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

Maha Hoteit, Lebanese University; Lebanese University; Lebanese University
Hussein Mortada, Lebanese University; Lebanese University
Ayoub Al-Jawaldeh, World Health Organization Regional Office for the Eastern Mediterranean
Rania Mansour, Lebanese University
Batoul Yazbeck, Lebanese University
Majid AlKhalaf
Khlood Bookari, Taibah University
Reema Tayyem, Qatar University
Narmeen J. Al-Awwad, Hashemite University
Haleama Al Sabbah, Zayed University
Leila Cheikh Ismail, University of Sharjah; University of Oxford
Radwan Qasrawi, Al-Quds University; Istinye University
Rania Abu Seir
Iman Kamel, National Research Centre
Somaia Dashti, Public Authority for Applied Education and Training
Sabika Allehdan, University of Bahrain
Mariam Al-Mannai, University of Bahrain
Hiba Bawadi, Qatar University
Mostafa Waly, Sultan Qaboos University
Charlotte De Backer
Kathleen Van Royen
Lauranna Teunissen
Isabelle Cuykx


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.