ABSTRACT:

This article analyzes factors affecting food access and consumption on the part of domestic groups during COVID-19 lockdown in Villa 21-24 of the City of Buenos Aires during April and June 2020. In a context marked by high rates of poverty and malnutrition due to excess, it was possible to observe the influence of food environments with abundant ultra-processed and industrialized products, especially flour, through different access channels. The relationship between the role of women and intra-household food management shows that those who bear the burden of hunger are women. Food availability is assured without questioning its quality, but access to food depends on individual management, rendering them invisible as rights-bearing subjects, with a particular impact on children and adolescents.

KEYWORDS:
Malnutrition; Social Inequality; COVID-19; Right to Food; Gender; Argentina

INTRODUCTION

The overlapping of hunger, food insecurity, overweight, and obesity are the main health public health problems, violating the human right to health and to nutrition.¹1. Naciones Unidas. Informe del Relator Especial sobre el derecho a la alimentación, Olivier De Schutter [Internet]. 2011 [citado 18 jul 2021]. Disponible en: Disponible en: http://tinyurl.com/gomd44k .
http://tinyurl.com/gomd44k... ⁾ There are serious malnutrition problems²2. Organización Mundial de la Salud. Malnutrición [Internet]. 9 jun 2021 [citado 18 jul 2021]. Disponible en: Disponible en: https://tinyurl.com/3ee9n8jj .
https://tinyurl.com/3ee9n8jj... ⁾ associated with climate change like “global syndemic,” a synergy of epidemics sharing common causes resulting from present-day unhealthy and minimally regulated food systems³3. Swinburn B , Kraak VI, Dietz WH, et al. The global syndemic of obesity, undernutrition, and climate change: The Lancet Commission report. The Lancet. 2019;393(10173):S791-S846. doi: 10.1016/S0140-6736(18)32822-8.^,44. Organización de las Naciones Unidas para la Alimentación y la Agricultura. Experto internacional identifica a Chile como país ejemplo en políticas contra la obesidad [Internet]. 23 ago. 2019 [citado 18 jul 2021]. Disponible en: Disponible en: https://tinyurl.com/3phwhna3 .
https://tinyurl.com/3phwhna3... ⁾ that are represented in obesogenic environments,⁵5. Swinburn B, Egger G, Raza F. Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. Preventive Medicine. 1999;29(6 Pt1):S563-S570. doi: 10.1006/pmed.1999.0585.^,66. Vandevijvere S, Chow C, Hall K, Umali E, Swinburn B. Increased food energy supply as a major driver of the obesity epidemic: a global analysis. Bulletin World Health Organization. 2015;93(7):S446-S456. doi: 10.2471/BLT.14.150565.^,77. Organización Panamericana de la Salud. Alimentos y bebidas ultraprocesados en América Latina: tendencias, efecto sobre la obesidad e implicaciones para las políticas públicas. Washington DC: OPS; 2015.^,88. Crovetto MM, Uauy R, Martins AP, Moubarac JC, Monteiro C. Disponibilidad de productos alimentarios listos para el consumo en los hogares de Chile y su impacto sobre la calidad de la dieta (2006-2007). Revista Médica de Chile. 2014;142(7):850-858.doi: 10.4067/S0034-98872014000700005.⁾ adversely affecting the protection of the right to adequate nutrition.⁹9. Naciones Unidas. Informe presentado por el Relator Especial sobre el derecho a la alimentación, Olivier De Schutter; Informe final: El potencial transformador del derecho a la alimentación [Internet]. 2014 [citado 18 jul 2021]. Disponible en: Disponible en: http://tinyurl.com/zhzhnoz .
http://tinyurl.com/zhzhnoz... ^,1010. Piaggio LR, Solans AM. Enfoques socioculturales de la alimentación: Lecturas para el equipo de salud. Buenos Aires: Akadi; 2014.⁾ It is under this scenario where global syndemic and COVID-19 pandemic are developed, accentuating inequality and vulnerability situations.¹¹11. Merril S, Scott C. Syndemics and public health: Reconceptualizing disease in bio-social context. Medical Anthropology Quarterly. 2003;17(4):S423-S441. doi: 10.1525/maq.2003.17.4.423.⁾ ECLAC’s Special Report COVID-19 No. 3 warns about the increase in income-based poverty and vulnerability in people having informal jobs under conditions of scarcity, who reside in peripheral areas, suffer from some form of disability or are migrants, living in the streets, micro and small-sized enterprises, and women having precarious employment.¹²12. Comisión Económica para América Latina y el Caribe. El desafío social en tiempos del COVID-19: Informe Especial COVID-19 No. 3 [Internet]. 12 may 2020 [citado 16 jun 2020]. Disponible en: Disponible en: https://bit.ly/2NfgQKd .
https://bit.ly/2NfgQKd...

This study was conducted at a time when poverty in Argentina accounted for 40.9% of the people, of whom 10.5% were classified as indigent, and among children aged 15 or younger, 56.3% were living in total poverty, whereas 15.6% were considered indigent.¹³13. Instituto Nacional de Estadística y Censos. Incidencia de la pobreza y la indigencia en 31 aglomerados urbanos: Segundo semestre de 2020. Informes Técnicos [Internet]. 2020;5(59) [citado 16 jun 2020]. Disponible en: Disponible en: https://tinyurl.com/kzjpzc5k .
https://tinyurl.com/kzjpzc5k... These data worsened by the second semester of 2020, with 57.7% of people aged 0 to 14 living in poverty.¹⁴14. Instituto Nacional de Estadística y Censos. Incidencia de la pobreza y la indigencia en 31 aglomerados urbanos: Segundo semestre de 2019. Informes Técnicos [Internet]. 2020;4(59) [citado 16 jun 2020]. Disponible en: Disponible en: https://tinyurl.com/3yucte22 .
https://tinyurl.com/3yucte22... The year-on-year variation of the monthly valorization of the basic food basket and of the total basic basket for a four-member household based in Greater Buenos Aires, between May 2019 and May 2020, had increased 47.9% and 42% respectively.¹⁵15. Instituto Nacional de Estadística y Censos. Canastas básicas en pesos y variación interanual: Gran Buenos Aires, mayo de 2019 y 2020 [Internet]. 17 jun 2020 [citado 16 jun 2020].https://tinyurl.com/29txwbwa
https://tinyurl.com/29txwbwa... During the conduct of this study, the pronounced rise in prices of foods and other basic items was aggravated by the epidemiologic, social and health situation affecting the population in general and, especially, the child population.¹⁶16. Unicef. Unicef actualiza la estimación de pobreza infantil: Alcanzaría a más de 8 millones de chicas y chicos [Internet]. 5 ago 2020 [citado 18 jul 2021]. Disponible en: Disponible en: https://tinyurl.com/ys62xxxa .
https://tinyurl.com/ys62xxxa...

The food and nutritional situation affecting the population was complex already, the prevalence of overweight, albeit affecting all age groups and income quintiles, the lower-income social groups evidenced higher rates of excess weight, with a 21% higher in the lower-income quintile against the highest quintile,¹⁷17. Argentina, Ministerio de Salud. 2° Encuesta Nacional de Nutrición y Salud: Resumen ejecutivo [Internet]. Buenos Aires: Ministerio de Salud; 2019 [citado 18 jul 2021]. Buenos Aires, Argentina. Disponible en: Disponible en: https://tinyurl.com/2cxw3fvh .
https://tinyurl.com/2cxw3fvh... ⁾ which aggravated due to the impact of COVID-19, violating human rights even more.¹⁸18. Unicef. La pobreza y la desigualdad de niñas, niños y adolescentes en la Argentina. Efectos del Covid-19 [Internet]. Buenos Aires: UNICEF Argentina; 2020[citado 16 jul 2020]. Disponible en: Disponible en: https://tinyurl.com/2p8e7s85 .
https://tinyurl.com/2p8e7s85... ^,1919. FAO, FIDA, OPS, WFP, Unicef. Panorama de la seguridad alimentaria y nutricional en América Latina y el Caribe 2020 [Internet]. Santiago: FAO, OPS, WFP, UNICEF; 2020[citado 16 jul 2020]. Disponible en: Disponible en: https://doi.org/10.4060/cb2242es
https://doi.org/10.4060/cb2242es... ^,2020. United Nations System Standing Committee on Nutrition. Food Environments in the COVID-19 Pandemic [Internet]. 2020 [citado 10 jul 2020]. Disponible en: Disponible en: https://tinyurl.com/npmmvxvf .
https://tinyurl.com/npmmvxvf... ⁾ This study was accomplished applying a qualitative approach that assumes food processes from a holistic perspective,²¹21. Fischler C. El (h)omnívoro: el gusto, la cocina, el cuerpo. Barcelona: Anagrama; 1995.^,2222. Contreras J, Gracia-Arnaiz M. Alimentación y cultura: Perspectivas antropológicas. Barcelona: Ariel; 2005.⁾ marked by power relations that have an effect on the meanings that people attribute to foods.²³23. Mintz S. Sabor a comida, sabor a libertad. México DF: CIESAS; 2003.⁾ Attention was paid to the relationships between malnutrition due to excess and the role of women. It should be noted that, although in Argentina the largest prevalence of overweight is found in men (37.5%), as for women (31.1%),²⁴24. FAO, OMS, OPS. Panorama de la Seguridad Alimentaria y Nutricional en América Latina y el Caribe 2016: Sistemas alimentarios sostenibles para poner fin al hambre y la malnutrición. Santiago: FAO, OMS, OPS; 2017.⁾ the trend in the increase of obesity has had a disproportionate impact on women across Latin America and the Caribbean: in more than 20 countries in the region the rate of female obesity is almost ten percentage points higher than that of men.²⁵25. FAO, OPS, WFP, Unicef. Panorama de la seguridad alimentaria y nutricional en América Latina y el Caribe 2019 [Internet]. 2019 [citado 16 jul 2020]. Disponible en: Disponible en: https://tinyurl.com/mr3zwuct .
https://tinyurl.com/mr3zwuct... ⁾ Similarly, the prevalence of food insecurity is higher in women than in men, which places Argentina among the countries that maintain wider gaps between men and women.¹⁹19. FAO, FIDA, OPS, WFP, Unicef. Panorama de la seguridad alimentaria y nutricional en América Latina y el Caribe 2020 [Internet]. Santiago: FAO, OPS, WFP, UNICEF; 2020[citado 16 jul 2020]. Disponible en: Disponible en: https://doi.org/10.4060/cb2242es
https://doi.org/10.4060/cb2242es... ⁾ These statistics reinforce the importance of considering a gender perspective, which helps to visibilize the fact that women assume the greater part of the burden of social reproductive work, including “responsibilities” concerning nutrition, which reproduce inequality and power structures.²⁶26. D’Argemir DC. Los cuidados y sus máscaras: Retos para la antropología feminista. Mora. 2014;20:167-182.^,2727. Carrasco C, Borderías C, Torns T. Introducción: El trabajo de cuidados, Antecedentes históricos y debates actuales. En: El trabajo de cuidados: Historia, teoría y política. Madrid: Catarata; 2011. p. 13-97.⁾ Women are found among the most vulnerable groups in terms of gender-based discrimination; of social, legal, and cultural constraints; they have a more limited access than men to employment opportunities, productive, and financial resources, education, decision making and labor markets.²⁷27. Carrasco C, Borderías C, Torns T. Introducción: El trabajo de cuidados, Antecedentes históricos y debates actuales. En: El trabajo de cuidados: Historia, teoría y política. Madrid: Catarata; 2011. p. 13-97.⁾ In this context, the cross-sectoral approach is crucial to describe how groups of people are at a disadvantage due to multiple sources of prejudices and discrimination, based on their overlapped identities and experiences, such as, inter alia, race, class, gender identity.²⁸28. Crenshaw K. Dermarginalizing the intersection of race and sex: A black feminist critique of antidiscrimination doctrine, feminist theory, and antiracist politics. Chicago: University of Chicago Legal Forum; 1989. p. 139-197.⁾ The notion of race refers to the existence of historically excluded groups amid a colonial structure and matrix of racialized and hierarchized power, with white and “whitened” people at the top but the other peoples (indigenous, peasants, afro-descendants, among others) in the lower strata.²⁹29. Kessler G. Las consecuencias de la estigmatización territorial: Reflexiones a partir de un caso particular. Espacios en Blanco. 2012;(22):165-197.⁾ This structure is linked to stigmatization processes relative to “the poor” and “their culture,”³⁰30. Goffman E, Guinsberg L. Estigma: la identidad deteriorada. Buenos Aires: Amorrortu, 1970.⁾ which reinforce preexisting prejudices toward those who belong to most disadvantaged sectors,³¹31. Bayón M. La construcción del otro y el discurso de la pobreza: Narrativas y experiencias desde la periferia de la ciudad de México. Revista Mexicana de Ciencias Políticas y Sociales. 2015;60(223):357-376.⁾ and are shown in racist and xenophobic discourses, within which residents of bordering countries are included.³²32. Walsh C. Interculturalidad crítica y educación intercultural. Construyendo Interculturalidad Crítica. 2010;75(96):167-181.

Account was taken of the care needs as something that affects all human beings in stages of the human lifecycle and as an essential part of social reproduction, which help to visualize how care is distributed among genders, generations, family, government, and market. This argument makes it possible to delve into relations and tensions among inequalities between men and women in the field of nutrition and malnutrition due to excess, in particular.²⁴24. FAO, OMS, OPS. Panorama de la Seguridad Alimentaria y Nutricional en América Latina y el Caribe 2016: Sistemas alimentarios sostenibles para poner fin al hambre y la malnutrición. Santiago: FAO, OMS, OPS; 2017.

This article describes aspects and significances that have an effect on food access and consumption, with a focus on ultra-processed products, on the part of domestic groups in the context of COVID-19 pandemic, in Villa 21-24 (hereinafter, neighborhood 21/24) of the Autonomous City of Buenos Aires (CABA) [Ciudad Autónoma de Buenos Aires], during the months of April and June 2020. The aspects analyzed here include, inter alia, channels of access to food and meals, identification of individuals in charge of nutrition inside the household, criteria for food purchasing, consideration of the most important foods, and possible obstacles that have an effect on their purchase, preparation, and consumption.

METHODOLOGICAL ASPECTS

This work results from a larger participant-observation, descriptive, and cross-sectional study, with a quantitative and quantitative approach, which describes aspects of environments, domestic units within the Metropolitan Area of Buenos Aires, and the relationship with the nutritional state of their members. Said study falls within the project “Alimentación y entornos obesogénicos: Estudio desde una mirada multidisciplinaria en contextos urbanos y periurbanos de Buenos Aires” [Food and obesogenic environments: A study from a multidisciplinary perspective in urban and peri-urbans contexts in Buenos Aires] (UBACyT 2018-2020 and research financial aid Beca Salud Investiga Dr. Abraam Sonis for multi-centric research studies 2018). The study, conducted between 2018 and 2019, included a population living in unfavorable socioeconomic conditions, residing in the Metropolitan Area of Buenos Aires, such as, neighborhood 21/24, located in Commune 4 of the Autonomous City of Buenos Aires. Some of their characteristics include, inter alia, high crowding levels, lack of gas, sewage and drinking water supply networks in a lot of households, and, in the case of gas, the population used bottled gas mainly. Most of the adult people had non-registered employment.³³33. Dirección General de Estadística y Censos. Resultados provisionales del Censo Nacional de Población, Hogares y Viviendas 2010 en la Ciudad de Buenos Aires [Internet]. [citado 25 jul 2020]. 2011 [citado 16 jul 2020]. Disponible en: Disponible en: https://tinyurl.com/yd7pnw7v .
https://tinyurl.com/yd7pnw7v... ^,3434. Autoridad de Cuenca Matanza Riachuelo. Informe final EISAAR Camino de Sirga del Barrio Villa 21-24, CABA [Internet]. 2018 [citado 25 jul 2020]. Disponible en: https://tinyurl.com/2p8aeuhn.
https://tinyurl.com/2p8aeuhn... ^,3535. Molek N. Procesos identitarios entre los migrantes eslovenos de entreguerras y sus descendientes en Argentina. La Rivada. 2016;4(7):3-21.⁾ Another characteristic was the overwhelming presence of migrants coming from Paraguay. Although there are no official data, the existence of multiple institutions could be observed as well as of food posts and regional products.

We worked with households made up of adult people and at least one child or adolescent, aged 5 to 19 years that attended one of the self-managed tea community centers, whose figurehead we had previously met. We included domestic units in which the information was provided by the person responsible for purchasing foods and lived at least with one child and/or adolescent aged 5 and 19 years. We discarded from the study adult people that had a disease that prevented them from responding and/or completing the study phases. The domestic units were selected by a convenience, non-probability sampling. In-depth interviews were performed, alternating such techniques as informal interviews and participant observation.³⁶36. Guber R. La etnografía: método, campo y reflexividad. Bogotá: Grupo Editorial Norma; 2001.

The study complies with all ethical requirements of autonomy, beneficence, and justice.³⁷37. Asociación Médica Mundial. Declaración de Helsinki. Declaración de Helsinki de la AMM - principios éticos para las investigaciones médicas en seres humanos [Internet]. 2017 [citado 25 jul 2020]. Disponible en: Disponible en: https://tinyurl.com/2p896vsm .
https://tinyurl.com/2p896vsm... It was evaluated and accepted by the committee of ethics at the Hospital “Prof. Dr. John P. Garrahan”. Each individual that took part in the study signed the relevant informed consent. The original names were changed to protect confidentiality of the respondents and the data obtained.

At the start of the pandemic, another study was proposed, accomplished with the support of UNICEF Argentina, applying an exclusively qualitative approach and phenomenological interpretation, titled “Prácticas alimentarias, obesidad y COVID-19 en contextos de pobreza urbana: Villa 21-24, Ciudad de Buenos Aires, Argentina, 2020” [“Food practices, obesity and COVID-19 in contexts of urban poverty: Villa 21-24, City of Buenos Aires, Argentina, 2020”.] For this study, we once again contacted the figurehead in charge of tea community center located in the neighborhood as well as 17 women that participated in the domestic groups of neighborhood 21/24, with whom we had worked before and with whom we were still in contact. All of these women lived with at least one child and/or adolescent, who attended the abovementioned tea community center. In-depth interviews were conducted, which lasted about one hour, between April and June 2020 through calls made to the women’s personal cellular phone. Although the qualitative methodology is traditionally based on face-to-face relationships,³⁸38. Guber R. El salvaje metropolitano: reconstrucción del conocimiento social en el trabajo de campo. Buenos Aires: Paidós; 2004.⁾ due to the mandatory lockdown, it was the only possible solution. Interviews were audio-recorded. After their transcription and reading, we elaborated qualitative matrixes with the analysis of the fragments included in the categories to establish conceptual topics and text construction.

RESULTS

Food environment and access to foods in neighborhood 21/24

Based on the analysis of the interviews, it was revealed that the ages ranged from 18 to 55 years. None of the participants, at the time of the interviews, had been diagnosed with COVID-19; however, one of the women, with whom an interview had been scheduled, died to COVID-19. Almost all of the interviewees were in charge of the domestic and care tasks, some in an exclusive way because they were the only adult responsible for those tasks, while others, to different degrees, shared them with their partners. Their economic situations presented different degrees of vulnerability. Unemployment, suspension of non-registered work activities, rise in prices, fear to contagion, low-quality Internet services (which proved to be an obstacle for children and adolescents who took online lessons) were gradually worsening in line with stricter confinement measures. As regards access to foods and produce, three channels were identified:

The main purchase criterion in this social and health context reported by the interviewees is the optimization of available economic resources, in combination with the search of foods that are considered basic and that “cannot be missing.” The main food is meat (mainly chicken - drumstick and thigh, and wings -, also beef - stewing beef, ossobuco, mince, honeycomb tripe -), which are bought every fifteen days and on a monthly basis, in some households they are stored in pieces in freezers - but not all the households had one - and bought at supermarkets and hypermarkets. Said method was mentioned by almost all the interviewees, but not all the domestic groups could be applied due to lack of resources. Also bread, flour, some vegetables, and fruits, milk, and drinkable yoghurt, cookies, snack products, sweets and sugared beverages. Some interviewees reported that they did emergency shopping in local stores, highlighting the practical aspect related to proximity at the risk of paying high prices as opposed to the prices found in hypermarket and supermarket chains located one and two kilometers away from the neighborhood. The main foods reported by the interviewees were bread, some vegetables or fruits, which they had not received through the food modules at schools or community kitchens, sugared beverages, snack products and sweets.

The following testimonies evidence the economic barrier as the main obstacle to have access to foods that are considered basic on the part of some interviewees, daily cleaning women, household breadwinners, who, when being unable to go to work outside of their neighborhoods, they stopped collecting a fundamental part of their income:

Both in the previous testimony as in the one that follows, we can observe the peripheral place that likes and preferences of the younger members of the family occupy, and the concern for cleaning products related to hygiene measures related to the pandemic:

The persons responsible for buying foods and collecting bags and/or viands were, without exception, women in charge of the domestic groups, while the role of their partners involved “helping” them. With respect to the role of social organizations, what should be highlighted is the response given by the persons who had undergone a more serious vulnerability situation. The emergence of common pots, tea community centers and community kitchens, as well as the substantial increase in the number of people attending these channels by the end of our field work, was in line with the rise in COVID-19 positive cases and the extension of lockdown. Among the least valued foods were legumes and pumpkins, alleging the great amount received through food assistance programs and lack of preference according to their eating habits and cooking abilities, which leads them to give away, exchange, and/or sell these items. In this sense, one of the interviewees commented that with her mother-in-law she exchanged chickpeas included in the school food module, for flour, sugar, or milk, explaining that she did not know how to cook them and that her children did not like them either.

We are made of flour

In relation to preparations and food consumptions during lockdown, the most common elaborations, prior to the pandemic, reappear with a greater proportion of refined flours and products high in sugar, salt, and fats at the expense of natural and fresh food like fruits, vegetables, meat, cheese, eggs, among others. The elaborations that were mostly mentioned by the interviewees are the same as the ones reported in the previous study (2018-2019), such as stews in their multiple variants (with chicken, with meat, with rice, with noodles, with polenta), braises, soups, among others. Also noodles or rice with butter and/or cheese; fried cutlets, although at times they are regarded as exceptional and “expensive” options. In all cases, the association of said elaborations with previous economic limitations are central and recurrent, as shown in the following extract from one of the interviews:

In line with lockdown, there is a clear reference to the elaboration of breads, cakes, and cookies. Another special mention includes fried dough and grilled tortillas, which are usually eaten in the afternoon or in the evening, as well as at the end of the day as the last meal. They were also mentioned by some women as the only food option available during weeks. Unlike other more privileged sectors, to which lockdown could possibly mean having more time and having a wide range of ingredients, it was evident that unfavorable structural conditions (lack of gas, ovens, utensils, ingredients, among others) were notably an obstacle affecting preparations in terms of quality and variety. Among the cooking options mentioned, also reported in the previous study stated above, regional foods were identified, whose ingredients were also available in local stores, like bori bori, a Paraguayan soup, fried cassava, chipá iguazú, chopped fish, elaborations with black beans, among others:

Although these foods were associated to what appears to be nice to eat, women also use such adjectives as “heavy” and “greasy.” As to the preparations at the community kitchens and common pots, the descriptions are often similar to the words used above, without reporting regional preparations. At tea community centers, elaborations of homemade pastry and bakery products (rolls and croissants, bread, cakes, fritter sticks), also any type of cookies and muffins, milk and mate cocido [a tea-like drink]. The most common beverages mentioned by the interviewees that are consumed at homes and that they receive in tea community centers and community kitchens are often sugared and industrialized beverages (powdered juice, concentrated juice, and soft drinks). Milk is also mentioned as a primary drink, mainly for breakfasts and tea time, with mate cocido.

Economic constraints play a central role, as noted by one of the interviewees, “because I find it hard to make end meets, I made stew with rice, and today I’m going to make stew with noodles.” This is related to the possibilities of buying food, which are limited to certain fresh products, mainly meat and a reduced variety of vegetables. Restriction is also found on the quantities of meat for food saving, the range of possibilities comes down to different elaborations with the same ingredients. Along with the usual reference to stew, similar status is given to the consumption of flours to make tortillas and fried dough, noodles, polenta or reviro (another Paraguayan elaboration whose ingredients include flour and fat).

In this testimony, emphasis is placed on the need that foods have to be cheap, abundant, and satisfying,⁴³43. Aguirre P. Patrón alimentario, estrategias de consumo e identidad en la Argentina, 1995. En: Pinotti LV, Álvarez M. Procesos socioculturales y alimentación. Buenos Aires: Edición del Sol; 1997. p. 161-187. which is combined in flours. For this reason, one of the interviewees commented “we are made of flour.” When there are no resources, preparations come down to a reduced range of foods, where flours and products containing flour are the easiest to obtain, being also accepted by all the members in the household. Another dimension has to do with likes, mainly those of the younger children. There is a marked preference for fried cutlets, noodles and “white” rice, that is to say, without sauce, with butter or oil and/or cheese. Another food that occupies a preferred place among children choices are cookies for tea time as well as fruits and yoghurt. Less accepted foods included legumes, as shown in following extracts from the testimonies:

From these extracts, we can identify references that reinforce the weight that flours have among children and adolescents, also their preferences for fruits and, at the same time, certain dislike for home-made foods elaborated with vegetables, which are usually the foods included in school bags.

Among other key factors that have an effect on the elaboration of foods, it was possible to observe the importance associated with the availability of gas cylinders. While some homes have electric ovens, it is not the case of the majority. Many interviewees commented that when the cylinder ran out of gas and they did not have enough means to renew it, they were likely to spend many days without being able to cook. Although access to water is not generally mentioned as an obstacle, because it is naturalized, in some houses faucet water smells like sewer. It is the case of one of the interviewees, who lives on the first floor of a building with several units for rent, and who fetches water every day in large bottles from the house of a neighbor of hers, who lives two hundred meters away.

Do not look a gift horse in the mouth

Another aspect linked to people’s likes has to do with the quality of foods offered at the tea community centers, which do not always prove to be acceptable:

Interviewees find it difficult to express dissatisfaction, because what underlies is the implied gratitude when you receive food. Different tactics are applied, such as cooking food at homes again, adding other ingredients and spices. A recurrent reference is made in relation to children and adolescents that do not always agree to eat the foods that their parents bring from community kitchens:

A question was also made to find out if they considered that in the neighborhood the people were experiencing a hunger crisis. The most generalized answer was that this would be impossible, given the existence of community kitchens, tea community centers, common pots, and goods distributed through food assistance networks established by the government and social organizations, as highlighted here:

It follows that the preparations that contain flours, sugar, noodles, rice, and polenta are the foods that circulate in abundance within the neighborhood. In line with this, the invisibilization of the pleasure dimension is highlighted. Another dimension that is brought about is the risk of experiencing hunger in the households when there is lack of individual capacities to manage foods or meals, either by attending different official spheres of food assistance, of social organizations or access channels organized on the part of the self-managed groups made up of people living in the neighborhood. Also shame is another dimension, within the context of acute lack of resources because they do not earn their own income, due to lockdown restrictive measures, and they have to go out and beg for food:

Embarrassment and shame are reflected in the testimonies as faced by some families that became poorer as a result of the economic crisis and the context of pandemic, which amounts to an obstacle when it comes to applying for food aid. Another aspect is the responsibility assumed by women, as much to access foods outside their homes and in terms of elaborating them inside their houses:

This is related to the reference to a lack of cooking abilities on the part of women as well as lack of interest in said culinary tasks.

It was possible to observe an association expressed by women between closure of face-to-face education and its beneficial impact on the food situation of their children, as reflected in this phrase: “Now he is eating well, now that he doesn’t go to school, he eats.” Other women highlight that their children no longer eat so many sweets, and they also describe the relief of not having to give in when their children insist on buying sweets on their way home after school.

DISCUSSION

In this section we will discuss the main findings by organizing them in four thematic areas: access to foods, food consumption, women’s role linked to tasks of care and family nutrition, and the relevance of civil society organizations. All these areas are marked by living conditions and impoverishment. These conditions were intensified by the social and health situation caused by the pandemic.³⁴34. Autoridad de Cuenca Matanza Riachuelo. Informe final EISAAR Camino de Sirga del Barrio Villa 21-24, CABA [Internet]. 2018 [citado 25 jul 2020]. Disponible en: https://tinyurl.com/2p8aeuhn.
https://tinyurl.com/2p8aeuhn... We should add the continuous rise in food prices, unemployment, and impossibility in many cases to go to work with the ensuing decrease in or loss of monetary income in the household.¹⁹19. FAO, FIDA, OPS, WFP, Unicef. Panorama de la seguridad alimentaria y nutricional en América Latina y el Caribe 2020 [Internet]. Santiago: FAO, OPS, WFP, UNICEF; 2020[citado 16 jul 2020]. Disponible en: Disponible en: https://doi.org/10.4060/cb2242es
https://doi.org/10.4060/cb2242es... ^,4444. Universidad Católica Argentina, Observatorio de la Deuda Social Argentina. Efectos del ASPO-COVID-19 en el desarrollo humano de las infancias argentinas. Informe de avance: Diciembre 2020 [Internet]. 2020 [citado 16 jul 2020]. Disponible en: Disponible en: https://tinyurl.com/yszacax8 .
https://tinyurl.com/yszacax8... In this context, access to foods, according to the voices of the interviewees, reveal the impact of the little competitive retail prices and the competition from supermarket networks in this sense, which control the distribution of foods, mainly of bottled products and already chopped-up meat, in order to maintain offers and promotions,⁴⁵45. Fundación Heinrich Böll, Fundación Rosa Luxemburg, Grupo de Ecología del Paisaje y Medio Ambiente. El atlas del agronegocio [Internet]. 2018 [citado 15 may 2021]. Disponible en: Disponible en: https://tinyurl.com/4rwydbpw .
https://tinyurl.com/4rwydbpw... which put retailers at a disadvantage, who yet managed “to survive.” Another aspect that is revealed by the power of companies or suppliers within the governmental sphere is that food modules are partially made up of ultra-processed products (as dairy desserts) high in critical nutrients. Interviews account for the positive incidence of the measures adopted by the federal government, through the monetary programs such as the Emergency Family Income (IFE)⁴⁰40. Administración Nacional de Seguridad Social. Ingreso Familiar de Emergencia [Internet]. 2020 [citado 25 jul 2020]. Disponible en: Disponible en: https://tinyurl.com/3t5wj5ps .
https://tinyurl.com/3t5wj5ps... ⁾ - the first payments were made while we were conducting our field work -, and the measures adopted by the municipal government of the Autonomous City of Buenos Aires, with the delivery of school food modules. These measures helped households to have minimal access to foods although, due to the rise in prices, the purchase was limited to items considered basic: flour, oil, potatoes, onions, and meat.

The relationship between the school food environment and its impact on food access, behavior, and consumption by children and adolescents proved to be an emerging dimension in our research study. Although the importance attributed to the direct food assistance offered by schools in general is clearly highlighted, the notion that “without schools, children eat better” is also expressed, arguing that, owing to lockdown measures, they are not exposed to the range of products of sweet shops, street sellers, and street advertising that promote the consumption of food products high in critical nutrients within the school environment. The 2nd National Survey of Nutrition and Health (ENNyS 2)¹⁷17. Argentina, Ministerio de Salud. 2° Encuesta Nacional de Nutrición y Salud: Resumen ejecutivo [Internet]. Buenos Aires: Ministerio de Salud; 2019 [citado 18 jul 2021]. Buenos Aires, Argentina. Disponible en: Disponible en: https://tinyurl.com/2cxw3fvh .
https://tinyurl.com/2cxw3fvh... ⁾ reveals that 71.2% of children and adolescents going to school sometimes or always receive from their schools rolls and croissants, pastry products, cookies, and/or cereals with sugar; whereas only 2 out of 10 students reported that their institution always supplies fresh fruits. We also observed that 6 out of 10 children and adolescents going to school aged 6 to 17 years had bought sweets from a sweet shop or cafeteria located within the school building during the last week. This shows the need to apply a regulatory scheme in school environments, for instance the newly passed Act No. 27642 for the Promotion of Healthy Nutrition,⁴⁶46. Argentina. Ley 27642 Promoción de la Alimentación Saludable [Internet]. 2021 [citado 30 dic 2021]. Disponible en: Disponible en: https://tinyurl.com/yetcaavf .
https://tinyurl.com/yetcaavf... for children and adolescents to have food environments guaranteeing their right to adequate nutrition.⁴⁷47. Piaggio LR. El derecho a la alimentación en entornos obesogénicos: Reflexiones sobre el rol de los profesionales de la salud. Salud Colectiva. 2016;12(4):605-619. doi: 10.18294/sc.2016.934. In turn, the need to regulate food donations is observed, mainly, those centered on the delivery of ultra-processed products, which reinforce the industrialized food pattern described above.

The relationship between food access and consumption is close. In this sense, although meat is highly valued,⁴⁸48. Aguirre P. Comida, cocina y consecuencias: la alimentación en Buenos Aires. En: Torrado S. Población y bienestar en la Argentina del primero al segundo centenario: Una historia social del siglo XX. Buenos Aires: Edhasa; 2007. as there are constraints on its purchase, it remains in a peripheral place in terms of elaborations as regards quantity and quality (there are plenty of fatty cuts). The same situation applies for fruits - they are highly praised, but interviewees insist on the fact that their purchase becomes relegated. This is in line with the fact that the population belonging to the lower quintiles has a consumption pattern that drops to a half in relation to the highest value, 22.8% versus 45.3%, respectively.¹⁷17. Argentina, Ministerio de Salud. 2° Encuesta Nacional de Nutrición y Salud: Resumen ejecutivo [Internet]. Buenos Aires: Ministerio de Salud; 2019 [citado 18 jul 2021]. Buenos Aires, Argentina. Disponible en: Disponible en: https://tinyurl.com/2cxw3fvh .
https://tinyurl.com/2cxw3fvh... Among other consumptions valued by the interviewees as being “prestigious,” they mention yoghurt, cookies, artificially sweetened beverages, and aperitif products (potato chips, cheese puffs, salty little sticks, among others), associated with the search of satisfying the likes and whims of their children and adolescents, and other members of the family. It should be noted that the consumption of artificial beverages with sugar and aperitif products in the survey ENNyS No. 2 proves to be twice higher in the lower quintiles than in the highest ones.

Food access and food consumption are influenced by the characteristics of obesogenic environments marked by an increase in the consumption of ultra-processed products,⁴⁹49. Swinburn B, Shelly A. Effects of TV time and other sedentary pursuits. International Journal of Obesity. 2008;32(Suppl 7):S132-S136. doi: 10.1038/ijo.2008.249.^,5050. Monteiro C, Bertazzi Levy R, Claro Moreira R, De Castro I, Cannon G. A new classification of foods based on the extent and purpose of their processing. Cadernos de Saúde Pública. 2010;26(11):2039-2049. doi: 10.1590/S0102-311X2010001100005. triggered by non-regulated marketing strategies that “tempt your palate,” targeted at child population.⁵¹51. Organización Mundial de la Salud. Conjunto de recomendaciones sobre la promoción de alimentos y bebidas no alcohólicas dirigida a los niños. Ginebra: OMS; 2010. We could find connections between the increase in available ultra-processed products,^(7.52) the configuration of the present-day hegemonic agro-food system,⁵³53. Arnaiz MG, Demonte F, Bom Kraemer F. Prevenir la obesidad en contextos de precarización: respuestas locales a estrategias globales. Salud Colectiva. 2020;17:e2838. doi: 10.18294/sc.2020.2838.⁾ and a lack or inexistence of public policies that can increasingly shape healthier and sustainable food environments⁵²52. Balan D, Palacios A, Bardach A, Rodriguez B, Ciapponi A, Garcia Marti S, Perelli L, Augustovski F, Gittens-Baynes KA, Vianna C, Guevara G, Pichon-Riviere A, Alcaraz A. Políticas fiscales para reducir el consumo de bebidas azucaradas: Evidencia para la implementación de políticas públicas en Latinoamérica y el Caribe (Documento Técnico N° 54). Buenos Aires: Instituto de Efectividad Clínica y Sanitaria; 2019. for the general population and for the child population in particular. This coincides with the local research studies that reveal an increase in the purchase⁷7. Organización Panamericana de la Salud. Alimentos y bebidas ultraprocesados en América Latina: tendencias, efecto sobre la obesidad e implicaciones para las políticas públicas. Washington DC: OPS; 2015.⁾ and consumption⁵⁴54. Zapata ME, Rovirosa A, Carmuega E. Cambios en el patrón de consumo de alimentos y bebidas en Argentina, 1996-2013. Salud Colectiva. 2016;12(4):473-486.⁾ of these products across Argentina. The weight of the agro-industrial chain within the global market economy is important.⁵⁵55. McMichael P. A food regime analysis of the ‘world food crisis’. Agriculture and Human Values. 2009;26:281. doi: 10.1007/s10460-009-9218-5.^,5656. ETC Group. Who Will Feed Us? [Internet]. 15 oct 2017 [citado 15 may 2021]. Disponible en: Disponible en: https://tinyurl.com/2wwcrmjf .
https://tinyurl.com/2wwcrmjf... ⁾ Another aspect is related to homemade elaborations in households, marked by unequal pleasure to cook, having cooking abilities and knowledge, material resources (gas, water, furniture, among others), access to the wide range of fresh and natural foods. As a result, spending lockdown at homes acquires different meanings: while to wealthier sectors it could entail having more time to cook and to eat “better,” to the interviewees participating in our study this possibility was limited.

All testimonies show women’s central role as much in the food responsibility inside their homes, as in the management of community resources to have access to foods outside their homes. We agree with research studies that highlight an excessive emphasis on individual responsibility in contexts of social and food precarization, where the right to nutrition is violated.⁵³53. Arnaiz MG, Demonte F, Bom Kraemer F. Prevenir la obesidad en contextos de precarización: respuestas locales a estrategias globales. Salud Colectiva. 2020;17:e2838. doi: 10.18294/sc.2020.2838. But responsibility is placed with more emphasis on women, showing how the patriarchal model and the configuration of the present-day food system take advantage from care tasks that are naturally assumed, and that prove to be essential. It is important to visibilize the non-remunerated social reproductive work that is yet to be socially recognized.²⁷27. Carrasco C, Borderías C, Torns T. Introducción: El trabajo de cuidados, Antecedentes históricos y debates actuales. En: El trabajo de cuidados: Historia, teoría y política. Madrid: Catarata; 2011. p. 13-97.^,5757. Esquivel V, Faur E, Jelin E. Las lógicas del cuidado infantil: Entre las familias, el Estado y el mercado. Buenos Aires: IDES; 2012.^,5858. Esteban ML. Crítica del pensamiento amoroso. Barcelona: Bellaterra; 2011.^,5959. Ali S, Mirza H, Phoenix A, Ringrose J. Intersectionality, Black British feminism and resistance in education: a roundtable discussion. Gender and Education. 2010;22(6):647-661.⁾ That way, the close relationship between the role of women and the intra-household food management shows that the ones that assume the burden of hunger are women.

It was possible to observe the relevance of civil society organizations, traditionally key social actors that strengthen availability and access to foods and meals in contexts of impoverishment.⁶⁰60. Fernández GJ. Experiencias de cuidados comunitarios en tiempos de Pandemia. Margen. 2020;(98):1-7. This network of civil society organizations, together with social and food programs established within governmental spheres, actions by self-organized neighbors, contribute to improving food availability in the neighborhood. Through the testimonies, interviewees describe the role played by these organizations in the context of pandemic, still with scarce care infrastructure and minimal financial resources, a precarious level of institutionalization or formalization. Foods that are mainly available, albeit abundant, are mostly foods high in critical nutrients, which in turn contribute to reproducing poverty and malnutrition, thus intensifying social and biological vulnerability in the context of pandemic. This situation becomes especially significant in the population of children and adolescents, the main hidden victims hit by the pandemic.¹⁹19. FAO, FIDA, OPS, WFP, Unicef. Panorama de la seguridad alimentaria y nutricional en América Latina y el Caribe 2020 [Internet]. Santiago: FAO, OPS, WFP, UNICEF; 2020[citado 16 jul 2020]. Disponible en: Disponible en: https://doi.org/10.4060/cb2242es
https://doi.org/10.4060/cb2242es... ^,4444. Universidad Católica Argentina, Observatorio de la Deuda Social Argentina. Efectos del ASPO-COVID-19 en el desarrollo humano de las infancias argentinas. Informe de avance: Diciembre 2020 [Internet]. 2020 [citado 16 jul 2020]. Disponible en: Disponible en: https://tinyurl.com/yszacax8 .
https://tinyurl.com/yszacax8...

There is no criticism of the types of foods that are distributed, even knowing the importance of consuming fresh food on a daily basis, as recommended by the Food-Based Dietary Guidelines for Argentina,⁶¹61. Argentina, Ministerio de Salud, Dirección de Promoción de La Salud y Control de Enfermedades No Transmisibles. Manual para la aplicación de las guías alimentarias para la población argentina [Internet]. 2018 [citado 16 jul 2020]. Disponible en: Disponible en: https://tinyurl.com/2p8s9d6w .
https://tinyurl.com/2p8s9d6w... mainly in epidemiologic situations where a good nutritional status is essential. This leads us to reflect on the lack of appropriation on the part of some population sectors of their condition as rights-bearing subjects. In the representations, “hunger” means not having foods available to eat. However, having no other choice but to stuff oneself with flours and stews through assistance and reassurance networks seem to be naturalized. Although, when asked to define good nutrition habits, some interviewees describe fresh foods as the most difficult foods to have access to, they are silent about this aspect in their discourses. The question about the importance of likes as a dimension separate from the right to nutrition is posed, because when nutrition and poverty are associated, what prevails is need but not taste, resorting to an optimization logic to explain poor people’s consuming behavior.⁶²62. Cattáneo A. Alimentación, salud y pobreza: la intervención desde un programa contra la desnutrición. Archivos Argentinos de Pediatría. 2002;100(3):222-232. This is reflected in the stigma of regarding oneself as a poor individual, with the shame this involves, in some cases, when having to go out and manage food resources, or, in other cases, when admitting that sometimes there is no other choice but to feed oneself during weeks off fried dough. This is why some women explained that in their homes they eat fried dough “only when it rains, as tradition says.” Another stigma has to do with being migrants from bordering countries and having a peasant origin when they refer to regional elaborations, by using adjectives like “heavy” and “greasy” when describing them. When this is also true for other preparations associated to Argentine middle classes, such as fast food or semi-elaborated foods. This shows that social inequality and discrimination against underprivileged and racism underlie malnutrition problems. Various research studies analyze the relationship between food insecurity, inequality, race, ethnicity, and gender,⁶³63. Woods D. Mujeres invisibles: hambre, pobreza, racismo y cuestiones de género en el Reino Unido [Internet]. 2019 [citado 16 jul 2020]. Disponible en: Disponible en: https://tinyurl.com/2v8fnd57 .
https://tinyurl.com/2v8fnd57... revealing that “otherness” is a marginalization tool. The voices of Paraguayan women are delegitimized and silenced in terms of their practices, abilities, and cooking knowledge.⁶⁴64. Mueller JC. Producing colorblindness: Everyday mechanisms of white ignorance. Social Problems. 2017;64(2):219-238. doi: 10.1093/socpro/spw061.^,6565. Mirza H. Black British feminism then and now. Media Diversified [Internet]. 13 mar 2014 [citado 16 jul 2020]. Disponible en: Disponible en: https://tinyurl.com/3asuu8xy .
https://tinyurl.com/3asuu8xy... Another aspect to highlight is that it is important that in the decision-making spheres they address ethnicity in strategies aimed at overcoming food security and nutrition. This means leaving behind visions that conceive underprivileged populations as passive actors, to begin validating their systems of knowledge, which are key to improve nutrition, to strengthen cultural diversity and the construction of societies with no discriminatory and exclusion behaviors.¹⁹19. FAO, FIDA, OPS, WFP, Unicef. Panorama de la seguridad alimentaria y nutricional en América Latina y el Caribe 2020 [Internet]. Santiago: FAO, OPS, WFP, UNICEF; 2020[citado 16 jul 2020]. Disponible en: Disponible en: https://doi.org/10.4060/cb2242es
https://doi.org/10.4060/cb2242es...

FINDINGS

This pandemic poses a social and health emergency with direct and indirect impacts on malnutrition due to excess, even more in children and adolescents, and vulnerable groups, where inequality, impoverishment, gender discrimination, the dimensions of impoverished groups and identity, and obsesogenic food environments intermingle and are ultimately determined. The different channels to access foods are through a direct purchase or through food assistance networks, whether official and/or by civil society organizations, as well as self-managed neighbors and food donations. In all cases the foods that prevail are highly industrialized and ultra-processed products, or items that are high in critical nutrients that reproduce malnutrition. Women’s role in food management inside and outside the household is clear, since they are the ones assuming the burden of hunger. Despite the fact that malnutrition indicates its link with excess, the main concern is not suffering from hunger, while the quality of foods to which they can have access through different channels is not questioned. A spiral is identified that deserves better investigation, into which concern about hunger in the context of a purported availability of foods is expressed. The problem is that these are foods whose consumption relates with health deterioration and a lack of elements on the part of the population to demand, under the law, healthier and more adequate foods, which results in the invisibilization of malnutrition due to excess. In this obesogenic spiral, we can see a combination of individual responsibility, impoverishment, the condition of impoverished and underprivileged sectors, gender and ethnicity, which are perceived as a stigma that ends up embarrassing them. At the time of the study, in the context of lockdown due to COVID-19 pandemic, it was clear that there were no regulatory and statutory frameworks that could transform obesogenic environments and configure food systems aimed at promoting access to healthy nutrition. Systemic changes based on human rights are necessary to address parallel foods crisis, pandemic, and living resources. It is also necessary to adopt public policies to promote fairer, more environmentally sustainable food systems, in order to democratize productive resources with short distribution channels. Only that way will it be possible to achieve greater equality and access to fresh foods.

ACKNOWLEDGEMENTS

We would like to thank Martín Miranda, whose collaboration in this study was essential; we are grateful to all our interviewees, especially, Ramona, who was gone and is in our thoughts. Thank you to everyone in the neighborhood 21/24, who shared with us time, feelings and life experiences

References

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