Impact of COVID-19 on food behavior and diet in Qatar: A cross-sectional survey on the Omicron variant

PURPOSE

The emergence of the Omicron variant in November 2021 appears to have impacted food-related activities and behaviors and caused disruptions in food supply systems. Accordingly, this article aims to explore the effects of the Omicron variant on consumers' food-related behaviors in Qatar.

DESIGN/METHODOLOGY/APPROACH

This research is based on an online survey performed in Qatar in December 2021 and January 2022. The survey consisted of 23 questions arranged into three sections, including both multiple-choice and one-option items. There were 459 valid responses in total.

FINDINGS

The Omicron variant has altered diets and food shopping in Qatar. Indeed, the findings indicated (i) consumers in Qatar are shopping less often and purchasing more each trip; (ii) an increase in food online shopping; (iii) an increase in the use of online applications to buy ready-made food; and (iv) an increase in the consumption of healthy foods, especially immunity-boosting ones. Furthermore, consumers' awareness and general understanding regarding the virus, its transmission, food safety risks, etc., have evolved. On the one hand, consumers take precautionary measures to protect themselves. On the other hand, they are learning to live with the virus.

ORIGINALITY

This research, along with subsequent ones, will provide the foundation for institutional and governmental readiness in the face of potential shocks, crises, and pandemics. The repercussions of the ongoing conflict in Ukraine on food systems throughout the globe (cf. food prices increase) imply that it's a crucial and pressing issue that needs immediate attention.

Changes to household food shopping practices during the COVID-19 restrictions: Evidence from the East of England

Measures to control the spread of COVID-19 have changed the way we shop for food and interact with food environments. This qualitative study explored food shopping practices in the East of England, a large diverse region including coastal, urban and rural settings. In 2020/2021 we interviewed 38 people living in the region and 27 professionals and volunteers providing local support around dietary health. Participants reported disruption to supermarket shopping routines; moving to online shopping; and increased reliance on local stores. COVID-19 has impacted disproportionately upon lower-income households and neighbourhoods. The longer-term implications for dietary health inequalities must be investigated.

Exploring food shopping, consumption and waste habits in North Macedonia during the COVID-19 pandemic

Household food waste (FW) has huge environmental and socio-economic impacts. During the COVID-19 pandemic, a survey was carried out in North Macedonia to explore perceptions and attitudes towards FW at the household level. A self-administered questionnaire was available online from 15th of May until June 30, 2020 and the sample size was 754. A very high percentage of the respondents (94.16%) expressed a high awareness of food waste and declared to worry about this issue trying to avoid food waste as much as possible. Moreover, the results showed that 41.38% of the respondents think to waste a low amount of food while 27.98% state not to throw almost anything. Meanwhile, 52.39% of the respondents believe that they do not throw away food that is still consumable. About 22.54% of them think to throw less than 250 g followed by those who think to throw between 250 and 500 g (18.04%). The survey showed that the most wasted food groups are cereals and bakery products, fruit, vegetables, and milk and dairy products. Concerning economic value, most of the respondents (53.18%) believe to spend less than 5 EUR on food wasted while 42.04% of them think to spend between 5 and 25 EUR. Regarding shopping behaviour during COVID-19, only about a half of the respondents (48.28%) stated to go shopping like they used to do. The respondents declared that they have bought during COVID-19 more vegetables (72.30%) and fruits (68.60%), which might imply that they are moving towards healthier diets. It seems that food wastage has increased during the COVID-19 for about a third of the respondents (34.70%). The survey showed that the COVID-19 pandemic affected food purchase, wastage and consumption behaviours in North Macedonia. Such a finding should inform future policies and initiatives relating to agriculture, food and health during the recovery period.

Assessment of household food waste management during the COVID-19 pandemic in Serbia: a cross-sectional online survey

The Serbian government has taken several measures to prevent the spread of COVID-19. These measures may have led to a disruption of daily life and affected food-related behaviors. This paper investigates the state of food waste management in Serbia and COVID-19's direct effect on consumer awareness, food consumption, and food waste behaviors. The study is based on an online survey using a structured questionnaire administered in Serbian from May 13 until June 13, 2020, through the Google forms platform. A total of 1212 valid answers were collected, mainly from female, young, and high-educated people. The survey results suggested that (i) household food waste in Serbia is low and there is a positive attitude toward food waste prevention; (ii) food waste increased during the COVID-19 pandemic; (iii) consumers reduced the number of shopping trips and shopped more than usual during the pandemic. This study contributes to a better understanding of consumers' consumption habits and attitudes toward food waste to prevent and reduce it.

Exploring food shopping behaviours through a study of Ottawa social media

This study explored the important attributes of the local food retail environments that residents from Ottawa, Ontario, Canada, used in recommending where to purchase fresh produce, including fruits and vegetables, in the Ottawa area. Drawing upon an approach originating in marketing and consumer research, qualitative thematic analysis was used to analyze 79 discussions from three social media platforms that occurred between 2015 and 2018. We identified three patterns of conversations about food shopping, characterized by participants describing important factors of their local retail food environments that shaped their recommendations for different retail food establishments: 1) Pleasant represented discussions where having a pleasurable food shopping experience was the main discussion point. 2) Thrifty discussions were marked primarily by economical management and discussed food shopping in pragmatic terms. 3) Compromise represented a group where discussions described needing to find a middle ground between affordability and quality. While not without limitations, our study was the first exploration of whether social media data could be useful for qualitatively evaluating local retail food environments. Our findings add to the conclusions of other researchers that social media data does not compromise on the breadth of views captured and can parallel findings from traditional methods. These findings have implications for nutrition researchers and practitioners who we encourage to consider social media discussion data in their work.

Resources in women's social networks for food shopping are more strongly associated with better dietary quality than people: A cross-sectional study

When healthy people are part of an individual's social network, those individuals will have better dietary quality. Little, however, is known about whether social networks for food shopping, including both people and resources (e.g. recipes, weight loss programmes and food advertisements) are associated with dietary quality. The aim of this study was to explore the relationship between social networks for food shopping and dietary quality, and whether this differs for people and resources, among women aged 18-45 years. A total of 129 participants completed a cross-sectional questionnaire including an ego-centric Social Network Exposure tool and short Food Frequency Questionnaire. Associations between dietary quality and type of network member, perceived healthiness and support for healthy shopping choices were explored using linear regression models. Analyses revealed that participants who nominated people in their food shopping social network that eat healthily or support healthy food shopping had better dietary quality (β = 0.16 SD per 1-point change on a 4-point scale, 95%CI -0.06, 0.39; β = 0.20, 95%CI -0.07, 0.46, respectively). Resources in participants' food shopping social networks which promote healthy eating or support healthy shopping were associated with better dietary quality. These associations remained robust after adjustment for confounding variables identified using a directed acyclic graph (β = 0.31 SD per 1-point change on a 4-point scale, 95%CI 0.03, 0.58; β = 0.44, 95%CI 0.09, 0.79 respectively). The results were strengthened when the outcome was multiplied by frequency of contact (β = 0.33, 95%CI 0.05, 0.61; β = 0.47, 95%CI 0.11, 0.83 respectively). This study suggests that resources which promote healthy eating and healthy food shopping have a stronger association with dietary quality than social support from people. Further research is required in a larger sample, including multiple time-points, to confirm these findings.

A relational approach to evaluate food environments finds that the proximate food environment matters for those who use it

Using a relational approach, this study investigates whether shopping close to home moderates the relationship between the proximate food environment and diet. To address this question, we develop the proximate food retail quality (PFRQ) score, an inverse-distance weighted measure of all food retailers within a resident's neighborhood that incorporates audit data of each food retailer. This study relies on data collected through 24-h dietary recalls and psychosocial surveys administered to 449 adults in two socioeconomically matched neighborhoods. Food retailer audits collected data on the availability, price, and quality of healthful foods. Seventy-one percent of study participants report conducting at least 50% of their food shopping within approximately one mile of their home. Household income and education are associated with likelihood to shop close to home, while access to a personal vehicle is not. Finally, results suggest that, for residents who shop primarily close to home, a one unit increase in proximate food retail environment score is associated with a 17.2-point increase in HEI-2010 score, a measure of overall diet quality that ranges from zero to 100. This study suggests that the food environment matters for those who use it and that a low-quality proximate food environment can amplify individual disadvantage.

The healthy food marketing strategies study: design, baseline characteristics, and supermarket compliance

Identifying effective strategies to promote healthy eating and reduce obesity is a priority in the USA, especially among low-income and minority groups, who often have less access to healthy food and higher rates of obesity. Efforts to improve food access have led to more supermarkets in low-income, ethnically diverse neighborhoods. However, this alone may not be enough to reduce food insecurity and improve residents' diet quality and health. This paper summarizes the design, methods, baseline findings, and supermarket in-store marketing strategy compliance for a randomized trial of the impact of healthy food marketing on the purchase of healthier "target" food items. Thirty-three supermarkets in low-income, high-minority neighborhoods in the metropolitan Philadelphia area were matched on store size and percentage of sales from government food assistance programs and randomly assigned to the intervention or control group. Healthy marketing strategies, including increased availability of healthier "target" products, prime shelf-placement and call-out promotion signs, and reduced availability of regular "comparison" products, were implemented in 16 intervention stores for an 18 month period for over 100 individual food items. Six product categories were studied: bread, checkout cooler beverages, cheese, frozen dinners, milk, and salty snacks. The primary outcome measure was weekly sales per store in each product category for 1 year preintervention and 18 months during the intervention. Compliance with the marketing strategies was assessed twice per month for the first 6 months and once a month thereafter. Store and neighborhood characteristics were not significantly different between control and intervention stores. Intercept surveys with customers to assess shopping habits and grocery marketing environment assessments to examine the food promotion environment were completed in the same six food categories. In intercept surveys, 51.0% of shoppers self-identified as overweight and 60.6% wanted to change their weight. Shoppers who typically purchased one type of food over another commonly did so out of habit or because the item was on sale. Findings revealed that preintervention sales of healthier "target" or regular "comparison" items did not differ between intervention and control stores for 1 year prior to intervention implementation. Rates of compliance with the healthy marketing strategies were high, averaging 76.5% over the first 12 months in all 16 stores. If healthy in-store marketing interventions are effective in this scaled-up, longer-term study, they should be translated into wider use in community supermarkets.

Small increments in diet cost can improve compliance with the Dietary Guidelines for Americans

Adherence to the Dietary Guidelines for Americans (DGA) may involve higher diet costs. This study assessed the relation between two measures of food spending and diet quality among adult participants (N = 768) in the Seattle Obesity Study (SOS III). All participants completed socio-demographic and food expenditure surveys and the Fred Hutch food frequency questionnaire. Dietary intakes were joined with local supermarket prices to estimate individual-level diet costs. Healthy Eating Index (HEI- 2015) scores measured compliance with DGA. Multiple linear regressions using Generalized Estimating Equations with robust standard errors showed that lower food spending was associated with younger age, Hispanic ethnicity, and lower socioeconomic status. Even though higher HEI-2015 scores were associated with higher diet costs per 2000 kcal, much individual variability was observed. A positive curvilinear relationship was observed in adjusted models. At lower cost diets, a $100/month increase in cost (from $150 to $250) was associated with a 20.6% increase in HEI-2015. For higher levels of diet cost (from $350 to $450) there were diminishing returns (2.8% increase in HEI- 2015). These findings indicate that increases in food spending at the lower end of the range have the most potential to improve diet quality.

Where do U.S. households purchase healthy foods? An analysis of food-at-home purchases across different types of retailers in a nationally representative dataset

Food shopping decisions are pathways between food environment, diet and health outcomes, including chronic diseases such as diabetes and obesity. The choices of where to shop and what to buy are interrelated, though a better understanding of this dynamic is needed. The U.S. Department of Agriculture's nationally representative Food Acquisitions and Purchase Survey food-at-home dataset was joined with other databases of retailer characteristics and Healthy Eating Index-2010 (HEI) of purchases. We used linear regression models with general estimating equations to assess relationships between trip, store, and shopper characteristics with trip HEI scores. We examined HEI component scores for conventional supermarkets and discount/limited assortment retailers with descriptive statistics. Overall, 4962 shoppers made 11,472 shopping trips over one-week periods, 2012-2013. Trips to conventional supermarkets were the most common (53.6%), followed by supercenters (18.6%). Compared to conventional supermarkets, purchases at natural/gourmet stores had significantly higher HEI scores (β = 6.48, 95% CI = [4.45, 8.51], while those from "other" retailers (including corner and convenience stores) were significantly lower (-3.89, [-5.87, -1.92]). Older participants (versus younger) and women (versus men) made significantly healthier purchases (1.19, [0.29, 2.10]). Shoppers with less than some college education made significantly less-healthy purchases, versus shoppers with more education, as did households participating in SNAP, versus those with incomes above 185% of the Federal Poverty Level. Individual, trip, and store characteristics influenced the healthfulness of foods purchased. Interventions to encourage healthy purchasing should reflect these dynamics in terms of how, where, and for whom they are implemented.

Family food purchases of high- and low-calorie foods in full-service supermarkets and other food retailers by Black women in an urban US setting

Public health interventions to increase supermarket access assume that shopping in supermarkets is associated with healthier food purchases compared to other store types. To test this assumption, we compared purchasing patterns by store-type for certain higher-calorie, less healthy foods (HCF) and lower-calorie, healthier foods (LCF) in a sample of 35 black women household shoppers in Philadelphia, PA. Data analyzed were from 450 food shopping receipts collected by these shoppers over four-week periods in 2012. We compared the likelihood of purchasing the HCF (sugar-sweetened beverages, sweet/salty snacks, and grain-based snacks) and LCF (low-fat dairy, fruits, and vegetables) at full-service supermarkets and six other types of food retailers, using generalized estimating equations. Thirty-seven percent of participants had household incomes at or below the poverty line, and 54% had a BMI >30. Participants shopped primarily at full-service supermarkets (55%) or discount/limited assortment supermarkets (22%), making an average of 11 shopping trips over a 4-week period and spending mean (SD) of $350 ($222). Of full-service supermarket receipts, 64% included at least one HCF item and 58% at least one LCF. Most trips including HCF (58%) and LCF (60%) expenditures were to full-service or discount/limited assortment supermarkets rather than smaller stores. Spending a greater percent of total dollars in full-service supermarkets was associated with spending more on HCF (p = 0.03) but not LCF items (p = 0.26). These findings in black women suggest a need for more attention to supermarket interventions that change retailing practices and/or consumer shopping behaviors related to foods in the HCF categories examined.

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In the study, most (55%) food shopping trips were to full-service supermarkets.

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Lower- vs. higher-income shoppers spent a higher share at limited-assortment stores.

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Most (65%) full-service supermarket trips included at least 1 higher-calorie food.

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Higher- but not lower-calorie food spending was greater in full-service supermarkets.

Exploratory Cross-Sectional Study of Factors Associated with the Healthfulness of Parental Responses to Child Food Purchasing Requests

Objective The main objective of this study was to investigate the relationship between various factors (e.g., sociodemographic, child, and parental factors) and the healthfulness of parental responses to child in-store food purchasing requests. Additionally, a secondary objective is to describe "resist strategies" used by parents to respond to child food-purchasing requests and their efficacy in avoiding conflict. Methods Parent-child dyads (children aged 2-6 years) completed an audio-/visual-recoded food shopping trip at their usual grocery store and time. Recordings of trips were coded for behavioral and environmental factors. Parental healthful response rate (i.e., percent of responses that were healthful) was the primary outcome variable. A healthful response occurred when a parent yielded to a healthful child request, or resisted a non-healthful request. Parents also completed a questionnaire. Kruskal-Wallis tests were used to assess the relationship between the main outcome variable and sociodemographic, child, and parent factors. Results Parents (n = 39) responded healthfully to 62.9 % (±26.7 %) of child food purchasing requests. Low- and middle-income parents, and black and white parents, had significantly higher healthful response rates compared to high-income parents (p = 0.03) and Hispanic/Indian-descent parents (p = 0.02), respectively. Using the "ignore" strategy proved an effective resist strategy in this study, leading to no parent-child conflicts. Conclusions Programming that seeks to improve the healthfulness of food purchasing in families with young children should address unhealthful response behaviors in Hispanic/Indian-descent parents and high-income parents; although, the needs of these groups are different. Further research is needed to confirm and expand on these findings.

Ethical imperatives against item restriction in the Supplemental Nutrition Assistance Program

The Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps) is the federal government's largest form of food assistance, and a frequent focus of political and scholarly debate. Previous discourse in the public health community and recent proposals in state legislatures have suggested limiting the use of SNAP benefits on unhealthy food items, such as sugar-sweetened beverages (SSBs). This paper identifies two possible underlying motivations for item restriction, health and morals, and analyzes the level of empirical support for claims about the current state of the program, as well as expectations about how item restriction would change participant outcomes. It also assesses how item restriction would reduce individual agency of low-income individuals, and identifies mechanisms by which this may adversely affect program participants. Finally, this paper offers alternative policies to promote healthier purchasing and eating among SNAP participants that can be pursued without reducing individual agency. Health advocates and officials must more fully weigh the attendant risks of implementing SNAP item restrictions, including the reduction of individual agency of a vulnerable population.

Associations between frequency of food shopping at different store types and diet and weight outcomes: findings from the NEWPATH study

Objective

The present study aimed to: (i) examine associations between food store patronage and diet and weight-related outcomes; and (ii) explore consumer motivations for visiting different types of food store.

Design

A stratified probability sample of residents completed household and individual-level surveys in 2009/2010 on food purchasing patterns and motivations, dietary intake, waist circumference (WC), weight and height. Diet quality was calculated using the Healthy Eating Index for Canada from a subset of participants (n 1362). Generalized estimating equations were created in 2015 to examine how frequency of patronizing different types of food store was associated with diet quality, intake of fruits and vegetable, mean intake of energy (kcal) sodium and saturated fat, WC and BMI.

Setting

Three mid-sized urban municipalities in Ontario, Canada.

Subjects

A representative sample of residents (n 4574).

Results

Participants who shopped frequently at food co-ops had significantly better diet quality (β=5·3; 99 % CI 0·3, 10·2) than those who did not. BMI and WC were significantly lower among those who frequently shopped at specialty shops (BMI, β=−2·1; 99 % CI −3·0, −1·1; WC, β=−4·8; 99 % CI −7·0, −2·5) and farmers’ markets (BMI, β=−1·4; 99 % CI −2·3, −0·5; WC, β=−3·8; 99 % CI −6·0, −1·6) compared with those who did not. Relative importance of reasons for food outlet selection differed by large (price, food quality) v. small (proximity, convenient hours) shopping trip and by outlet type.

Conclusions

Findings contribute to our understanding of food store selection and have implications for potentially relevant retail food intervention settings.

Food shopping profiles and their association with dietary patterns: a latent class analysis

BACKGROUND

Food shopping is a complex behavior that consists of multiple dimensions. Little research has explored multiple dimensions of food shopping or examined how it relates to dietary intake.

OBJECTIVE

To identify patterns (or classes) of food shopping across four domains (fresh food purchasing, conscientious food shopping, food shopping locations, and food/beverage purchasing on or near campus) and explore how these patterns relate to dietary intake among college students.

DESIGN

A cross-sectional online survey was administered.

PARTICIPANTS/SETTING

Students attending a public 4-year university and a 2-year community college in the Twin Cities (Minnesota) metropolitan area (N=1,201) participated in this study.

MAIN OUTCOME MEASURES

Fast-food and soda consumption as well as meeting fruit and vegetable, fiber, added sugar, calcium, dairy, and fat recommendations.

STATISTICAL ANALYSES

Crude and adjusted latent class models and adjusted logistic regression models were fit.

RESULTS

An eight-class solution was identified: "traditional shopper" (14.9%), "fresh food and supermarket shopper" (14.1%), "convenience shopper" (18.8%), "conscientious convenience shopper" (13.8%), "conscientious, fresh food, convenience shopper" (11.8%), "conscientious fresh food shopper" (6.6%), "conscientious nonshopper" (10.2%), and "nonshopper" (9.8%). "Fresh food and supermarket shoppers" and "conscientious fresh food shoppers" had better dietary intake (for fast food, calcium, dairy, and added sugar), whereas "convenience shoppers" and "conscientious convenience shoppers," and "nonshoppers" had worse dietary intake (for soda, calcium, dairy, fiber, and fat) than "traditional shoppers."

CONCLUSIONS

These findings highlight unique patterns in food shopping and associated dietary patterns that could inform tailoring of nutrition interventions for college students. Additional research is needed to understand modifiable contextual influences of healthy food shopping.

Food prices and food shopping decisions of black women

Identifying food pricing strategies to encourage purchases of lower-calorie food products may be particularly important for black Americans. Black children and adults have higher than average obesity prevalence and disproportionate exposure to food marketing environments in which high calorie foods are readily available and heavily promoted. The main objective of this study was to characterize effects of price on food purchases of black female household shoppers in conjunction with other key decision attributes (calorie content/healthfulness, package size, and convenience). Factorial discrete choice experiments were conducted with 65 low- and middle-/higher-income black women. The within-subject study design assessed responses to hypothetical scenarios for purchasing frozen vegetables, bread, chips, soda, fruit drinks, chicken, and cheese. Linear models were used to estimate the effects of price, calorie level (or healthfulness for bread), package size, and convenience on the propensity to purchase items. Moderating effects of demographic and personal characteristics were assessed. Compared with a price that was 35% lower, the regular price was associated with a lesser propensity to purchase foods in all categories (β = -0.33 to -0.82 points on a 1 to 5 scale). Other attributes, primarily calorie content/healthfulness, were more influential than price for four of seven foods. The moderating variable most often associated with propensity to pay the regular versus lower price was the reported use of nutrition labels. Price reductions alone may increase purchases of certain lower-calorie or more healthful foods by black female shoppers. In other cases, effects may depend on combining price changes with nutrition education or improvements in other valued attributes.