The COVID-19 has formed a pandemic that is very different from previous pandemics and covers almost all countries around the world, especially the major economies. In addition to the negative effects on health, the COVID-19 crisis has put both people's lives and livelihoods at risk (1, 2). COVID-19 threatens the years of progress in health care, hunger, poverty, and education. Since the great depression, the world has been facing the worst recession. Real per capita gross domestic product (GDP) fell by 3.3 percent in 2020, and it is estimated that the economic instability created by the global epidemic has led to the loss of 114 million jobs worldwide (3). COVID-19 also threatens access to food mainly through the loss of income and assets, which impairs the ability to buy food. The effects of COVID-19 have led to a sharp and widespread increase in global food insecurity, which affects vulnerable families in nearly all countries, and are expected to endure through 2022 and perhaps beyond. The poorest households spend about 70 percent of their income on food and have limited access to financial markets, which makes food security vulnerable to income shocks (4–6). More than half of the world's undernourished are found in Asia (418 million), and a significant portion of these people live in rural areas (7). Thus, food security in rural areas has become a significant issue in global decision-making and is considered a major challenge for national policies and public concerns (8, 9). More than two billion small producers, farmworkers, rural workers, and their families, who represent a large section of the population affected by food insecurity, are affected by the economic shock caused by and their incomes are at risk (10). In developing countries, most of the livelihoods of rural households come from the agricultural sector (11). Hence, rural households are the most affected by poverty and vulnerability and face economic, financial, and social risks (12). According to the clinical studies, the lack of micronutrients is one of Iran's main health and nutritional problems, especially in rural areas, so the rural community is facing food insecurity problems, especially among women and children (13). Results of the previous studies have shown that one-third (32.4%) of all rural households in Iran were faced with food insecurity, which is determined based on per capita calories consumed. They have lower socioeconomic status, experience more food shortages than others, have less chance of buying the healthy and nutritious foods offered, and generally consume fewer types of fruits and vegetables. Also, 50% of rural households in Iran are deficient in iron, calcium, iodine, and a variety of vitamins (14–16). Therefore, they are at risk of a food crisis until measures are taken to protect this vulnerable group. Global and national interventions are necessary to reduce the impact of the COVID-19 pandemic across the food system. Measures taken to maintain and reorganize food supply chains should be complemented by specific solutions using locally available resources and goods (17).

Due to the importance of the different impacts of COVID-19 on food security and nutrient status, some scholars endeavored to assess and calculate these effects. Nechifor et al. (18) claimed 1.3% of the participated households still fall below calorie intake thresholds in sub-Saharan Africa, especially in rural areas. Results also showed that food security remains vulnerable to the growth of the pandemic abroad in Kenya. Yazdanpanah et al. (19) reported that the food security of rural households in southern Iran reduced during the COVID-19 pandemic. The regression analysis results also showed that financial, psychological, physical, and human assets affect the food security of rural households under COVID-19. Pakravan et al. (20) demonstrated that the food security status of Iranian households has improved at the first stages of COVID-19 pandemic disease. In fact, they believed that the impacts of the COVID-19 should be analyzed in different periods that include short-term and long-term time. Ceballos et al. (21) assessed the short-term effects of COVID-19 on the food security of rural households in Guatemala. They found that during COVID-19, food security and food diversity among rural households decreased due to rising prices, decreasing incomes, and reduced access to food in local markets. Egwue et al. (22) reported that most of Nigeria's rural households were food insecure during COVID-19. The results also showed that marital status, education level, cooperative membership, and annual income of heads of households positively affected food security. In contrast, the household head's age and household size negatively affected the food security status of rural households. Cardarelli et al. (23) contended that although the COVID-19 pandemic initially reduced access to food and disrupted food supply, in the long run, rural households' access to food has increased through federal aid. Ouoba and Sawadogo (24) reported that the COVID-19 pandemic disease had reduced households' incomes in Burkina Faso by increasing their likelihood of entering poverty. They showed that the households could adjust to the shock (COVID-19) during a long-term period. Rahman et al. (25) contended that during COVID-19, the incomes of certain groups of people declined, which may have contributed to the growth of the poverty rate. Also, quarantine, movement and social restrictions, agro-food systems, supply–value chains, and market levels were affected. Also, the overall state of food consumption was affected by the COVID-19 pandemic throughout the country and affects all parts of the population.

This paper assesses the impact of the COVID-19 pandemic on food security and food diversity of rural households in the Khorramabad township. Whereas, most of the previous studies have tried to assess food security in urban areas, in this study, we tried to focus on local levels, where people are more vulnerable and affected by the hazard. The findings of this study can help better understand the rural population's needs during crises such as the COVID-19 epidemic. This can help better plan and take preventive measures for such populations after understanding their needs. In addition, it can help deprived people to have a minimum level of preparedness and food security in such a crisis in the future. Therefore, this study tries to address the following objectives:

The main aim of this study was to examine the impact of the COVID-19 pandemic on food security and food diversity of rural households. In the first step, the food security situation of rural households was assessed. The results showed that 14% of rural households have food security, and 52.5% need urgent assistance to struggle with inappropriate food insecurity conditions. This finding is consistent with the results of other studies (19, 25, 38). In developing countries, most of the livelihoods of rural households come from the agricultural sector (39, 40). Hence, rural households are most affected by poverty and vulnerability and face economic, financial, and social risks (41). COVID-19 disrupts various stages of the food supply chain and simultaneously affects farm production, food processing, access to inputs, transportation, logistics, and consumer's demand. Decreased exports of food and agricultural products due to the closure of borders and health quarantines are other consequences that can lead to the accumulation and cheaper products. Another problem is labor shortages due to the fear of transmitting the virus, which ultimately leads to the waste of the product (42–44). Thus, the income of many rural households has been reduced due to restrictions and quarantine measures and business closures (45). Access to valuable foods has been reduced and replaced by high-calorie, low-value foods, which have led to obesity along with cell starvation, increasingly putting rural people at risk for coronavirus disease and other diseases (46, 47).

Our results on the dietary diversity of rural households showed that the consumption of some food groups changed during the COVID-19 pandemic. Consumption of meat, fruits, and eggs among households has decreased during the COVID-19 pandemic. This finding aligns with several recent studies that reported rapid changes in diets and food consumption habits during the COVID-19 pandemic (46, 48, 49). During the COVID outbreak, due to the increase in the price of animal protein sources, the access of low-income decile groups to these items has decreased (50). Even the results of recent studies by the Ministry of Health and medical education in Iran have also shown that due to the increase in prices by up to 35%, the consumption of some food items including red meat, chicken, milk, dairy products, and fruits has decreased in Iranian households that the continuation of this issue can lead to food insecurity and malnutrition. Therefore, serious government oversight is essential to control food prices; protein sources should be available to people at a reasonable price, especially vulnerable groups. During the COVID-19 pandemic, it is very important to have a proper function of the immune system following proper nutrition, which the body fights against the disease in case of COVID-19 infection, and even after getting a COVID-19 vaccine, the vaccine response is very much related to the immune system function (51).

Also, the results showed that the consumption of cereals and legumes among rural households increased during COVID-19. The results of the previous studies also confirm this finding (52, 53). Rural households prefer to use legumes as a cheaper source of protein in the diet. Legumes are a good alternative to meat, milk, and eggs for a lower price. However, that does not mean that people can stay healthy, get the protein, and provide the protein their bodies need. Proper nutrition plays an important role in strengthening the immune system. Basically, in people whose immune systems are weakened due to poor nutrition, the body's resistance to the virus is usually lower, and the severity of the disease and the recovery period may even increase (46). Also, increasing grain consumption among rural households can cause them to gain weight during the COVID-19 pandemic. This finding is consistent with the previous studies (52, 54) that have reported increased cereal intake during the COVID-19 epidemic, which leads to more meals per day and weight gain.

We found that the consumption of sweets and sugars among rural households increased during the COVID-19 pandemic, which can increase the risk of COVID-19 infection by stimulating the immune system. In line with this, the results of a study in Norway showed that due to the psychological stress caused by COVID-19, the consumption of high-sugar foods has increased among households (55). Some people struggle with sugar and unhealthy foods as a way to replace stress (56). Eating sugary and highly caloric foods can also affect feelings such as loneliness during social isolation (57, 58).

The results showed that the head's gender was directly associated with food security and dietary diversity during the COVID-19 pandemic. Other scholars have also reported a female-headed households were more likely prone to food insecurity (59). The female-headed households faced challenges such as lower-income, limited access to capital, land ownership, market, and new technologies (60, 61). Also, most female-headed households in rural areas lack access to information and natural resources, which significantly affects increasing food insecurity (62). They tend to be in more precarious positions, earn lower-income, and epidemic may also expose them to higher levels of stress and violence (63–65). Therefore, gender-sensitive design and implementation of social protection interventions are crucial to ensure that rural women can participate in and equally benefit from these interventions.

Household head's employment status was positively and significantly associated with the food security of rural households. In other words, if the household head has a full-time job, less likely to experience a complete decline in income during the COVID-19 pandemic. Previous studies have confirmed the household head's employment status as a determinant of household's food security studies (38, 66, 67). Households with the unemployed head of households having either no fixed income or no income at all are more likely to have food insecurity (68). The purchasing power of these households is reduced due to a lack of sufficient income, so they cannot have sufficient access to food.

Household heads' monthly income was significantly related to the food security of rural households. Household heads put the food security situation of the family in a favorable position through the income from the income-generating activities. Some studies have shown a direct relationship between the income of household heads (in the agricultural and nonagricultural sectors) and food security (59, 69–71). High-income household heads are more likely to use food-based coping strategies during the COVID-19 epidemic to improve household nutrition. Therefore, their income can have a significant impact on the economic accessibility of the household. Higher-income households have greater food security because they have more choice in buying their household food (20). As income increases, household purchasing power increases, and they can prepare more food to meet their nutritional needs.

The education level of household heads was directly related to household food security. The higher education level of household heads likely provides more opportunities to find an appropriate job, thus enabling them to earn enough income to meet different nutritional needs (72). In rural areas, education influences food security through access to information on healthy nutrition in COVID-19 pandemic and quarantine conditions. Educated household heads are more likely to have more nutritional knowledge and know the importance of having all the nutrients and micronutrients in the family diet to maintain the immune system functioning to prevent and treat COVID-19 disease. They can also diversify household incomes, which increases the food supply of households (73).

The results showed that livestock ownership directly and significantly relates to household food security. Livestock ownership can reduce household food insecurity by increasing available disposable income that could be used to buy food and thus increase access to food. It also might directly increase the availability of livestock products for home consumption (74, 75).

The results showed that nutrition knowledge was significantly related to food security and diversity before and during the COVID-19 pandemic. This finding is in line with several recent studies that reported that increasing the level of nutritional knowledge of the head of the household can help perform appropriate nutritional behavior during the COVID-19 pandemic and improve the level of food diversity of households (20, 76). Adequate knowledge on the importance of a healthy diet during COVID-19 which can be optimal nutrition and dietary intake is the only sustainable way to survive in the current situation. A proper diet can ensure that the body can correctly defeat the virus (77). Basically, in people whose immune systems are weakened due to poor nutrition, the body's resistance to the virus is usually lower, and the severity of the disease and the recovery period may even increase (78).

In this study, several limitations need to be considered in future studies. First, because of the cross-sectional design, this study does not allow to draw causality, despite the use of retrospective data. Second, rural people are reluctant to provide their information due to a lack of trust in government agencies. However, we minimized their fears and built trust by clearly and openly communicating with them and providing transparency about using the data. Third, because the study was conducted during quarantine, access to research samples was difficult due to health protocols. Fourth, because many villagers did not wear masks and did not maintain social distance, communicating with them and distributing questionnaires was associated with problems such as fear of contracting the coronavirus. Finally, some heads of household did not remember the previous information, and we had to replace another household to complete the questionnaire.

The results of our study showed that during the COVID-19 pandemic, food insecurity has increased among rural households, and they were concerned about not having enough food. Therefore, to prevent a food security crisis in rural communities, the government needs to develop support packages to support insecure households. Also, using the capacity of existing NGOs to identify and support food-insecure households in the current crisis can be very helpful. The government should provide sufficient funds to cover food-insecure rural households with free food baskets. The identification of these households will be possible using the capacity of the Iranian Welfare Database, which determines basket items and their necessities with the cooperation of nutritionists in the institutions in charge of nutrition in the country. Also, the results showed that the consumption of food groups was limited among rural households during the COVID-19. Due to quarantine and business closures, many rural households' incomes have been reduced to zero. Access to valuable foods has been reduced and replaced by high-calorie, low-value foods, which have led to obesity along with cell starvation, increasingly putting rural people at risk for coronavirus disease and other diseases. Therefore, the government can solve this problem with the right policies and allocating subsidies to the lower-income deciles so that the sources of protein and micronutrients enter the food basket of the people. Also, appropriate training and information by healthcare providers, the use of the capacity of health centers, health houses, and the social media in the field of healthy cooking training, and the use of nutritious and low-calorie foods and nutritional methods effective in improving the immune system among rural households can be effective in improving these conditions. Finally, government policies should focus on increasing the resilience of rural households to reduce their vulnerability to crises such as COVID-19. Therefore, the use of technology and cyberspace and changing the nature of some rural workshops and businesses should be on the agenda of the related institutions of rural policies to achieve a roadmap to strengthen businesses and employment of rural groups in the post-COVID-19 situation. Also, planting food crops and home gardening can be considered an option to increase the resilience of rural households in the medium term.

The datasets presented in this article are not readily available because due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available. Requests to access the datasets should be directed to ghanbari.re@lu.ac.ir.

RG: conceptualization, methodology, validation, resources, and data mining. FM: supervision, formal analysis, methodology, writing–original draft, and interpretation. SG: conceptualization, methodology, advisor, and investigation. MP-C: advisor, investigation, validation, questionnaire preparation, and writing, reviewing and editing. All authors contributed to the article and approved the submitted version.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.