimentar grave, comparativamente àqueles em segurança alimentar. Em conclusão, verificou-se alta prevalência de insegurança alimentar no Município de Itapiranga, Amazonas, Região Norte do Brasil, associada à situação de vulnerabilidade social e econômica, à falta de serviços públicos e à insegurança hídrica domiciliar.
Este estudio analiza la inseguridad alimentaria y los factores asociados, en el área urbana de un municipio de la cuenca hidrográfica del río Amazonas, Amazonia occidental. Se trata de una encuesta transversal, de base poblacional, realizada en el período de agosto a noviembre del 2021, con 983 hogares seleccionados mediante muestreo probabilístico estratificado. Se utilizó el modelo de regresión logística multinomial, adoptando los siguientes criterios: valor de p < 20% en el análisis bivariado y valor de p < 5% para el ajuste multivariado. Los resultados de los análisis se describieron como odds ratios (OR) e intervalo de 95% de confianza (IC95%). Las siguientes variables se asociaron significativamente con la inseguridad alimentaria leve o moderada: inseguridad hídrica en el hogar, número de residentes ≥ 5 en el hogar, pertenecer a la clase socioeconómica "D" o "E", tener padre, madre u otra persona como cabeza de familia y tener a algún residente como beneficiario del Programa Bolsa Familia. En el modelo de análisis para la inseguridad alimentaria severa se encontró que vivir en hogar con inseguridad hídrica, pertenecer a la clase socioeconómica D o E, tener padre, madre u otra persona como cabeza de familia, edad del jefe de familia < 55 años, y un ingreso familiar más bajo que dos salarios mínimos aumentó las probabilidades de sufrir inseguridad alimentaria grave, en comparación con aquellos en situación de seguridad alimentaria. En conclusión, se constató una alta prevalencia de inseguridad alimentaria en el Municipio de Itapiranga, en el interior del Amazonas, Región Norte de Brasil, asociada a la situación de vulnerabilidad social y económica, a la falta de servicios públicos y a la inseguridad hídrica de los hogares.
Asunto(s)
Composición Familiar , Inseguridad Alimentaria , Factores Socioeconómicos , Humanos , Brasil/epidemiología , Estudios Transversales , Femenino , Masculino , Adulto , Persona de Mediana Edad , Inseguridad Hídrica , Población Urbana/estadística & datos numéricos , Adulto Joven , Ríos , Abastecimiento de Alimentos/estadística & datos numéricosRESUMEN
Introduction: Food insecurity is a global priority that has been found to negatively impact mental health, increasing the risk of mental disorders and severe mental illness. International migrants may face food insecurity throughout their migratory cycle due to a range of risk factors, such as poor transit conditions, precarious employment, financial pressure, discrimination, and lack of availability and access to culturally relevant food, among others. Although there are multiple reviews on migration, food insecurity, and health in general, no scoping review has been conducted on food insecurity among international migrants focusing on mental health. Objective: To investigate the available evidence on food insecurity and mental health among international migrants. Methods: A search of scientific literature in English, Spanish, French, Italian, and Portuguese published since 2013 will be performed in the Web of Science, PubMed, Medline, APA PsycArticles, Cinahl, and ASSIA databases, including grey literature available in Google Scholar. Two authors will independently review titles, abstracts, and full texts before extracting data from publications complying with the eligibility criteria. Extracted data will be descriptively mapped according to emerging thematic categories. Expected results: The review will contribute to identifying what is known about international migration, food insecurity, and mental health, gaps in the literature, opportunities for specific research subtopics, and how food insecurity and mental health can be linked in the existing literature.
Introducción: La inseguridad alimentaria es una prioridad mundial que, según se ha constatado, repercute negativamente en la salud mental, aumentando los riesgos de padecer trastornos mentales comunes y enfermedades mentales graves. Los migrantes internacionales pueden enfrentarse a la inseguridad alimentaria a lo largo del ciclo migratorio, debido a una serie de factores de riesgo como las precarias condiciones de tránsito, la precariedad laboral, la presión financiera, la discriminación y la falta de disponibilidad y acceso a alimentos culturalmente relevantes, entre otros. Aunque existen varias revisiones sobre migración, inseguridad alimentaria y salud en general, no se ha realizado ninguna revisión de alcance sobre la inseguridad alimentaria entre los migrantes internacionales con especial atención a la salud mental. Objetivo: Investigar la evidencia sobre inseguridad alimentaria y salud mental entre los migrantes internacionales. Métodos: Se realizará una búsqueda de literatura científica en inglés, español, francés, italiano y portugués publicada desde 2013 en las bases de datos Web of Science, PubMed, Medline, APA PsycArticles, Cinahl, y ASSIA, y de literatura gris en Google Scholar. Dos autores revisarán de forma independiente los títulos, resúmenes y textos completos, antes de extraer los datos de las publicaciones que cumplan los criterios de elegibilidad. Los datos extraídos se mapearán descriptivamente según categorías temáticas generales emergentes. Resultados esperados: La revisión contribuirá a identificar lo que se sabe sobre la migración internacional, la inseguridad alimentaria y la salud mental, las lagunas en la literatura sobre el tema, las oportunidades para subtemas específicos de investigación, y explorar cómo la inseguridad alimentaria y la salud mental pueden estar vinculadas en la literatura existente.