EC References
EC References
EC References
Contextualization of Findings
1.1 National Data:
- Please find and include data from national surveys or studies that address dietary habits
in Lahore or Pakistan as a whole.
With urbanization, the intake of fat and sugar increased steadily. The intake of carbohydrate, fibre,
riboflavin, and vitamin E decreased with urbanization. The intake of vitamin C, vitamin B12, and
folates was higher among group 4, 5, and 6 than other groups. Due to various factors, in terms of
micronutrient density, diets of various urban groups could have more differences than similarities.
1. https://www.jstor.org/stable/23498807
most of the female were involved in unhealthy dietary habits concerning skipping meals and
having fast food, whereas there is no difference found between genders in their physical activity.
1. https://dietfactor.com.pk/index.php/df/article/view/129
Only one in seven children (14.2%) aged 6–23 months receive a meal with minimum dietary
diversity, with at least four diff erent food groups. One in four children (18.2%) receives the
minimum number of meals a day. Complementary foods that meet the requirements of a
minimum acceptable diet to ensure optimal growth and development for children aged 6–23
months are provided to less than one in 20 children (3.6%). More children in urban areas receive
adequate complementary foods than their peers in rural areas, but rates are critically low in both
localities
1.2 References:
- Aim to gather at least 2 references to support each section in the results (e.g., one
reference for meal frequency, another for meat consumption, etc.).
More than half of households (63.1%) are “food secure” on the FIES measure, however over
third (36.9%) remain food insecure. A larger percentage of households are food secure in GB
(75.6%) and KP (70.9%) and experience less severe food insecurity than in Balochistan (50.3%)
and KP-NMD (54.6%)
14.2% minimum dietry diversity
18.2% minimum meal frequency
3.6% minimum acceptable diet
1. https://www.unicef.org/pakistan/media/1951/file/Final%20Key%20Findings%20Report
%202019.pdf
According to the National Nutrition Survey 2018 – a copy of which is available with The
Express Tribune – poverty keeps more than 50 per cent of Pakistani families from having two
meals a day, leading to severe dietary deficiencies.
1. https://tribune.com.pk/story/2019836/50-families-cant-two-meals-day
2. 2. Comparison with Previous Studies
3. 2.2 Systematic Reviews:
4. - Include systematic reviews that discuss dietary changes during economic crises or
comparable situations.
Most studies used recall to assess changes (48/67; 71.6%). Most studies found an increase in
fruits and vegetables (24/46; 52.2%), grain products (6/11; 54.5%), meat, poultry, and eggs (4/8,
50.0%), diet quality indices and/or overall dietary assessments (7/13, 53.8%), and the frequency
of snacking (9/12; 75.0%), whereas generally finding a decrease in ultraprocessed foods (32/53;
60.4%), compared with before the COVID-19 pandemic. Mixed findings or primarily no changes
were found for fish and aquatic products, legumes, beans, seeds and nuts, milk and milk
products, breakfast consumption, and nutrient intake.
1. https://pmc.ncbi.nlm.nih.gov/articles/PMC11007747/#:~:text=More%20individuals
%20decreased%20their%20intake,energy%2Fsport%2Ffruit%20drinks.&text=Fruits
%20and%20fresh%20juices%2C%20vegetables,significantly%20decreased
%20compared%20with%20prior.
Among these changes, they have increased (p < 0.05) the prevalence of fruit and vegetable,
immune boosters, water, and hot beverage consumption, as well as decreased (p < 0.05) eating in
restaurants and fatty food consumption, indicating a positive change. Conversely, a larger
(p < 0.05) proportion of participants reported increased consumption of high-calorie food and
late-night eating, indicating a risky behavior for obesity and subsequent chronic complications.
Additionally, age, sex, obesity, education, income, and type of job appeared to contribute
(p < 0.05) to changes in DH and EB. Overall, confinement caused by COVID-19 appears to
compel adults to adopt a specific DH and EB. Although most of these changes were positive,
some were negative.
1. https://www.sciencedirect.com/science/article/pii/S2666149722000329
When we combine these changes, we find that the pandemic led to a large increase in total
calories. By the end of the first national lockdown, calories were 15% (around 280 per adult per
day) above normal, and they remained 8–10% higher than normal towards the end of 2020.
There is significant variation in the impact of the pandemic across households. Around a quarter
of households exhibited reductions in calorie purchases during the first month of the UK’s first
national lockdown.
2. https://www.sciencedirect.com/science/article/pii/S0167629622000601
1. https://pubmed.ncbi.nlm.nih.gov/33421383/
Malnutrition impaired the integrity of the gastrointestinal mucosa of patients leading to reduced
gastric acid secretion and increased susceptibility to some pathogens
1. https://pubmed.ncbi.nlm.nih.gov/24566914/
2. https://pubmed.ncbi.nlm.nih.gov/15679471/
3.2 Economic Analyses:
- Search for literature on the economic impact of food insecurity on health
outcomes.
USA: Approximately 1 in 25 households experienced very low food security. The same data
pointed to social disparities, showing that food insecurity was higher in lower-income states,
affected 1 in 4 female-headed households and 1 in every 3 households living below the federal
poverty level. Our successive WAFOOD surveys in Washington state4,5,6 likewise pointed to
multifold differences in food insecurity rates by education, income and race/ethnicity. High and
rising food prices were the most frequently cited barriers to adopting healthier diets. Food-
insecure households spent less on food, reporting poor and worsening diet quality and more
limited access to meat, fresh vegetables and fresh fruit
1. https://www.nature.com/articles/s43016-022-00577-w
In addition to swelling the number of people suffering from chronic diseases—thereby straining
the healthcare and social safety net systems in countries like the United States—food insecurity
slashes workforce productivity by increasing the number of sick days that workers take and
reducing their performance on the job. The cumulative effect can be costly, with one estimate
suggesting it costs billions annually.
1. https://www.nimhd.nih.gov/resources/understanding-health-disparities/food-
accessibility-insecurity-and-health-outcomes.html
4. Coping Strategies
4.1 Food Insecurity Coping:
- Search for studies that describe how populations cope with food insecurity.
All coping strategies were used to some extent in South African households, with 46·0 % relying
on less preferred and less expensive foods and 20·9 % sending a household member to beg for
food. These coping strategies were mostly used by food-insecure households. Although the odds
of moving to a higher category of anxiety and depression were observed among all coping
strategies (all P < 0·001), begging for food was associated with the highest odds (OR = 2·3).
1. https://pmc.ncbi.nlm.nih.gov/articles/PMC10131152/#:~:text=There%20are%20a
%20variety%20of,begging%20for%20food(8).
Compromising the quality and quantity of food were the two most common coping strategies
adopted .More exorbitant strategies involving financial compromisation such as selling or
mortgaging assets were adopted when food insecurity condition worsens.
1. https://pmc.ncbi.nlm.nih.gov/articles/PMC5391923/
We identified 22 coping strategies used in situations of household FI, with the most common
ones being cooking whatever is available, skipping meals, receiving money or food from friends
and relatives, eating unsafe and low-quality foods, taking on additional work, cooking least-
preferred foods, having a monotonous and less-nutritious diet, and reducing the costs of meal
preparation
1. https://www.mdpi.com/2071-1050/14/14/8710
(24.3%) of the studied households did not reduce food consumption during food shortages,
while 99 (68.8%) responded that they occasionally reduced food consumption during food
shortages. To deal with food scarcity, the remaining 10 households (6.9% of the total) reduced
their food intake.
1. https://www.sciencedirect.com/science/article/pii/S2666154323002892
Even while our moods can affect our food choices, there are likely mechanisms by which higher
consumption of processed carbohydrates could enhance the risk of depression and anxiety, such
as through frequent, sharp peaks and falls in blood sugar
1. https://pmc.ncbi.nlm.nih.gov/articles/PMC10490081/#:~:text=Food%20insecurity
%20has%20been%20demonstrated,microbiota%20and%20treat%20mood%20disorders.
Jones conducted a global analysis of food insecurity and mental health status using cross-
sectional data from individuals located in 149 countries across the world.[11]•• Results
demonstrated a dose-response relationship between food insecurity and poorer mental health
indicating that as levels of food insecurity worsened (i.e., mild to moderate to severe) so did
reported mental health status.
1. https://pmc.ncbi.nlm.nih.gov/articles/PMC7282962/
They found that food insecurity was associated with poor subjective well-being, with this
relationship being stronger in more-developed versus less-developed countries. They also found
that the frequency of insufficient sleep was more prevalent in those who reported food
insecurity.
1. https://pubmed.ncbi.nlm.nih.gov/29921540/
Data from in-depth, semi-structured interviews demonstrated that students who experienced
food insecurity also discussed feelings of sadness and hopelessness as a consequence.
1. https://pubmed.ncbi.nlm.nih.gov/30553586/