Socioeconomic risks of food insecurity during the Covid-19 pandemic in the UK: findings from the Understanding Society Covid Survey

A Group-Based, Six-Lesson Healthy Eating Curriculum for Individuals With Serious Mental Illnesses: Development and Implementation

As part of an intervention tailored to individuals with serious mental illnesses in residential settings that aimed to increase dietary intake of fresh vegetables and fruits, we developed and implemented a nutrition and cooking curriculum. To develop the curriculum, we assembled a Workgroup that consisted of professionals from multiple fields. The Workgroup held weekly discussions before drafting what would become the Workbook. Residential staff at partnering housing agencies taught the curriculum to residents. The curriculum Workbook contains six lessons, which are organized around two field trips to a mobile farmers market and a grocery store, and four cooking methods. The Workbook also includes instructions on using FreshConnect Checks at mobile farmers markets. The new curriculum distinguishes itself from other nutrition and culinary literacy curricula in that it delivers knowledge about fresh produce and skills in preparing fruits and vegetables in a way that is tailored to individuals with serious mental illnesses.

Age-related differences in the association between financial hardship and weight change during the COVID-19 pandemic

Objective

To examine the association of financial hardship with weight changes in the US during the COVID-19 pandemic.

Methods

We used data from the COVID-19's Unequal Racial Burden survey, a nationally representative, cross-sectional, online survey of diverse adults living in the US, 12/2020-2/2021. This study included 1000 Asian, Black, Latino (half Spanish-speaking), and White adults and 500 American Indian or Alaska Native, Native Hawaiian or Pacific Islander, and multiracial adults (5500 total). Age-specific (18-39, 40-59, ≥60) associations between financial hardship domains and weight change were estimated using multinomial logistic regression, adjusted for demographic and health characteristics.

Results

Financial hardship during the COVID-19 pandemic was prevalent across all age groups (18-39: 76.2 %; 40-59: 75.6 %; ≥60: 50.6 %). Among adults aged 18-39 and ≥ 60 years old, food insecurity was significantly associated with weight loss (18-39: aOR = 1.42, 95 % CI = 1.04, 1.95; ≥60: aOR = 3.67, 95 % CI = 1.50, 8.98). Among all age groups, unmet healthcare expenses was also associated with weight loss (18-39: aOR = 1.31, 95 % CI = 1.01, 1.70; 40-59: aOR = 1.49, 95 % CI = 1.06, 2.08; ≥60: aOR = 1.73, 95 % CI = 1.03, 2.91). Among adults aged 18-39 and ≥ 60 years old, lost income was significantly associated with weight gain (18-39: aOR = 1.36, 95 % CI = 1.09-1.69; ≥60: aOR = 1.46, 95 % CI = 1.04, 2.06), and among adults 40-59 years old, experiencing increased debt was significantly associated with weight gain (aOR = 1.50, 95 % CI = 1.13, 1.99).

Conclusions

For those aged 18-39 and ≥ 60 years old experiencing financial hardship during the COVID-19 pandemic was associated with both weight loss and weight gain. Less correlation was observed among adults aged 40-59.

Has food security in the EU countries worsened during the COVID-19 pandemic? Analysis of physical and economic access to food

The aim of the paper is to provide an ex-post assessment of the impact of the COVID-19 pandemic on food insecurity in the EU-27 countries expressed by physical and economic food access. We analysed trade and price effects, together with food insecurity and malnutrition indicators. Actual levels of the indicators were compared with their pre-pandemic magnitudes and/or with counterfactual levels derived from predictive models. We also aimed to compare the objective statistics with the subjective consumers' perception of their households' food security. Our research indicates that the EU food trade was more resilient to COVID-19 impacts than the trade in non-food products, while food trade decreases were of a temporary nature. This did not affect the trade balance significantly; however, the import reduction threatened the physical food access in most EU countries. Regarding economic food access, the results indicate that the increase in food prices was offset by the increase in disposable income. It may suggest that the COVID-19 pandemic did not significantly affect the deterioration of economic access to food in the EU countries. However, the prevalence of severe food insecurity in the total population or the proportion of households reporting inability to afford a meal with meat, chicken, fish, or a vegetarian equivalent increased in 2020-2021 compared to 2019. This means that the comparative analysis of the real data on prices and households' income, as well as consumer financial situation and food consumption affordability, does not offer a clear answer concerning the impact of the COVID-19 pandemic on the food security of EU households.

Exploring the world of food with families: perspectives of low-income families on factors influencing their food choices

OBJECTIVE

The aim of this study was to investigate the social and environmental factors involved in the food decision-making processes of families living on lower incomes on the Island of Ireland.

DESIGN

A qualitative design was employed for this study, using photovoice and creative mapping methods. Parents were requested to take photos and draw maps of their food environments. Interviews were then conducted with parents, using the materials produced by parents as a cue to discuss their food environments, influences and decision-making processes around food choices.

SETTING

The participants were interviewed online via Microsoft Teams.

PARTICIPANTS

The participants were parents or guardians of children between the ages of 2 and 18 who self-defined as 'living on a tight budget'.

RESULTS

Twenty-eight participants were recruited and interviewed for this study, including twelve parents in Northern Ireland and sixteen in the Republic of Ireland. The findings were mapped on to Bronfenbrenner's Ecological Systems Theory and showed that multiple, overlapping and intersecting factors at the individual, micro-, meso-, exo-, macro- and chrono-system were implicated in family food choices. Upstream factors in particular, including structural, policy and commercial determinants, appear to be significant drivers of behaviour.

CONCLUSIONS

While the findings suggest that a complex range of factors are involved in family food choices, it is clear that policy measures and regulations are needed to stave off the impacts of rising social inequality and food poverty. Health promoters should strive to find non-stigmatising interventions to bridge the nutritional divide experienced by lower-income families.

Level of minimum acceptable diet and its associated factors among children aged 12-23 months in Ugandan districts

Uganda has made notable progress in improving child nutrition indicators, albeit not fast enough to meet global targets. Navigating the landscape of child nutrition in Uganda demands attention, particularly in light of the necessity for a minimum acceptable diet (MAD) for children aged 12-23 months. While the focus on local nutritional planning is crucial, the absence of routine-specific nutritional status data creates a significant information gap. To bridge this void, this study used datasets from the 2021 Lot Quality Assurance Sampling (LQAS) survey. Data were analysed using multilevel mixed-effects logistic regression (clustering districts based on regional boundaries) at a 5% statistical significance level using STATA version 17. Of the 7,111 children surveyed, 3,256 (49.20%) received the minimum meal frequency, 695 (9.80%) received the minimum dietary diversity, and only 380 (5.34%) received the MAD. There was a notable variation in the proportion of children that received the MAD across regions and districts. Children living in urban areas, children whose mothers had a higher education, and children whose mothers had a diverse diet were more likely to receive the MAD. Children were less likely to receive the MAD if they lived in a household that did not receive a health worker visit within the year. These findings suggest a need to prioritize initiatives aimed at increasing dietary diversity among children in Uganda. This could be done through a variety of approaches, such as leveraging the use of home gardens to boost nutrition through diverse crop cultivation, demonstration gardens, and offering nutrition counselling through village health teams.

The Health and Nutritional Status of Children (10-18 years) Belonging to Food Insecure Households: The Korea National Health and Nutrition Examination Survey (2012-2019)

To research the health and nutritional status in Korean children and adolescents belonging to food insecure households (FI), the preregistered secondary data of 18 items from the Food Security Evaluation in the Korea National Health and Nutrition Examination Survey (KNHANES; 2012-2019) were used. Comparative analyses (food security group [FS], (n = 3150) vs. FI, (n = 405) of household characteristics, health status (anthropometrics, clinics, mentality), and nutritional status (nutrient intake, diet-quality, and pattern) were performed in children (boys: 1871, girls: 1684) aged 10-18 years. The FI comprised higher proportions of participants from low-income families, basic livelihood-security recipients, and vulnerability (characteristics: female household heads, aged ≥50, single, unemployed, with low education and unmet healthcare needs). Compared to FS, boys had higher abdominal obesity and alcohol use, whereas girls had lower high-density-lipoprotein cholesterol (HDLc) and mental vulnerability (self-perceived obesity despite FS-similar anthropometry) in FI. Inadequate protein intake among boys and girls, and high carbohydrate and inadequate fat intake among girls were especially found in the FI status. From the results of a nutrition quality test, Vit-A in boys, and protein, niacin, and iron intakes in girls were insufficient, respectively. Health-nutritional policies to improve children's lifestyles should reinforce FI-based intake of deficient nutrients.

Changes in retirement plans in the English older population during the COVID-19 pandemic: The roles of health factors and financial insecurity

Over the course of 2020 and 2021, the COVID-19 pandemic disrupted lives globally. In the UK, unemployment rate continued to increase during and post-lockdown periods, and job security and financial wellbeing deteriorated. It is important to understand whether individual decisions related to retirement plans have changed systematically as a result of the pandemic, especially among older adults who experienced greater rates of pandemic unemployment. Using the English Longitudinal Study of Ageing, this article examines changes in retirement plans of older adults during the COVID-19 pandemic and estimates the impact of health and financial circumstances on these changes. In June/July 2020, 5% of 2095 participants reported planning earlier retirement, while 9% reported planning later retirement. We found that poor self-rated health and financial insecurity were associated with intentions to postpone retirement. Additional risk of later retirement associated with poor health was detected among those experiencing financial insecurity. In November/December 2020, 7% of 1845 participants reported planning earlier retirement, while 12% reported planning later retirement. We found that poor health was predictive of a lower relative risk of later retirement, while depressive symptomology and financial insecurity predicted a higher relative risk of later retirement. The findings imply a contextual role of health factors in, and a persistent influence of financial insecurity on, retirement planning in the older population.

Financial adversity and subsequent health and wellbeing during the COVID-19 pandemic in the UK: A qualitative interview study

Aims

There are concerns that the economic impacts of the COVID-19 pandemic, including employment inactivity and job loss, will have consequences for the UK population's health and wellbeing. However, there is limited qualitative research into how financial adversity contributes to poor health outcomes in this context. This study aimed to explore forms of financial adversity experienced during the pandemic and their subsequent impacts for health and wellbeing.

Methods

Qualitative semi-structured interviews with 20 people who experienced a form of financial adversity during the pandemic and six service providers employed in social welfare support services. Data were analysed using reflexive thematic analysis.

Results

Two main sources of financial adversity were identified: reductions in household incomes and increased living costs which engendered emotional and physical burdens. Coping strategies included increased financial borrowing, support from informal and formal networks and cutting back on energy use, food and non-essential items.

Conclusion

Our study highlighted exposure to multiple financial adversities because of the pandemic and how these experiences led to poor mental and physical health. The findings underline the importance of measures attending to the immediate needs of individuals, including accessible, co-located financial and psychological services, as well as broader measures that seek to reduce social and economic inequalities.

Food Insecurity and Nutritional Challenges in Adolescent and Young Adult Cancer Survivors in the U.S.A.: A Narrative Review and Call to Action

Advancements in cancer treatments over the past several decades have led to improved cancer survival in adolescents and young adults (AYAs, ages 15–39 years). However, AYA cancer survivors are at an increased risk for “late effects”, including cardiovascular, pulmonary and bone diseases as well as fatigue, infertility and secondary cancers. The treatments for cancer may also alter taste, lead to nutritional deficiencies and increase financial burdens that, when taken together, may increase the risk of food and nutrition security in AYA cancer survivors. Furthermore, although AYAs are often merged together in cancer survivorship studies, adolescents and young adults have distinct developmental, psychosocial and pathophysiological differences that may modify their risk of nutritional challenges. In this narrative review and “Call to Action”, rationale is provided for why there is a need to better understand nutritional challenges and food insecurity in AYA cancer survivors as a special population. Then, recommendations for next steps to advance knowledge and policy in this field are provided. In particular, integrating screening for food and nutrition insecurity and enhancing awareness of existing resources (e.g., the Supplemental Nutrition Assistance Program, SNAP) might help AYA cancer survivors combat nutritional deficiencies and reduce late effects while improving their overall survival and quality of life.

Food Insecurity Is Associated with Dietary Consumption during the COVID-19 Pandemic: Data from the Korea National Health and Nutrition Examination Survey 2019-2020

Coronavirus disease 2019 (COVID-19) has become a pandemic and has affected people's dietary behaviors, including food insecurity. This study aimed to ascertain whether COVID-19 may alter the prevalence of food insecurity, and if such food security status may be associated with dietary intake among Koreans. The general characteristics, dietary intake and food security status data in the Korea National Health and Nutrition Examination Survey VIII (2019~2020) were analyzed. The prevalence of food insecurity and food group and nutrient consumption by food security status were analyzed before (2019) and after the start of the pandemic (2020). Findings suggested 4.3% of Koreans experienced food insecurity during the first year of the pandemic, yet it did not differ from that in the year before the pandemic. Before COVID-19, there was no significant difference in food group or nutrition consumption by food security status. However, in 2020, the fruit and vitamin C intake of the food-insecure group was significantly lower than that of the food-secure group. Additionally, the food-insecure group's ratio of subjects who did not meet the recommended level of fruits and the vitamin was higher compared to that of the secure group. In conclusion, COVID-19 did not affect food insecurity status, but did have a negative influence on dietary intake for food-insecure Koreans.

Digital food sharing and food insecurity in the COVID-19 era

Sharing food surplus via the digital sharing economy is often discussed as a promising strategy to reduce food waste and mitigate food insecurity at the same time. Yet if and how the global pandemic has affected digital food sharing are not yet well understood. Leveraging a comprehensive dataset covering over 1.8 million food exchanges facilitated by a popular peer-to-peer food sharing platform, we find that UK activity levels not only rose during the Covid-19 pandemic, but outperformed projections. A potential explanation for this growth might be the rise of food insecurity during the pandemic. Yet examining the sociodemographic characteristics of platform users, average user activity and food exchanges before and during the pandemic, we find no compelling evidence that the platform's pandemic-era growth results from a large influx of food insecure users. Instead, we poist that the growth in digital food sharing relates to lifestyle changes potentially triggered by the pandemic.

The impact of living through COVID-19 pandemic on mental health, food insecurity, loneliness and health behaviours in people with obesity

BACKGROUND

The COVID-19 pandemic has negatively impacted people living with obesity. The aim was to examine the continued impact of the COVID-19 pandemic on the mental health of people living with obesity and associations with food insecurity, loneliness and health-related behaviours.

METHODS

The study recruited 1187 UK adults living with obesity who completed an online survey, which examined mental health and associations with food insecurity, loneliness and health-related behaviours from July 2020 (end of the first lockdown in the United Kingdom) to the point they completed the survey in 2021. Regression analyses were used to examine relationships between outcome variables and demographic factors, and hierarchical linear regression models were used to assess levels of loneliness, depression and well-being.

RESULTS

Participants reported worse loneliness, depression, well-being and food insecurity compared to pre-COVID. However, participants reported attempting to lose weight, healthier food shopping, diet and increased physical activity. Quality and quantity of sleep deteriorated compared to prior to COVID-19.

CONCLUSIONS

Adults living with obesity in the United Kingdom report a continued negative impact of the COVID-19 pandemic upon their mental health together with increased loneliness and food insecurity. However, our findings suggest that UK adults living with obesity have increased their engagement in positive health behaviours and were attempting to lose weight.

The Global Burden of Food Insecurity Due to COVID-19

The insurgence of the COVID-19 pandemic has demonstrated that no country or region was prepared to face such a devastating emergency, nor have researchers uncovered permanent solutions to solve this everlasting crisis thus far [...]