Household Dietary Diversity among Households with and without Children with Disabilities in Three Low-Income Communities in Lusaka, Zambia.

The purpose of this manuscript is to describe household dietary diversity (HDDS) in Lusaka, Zambia between households with and without a child with a disability living in the same communities. Cross-sectional data were collected in three low-income compounds in September 2021. Participants included households with a child with a disability enrolled in Kusamala+, a community-based program, (n = 444) and a convenience sample of adults living in the same area without a child with a disability (n = 1027). The HDDS tool asked about food groups consumed in the past 24 h by people in the household. The responses were summed (yes = 1, no = 0), range 0-12. Individual dietary diversity scores (IDDSs) were calculated for children (0-8 items). Analysis included descriptive statistics and linear regression. Mean HDDS for the households with a child with a disability was 4.8 (SD 2.1) vs. 6.1 (SD = 2.2) among households without a child with a disability (p < 0.001). The individual score for children (IDDS) for households with children with disabilities was 2.6 (SD = 1.4) vs. 3.7 (SD = 1.6) for households without a child with a disability. Households with a child with a disability had a significantly lower HDDS and IDDS in unadjusted and adjusted models (p < 0.001). National policy must assure the most vulnerable populations, and often hidden, receive focused financial and food support.

Dietary Diversity among Chinese Residents during the COVID-19 Outbreak and Its Associated Factors.

COVID-19, a Public Health Emergency of International Concern, has imposed enormous challenges on the health system, economy, and food supply and has substantially modified people's lifestyles. This study aimed to (1) explore the dietary diversity during the lockdown time in China and (2) examine factors associated with dietary diversity including socio-economic characteristics, sources for food and food purchases, and specific dietary behaviors responding to COVID-19 and isolation. A cross-sectional questionnaire-based survey was conducted online in March 2020. Multi-stage sampling was used to recruit participants living in Hubei Province and other parts of China. Dietary diversity was assessed using the Household Dietary Diversity Score (HDDS) and clustering analysis was used to categorize people with different propensities of methods for purchasing or obtaining foods. Logistic regression was used to model the associations among HDDS, participants' characteristics, approaches to purchase or obtain food, and behaviors adopted to cope with COVID-19. Results: A total of 1938 participants were included in the analysis. The overall mean HDDS was 9.7 ± 2.1, and the median (25th, 75th) was 10 (8, 12). There were relatively low consumptions of fish, legumes, and miscellaneous foods (e.g., processed food like snacks and beverages). After adjusting for age, family income, and geographic regions, people living in places where laboratory confirmed COVID-19 cases were above 500 (ORadjusted = 0.79, 95%CI 0.65, 0.96), or living in Hubei Province (ORadjusted = 0.60, 95%CI 0.39, 0.93) had a lower HDDS. During isolation time, the most common sources for food and food purchases were in-house storage and in person grocery shopping. More than half of the participants (55.9%) purchased food at least once via online ordering and delivery services. There was no significant difference in HDDS among people with distinct dependences on different ways to obtain or purchase food (i.e., dependence on in-person grocery shopping, dependence on both in-house storage and in-person grocery shopping, or dependence on online food purchasing). We also identified a total of 37.7% participants who consumed certain foods or nutritional supplements to cope with COVID-19, which included vitamin C, probiotics, other dietary supplements, alcohol, and vinegar. People who reported these specific dietary behaviors had a significantly higher HDDS (ORadjusted = 1.23, 95%CI 1.02, 1.45) than those who did not do so. This study revealed an overall good dietary diversity among the studied Chinese residents during the COVID-19 pandemic. However, we observed a lower dietary diversity among people living in areas with a high number of confirmed COVID-19 cases. Online ordering and delivery services were popular and could serve as a feasible method to obtain and purchase food, contributing to ensure diversified diets during the time of lockdown. Certain dietary behaviors associated with COVID-19 were also identified and had significant impacts on HDDS.

Determinants of household food security and dietary diversity during the COVID-19 pandemic in Bangladesh.

OBJECTIVES: The study aimed to determine the associated factors of household food security (HFS) and household dietary diversity (HDD) during the COVID-19 pandemic in Bangladesh. DESIGN: Both online survey and face-to-face interviews were employed in this cross-sectional study. The Household Food Security Scale and Household Dietary Diversity Score were used to access HFS and HDD, respectively. The HDD scores were derived from a 24-h recall of food intake from 12 groups. SETTING: Bangladesh. PARTICIPANTS: A total sample of 1876 households were recruited. RESULTS: The overall mean scores of HFS and HDD were 31·86 (sd 2·52) and 6·22 (sd 5·49), respectively. Being a rural resident, having no formal education, occupation of household head other than government job and low monthly income were potential determinants of lower HFS and HDD. Approximately 45 % and 61 % of Bangladeshi households did not get the same quantity and same type of food, respectively, as they got before the pandemic. Over 10 % of respondents reported that they lost their job or had to close their businesses, and income reduction was reported by over 70 % of household income earners during the COVID-19 pandemic, which in turn was negatively associated with HFS and HDD. CONCLUSION: Household socio-economic variables and COVID-19 effects on occupation and income are potential predictors of lower HFS and HDD scores. HFS and HDD deserve more attention during this pandemic particularly with reference to low-earning households and the households whose earning persons' occupation has been negatively impacted during the COVID-19 pandemic.