Scoping review protocol exploring the relationship between food insecurity, mental health and diet intake among adolescents across the globe.

INTRODUCTION: Studies, exploring the effect of food insecurity on physical and mental health, have shown that food insecurity is associated with lower self-reports of physical and mental health. With the COVID-19 pandemic, food insecurity has increased leading to higher risks of poor mental health. Despite evidence of the negative implications of food insecurity on mental health, there is a paucity of research on these variables for adolescents specifically. The current evidence shows there is a gap in adolescent centred research linking mental health and food insecurity globally. Adolescence is a crucial period of development where habits, nutritional inadequacies linked to food insecurity and mental health problems formed due to these inadequacies can be conveyed into adulthood. The aim of this study is to systematically scope the literature exploring the relationship between mental health, food (in)security and/or diet intake of adolescents. METHODS: This review will be guided by Arksey and O'Malley's extended framework. The search strategy was developed by two of the authors and will be used to search literature from January 2012 to December 2022 in PubMed, Academic search complete, PsychARTICLES, Google, ScienceDirect, Scopus and Web of science core collection. Searching published and unpublished literature will be done in the chosen databases. References used in included literature will be reviewed for additional studies/sources. Articles will be assessed for eligibility by two reviewers, and any discrepancies reviewed by a third reviewer. The inclusion and exclusion criteria will be used for screening. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram will be used to document the selection process. A narrative summary and descriptive analysis will be used to summarise and report the extracted data. ETHICS AND DISSEMINATION: Approval for this study has been granted by the University of the Western Cape Biomedical Research Ethics Committee (BM21/8/3). Strict measures will be followed to ensure methodological rigour.

Lockdown-Associated Hunger May Be Affecting Breastfeeding: Findings from a Large SMS Survey in South Africa.

The impact that the COVID-19 pandemic has had, and will continue to have, on food security and child health is especially concerning. A rapid, Short Message Service (SMS) Maternal and Child Health survey was conducted in South Africa in June 2020 (n = 3140), with a follow-up in July 2020 (n = 2287). This was a national cross-sectional survey conducted among pregnant women and mothers registered with the MomConnect mhealth platform. Logistic regression was conducted to explore the associations between breastfeeding, maternal depressive symptoms, and hunger in the household. High breastfeeding initiation rates and the early introduction of other foods or mixed milk feeding were found. The prevalence of depressive symptoms in this survey sample was 26.95%, but there was no association between breastfeeding behaviour and depressive symptom scores (OR = 0.89; 95% CI: 0.63, 1.27). A positive correlation was found between not breastfeeding and not going to the health clinic. The odds of hungry mothers breastfeeding were significantly lower (OR = 0.66; p = 0.045). This result also holds in a multivariate framework, including covariates such as depressive symptoms, attendance of a PHC facility, and whether the infant was older than 3 months. Support for breastfeeding must include support, such as economic support, for breastfeeding mothers, to enable them to access nutritious diets. Mothers also need reassurance on the quality of their breastmilk and their ability to breastfeed and should be encouraged to continue to attend the health clinic regularly.