| Literature DB >> 35057539 |
Bruna Leal Lima Maciel1, Clélia de Oliveira Lyra1, Jéssica Raissa Carlos Gomes1, Priscilla Moura Rolim1, Bartira Mendes Gorgulho2, Patrícia Simone Nogueira2, Paulo Rogério Melo Rodrigues2, Tiago Feitosa da Silva3, Fernanda Andrade Martins4, Tatiane Dalamaria5, Thanise Sabrina Souza Santos6,7, Doroteia Aparecida Höfelmann8, Sandra Patricia Crispim8, Betzabeth Slater9, Alanderson Alves Ramalho3,4, Dirce Maria Marchioni9.
Abstract
Undergraduates may face challenges to assure food security, related to economic and mental distress, especially during the COVID-19 pandemic. This study aimed to assess food insecurity and its associated factors in undergraduates during the COVID-19 pandemic. An online cross-sectional study was conducted from August 2020 to February 2021 with 4775 undergraduates from all Brazilian regions. The questionnaire contained socio-economic variables, the validated Brazilian food insecurity scale, and the ESQUADA scale to assess diet quality. The median age of the students was 22.0 years, and 48.0% reported income decreasing with the pandemic. Food insecurity was present in 38.6% of the students, 4.5% with severe food insecurity and 7.7% moderate. Logistic regressions showed students with brown and black skin color/race presented the highest OR for food insecurity; both income and weight increase or reduction during the pandemic was also associated with a higher OR for food insecurity, and better diet quality was associated with decreased OR for food insecurity. Our study showed a considerable presence of food insecurity in undergraduates. Policy for this population must be directed to the most vulnerable: those with brown and black skin color/race, who changed income during the pandemic, and those presented with difficulties maintaining weight and with poor diet quality.Entities:
Keywords: diet quality; food security; nutrition
Mesh:
Year: 2022 PMID: 35057539 PMCID: PMC8780004 DOI: 10.3390/nu14020358
Source DB: PubMed Journal: Nutrients ISSN: 2072-6643 Impact factor: 5.717
Figure 1Flowchart of studied undergraduates (n = 4775), considering the study sites.
Characterization of the undergraduates (n = 4775), according to study site.
| Variables | Total | Acre | Mato Grosso | Paraná | Rio Grande do Norte | São Paulo | |
|---|---|---|---|---|---|---|---|
| Age, median (Q1–Q3) | 22.0 (20.0–26.0) | 22.0 (20.0–25.0) | 25.0 (21.8–36.3) | 22.0 (20.0–26.0) | 24.0 (21.0–29.3) | 22.0 (20.0–25.0) | <0.001 1 |
| Sex, | |||||||
| Male | 1596 (33.4) | 219 (32.2) | 51 (34.9) | 313 (32.0) | 307 (35.0) | 706 (33.7) | 0.634 2 |
| Female | 3179 (66.6) | 462 (67.8) | 95 (65.1) | 665 (68.0) | 571 (65.0) | 1386 (66.3) | |
| Total | 4775 (100.0) | 681 (100.0) | 146 (100.0) | 978 (100.0) | 878 (100.0) | 2092 (100.0) | |
| Race, | |||||||
| Asiatic | 165 (3.5) | 10 (1.5) | 2 (1.4) | 30 (3.1) | 4 (0.5) | 119 (5.7) | <0.001 2 |
| White | 2914 (61.0) | 158 (23.2) | 82 (56.2) | 761 (77.8) | 444 (50.6) | 1469 (70.2) | |
| Indigenous | 15 (0.3) | 7 (1.0) | 0 (0.0) | 0 (0.0) | 2 (0.2) | 6 (0.3) | |
| Brown | 1326 (27.8) | 416 (61.1) | 52 (35.6) | 142 (14.5) | 346 (39.4) | 370 (17.7) | |
| Black | 333 (7.0) | 77 (11.3) | 10 (6.8) | 41 (4.2) | 82 (9.3) | 123 (5.9) | |
| NI/NWI | 22 (0.5) | 13 (1.9) | 0 (0.0) | 4 (0.4) | 0 (0.0) | 5 (0.2) | |
| Total | 4775 (100.0) | 681 (100.0) | 146 (100.0) | 978 (100.0) | 878 (100.0) | 2092 (100.0) | |
| Family income in minimum wages, | |||||||
| None | 130 (2.7) | 30 (4.4) | 5 (3.4) | 8 (0.8) | 47 (5.4) | 40 (1.9) | <0.001 2 |
| 0–1 | 704 (14.7) | 242 (35.5) | 24 (16.4) | 92 (9.4) | 198 (22.6) | 148 (7.1) | |
| 1–3 | 1471 (30.8) | 209 (30.7) | 33 (22.6) | 329 (33.6) | 326 (37.1) | 574 (27.4) | |
| 3–6 | 1034 (21.7) | 82 (12.0) | 22 (15.1) | 259 (26.5) | 177 (20.2) | 494 (23.6) | |
| 6–9 | 524 (11.0) | 41 (6.0) | 20 (13.7) | 114 (11.7) | 57 (6.5) | 292 (14.0) | |
| 9–12 | 330 (6.9) | 16 (2.3) | 20 (13.7) | 76 (7.8) | 28 (3.2) | 190 (9.1) | |
| 12–15 | 220 (4.6) | 11 (1.6) | 11 (7.5) | 48 (4.9) | 19 (2.2) | 131 (6.3) | |
| >15 | 323 (6.8) | 11 (1.6) | 11 (7.5) | 52 (5.3) | 26 (3.0) | 223 (10.7) | |
| NI/NWI | 39 (0.8) | 39 (5.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| Total | 4775 (100.0) | 681 (100.0) | 146 (100.0) | 978 (100.0) | 878 (100.0) | 2092 (100.0) | |
| Income change during the pandemic, | |||||||
| No | 1975 (41.4) | 296 (43.5) | 79 (54.1) | 398 (40.7) | 329 (37.5) | 873 (41.7) | <0.001 2 |
| Yes, for more | 464 (9.7) | 81 (11.9) | 10 (6.8) | 98 (10.0) | 103 (11.7) | 172 (8.2) | |
| Yes, for less | 2291 (48.0) | 265 (38.9) | 51 (34.9) | 482 (49.3) | 446 (50.8) | 1047 (50.0) | |
| NI/NWI | 45 (0.9) | 39 (5.7) | 6 (4.1) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| Total | 4775 (100.0) | 681 (100.0) | 146 (100.0) | 978 (100.0) | 878 (100.0) | 2092 (100.0) | |
| Weight change during the pandemic, | |||||||
| No | 583 (12.6) | 78 (11.9) | 27 (19.4) | 129 (13.6) | 71 (8.4) | 278 (13.6) | <0.001 2 |
| Yes, for less | 1273 (27.4) | 182 (27.7) | 34 (24.5) | 249 (26.3) | 229 (27.1) | 579 (28.2) | |
| Yes, for more | 2578 (55.6) | 384 (58.4) | 74 (53.2) | 511 (54.0) | 524 (62.0) | 1085 (52.9) | |
| NI/NWI | 204 (4.4) | 14 (2.1) | 4 (2.9) | 57 (6.0) | 21 (2.5) | 108 (5.3) | |
| Total | 4638 (100.0) | 658 (100.0) | 139 (100.0) | 946 (100.) | 845 (100.0) | 2050 (100.0) | |
| ESQUADA classification, | |||||||
| Very poor | 64 (1.4) | 13 (1.9) | 1 (0.7) | 13 (1.3) | 10 (1.1) | 27 (1.3) | <0.001 2 |
| Poor | 402 (8.5) | 50 (7.4) | 8 (5.5) | 80 (8.2) | 88 (10.1) | 176 (8.5) | |
| Good | 2463 (52.0) | 391 (58.1) | 66 (45.5) | 535 (55.2) | 472 (54.3) | 999 (48.2) | |
| Very good | 1755 (37.1) | 217 (32.2) | 69 (47.6) | 337 (34.7) | 295 (33.9) | 837 (40.4) | |
| Excellent | 48 (1.0) | 2 (0.3) | 1 (0.7) | 5 (0.5) | 5 (0.6) | 35 (1.7) | |
| Total | 4732 (100.0) | 673 (100.0) | 145 (100.0) | 970 (100.0) | 870 (100.0) | 2074 (100.0) | |
1p-value for the Kruskal Wallis test. 2p-value for the chi-square. 3 The minimum wage in Brazil is R$ 1100, around $212. NI/NWI, not informed/did not wish to inform.
Figure 2Food insecurity in undergraduates (n = 4775), assessed using the Brazilian Food Insecurity Scale. Chi-square test, p < 0.001.
Food security of undergraduate students (n = 4775) according to social, anthropometric, and food variables during the pandemic.
| Variables | Total | Food Security | Mild Food Insecurity | Moderate Food Insecurity | Severe Food Insecurity | Chi-Square Test, |
|---|---|---|---|---|---|---|
| Race, | ||||||
| Asiatic | 165 (3.5) | 124 (4.2) | 32 (2.5) | 6 (1.6) | 3 (1.4) | <0.001 |
| White | 2914 (61.0) | 2030 (69.2) | 644 (51.1) | 151 (41.3) | 89 (41.6) | |
| Indigenous | 15 (0.3) | 6 (0.2) | 5 (0.4) | 3 (0.8) | 1 (0.5) | |
| Brown | 1326 (27.8) | 625 (21.3) | 454 (36.0) | 154 (42.1) | 93 (43.5) | |
| Black | 333 (7.0) | 135 (4.6) | 121 (9.6) | 49 (13.4) | 28 (13.1) | |
| NI/NWI | 22 (0.5) | 14 (0.5) | 5 (0.4) | 3 (0.8) | 0 (0.0) | |
| Total | 4775 (100.0) | 2934 (100.0) | 1261 (100.0) | 366 (100.0) | 214 (100.0) | |
| Family income change during the pandemic, | ||||||
| No | 1975 (41.4) | 1448 (49.4) | 388 (30.8) | 87 (23.8) | 52 (24.3) | <0.001 |
| Yes, for more | 464 (9.7) | 268 (9.1) | 119 (9.4) | 49 (13.4) | 28 (13.1) | |
| Yes, for less | 2291 (48.0) | 1198 (40.8) | 738 (58.5) | 223 (60.9) | 132 (61.7) | |
| NI/NWI | 45 (0.9) | 20 (0.7) | 16 (1.3) | 7 (1.9) | 2 (0.9) | |
| Total | 4775 (100.0) | 2934 (100.0) | 1261 (100.0) | 366 (100.0) | 214 (100.0) | |
| Weight change during the pandemic, | ||||||
| No | 583 (12.6) | 409 (14.3) | 129 (10.6) | 26 (7.4) | 19 (9.3) | <0.001 |
| Yes, for less | 1273 (27.4) | 783 (27.3) | 315 (25.9) | 97 (27.8) | 78 (38.2) | |
| Yes, for more | 2578 (55.6) | 1550 (54.0) | 720 (59.2) | 209 (59.9) | 99 (48.5) | |
| NI/NWI | 204 (4.4) | 127 (4.4) | 52 (4.3) | 17 (4.9) | 8 (3.9) | |
| Total | 4638 (100.0) | 2869 (100.0) | 1216 (100.0) | 349 (100.0) | 204 (100.0) | |
| ESQUADA classification, | ||||||
| Very poor | 64 (1.4) | 32 (1.1) | 22 (1.8) | 5 (1.4) | 5 (2.4) | <0.001 |
| Poor | 402 (8.5) | 232 (8.0) | 112 (9.0) | 31 (8.5) | 27 (12.8) | |
| Good | 2463 (52.0) | 1412 (48.5) | 717 (57.5) | 228 (62.6) | 106 (50.2) | |
| Very good | 1755 (37.1) | 1195 (41.1) | 389 (31.2) | 98 (26.9) | 73 (34.6) | |
| Excellent | 48 (1.0) | 39 (1.3) | 7 (0.6) | 2 (0.5) | 0 (0.0) | |
| Total | 4732 (100.0) | 2910 (100.0) | 1247 (100.0) | 364 (100.0) | 211 (100.0) | |
NI/NWI, not informed/did not wish to inform.
Logistic regression for variables associated with food insecurity in Brazilian undergraduates during the COVID-19 pandemic.
| Food Insecurity | ||||
|---|---|---|---|---|
| Indepenent Variables | OR (95% CI) | AOR (95% CI) | ||
| Race | ||||
| White | − | − | ||
| Asiatic | 0.76 (0.53–1.09) | 0.136 | 0.80 (0.55–1.17) | 0.252 |
| Indigenous | 3.45 (1.22–9.71) | 0.019 | 2.57 (0.81–8.15) | 0.107 |
| Brown | 2.58 (2.25–2.94) | <0.001 | 1.93 (1.67–2.24) | <0.001 |
| Black | 3.37 (2.67–4.25) | <0.001 | 2.89 (2.27–3.68) | <0.001 |
| Income change during the pandemic | ||||
| No | − | − | ||
| Yes, for more | 2.01 (1.63–2.48) | <0.001 | 1.83 (1.47–2.28) | <0.001 |
| Yes, for less | 2.51 (2.20–2.85) | <0.001 | 2.78 (2.43–3.18) | <0.001 |
| Weight change during the pandemic | ||||
| No | − | − | ||
| Yes, for less | 1.47 (1.19–1.82) | <0.001 | 1.44 (1.16–1.79) | 0.001 |
| Yes, for more | 1.56 (1.28–1.89) | <0.001 | 1.36 (1.11–1.67) | 0.003 |
| ESQUADA classification | ||||
| Very poor | − | − | ||
| Poor | 0.73 (0.43–1.24) | 0.249 | 0.73 (0.41–1.29) | 0.276 |
| Good | 0.74 (0.45–1.22) | 0.244 | 0.72 (0.42–1.23) | 0.230 |
| Very good | 0.47 (0.28–0.77) | 0.003 | 0.46 (0.27–0.79) | 0.005 |
| Excellent | 0.23 (0.10–0.55) | 0.001 | 0.26 (0.11–0.65) | 0.004 |
OR, crude odds ratio, from bivariate analysis; AOR, adjusted odds ratio, considering all variables in the model. Sex, age, and study site were included as adjustment variables.