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D’Angelo Campos A, Ng SW. Nutritional quality of food purchases during the COVID-19 public health crisis: An analysis of geographic disparities in North Carolina. Prev Med Rep 2024; 44:102812. [PMID: 39091570 PMCID: PMC11292539 DOI: 10.1016/j.pmedr.2024.102812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 06/28/2024] [Accepted: 06/30/2024] [Indexed: 08/04/2024] Open
Abstract
Objective To examine geographic disparities in the nutritional quality of food purchases during the COVID-19 public health crisis in North Carolina (NC). Methods Using shopper-level longitudinal transaction records between October 2019- and December 2020 from NC's largest grocery retailer, we fit mixed-effect models to examine disparities in the nutritional quality of food purchases among shoppers in counties with different levels of socioeconomic development and how such disparities changed after March 2020, accounting for other observed and contextual factors. Results Shoppers in counties with lower development levels purchased a larger share of calories from least healthy foods and a smaller share from healthier foods compared to shoppers in counties with higher development levels. These disparities were slightly attenuated for the least healthy foods and did not change for healthier foods after the onset of the COVID crisis. Conclusion Despite existing nutritional disparities among shoppers in counties with different levels of socioeconomic development, we did not observe a large-scale accentuation of inequities in dietary quality during the COVID-19 crisis. This pattern may have resulted from programmatic responses to mitigate the adverse effects of the COVID crisis on vulnerable populations. Future work should further explore the role of such responses.
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Affiliation(s)
- Aline D’Angelo Campos
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Shu Wen Ng
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Bernhart JA, Quattlebaum M, Eustis S, Okpara N, Wilson MJ, Sentman C, Turner-McGrievy GM. "It's Gonna Be Okay"-A Qualitative Exploration of the COVID-19 Pandemic's Effects on African American Participants During a Dietary Intervention Study. J Acad Nutr Diet 2023; 123:1763-1771. [PMID: 37437808 PMCID: PMC10789910 DOI: 10.1016/j.jand.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 06/20/2023] [Accepted: 07/06/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND African American adults are at increased risk for chronic diseases. Limited research exists regarding how the COVID-19 pandemic affected African American adults in behavioral interventions. OBJECTIVE This study assessed how the early months of the COVID-19 pandemic, before vaccine availability and widespread testing, affected stress, nutrition, and exercise behaviors of African American adults participating in a dietary intervention study. DESIGN This was a qualitative interview study conducted with participants from both diet groups as part of the ongoing Nutritious Eating with Soul (NEW Soul) study. NEW Soul is a 2-year, randomized dietary intervention study with participants randomized to follow a vegan (intervention) or low-fat omnivorous diet (control), with both diets focused on soul food. PARTICIPANTS/SETTING Participants (n = 20) came from 2 cohorts of the larger intervention study in South Carolina and were purposefully recruited based on high and low attendance at intervention sessions. Participants in the first cohort were near the end of the intervention, and participants in the second cohort were near the mid-point. The interviews were conducted from June to July 2020. MAIN OUTCOME MEASURES Outcomes included participants' experiences related to stress, nutrition, and exercise behaviors during the early months of the COVID-19 pandemic. ANALYSIS Interviews were recorded and transcribed verbatim. Interview transcripts were coded by two coders using NVivo software. Interviews were coded through content analysis using a constant comparative method. RESULTS Participants discussed the following 3 themes in relation to health behaviors: increased stress, change in routines, and advice to follow health goals. CONCLUSIONS Findings provide perspectives for designing interventions for African American adults establishing new routines to overcome setbacks and changes in routines created by the COVID-19 pandemic.
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Affiliation(s)
- John A Bernhart
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
| | - Mary Quattlebaum
- Department of Psychology, University of South Carolina, Columbia, South Carolina
| | - Sarah Eustis
- Tufts University School of Medicine, Boston, Massachusetts
| | - Nkechi Okpara
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Mary J Wilson
- Department of Health Services, Policy, and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Claudia Sentman
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Gabrielle M Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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Gerber S, O'Hearn M, Cruz SM, Reedy J, Mozaffarian D. Changes in Food Security, Healthfulness, and Access During the Coronavirus Disease 2019 Pandemic: Results From a National United States Survey. Curr Dev Nutr 2023; 7:100060. [PMID: 36937244 PMCID: PMC9968449 DOI: 10.1016/j.cdnut.2023.100060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/15/2023] [Accepted: 02/18/2023] [Indexed: 02/27/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) disrupted access to food and adequate nutrition and the types of foods consumed. However, little empiric data exists on the changes in American's food and nutrition habits 2 y into the pandemic. Objectives To assess current and altered food choices ∼2 y into the COVID-19 pandemic in the months after historic public pandemic relief. Methods A national sample of 1878 United States adults balanced by age, sex, race/ethnicity, and income completed a one-time, online, semi-quantitative, 44-item questionnaire in Fall 2021 asking about the demographics, COVID-19 food choice changes (including free-text), and consumer priorities. This analysis investigates COVID-19 impacts on food security, healthfulness, and access. Results More than 35% of respondents reported improved food security and >45% reported improved food healthfulness compared with prepandemic status. Improvement was reported in more than 30% of Black/African-American and Hispanic/Latinx adults, adults with lower annual income, and female sex, despite over 75% reporting reduced choice of where to eat or buy food. The pandemic offered occasion for many to improve diet, but a similar number expressed that the pandemic destabilized healthy habits. Conclusions Our novel findings suggest that by late 2021, most Americans had improved food security and food choice healthfulness, despite reduced access to food service and retail, although with worsening among a meaningful proportion of Americans as well as heterogeneity in these changes. Vigorous federal, state, city, and community responses to the pandemic may have played a role in improving the food security and food choice healthfulness during the COVID-19 pandemic. Health crises differently impact health behaviors, but when accompanied by vigorous civic and community response, food security, and food healthfulness can be fortified.
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Affiliation(s)
- Suzannah Gerber
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
- Betty and Guy Beatty Liver and Obesity Research Center, Inova Medical System, Fairfax, VA, United States
| | - Meghan O'Hearn
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Sylara Marie Cruz
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Julia Reedy
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Dariush Mozaffarian
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
- Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States
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Johnson AN, Clockston RLM, Fremling L, Clark E, Lundeberg P, Mueller M, Graham DJ. Changes in Adults' Eating Behaviors During the Initial Months of the COVID-19 Pandemic: A Narrative Review. J Acad Nutr Diet 2023; 123:144-194.e30. [PMID: 36075551 PMCID: PMC9444582 DOI: 10.1016/j.jand.2022.08.132] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 08/20/2022] [Accepted: 08/31/2022] [Indexed: 11/18/2022]
Abstract
Factors such as regulations and health concerns shifted daily habits, including eating behaviors, during the early months of the coronavirus disease 2019 (COVID-19) pandemic. This comprehensive narrative review synthesizes research on eating behavior changes during the early months of the pandemic (February to June 2020), including changes in amount, rate, and timing of food consumption, types and healthfulness of foods consumed, the occurrence of other specified eating behaviors (eg, restrained eating or binging), and reasons for eating (eg, stress or cravings), among adults. A literature search using three EBSCOhost databases and Google Scholar was conducted to identify relevant articles made available in 2020. A total of 71 articles representing 250,715 individuals from more than 30 countries were reviewed. Findings show eating behaviors changed little during the early COVID-19 pandemic for most participants. Among those whose eating behaviors changed, increases in both intake and frequency of eating meals and snacks were more common than decreases. Findings on timing of eating and healthfulness of food consumed showed mixed results. However, when changes occurred in the type of food consumed, increases were more common for snacks, homemade pastries, white bread/pasta, legumes, and fruits/vegetables; decreases were more common for meats, seafood/fish, frozen foods, fast food, dark breads/grains, and dark leafy green vegetables. During the pandemic, binging, uncontrolled eating, and overeating increased, meal skipping decreased, and restrictive eating had mixed findings. Changes in factors such as emotions and mood (eg, depression), cravings, and environmental factors (eg, food insecurity) were related to changes in eating behaviors. Findings can inform clinical practitioners in efforts to mitigate disruptions to normal, healthy eating patterns among adults both in and outside of global health catastrophes.
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Affiliation(s)
- Ashlie N Johnson
- Department of Psychology, Linfield University, McMinnville, Oregon.
| | | | - Lindsey Fremling
- Department of Psychology, Colorado State University, Fort Collins, Colorado
| | - Emma Clark
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado
| | - Pamela Lundeberg
- Department of Psychology, Colorado State University, Fort Collins, Colorado
| | - Megan Mueller
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, Colorado
| | - Dan J Graham
- Department of Psychology, Colorado State University, Fort Collins, Colorado
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Phares S, Irving A, McCoy M, Johnston CS. Associations Between Food Skills and Resilience in Adults Ages 18 to 45 in the USA During the COVID-19 Pandemic (2020 April-June): A Brief Report. ADVERSITY AND RESILIENCE SCIENCE 2022; 4:171-176. [PMID: 36569589 PMCID: PMC9764296 DOI: 10.1007/s42844-022-00087-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
Early in the COVID-19 pandemic, there were limited options for eating away from home, obligating many US adults to prepare foods at home, a situation that provided an opportunity to examine relationships between food skills, resilience, and coping in the initial months of the pandemic. This research surveyed a convenience sample of adults (n = 134; 18-45 years of age) from the Phoenix Metropolitan area when a "stay at home" pandemic directive was mandated in the state of AZ. The study objective was to explore how food skills correlated to resilience and whether resilience directly related to the ability to manage oneself during this time. Previously validated measures for food skills and resiliency were utilized for the online questionnaire, which also included the question, "I was able to manage myself during the Coronavirus Pandemic." The Spearman's rank order correlation test and a linear, stepwise regression analysis were used to examine relationships between scores. Participants scored at the 77% percentile for total food skill proficiency, and at the 84th percentile for resilience. Both total food skills and resilience were correlated to the ability to self-manage during COVID-19 (r = 0.246 and r = 0.444, respectively; p ≤ 0.004). The stepwise linear regression model retained only the food skill domain "food selection and planning" as a significant predictor of resilience (standardized coefficient, 0.278; 99% CI [- 0.056, 0.414]; p < 0.05). These data suggest that resilience and food skills factored into participants' ability to self-manage during the COVID-19 mandate, "stay at home."
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Affiliation(s)
- Savanna Phares
- grid.215654.10000 0001 2151 2636College of Health Solutions, Arizona State University, 550 N. 3Rd Street, Phoenix, AZ 85004 USA
| | - Andrea Irving
- grid.215654.10000 0001 2151 2636College of Health Solutions, Arizona State University, 550 N. 3Rd Street, Phoenix, AZ 85004 USA
| | - Maureen McCoy
- grid.215654.10000 0001 2151 2636College of Health Solutions, Arizona State University, 550 N. 3Rd Street, Phoenix, AZ 85004 USA
| | - Carol S. Johnston
- grid.215654.10000 0001 2151 2636College of Health Solutions, Arizona State University, 550 N. 3Rd Street, Phoenix, AZ 85004 USA
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Lally AE, Morina A, Vermont LN, Tirabassi JN, Leone LA. Impacts of the COVID-19 Pandemic on Mobile Produce Market Operations: Adaptations, Barriers, and Future Directions for Increasing Food Access. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11390. [PMID: 36141664 PMCID: PMC9517362 DOI: 10.3390/ijerph191811390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/26/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Mobile produce markets were increasingly recognized as an effective and accepted approach to improving access to fruits and vegetables in lower-income and at-risk communities during the first year of the COVID-19 pandemic in the United States. This study provides insights into how mobile market operations were impacted by, and evolved in response to, challenges posed by the pandemic. METHODS A survey evaluating impacts of the pandemic on mobile markets was distributed to a database of mobile market operators in the United States. Respondents were asked to describe impacts to their mobile market's operations, and what adaptations were needed to continue to effectively serve their communities during 2020. RESULTS Surveys representing 48 unique mobile markets were collected from March to July 2021. Of the respondents, 63% reported an increase in demand for mobile market services from community members. Furthermore, 65% increased the amount of produce they distributed in 2020 as compared to 2019, often through adopting low or no-cost models or participating in pandemic government programs. DISCUSSION Emergency adaptations employed by mobile markets can inform long-term operational modifications for not only mobile markets, but also other food access programs, beyond the COVID-19 pandemic.
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Affiliation(s)
- Anne E. Lally
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA
- Department of Anthropology, The College of Arts and Sciences, University at Buffalo, Buffalo, NY 14261, USA
| | - Alban Morina
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA
| | - Leah N. Vermont
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA
| | - Jill N. Tirabassi
- Department of Family Medicine, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Lucia A. Leone
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA
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