Covid-19 lockdown exacerbates food insecurity among hemodialysis patients in Pulau Pinang, Malaysia

Introduction. Movement Control Order (MCO) imposed due to Covid-19 pandemic has disrupted economic activities. However, MCO’s impact on food security at household level among vulnerable hemodialysis population is unknown. Therefore, this study was conducted to determine the impact of full-blown MCO on food intakes and body weight among hemodialysis (HD) patients according to food security status. Method. : In this retrospective study, multiethnic HD patients (n=107) were recruited from 3 dialysis centres in Pulau Pinang, Malaysia. Food security status was assessed using the validated 10-items USDA-FSSM via face-to-face interview. Differences in food intakes and post-dialysis weight before and during the full-blown MCO in 2020 were analyzed using general linear model. Modified food consumption score was used to measure food intakes before and during full-blown MCO. Results. Food insecurity during MCO was evidenced in 22.4% of HD patients with a greater proportion observed in female (p < 0.001), unemployed (p < 0.011), and those who had lower education level (p < 0.012), household income (p < 0.003), and number of working family members (p < 0.016). Regardless of food security status, significant reductions of dietary intakes were observed during MCO for fruits (p < 0.001), vegetables (p < 0.005), and kuih and snacks (p < 0.011) but not for fish and seafood, meat and poultry, cereal and tubers, milk and dairy product, and sugarsweetened beverages (p > 0.05). Food-insecure HD patients experienced a greater reduction in fruits, kuih and snacks intakes as compared to food-secure HD patients. Nevertheless, no significant change in post-dialysis weight (p = 0.13) was found in HD patients with and without food security problem. Conclusion. MCO exacerbates the food accessibility problem in foodinsecure HD patients.