The current global pandemic of Coronavirus (COVID-19), and measures adopted to reduce its spread, threaten the nutritional status of populations in Low- and middle-income countries (LMICs). Documenting how the COVID-19 affects diets, nutrition and food security can help generating evidence-informed recommendations for mitigating interventions and policies. We carried out a systematic literature review. A structured search strategy was applied in MEDLINE (Pubmed®), EMBASE®, Scopus® and Web of Science®. Grey literature was retrieved by screening a pre-set list of institutions involved in monitoring the impact of the COVID-19 pandemic on nutrition and food security. The first search was done on 20th August 2020, and updated in mid-November 2020 and mid-January 2021. All research steps were described as recommended in the PRISMA statement. Out of the 2085 references identified, thirty-five primary studies were included. In spite of their heterogeneity, studies converge to demonstrate a detrimental effect of COVID-19 pandemic and associated containment measures on diet quality and food insecurity. One of the major direct effects of COVID-19 on food and nutrition outcomes has been through its impact on employment, income generating activities and associated purchasing power. Other channels of impact, such as physical access, availability and affordability of food provided a heterogeneous picture and were assessed via binary and often simplistic questions. The impacts of COVID-19 on food systems and diets manifested with various intensity degrees, duration and in different forms. Factors contributing to these variations between and within countries were: 1) timing, duration and stringency of national COVID-19 restriction measures and policies to mitigate their adverse impacts; 2) context specific food value chain responses to domestic and international containment measures; 3) differentiated impacts of restriction measures on different groups, along lines of gender, age, socio-economic status and employment conditions. Shorter value chains and traditional smallholder farms were somewhat more resilient in the face of COVID-19 pandemic. Additionally, the impact of the pandemic has been particularly adverse on women, individuals with a low socio-economic status, informal workers and young adults that relied on daily wages. Finally, there were heterogeneous government responses to curb the virus and to mitigate the damaging effects of the pandemic. It has been demonstrated that existing and well-functioning social protection programmes and public distribution of food can buffer the adverse effects on food insecurity. But social safety nets cannot be effective on their own and there is a need for broader food systems interventions and investments to support sustainable and inclusive food systems to holistically achieve food and nutrition security. The current economic and heath crisis impacted diet quality and food security. This raises concerns about long term impacts on access to and affordability of nutrient-rich, healthy diets and their health implications. Women and individuals with a low socio-economic are likely to be the most at risk of food insecurity. Social safety nets can be effective to protect them and must be urgently implemented. We advocate for improved data collection to identify vulnerable groups and measure how interventions are successful in protecting them.

COVID-19 has revealed new tensions and exacerbated old fragilities in global food systems, characterised by the systemic socio-economic reliance on invisible, unpaid and devalued work. We argue that, in the same way environmental concerns have become integral to the Sustainable Food Systems agenda, a social reproduction approach, informed by geographies of care, are essential for a critical analysis and the search for alternatives. By linking analytical concepts to examples from social movements, the commentary calls for a paradigm shift and a new research agenda involving these critical perspectives on resilient and sustainable food systems.

The uptake of innovative technologies and practices in agriculture aimed at the valorisation of natural resources can be scant in Low and Middle Income Countries (LMICs). Integration of financial viability assessments with farmers and environmental evaluations can help to understand some aspects of the low uptakes of innovations. Using the case study of Cocoa Pod Husk (CPH) valorisation in Indonesia, we provide insights into (i) a choice modelling method to assess the economic viability of CPH valorisation and (ii) an agronomic trial assessing the consequences on soil quality of diverting CPH from its role as a natural fertilizer. The economic viability assessment suggested that farmers require higher levels of compensation than might be expected to collect or process CPH (a small proportion of farmers would undertake all processing activities for 117 GBP/t CPH). The agronomic trial concluded that CPH plays only a minor role in the maintenance of soil phosphorus, calcium and magnesium, but it plays an important role for crop potassium. CPH removal would reduce the partial balances for carbon and nitrogen by 15.6% and 19.6%, respectively. Diversion of CPH from current practices should consider the long-term effects on soil quality, especially because it might create increased reliance on mineral fertilizers.

This paper evidences how many rural poor Cambodians are sick of debt. Based on original, mixed-method data (2020-2022), exploring credit provisioning in this context, the aim of this paper is to illuminate some of the conditions leading to rural Cambodians taking on debt to bolster their health, and the effects this is having on borrowers' physical, psychological, emotional and social health. Specifically, we show how the health of our participants is constrained by a range of major illnesses that many suffer from and their poor food conditions, both exacerbated by the effects of climate change. Against this backdrop, many resort to debt-taking from multiple sources, including microfinance, as a coping strategy to pay for out-of-pocket health expenses and to cover food costs. While such loans offer a short-term means of sustaining health, we show that the extent of debt needed is leading to over-indebtedness which ultimately undermines health in the longer-term. Debtors are pushed to make further undue sacrifices to their food, treatment options and living conditions, specifically to service debt. We show how they are then rendered vulnerable to being exposed to, and experiencing, the negative effects of health and economic shocks, as well as to different forms of psychological, physical, emotional, social, and moral suffering to meet payments. Being sick of debt is especially acute for overindebted women who take on an increased double shift of productive and reproductive work to pay loans. While some of the adverse effects of over-indebtedness are made visible here, we warn that other forms of suffering potentially remain hidden, and will likely be expressed as longer-term population patterns of ill-health. In this context, over-indebtedness is hampering the government's aim of achieving universal health coverage and interventions are needed that reduce the debt crisis among the rural poor in order to improve health.

Unhealthy diets are among the main risk factors associated with non-communicable diseases (NCDs). In Sub Saharan Africa, NCDs were responsible for 37% of deaths in 2019, rising from 24% in 2000. There is an increasing emphasis on health-harming industrial foods, such as ultra-processed foods (UPFs), in driving the incidence of diet-related NCDs. However, there is a methodological gap in food systems research to adequately account for the processes and actors that shape UPFs consumption across the different domains of the food systems framework and macro-meso-micro levels of analysis. This paper interrogates how the Food Systems Framework for Improved Nutrition (HLPE in Nutrition and food systems. A report by the high level panel of experts on food security and nutrition of the committee on world food security, 2017), considered the dominant framework to analyse nutrition, and language of interdisciplinarity are practised in research with regards to consumption of UPFs among adolescents in Ghana, a population group that is often at the forefront of dramatic shifts in diets and lifestyles. We conducted a scoping review of studies published between 2010 and February 2022, retrieved 25 studies, and mapped the findings against the domains and analysis levels of the Food Systems Framework for Improved Nutrition (HLPE in Nutrition and food systems. A report by the high level panel of experts on food security and nutrition of the committee on world food security, 2017). Our study illustrates that there is a tendency to address unhealthy diets among adolescents in a siloed manner, and as a behavioural and nutritional issue. In most cases, the analyses fail to show how domains of the food systems framework are connected and do not account for linkages across different levels of analysis. Methodologically, there is a quantitative bias. From the policy point of view, there is a disconnect between national food policies and food governance (i.e., trade and regulations) and initiatives and measures specifically targeted at adolescent’s food environments and the drivers of UPFs consumption.