Economic inequality in nutritional knowledge, attitude and practice of Iranian households: The NUTRI-KAP study.

Background: Improper nutritional knowledge is one of the most important causes of nutritional problems, which can affect practice and cause more complications. The aim of this study was to assess the association between nutritional knowledge, attitude and practice (KAP) of Iranian households with socioeconomic status (SES). Methods: The study population was 14,136 households (57 clusters of 8 individuals in each province) who lived in urban and rural regions of 31 provinces of Iran. The sample size of the study was selected using multistage cluster sampling technique. A structured questionnaire and interview with the qualified person in each family was used to collect data. The questionnaire included demographic, SES and nutritional KAP questions. Using principle component analysis, some variables including household assets, occupation and education level of the heads of the families and respondents and the number of family members were used to construct family SES. The SES was categorized as good, moderate and weak. Pearson's Chi-square test was used to analyze categorical variables. Results: The percentage of knowledge about growing up, acquiring energy and being healthy as reasons for eating food was 24.1%, 44.8% and 54.7%, respectively. Only 69.7%, 60.5% and 52.5% of the participants had knowledge of identification of meat and legumes, grain and dairy group, respectively. More than 97% of the participants had a favorable attitude toward importance of nutrition in health. The nutritional knowledge linearly increased with increasing SES. Families with good SES significantly consumed more fruit, vegetable, dairy group, red meat, chicken and poultry, fish and egg while sugar consumption was significantly higher in families with weak SES (p<0.05). Conclusion: SES can influence the rate of nutritional KAP. Some policies should be considered to increase nutritional KAP especially in lower SES group in the society.

Consensus development on the essential competencies for Iranian public health nutritionists.

OBJECTIVE: To assess key experts' opinion regarding essential competencies required for effective public health nutrition practice within the health-care system of Iran. DESIGN: Qualitative study using the modified Delphi technique through an email-delivered questionnaire. SETTING: Iran. SUBJECTS: Fifty-five experts were contacted through email. The inclusion criterion for the study panel was being in a relevant senior-level position in nutrition science or public health nutrition in Iran. RESULTS: In the first round, forty-two out of fifty-five experts responded to the questionnaire (response rate=76 %). A sixty-five-item questionnaire was designed with nine competency areas, including 'nutrition science', 'planning and implementing nutritional interventions', 'health and nutrition services', 'advocacy and communication', 'assessment and analysis', 'evaluation', 'cultural, social and political aspects', 'using technology' and 'leadership and management'. All experts who had participated in the first round completed a modified version of the questionnaire with seventy-seven items in the second round. The experts scored 'nutrition science' as the most essential competency area, while more applied areas such as 'management and leadership' were less emphasized. In both rounds, the mean difference between the opinions of the necessity of each area was 5.6 %. CONCLUSIONS: The Iranian experts had general agreement on most of the core competency areas of public health nutritionists. The results indicated the need for capacity building and revisions to educational curricula for public health nutritionist programmes, with more emphasis on skill-based competency development.

Changes in fast food intake in Iranian households during the lockdown period caused by COVID-19 virus emergency, National Food and Nutrition Surveillance.

Background: Fast foods, though very popular, are commonly known as unhealthy foods. However, coronavirus pandemic may have influenced on food choices of the general population. This study investigated the changes in fast food consumption during epidemic lockdown 2020. Materials and Methods: This study was part of a nationwide survey having been conducted using a web-based electronic self-administered questionnaire. The questionnaire link was extensively distributed among the whole population both through popular social media platforms and by nutrition and health workers of health offices and medical universities of all provinces. The questionnaire included questions about socio-demographic characteristics, changes in frequency of fast food consumption as compared with before pandemic, and the reasons for these changes. Results: A total of 21,290 households took part in the study of whom 89.8% were male-headed, and almost 74% were from urban areas. Decrease in fast food consumption was reported by 74.8%, while increase in fast food consumption was reported by 2% of the households during the COVID-19 quarantine. Among those who decreased their fast food consumption, about 82% had completely omitted them from their food baskets. Fear of contamination of fast foods by coronavirus and increase in the number of people at home were the most and the least frequent reasons for decreasing fast food consumption, respectively. Conclusion: Fast food consumption has dramatically decreased during the lockdown period in Iranian households. Though it may be considered a pleasant offshoot of disastrous COVID-19 epidemic, the foods replaced fast foods in Iranian households and the overall health consequences warrant further studies.