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Cited by 246Food Security and Health in Diverse PopulationsChild Nutrition and Water AccessFood Security and Socioeconomic Dynamics

The impact of COVID-19 on diet quality, food security and nutrition in low and middle income countries: a systematic review of the evidence

Open access
Picchioni, Fiorella, Goulao, Luis F., Roberfroid, Dominique·2022·Clinical Nutrition
DOI 10.1016/j.clnu.2021.08.015PMC PMC8390094
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Abstract

BACKGROUND & AIMS: The current global pandemic of Coronavirus (COVID-19), and measures adopted to reduce its spread, threaten the nutritional status of populations in Low- and middle-income countries (LMICs). Documenting how the COVID-19 affects diets, nutrition and food security can help generating evidence-informed recommendations for mitigating interventions and policies. METHODS: We carried out a systematic literature review. A structured search strategy was applied in MEDLINE (Pubmed®), EMBASE®, Scopus® and Web of Science®. Grey literature was retrieved by screening a pre-set list of institutions involved in monitoring the impact of the COVID-19 pandemic on nutrition and food security. The first search was done on 20th August 2020, and updated in mid-November 2020 and mid-January 2021. All research steps were described as recommended in the PRISMA statement. RESULTS: Out of the 2085 references identified, thirty-five primary studies were included. In spite of their heterogeneity, studies converge to demonstrate a detrimental effect of COVID-19 pandemic and associated containment measures on diet quality and food insecurity. One of the major direct effects of COVID-19 on food and nutrition outcomes has been through its impact on employment, income generating activities and associated purchasing power. Other channels of impact, such as physical access, availability and affordability of food provided a heterogeneous picture and were assessed via binary and often simplistic questions. The impacts of COVID-19 on food systems and diets manifested with various intensity degrees, duration and in different forms. Factors contributing to these variations between and within countries were: 1) timing, duration and stringency of national COVID-19 restriction measures and policies to mitigate their adverse impacts; 2) context specific food value chain responses to domestic and international containment measures; 3) differentiated impacts of restriction measures on different groups, along lines of gender, age, socio-economic status and employment conditions. Shorter value chains and traditional smallholder farms were somewhat more resilient in the face of COVID-19 pandemic. Additionally, the impact of the pandemic has been particularly adverse on women, individuals with a low socio-economic status, informal workers and young adults that relied on daily wages. Finally, there were heterogeneous government responses to curb the virus and to mitigate the damaging effects of the pandemic. It has been demonstrated that existing and well-functioning social protection programmes and public distribution of food can buffer the adverse effects on food insecurity. But social safety nets cannot be effective on their own and there is a need for broader food systems interventions and investments to support sustainable and inclusive food systems to holistically achieve food and nutrition security. CONCLUSION: The current economic and heath crisis impacted diet quality and food security. This raises concerns about long term impacts on access to and affordability of nutrient-rich, healthy diets and their health implications. Women and individuals with a low socio-economic are likely to be the most at risk of food insecurity. Social safety nets can be effective to protect them and must be urgently implemented. We advocate for improved data collection to identify vulnerable groups and measure how interventions are successful in protecting them.

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  • Studies from low-income and middle-income countries have indicated worsening food security and diet quality during and after the pandemic, but did not measure underweight prevalence.

    “Studies from low-income and middle-income countries have indicated worsening food security and diet quality during and after the pandemic, but did not measure underweight prevalence.18”

    From Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults (2024) · cites this paper as [18]

    The Discussion (Impact on diet and nutrition outcomes) reports worsening diet quality and food insecurity in LMICs, and Results (Nutritional indicators) says no reviewed study reported nutritional status, which includes underweight prevalence. The evidence concerns the pandemic and later stages of restrictions, not a period after the pandemic. (LLM, conf=0.88)

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5 of the 39 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. [2]Turner C. Aggarwal A. Walls H. Herforth A. Drewnowski A. Coates J. Concepts and critical perspectives for food environment research: a global framework with implications for action in low- and middle-income countries Vol. 18 2018 Global Food Security 93 101
  2. [22]Harris D. Teklu A. Medhin G. Mitiku I. Tadesse B. Demissie M. The effect of COVID-19 and government response measures on poor and vulnerable groups in urban areas in Ethiopia 2020 Oxford Policy Management London, UK

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Authors
Picchioni, F., Goulao, L. F., & Roberfroid, D.
Affiliations
  • Natural Resources Institute (GB)
  • University of Namur (BE)
Corresponding author
Picchioni, Fiorella
ORCID
Venue
Clinical Nutrition
Publisher
Elsevier BV
Published
2022-12
Volume
41
Issue
12
Pages
2955-2964
ISSN
0261-5614 (ISSN-L)
DOI
10.1016/j.clnu.2021.08.015
PMC
PMC8390094
OpenAlex
W3194928011
Cited by
245
References
39
Citations by year
2026: 21 · 2025: 36 · 2024: 73 · 2023: 57 · 2022: 51 · 2021: 6
FWCI
9.71
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Nutrition (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Repository of the University of Namur (publishedVersion, cc-by-nc-nd)
  • Greenwich Academic Literature Archive (University of Greenwich) (acceptedVersion)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion, cc-by-nc-nd)
  • Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
  • Explore Bristol Research (submittedVersion, cc-by-nc-nd)
  • Bristol Research (University of Bristol) (submittedVersion, cc-by-nc-nd)
Funders
  • European Commission (DCI/FOOD/2019/408-364)
  • Fundação para a Ciência e a Tecnologia (UID/AGR/04129/2020)
Topics
  • Health Sciences › Health Professions › General Health Professions › Food Security and Health in Diverse Populations
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
  • Life Sciences › Agricultural and Biological Sciences › General Agricultural and Biological Sciences › Food Security and Socioeconomic Dynamics
Keywords
COVID-19 pandemic, diet quality, food security, nutrition, low- and middle-income countries, food systems, food value chains, smallholder farming, food affordability, food availability, food access, socioeconomic disparities, women's nutrition, social protection, government pandemic response, containment measures, nutrition policy, informal workers, young adults
MeSH terms
Food Security, COVID-19, Developing Countries, Diet, Female, Food Supply, Humans, Nutritional Status, Young Adult, Pandemics

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