Shorter Telomere Length is Associated with Food Insecurity in Older People: A Cross-Sectional Study.

BACKGROUND: Telomere length has been investigated as a biomarker of biological aging and is associated with several diseases, lifestyle, and socioeconomic factors. OBJECTIVE: This study aimed to verify whether food insecurity is associated with shorter telomere length in older people. METHODS: This is a cross-sectional study carried out in a municipality in the interior of Brazil, with a sample of 440 older people from the community. For telomere length analysis, a blood sample was obtained from each participant, followed by real-time qPCR, and sociodemographic and health information was collected through interviews. Food security/insecurity was measured using the reduced version of the Brazilian Food Insecurity Scale. Descriptive analysis and multiple logistic regression were performed to analyze the factors associated with shorter telomere length, adopting a significance level of 5%. RESULTS: We found that food insecurity was significantly associated with shorter telomere length, regardless of age group, skin color, tabagism, physical activity, milk and dairy consumption, living arrangement, and basic activities of daily life. CONCLUSION: The findings show the importance of ensuring full access to adequate nutrition for the older population, who are physiologically and socially vulnerable.

Health, economic and social impacts of the Brazilian cash transfer program on the lives of its beneficiaries: a scoping review.

BACKGROUND: The Bolsa Família cash transfer Program (BFP) aims to break the poverty cycle by providing a minimum income to poor families conditioned on their investment in human capital (such as, education and health) and currently is the largest Program in the world in terms of the number of beneficiaries. Because there is a scarcity of reviews grouping studies on the impacts of the BFP, the objective of this scoping review was to identify and describe studies which evaluate the impact of the BFP on poverty, health, education, and other related outcomes. METHODS: We searched for quantitative, qualitative, and mixed-method articles that assessed the impact of the BFP on any aspect of the beneficiaries' lives between 2003 and March 2021. We included quantitative articles that used experimental, quasi-experimental or pre and post comparison designs. We excluded articles that analyzed impacts on political outcomes. There was no age restriction for the participants. The search was done in seven electronic databases. RESULTS: One thousand five hundred forty-six papers were identified and 94 fulfilled the inclusion criteria. Poverty and health outcomes were the most common outcomes studied. We found consistent evidence of the positive impact of the BFP on poverty reduction, as well as employment outcomes. We also found positive impacts in relation to mortality rates for children and adults, school dropout and school attendance among children and adolescents, and violence related outcomes such as homicide, suicide, crime, and hospitalization. However, we also found some evidence that BFP increased intimate partner violence and gender stereotypes among women and no evidence of impact on teenage pregnancy. CONCLUSIONS: Overall, the studies included found that BFP showed positive impacts on most poverty, health and education outcomes. More studies are needed to confirm some results, especially about violence and stereotype against women as there were few evaluations on these outcomes.

Household food insecurity and symptoms of anxiety and depression during pregnancy: Systematic review and meta-analysis.

Household food insecurity (HFI) has been related to adverse maternal-child health outcomes and mental health worsening during pregnancy. Few studies evaluated the temporal association between HFI and anxiety and depressive symptoms in pregnant women, and this association remains not completely understood. This study aimed to systematically review the association between HFI and symptoms of depression and anxiety in pregnant individuals. The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (CRD42022373615). Systematic searches were conducted on 10 electronic databases and grey literature. Two researchers independently conducted the study selection, data extraction process, and the risk of bias assessment. Random-effects meta-analysis models were used, and I2 > 40% indicated high heterogeneity across studies. Eighteen articles were included for the systematic review, comprising n = 27,882, and a total of 18,987 pregnant individuals aged between 14 and 45 years were included in the meta-analysis. The prevalence of HFI reported in studies ranged from 12.6% to 62.1% (n = 17). The prevalence of depressive and anxiety symptoms ranged from 18% to 49% (n = 11) and 23% to 34% (n = 2), respectively. HFI during pregnancy was associated with increased odds of experiencing symptoms of depression [(OR: 2.52; 95% CI: 2.11-3.02), I2 = 73.23%]. The quality of evidence was very low due to high heterogeneity. Our findings highlighted the association between HFI and depression symptoms during pregnancy. Findings from this study suggest the importance of assessing HFI and mental health during pregnancy.

The Happy Child Program's Intersectionality: Prenatal Home Visit Frequency, Food Insecurity Risk, Symptoms of Depression, and Parental Practices in Brazilian Women Assisted during Pregnancy.

Food insecurity (FI) is a critical issue in developing countries, particularly in low-resource settings, where it can worsen women's mental health. Psychosocial factors such as low household income, limited education, multiparity, and vulnerability are linked to depressive symptoms during pregnancy. Additionally, the family environment influences parental practices, which may impact mental health. This study evaluates the association of socioeconomic factors, parental practices, FI risk, and home visit frequency with depressive symptoms in pregnant women enrolled in the Happy Child Program (Programa Criança Feliz-PCF) in the Federal District, Brazil. In this cross-sectional study, 132 pregnant women monitored by PCF from May to July 2023 were assessed using a self-administered questionnaire for socioeconomic data, the two-item Triage for Food Insecurity (TRIA) instrument for FI risk, the Scale of Parental Beliefs and Early Childhood Care Practices, and the Beck Depression Inventory-II for depressive symptoms. Most participants were multiparous (87.9%), had low income (under 200 USD/month; 80.8%), presented depressive symptoms (67.4%) and were at risk of FI (81.8%). About half demonstrated adequate parental practices (50.8%) and received four home visits per month during pregnancy (54.5%). Women who received four PCF home visits had a lower prevalence of depressive symptoms compared to those with fewer visits (PR 0.76, 95% CI 0.59-0.98). No significant association was found between FI or parental practices and depressive symptoms. These findings suggest that the PCF home-visiting program may strengthen vulnerable families, support social networks, and improve mental health during pregnancy. Additionally, the results of this study highlight the need for targeted interventions aimed at reducing food insecurity and promoting mental health during pregnancy, particularly among socially vulnerable populations. Furthermore, they reinforce the importance of expanding access to home-visiting programs as an effective strategy to improve maternal mental health and well-being, while fostering healthier prenatal environments for both mothers and their children.

Qualidade e acesso à água para consumo humano: um olhar sobre o estado do Amazonas, Brasil / Quality and access to water for human consumption: a look at the state of Amazonas, Brazil

Resumo Analisaram-se indicadores de vigilância da qualidade da água para consumo humano no Amazonas, de 2016 a 2020, utilizando 185.528 amostras provenientes de 11 microrregiões. Das amostras analisadas, 93,20% são da área urbana, 66,65% provinham do sistema público (SAA), 31,02% da Solução Alternativa Coletiva (SAC) e 2,33% da Solução de Alternativa Individual (SAI). Observou-se aumento do número de registros pelo SAA, com tendência de queda e oscilações de registros para a SAC e a SAI. Os indicadores de qualidade dos parâmetros químicos e físicos da área urbana foram superiores aos das áreas rurais e de comunidades tradicionais. A maior parte das amostras apresentou valores de pH abaixo do recomendado. Na quantificação dos parâmetros microbiológicos, identificou-se maior presença de coliformes totais e E.coli na área rural e em comunidades tradicionais. Em conclusão, verificaram-se inadequações nos parâmetros químicos, físicos e microbiológicos, assim como problemas relativos ao abastecimento, armazenamento e à vigilância da água distribuída para consumo humano. Tais achados indicam a necessidade de construir uma agenda, pela gestão pública, para o enfrentamento da insegurança hídrica e seus prováveis efeitos sobre a insegurança alimentar existente na região.

Abstract Surveillance indicators of the quality of water for human consumption in the Amazon were analysed from 2016 to 2020 using 185,528 samples from 11 microregions. Of the samples analysed, 93.20% were from urban areas, 66.65% were from the public water supply system (WSS), 31.02% were from the Collective Alternative Solution-CAS, and 2.33% from the Individual Alternative Solution-IAS. There was an increase in the number of records by the WSS, with a downwards trend and fluctuations in records for the CAS and the IAS. The quality indicators of chemical and physical parameters for urban areas were higher than those for rural areas and traditional communities. Most of the samples presented pH values below the recommended level. In the quantification of microbiological parameters, a higher presence of total coliforms and E. coli was identified in samples from rural areas and in traditional communities. In conclusion, there were inadequacies in the chemical, physical and microbiological parameters as well as problems related to the supply, storage and surveillance of water distributed for human consumption. These findings indicate the need to build an agenda for public management to address water insecurity and its likely effects on food insecurity in the region.

Clusters of Sociodemographic Characteristics and Their Association with Food Insecurity in Mexican University Students.

Food insecurity (FI) expresses irregular access to sufficient, safe, and nutritious food. We analyze the association between clusters of sociodemographic characteristics and FI in university students from Mexico. The Latin American and Caribbean Food Security Scale was applied, and household type, socioeconomic status (SES), and the characteristics of the head of the household, among others, were asked in a cross-sectional study. We performed Two-Step cluster analysis and logistic regression models. We included 466 university students (72.5% women, 47% with FI). We identified three clusters; Cluster-1 (n = 163) included a single-parent (37.4%) or co-resident/roommate (27%) household type, middle SES (63.2%); the head of the household is usually a woman (76.1%), single (71.8%), and with bachelor's degree (41.7%) or less educational level (46.6%). Cluster-2 (n = 144) included the nuclear (89.6%) household type, high SES (76.4%); the head of the household is usually a man (79.2%), in a relationship (99.3%), and with a bachelor's degree (63.2%) or graduate level (33.3%). Cluster-3 (n = 147) is very similar to Cluster-2. The difference is that Cluster-3 includes middle SES (70.1%), and the head of the household's educational level is high school or less (100%). Only belonging to Cluster-1 was positively associated with FI (OR = 1.96, 95%CI: 1.24, 3.09). These results show the interrelationships between multiple sociodemographic characteristics and should contribute to developing interventions that simultaneously address numerous sociodemographic factors to diminish FI in university students.

Beyond the Classroom: The Influence of Food Insecurity, Mental Health, and Sleep Quality on University Students' Academic Performance.

We aimed to analyze the association between food insecurity (FI) and academic performance in university students, including mental health and sleep quality (SQ), in an association model. A cross-sectional design included university students (n = 466, 72.5% women) from Mexico. We applied the Latin American and Caribbean Food Security Scale, the Depression Anxiety and Stress Scale (DASS-21), and the Pittsburgh Sleep Quality Index. Students self-reported their academic grading (AG) and perceptions about their academic performance. Spearman's rho and multiple logistic regression models were used. Almost half (47%) experienced some level of FI. The median AG was 95. AG was not significantly (p > 0.05) correlated with FI, nor with depression, anxiety, stress, and SQ. Considering mental health and SQ, moderate/severe FI remained significantly associated with perceived overall progress in college (OR: 2.96; 95%CI: 1.49, 5.88) and attendance to classes (OR:3.14; 95%CI: 1.19, 8.28) as poor or regular, and it was positively related to perceiving difficulties in completing their studies (OR:2.75; 95%CI: 1.43, 5.29). Stress, anxiety, depression symptoms, and poor SQ were also significantly associated with poor/regular perception of academic performance. These findings highlight the need to address psychological and nutritional factors in university students to promote their well-being and academic success.

Findings on dietary characteristics among Haitian immigrants and the threat of food insecurity: A scoping review.

Objectives: This study aimed to map and describe the available evidence on dietary characteristics and diet-related health conditions among Haitian immigrants across the globe. Study design: Scoping review. Methods: This review was based on the international guide Preferred Reporting Items for Systematic review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The searches were conducted in several electronic databases in July 2023. Reports focusing on diet, nutrition, and diet-related health conditions among international Haitian immigrants published in English, Portuguese, French, or Spanish with no year limit were included. The data extracted was tabulated and presented in a narrative summary. Results: Database search retrieved 502 records, of which 30 met the inclusion criteria. The categories that emerged from the analysis were: food consumption patterns and trends, food and nutrition insecurity, cultural identity, and diet-related health conditions. Findings suggest: available evidence underrepresents Latin America and the Caribbean context; research gaps related to adolescents and the elderly and also to noncommunicable diseases except obesity; changes in food consumption after immigration towards less healthy eating; the Haitian immigrant's preference for healthy and traditional eating patterns; many experiences of food insecurity related to poverty, unemployment, and lack of social support, especially in host countries in Latin America and the Caribbean; and a high prevalence of obesity, especially among women. Conclusions: Further research is required in countries in Latin America, mainly. Diet-related chronic diseases, adolescents, and the elderly should be targeted for further research. We recommend: longitudinal and qualitative research; field action reports describing local and global strategies to manage Haitian migration-related food and nutrition issues; culturally appropriate dietary interventions; and policies to protect and support the most vulnerable Haitian immigrants to have their fundamental right to adequate food guaranteed, reducing health inequalities.

Consumption of Ultra-Processed Foods in the Brazilian Amazon during COVID-19.

BACKGROUND: A COVID-19 pandemic erupted, causing a global viral pneumonia outbreak, marking the most significant public health crisis of the 21st century. These changes profoundly impacted population health and well-being, leading to shifts in dietary habits. This study aimed to evaluate the consumption of ultra-processed foods in the Brazilian Amazon before, during, and after the COVID-19 pandemic. METHODS: This is a secondary data analysis study derived from the Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel, 2019-2021) of the Brazilian Ministry of Health. All statistical analyses were performed using the Stata 17 statistical program in the survey module (svy). RESULTS: We found an increased frequency in the subgroups of consumption of ultra-processed foods in the capital of the Brazilian Amazon region between the years 2019 and 2021. In the cities of Boa Vista and Macapá, there was a significant increase in the consumption of snacks, salty snacks, cookies, and meat products. Boa Vista and Macapá showed an increase in the percentage difference in the consumption ≥5 of ultra-processed subgroups, being 30.4% (p = 0.014) and 53.7% (p = 0.014), respectively. CONCLUSIONS: The study indicated an increase in the consumption of ultra-processed foods in the Brazilian Amazon region during and after social distancing.

Predictors of persistent moderate and severe food insecurity in a longitudinal survey in Mexico during the COVID-19 pandemic.

Background: Household food insecurity (HFI) increased in Latin America by 9% between 2019 and 2020. Scant evidence shows who was unable to recover from the COVID-19 pandemic. Our aim was to use a Machine Learning (ML) approach to identify consistent and influential predictors of persistent moderate or severe HFI over 2 years. Methods: We use a three-wave longitudinal telephone survey with a probabilistic sample representative of the Mexican population. With a response rate of 51.3 and 60.8% for the second and third waves, the final sample size consisted of 1,074 individuals. The primary outcome was persistent HFI, i.e., respondents who reported moderate or severe HFI in 2021 and 2022. Twelve income-related predictors were measured in 2020, including baseline HFI. We employed 6 supervised ML algorithms to cross-validate findings in models, examined its precision with 4 standard performance indicators to assess precision, and used SHAP values (Shapley Additive exPlanations) to identify influential predictors in each model. Results: Prevalence of persistent moderate/severe HFI in 2021 and 2022 was 8.8%. Models with only a HFI 2020 baseline measure were used as a reference for comparisons; they had an accuracy of 0.79, a Cohen's Kappa of 0.57, a sensitivity of 0.68, and a specificity of 0.88. When HFI was substituted by the suite of socioeconomic indicators, accuracy ranged from 0.70 to 0.84, Cohen's Kappa from 0.40 to 0.67, sensitivity from 0.86 to 0.90, and specificity from 0.75 to 0.82. The best performing models included baseline HFI and socioeconomic indicators; they had an accuracy between 0.81 and 0.92, a Cohen's Kappa between 0.61 and 0.85, a sensitivity from 0.74 to 0.95, and a specificity from 0.85 to 0.92. Influential and consistent predictors across the algorithms were baseline HFI, socioeconomic status (SES), adoption of financial coping strategies, and receiving government support. Discussion: Persistent HFI can be a relevant indicator to identify households that are less responsive to food security policies. These households should be prioritized for innovative government support and monitored to assess changes. Forecasting systems of HFI can be improved with longitudinal designs including baseline measures of HFI and socioeconomic predictors.

Association between food insecurity and long COVID in adults from southern Brazil: findings of the PAMPA cohort.

BACKGROUND: Social and economic factors, such as food insecurity, contribute to long coronavirus disease (COVID). During the pandemic, a significant rise in food insecurity was observed, both in Brazil and worldwide. We aimed to investigate the association between food insecurity and long COVID in Brazilian adults. METHODS: Cross-sectional study nested within the Prospective study About Mental and Physical Health in Adults (PAMPA) Cohort. Participants completed an online questionnaire in June 2022. We assessed food insecurity using the Brazilian Scale of Food Insecurity. Long COVID was defined as any post-coronavirus disease 2019 symptoms that persisted for at least 3 months after infection. RESULTS: A total of 956 participants were included (74.0% female, median age 36 (Interquartile Range [IQR] (29-45.7). The prevalence of food insecurity was 29.4%, and 77.8% had long COVID. Food insecurity was associated with an increased probability of long COVID (prevalence ratio [PR]: 1.15, 95% confidence interval [CI]: 1.08-1.22). Participants in food insecurity situations had a higher likelihood of experiencing neurological (PR: 1.19, 95% CI: 1.10-1.28), pulmonary (PR: 1.33, 95% CI: 1.17-1.52) and gastrointestinal (PR: 1.57, 95% CI: 1.31-1.88) symptoms after infection. CONCLUSIONS: Food insecurity was associated with long COVID. Governments must plan public policies to mitigate the effects of long COVID and food insecurity.

Socioeconomic determinants of cognition among older adults in the Brazilian longitudinal study of aging (ELSI-Brazil): a life-course approach.

BACKGROUND: The prevalence of cognitive impairment no dementia (CIND) and dementia appears to be higher in low- and middle-income countries (LMICs) compared to high-income economies. Yet few nationally representative studies from Latin American LMICs have investigated life-course socioeconomic factors associated with the susceptibility to these two cognitive conditions. Hence, the present study aimed to examine the associations of early- (education and food insecurity), mid- (employment stability), and late-life (personal income and household per capita income) socioeconomic determinants of CIND and dementia among older adults from Brazil, while simultaneously exploring whether sex plays an effect-modifier role on these associations. METHODS: This population-based study comprised a nationally representative sample of older adults (N = 5,249) aged 60 years and over from the Brazilian Longitudinal Study of Aging (ELSI-Brazil). We fitted multinomial regressions and estimated odds ratios with the respective 95% confidence intervals (CIs). RESULTS: In multivariate analyses, participants with more years of early-life education (0.89, 95% CI [0.81, 0.97]) and mid-life employment stability (0.97, 95% CI [0.96, 0.99]) and higher late-life household per capita income (0.70, 95% CI [0.51, 0.95) were less likely to have dementia. Regarding CIND, more years of mid-life employment stability (0.97, 95% CI [0.96, 0.98]) was the only determinant to confer protection. Notably, secondary sex-based analyses showed the higher the early-life educational attainment, the lower the odds of dementia in women (0.81, 95% CI [0.75, 0.87]) but not in men (1.00, 95% CI [0.86, 1.16]). CONCLUSIONS: These findings may have implications for population health and health policy by advancing our understanding of socioeconomic determinants of CIND and dementia, especially in Latin America.

Sleep duration, overweight status, and the modifying role of food insecurity in a sample of 10- to 14-year-old Mexican early adolescents.

OBJECTIVES: Short sleep duration has been associated with an increased risk of childhood overweight and obesity in high-income countries, but data from low- and middle-income countries are scarce. Independently, short sleep and food insecurity may increase the risk of overweight/obesity, but it is unknown whether they concurrently affect it. METHODS: We included 3350 adolescents aged 10-14 from the 2012 and 2016 Mexican National Health and Nutrition Survey. Short sleep was categorized as less than 9 hours for ages 10-12 and less than 8 hours for ages 13-14. Overweight/obesity was assessed via anthropometry. Modified Poisson regression models assessed prevalence ratios between short sleep and overweight, examining effect modification by food security status. RESULTS: 86% met sleep duration recommendations. Short sleep was associated with an increased prevalence of overweight/obesity (prevalence ratio, 1.16; 95% CI, 1.05, 1.31). Multiplicative interaction was found between low and very low food security status and short sleep: adolescents in low food secure households with short sleep had 1.38 (95% CI: 1.10, 1.75) times the prevalence of overweight/obesity compared to adequate sleepers. Very low food secure households had 1.16 (95% CI: 1.14, 1.31) times the prevalence compared to adequate sleepers. This association was not significant in fully or marginally food secure households. CONCLUSIONS: Short sleep is associated with an increased obesity risk among Mexican adolescents 10-14years, particularly in the context of low and very low food security. These findings highlight the importance of addressing both sleep hygiene and food security in strategies to reduce obesity risk.

Solidarity through food: Coping with food insecurity among adolescent migrants in transit through Mexico and Central America.

BACKGROUND: The food choices of migrants are frequently limited by lack of access to sufficient and adequate food. Food insecurity (FI) during adolescence has potential negative health consequences, however the experiences of FI of adolescent in-transit migrants have seldom been reported. OBJECTIVE: To explore the experiences of FI of adolescent in-transit migrants and their ways of coping with it. METHODS: Qualitative study, with 19 semi-structured interviews with adolescents (ages 13-19 years), in shelters for migrants in Mexico in 2022-2023. We followed a reflexive thematic analysis strategy. RESULTS: Most participants had experienced FI during the journey, and responded by limiting intake, choosing food according to price, seeking temporary work or asking for food or money in the streets. We defined "solidarity through food" as a central theme that summarized participants' experiences of sharing food with other migrants, as givers or recipients. Solidarity through food was a response to FI, benefitting the more disadvantaged (e.g. young children, those who had been robbed). Despite their young age, interviewees took part in this, giving their food to others and restricting their intake to prioritize younger siblings. DISCUSSION/CONCLUSIONS: Solidarity through food was a form of generalized reciprocity, enacted not only among family members or friends, but extended to other migrants sharing the route. In further studies, it will be important to explore the role and nuances of food sharing as a practice of social exchange of responsibility and care, on adolescent migrants' health, and in their psychological and relational development into adulthood.

Analysis of Food Security of Older Rural Indigenous People in Latin America and the Caribbean.

Food insecurity is a critical issue in the Americas, with severe impacts in the Caribbean, Mesoamerica, and South America, particularly affecting older adults in Indigenous and rural contexts where it intersects with poverty, gender, and ethnicity. This study aims to provide an in-depth understanding of the current research about food insecurity among older Indigenous adults in Latin America and the Caribbean. A comprehensive literature review was conducted, utilizing specific search queries and the population, intervention, comparison, and outcome (PICO) strategy across multiple databases to identify the pertinent studies. The findings indicate an increase in academic output on this topic since 2018, with significant emphasis on the interplay between climate change and food insecurity. The review highlights the importance of developing targeted food programs, reforming policies, and fostering collaboration between academia and local communities to implement practical interventions. Despite the growing body of literature, a notable research gap persists in rural areas of Latin America and the Caribbean. This study underscores the necessity of balancing the geographic distribution of research and emphasizes the preservation of cultural practices and the adaptation of public policies to support traditional food practices. It advocates for culturally sensitive interventions and interdisciplinary collaboration to formulate comprehensive strategies. The originality and value of this study lie in its focused analysis of older Indigenous adults, contributing crucial insights to the international literature on food security.

Maternal food insecurity increases the risk of low birth weight babies: Systematic review and meta-analysis.

AIM: To ascertain whether maternal food insecurity was associated with low birth weight of their babies. METHODS: Systematic review conducted following the items of the Preferred Reporting Items for Systematic Reviews-PRISMA, and recorded in PROSPERO. The descriptors food security, low birth weight and infant low birth weight were combined in the electronic databases: Scopus, PubMed, Cochrane Library, Latin American and Caribbean Health Sciences Literature and Google Scholar, independently by two researchers, between October 2022 and September 2023. The meta-analysis of the association between food insecurity and low birth weight was conducted. The included studies underwent quality and risk of bias assessment. RESULTS: The initial search resulted in 631 records, 12 of which met the inclusion criteria and were selected for this study. Mothers experiencing food insecurity presented 3.09 more risk of having low birth weight babies when compared to those in food security situations. CONCLUSION: Evaluating and monitoring the food and nutritional situation of pregnant women is necessary, with emphasis on the importance of prenatal care, to direct public policies that ensure food security and strengthen adequate nutritional conditions for pregnant women and their babies.

Water, sanitation and hygiene insecurity predict abscess incidence among people who inject drugs in a binational US-Mexico metropolitan area: A longitudinal cohort study.

INTRODUCTION: People who inject drugs (PWID) are at high risk of developing injection-related infections, including abscesses. Access to water, sanitation, and hygiene (WASH) are key human rights and services; yet these services have been underexplored as predictors of abscesses among PWID. METHODS: Longitudinal analysis was employed among a cohort of PWID to determine if WASH insecurity (lack of access) was associated with abscess incidence in the Tijuana, Mexico and San Diego, United States metropolitan area during 24-months of follow-up survey data from 2020 to 2023. We calculated abscess prevalence at baseline and tracked the incidence of new abscesses among individuals without an abscess during the previous visit. Time dependent Cox regression modeling was employed with variance clustered by participant to characterize the relationship between WASH insecurity and abscess incidence. RESULTS: At baseline, hand hygiene insecurity, bathing insecurity in the previous six months and open defecation in the last week, were reported by 60 %, 54 % and 38 % of participants, respectively; 21 % reported an abscess in the last six months. The incidence of abscesses was 24.4 (95 %CI: 21.1-27.6) per 100 person-years. After adjusting for covariates, the hazard of developing an abscess remained significantly elevated among individuals using non-improved (with risk of contamination) water sources (e.g., surface water) for preparing drugs (adjusted HR [adjHR]: 1.49 [95 %CI: 1.01-2.21], experiencing bathing insecurity (adjHR: 1.59 [95 %CI: 1.12-2.24]) and open defecation (adjHR: 1.65 [95 %CI: 1.16-2.35]). CONCLUSIONS: PWID in the Tijuana-San Diego metropolitan area reported facing high rates of insecurity accessing WASH services. Abscess incidence was higher (four to nine times) than observed rate among PWID cohorts in other settings. Access to continuously available toilet facilities, bathing infrastructure, and safe water sources for preparing drugs for injection could prevent abscesses among PWID. Accessible WASH infrastructure should be ensured among PWID communities and promoted as a key component of harm reduction infrastructure.

Insegurança alimentar e nutricional e os comportamentos de risco e proteção para saúde em adolescentes durante a pandemia de covid-19 / Food and nutritional insecurity and health risk behaviors in adolescents during the COVID-19 pandemic

RESUMO A pandemia de covid-19 reduziu o acesso aos alimentos e aumentou a insegurança alimentar. Objetivouse analisar a prevalência de Insegurança Alimentar e Nutricional (IAN) em adolescentes brasileiros durante a pandemia de covid-19 segundo características sociodemográficas e examinar a associação entre IAN e comportamentos de risco e proteção em adolescentes brasileiros durante esse período. Estudo transversal com dados da 'ConVid Adolescentes - Pesquisa de Comportamentos', realizada entre junho e outubro de 2020, utilizando-se um questionário autoaplicado por meio de celular ou computador. A população foi adolescentes de 12 a 17 anos, totalizando 9.470. Utilizou-se a Razão de Prevalência (RP) e Intervalo de Confiança de 95% (IC95%), por meio da regressão de Poisson com variância robusta. A prevalência de IAN (26,1%) foi mais elevada entre os adolescentes da raça/cor preta e parda e que estudam em escola pública. Os adolescentes que relataram IAN tiveram menor consumo de hortaliças e frutas, menor prática de atividade física e maior uso de cigarros e álcool. A IAN foi mais prevalente em adolescentes com piores condições socioeconômicas, e, adolescentes com IAN apresentaram maior frequência de comportamentos de risco para a saúde evidenciando a importância de políticas públicas intersetoriais para a redução de desigualdades.

ABSTRACT The COVID-19 pandemic has reduced access to food and increased food insecurity. The objectives were to analyse the prevalence of Food and Nutritional Insecurity (FNI) in Brazilian adolescents during the COVID-19 pandemic according to sociodemographic characteristics and to examine the association between FNI and risk and protective behaviours in Brazilian adolescents during the that period. Cross-sectional study with data from the 'ConVid teenagers - Behaviour Survey,' carried out between June and October 2020, using a self-administered questionnaire via mobile phone or computer. The population was made up of teenagers aged 12 to 17, totalling 9,470. The Prevalence Ratio (PR) and 95% Confidence Interval (95% CI) were used, using Poisson regression with robust variance. The prevalence of FNI (26.1%) was higher among adolescents of black and mixed race/colour and who study in public schools. Adolescents who reported FNI had lower consumption of vegetables and fruits, less physical activity, and greater use of cigarettes and alcohol. FNI was more prevalent in adolescents with worse socioeconomic conditions, and adolescents with FNI showed a higher frequency of health risk behaviours, highlighting the importance of intersectoral public policies to reduce inequalities.

International migration, food insecurity, and mental health: a scoping review protocol / Migración internacional, inseguridad alimentaria y salud mental: protocolo de una revisión de alcance

INTRODUCCIÓN: La inseguridad alimentaria es una prioridad mundial que, según se ha constatado, repercute negativamente en la salud mental, aumentando los riesgos de padecer trastornos mentales comunes y enfermedades mentales graves. Los migrantes internacionales pueden enfrentarse a la inseguridad alimentaria a lo largo del ciclo migratorio, debido a una serie de factores de riesgo como las precarias condiciones de tránsito, la precariedad laboral, la presión financiera, la discriminación y la falta de disponibilidad y acceso a alimentos culturalmente relevantes, entre otros. Aunque existen varias revisiones sobre migración, inseguridad alimentaria y salud en general, no se ha realizado ninguna revisión de alcance sobre la inseguridad alimentaria entre los migrantes internacionales con especial atención a la salud mental. OBJETIVO: Investigar la evidencia sobre inseguridad alimentaria y salud mental entre los migrantes internacionales. MÉTODOS: Se realizará una búsqueda de literatura científica en inglés, español, francés, italiano y portugués publicada desde 2013 en las bases de datos Web of Science, PubMed, Medline, APA PsycArticles, Cinahl, y ASSIA, y de literatura gris en Google Scholar. Dos autores revisarán de forma independiente los títulos, resúmenes y textos completos, antes de extraer los datos de las publicaciones que cumplan los criterios de elegibilidad. Los datos extraídos se mapearán descriptivamente según categorías temáticas generales emergentes. RESULTADOS: esperados La revisión contribuirá a identificar lo que se sabe sobre la migración internacional, la inseguridad alimentaria y la salud mental, las lagunas en la literatura sobre el tema, las oportunidades para subtemas específicos de investigación, y explorar cómo la inseguridad alimentaria y la salud mental pueden estar vinculadas en la literatura existente.

INTRODUCTION: Food insecurity is a global priority that has been found to negatively impact mental health, increasing the risk of mental disorders and severe mental illness. International migrants may face food insecurity throughout their migratory cycle due to a range of risk factors, such as poor transit conditions, precarious employment, financial pressure, discrimination, and lack of availability and access to culturally relevant food, among others. Although there are multiple reviews on migration, food insecurity, and health in general, no scoping review has been conducted on food insecurity among international migrants focusing on mental health. OBJECTIVE: To investigate the available evidence on food insecurity and mental health among international migrants. METHODS: A search of scientific literature in English, Spanish, French, Italian, and Portuguese published since 2013 will be performed in the Web of Science, PubMed, Medline, APA PsycArticles, Cinahl, and ASSIA databases, including grey literature available in Google Scholar. Two authors will independently review titles, abstracts, and full texts before extracting data from publications complying with the eligibility criteria. Extracted data will be descriptively mapped according to emerging thematic categories. EXPECTED RESULTS: The review will contribute to identifying what is known about international migration, food insecurity, and mental health, gaps in the literature, opportunities for specific research subtopics, and how food insecurity and mental health can be linked in the existing literature.

International migration, food insecurity, and mental health: A scoping review protocol.

Introduction: Food insecurity is a global priority that has been found to negatively impact mental health, increasing the risk of mental disorders and severe mental illness. International migrants may face food insecurity throughout their migratory cycle due to a range of risk factors, such as poor transit conditions, precarious employment, financial pressure, discrimination, and lack of availability and access to culturally relevant food, among others. Although there are multiple reviews on migration, food insecurity, and health in general, no scoping review has been conducted on food insecurity among international migrants focusing on mental health. Objective: To investigate the available evidence on food insecurity and mental health among international migrants. Methods: A search of scientific literature in English, Spanish, French, Italian, and Portuguese published since 2013 will be performed in the Web of Science, PubMed, Medline, APA PsycArticles, Cinahl, and ASSIA databases, including grey literature available in Google Scholar. Two authors will independently review titles, abstracts, and full texts before extracting data from publications complying with the eligibility criteria. Extracted data will be descriptively mapped according to emerging thematic categories. Expected results: The review will contribute to identifying what is known about international migration, food insecurity, and mental health, gaps in the literature, opportunities for specific research subtopics, and how food insecurity and mental health can be linked in the existing literature.

Introducción: La inseguridad alimentaria es una prioridad mundial que, según se ha constatado, repercute negativamente en la salud mental, aumentando los riesgos de padecer trastornos mentales comunes y enfermedades mentales graves. Los migrantes internacionales pueden enfrentarse a la inseguridad alimentaria a lo largo del ciclo migratorio, debido a una serie de factores de riesgo como las precarias condiciones de tránsito, la precariedad laboral, la presión financiera, la discriminación y la falta de disponibilidad y acceso a alimentos culturalmente relevantes, entre otros. Aunque existen varias revisiones sobre migración, inseguridad alimentaria y salud en general, no se ha realizado ninguna revisión de alcance sobre la inseguridad alimentaria entre los migrantes internacionales con especial atención a la salud mental. Objetivo: Investigar la evidencia sobre inseguridad alimentaria y salud mental entre los migrantes internacionales. Métodos: Se realizará una búsqueda de literatura científica en inglés, español, francés, italiano y portugués publicada desde 2013 en las bases de datos Web of Science, PubMed, Medline, APA PsycArticles, Cinahl, y ASSIA, y de literatura gris en Google Scholar. Dos autores revisarán de forma independiente los títulos, resúmenes y textos completos, antes de extraer los datos de las publicaciones que cumplan los criterios de elegibilidad. Los datos extraídos se mapearán descriptivamente según categorías temáticas generales emergentes. Resultados esperados: La revisión contribuirá a identificar lo que se sabe sobre la migración internacional, la inseguridad alimentaria y la salud mental, las lagunas en la literatura sobre el tema, las oportunidades para subtemas específicos de investigación, y explorar cómo la inseguridad alimentaria y la salud mental pueden estar vinculadas en la literatura existente.