Table_1_Dietary Diversity in the Eastern Mediterranean Region Before and During the COVID-19 Pandemic: Disparities, Challenges, and Mitigation Measures.DOCX

The COVID-19 pandemic has revealed the Eastern Mediterranean Region's food system's fragility posing severe challenges to maintaining healthy sustainable lifestyle. The aim of this cross-sectional study (N = 13,527 household's family members, mean age: 30.3 ±11.6, 80% women) is to examine the impact of the COVID-19 pandemic on food consumption patterns and household's dietary diversity in 10 Eastern Mediterranean countries. A food frequency questionnaire was used to investigate the consumption patterns along with the calculation of the Food Consumption Score (FCS), a proxy indicator of dietary diversity. Data collected on cooking attitudes, shopping and food stock explore the community mitigation measures. In the overall population, before and during the pandemic, most food groups were consumed less or equal to 4 times per week. As evident from our findings and considering that the pandemic may be better, but it's not over, small to moderate changes in food consumption patterns in relatively short time periods can become permanent and lead to substantial poor dietary diversity over time. While it is a priority to mitigate the immediate impact, one area of great concern is the long-term effects of this pandemic on dietary patterns and dietary diversity in Eastern Mediterranean households. To conclude, the COVID-19 crisis revealed the region's unpreparedness to deal with a pandemic. While the aggressive containment strategy was essential for most countries to help prevent the spread, it came at a high nutritional cost, driving poor dietary diversity.

新冠疫情（COVID-19 pandemic）暴露了东地中海区域食品系统的脆弱性，为维持健康可持续的生活方式带来了严峻挑战。本横断面研究（cross-sectional study）的样本量为13527名家庭成员，平均年龄30.3±11.6岁，女性占比80%，其研究目的为探究新冠疫情对东地中海10个国家居民食品消费模式及家庭膳食多样性的影响。本研究采用食物频率问卷（Food Frequency Questionnaire）调研消费模式，并计算作为膳食多样性替代指标的食物消费评分（Food Consumption Score, FCS）；同时收集居民烹饪态度、购物行为与食品储备相关数据，以探析社区层面的疫情缓解举措。在全部研究对象中，疫情前后多数食物类别的周摄入频次均小于或等于4次。结合本研究结果来看，尽管疫情形势或有所缓和但尚未结束，短期内食品消费模式出现的小幅至中度变化可能会演变为长期习惯，并随时间推移导致膳食多样性显著下降。尽管缓解疫情的即时影响是当务之急，但令人高度担忧的是，此次疫情可能会对东地中海国家家庭的膳食模式与膳食多样性产生长期负面影响。综上，新冠疫情危机暴露了该区域应对公共卫生突发事件的准备不足。尽管多数国家采取的严格防控策略对遏制病毒传播至关重要，但此举却付出了高昂的营养健康代价，导致居民膳食多样性水平下降。