Dietary behaviours during COVID-19 among households at risk for food insecurity

Authors: ALMOHAMAD, MAHA - University Of Texas Health Science Center; MARSHALL, ALLISON - University Of Texas Health Science Center; DAVE, JAYNA - Children'S Nutrition Research Center (CNRC); CHUANG, RU - University Of Texas Health Science Center; MARKHAM, CHRISTINE - University Of Texas Health Science Center; SHARMA, SHEELA - University Of Texas Health Science Center

Submitted to: Journal of Nutritional Science
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/17/2023
Publication Date: 5/2/2023
Citation: Almohamad, M., Marshall, A., Dave, J.M., Chuang, R.J., Markham, C., Sharma, S. 2023. Dietary behaviours during COVID-19 among households at risk for food insecurity. Journal of Nutritional Science. 12. Article e54. https://doi.org/10.1017/jns.2023.36.
DOI: https://doi.org/10.1017/jns.2023.36

Interpretive Summary: COVID-19 is a global pandemic that impacted lifestyle-related habits, food choices and diet. There is a significant increase in the number of households who experience food insecurity. The state and local stay at home orders affected food shopping behaviors and diet, especially among low-income households, and increased their concerns about financial stability, employment, availability and affordability of food, among other issues. The purpose of this study was to assess the relationship between COVID-19-related concerns and food shopping behaviors with self-reported changes in fruit and vegetable (FV) consumption using an online survey among a sample of individuals from households who reported being food insecure (n=1639). Majority of the participants were Hispanic with a mean age of about 37 years. A majority of the participants (41%) reported a decrease, 32% reported an increase and 27% reported no change in FV intake. Due to COVID-19, FV shopping behaviors, specifically at large grocery stores/supermarkets, showed positive and negative associations with changes in FV consumption. Participants who shopped for groceries at small local stores/corner stores reported significantly decreased FV intake compared to no change in FV consumption. However, individuals who reported shopping at a food bank/food pantry had significant increases in FV intake. Controlling for demographics and shopping behaviors, concern about financial stability was significantly associated with decreased FV intake. Concern about change in employment status was significantly associated with increased FV intake. Concerns about availability and affordability of foods were significantly associated with decreased as well as increased FV intake; however, the association was stronger for decreased FV intake. These findings demonstrate the dynamic and complex influences on FV consumption, especially during a pandemic. More effective interventions are needed to diminish the negative impact of COVID-19 on diet and overall population's health.

Technical Abstract: The objective of the present study was to examine associations between variables of COVID-19-related concerns and changes in fruit and vegetable (FV) consumption among a sample of participants from the Brighter Bites program at risk for food insecurity. Cross-sectional data were collected during April–June 2020 using a rapid-response survey to understand social needs, COVID-19-related concerns and diet-related behaviours among families with children participating in Brighter Bites (n=1777) in the 2019–2020 school year at risk for food insecurity, within the surrounding Houston, Dallas, Austin, Texas area; Southwest Florida; Washington, D.C., United States. Of the 1777 respondents, 92% of households reported being at risk for food insecurity. Among those from food insecure households, the majority were of Hispanic/Mexican-American/Latino (84.1%) ethnic background, predominantly from Houston, Texas (71.4%). During the pandemic, among individuals from food insecure households, 41% (n=672) reported a decrease in FV intake, 32% (n=527) reported an increase in FV intake, and 27% (n=439) reported no change in FV intake. Those who reported concerns about financial stability had a 40% greater risk of decreased FV intake compared to those not concerned about financial stability (RR 1.4; 95% CI 1.0, 2.0; P=0.03). The present study adds to this current body of sparse literature on how the initial phase of the pandemic impacted FV consumption behaviours among food insecure households with children. Effective interventions are needed to diminish the negative impact of COVID-19 on the population's health.