Who We Seek and What We Eat? Sources of Food Choice Inspirations and Their Associations with Adult Dietary Patterns before and during the COVID-19 Lockdown in New Zealand

Population Subgroups at Risk of Unhealthy Changes in Food and Beverage Consumption During COVID-19 Lockdowns

BACKGROUND

Understanding health behaviour changes during the COVID-19 pandemic can assist in developing strategies to promote healthy lifestyles at such times. The aim of this exploratory study was to examine whether the frequency of consuming unhealthy foods and beverages changed during lockdown and whether certain population subgroups were more likely to make such changes.

METHOD

An online survey was administered to a national sample of 4022 Australian adults (51% female, mean age 48 years). Generalised linear models with generalised estimating equations were used to identify whether demographic characteristics (age, gender, education, presence of children in the household, number of people in the household) and beliefs related to COVID-19 were associated with changes in the frequency of consuming alcohol, sweet snacks, salty snacks, and sugary beverages from pre to during lockdown.

RESULTS

Overall, the frequency of consuming the four assessed unhealthy products did not change during lockdown. However, being male and having children at home were consistently associated with unhealthy changes, whereas believing that alcohol or unhealthy diets would exacerbate COVID-19 severity was linked to a decreased frequency of consuming these products respectively. Age, education, and living with more people were also associated with changes in the frequency of consuming some product categories.

CONCLUSION

During lockdown, certain population subgroups appeared to be at increased risk of more frequent consumption of unhealthy foods and beverages. Believing certain consumption habits are linked to adverse health impacts of COVID was found to reduce frequency of consumption of related products, presenting a potential focus for future public health actions.

Habitual Dietary Patterns, Nutrient Intakes, and Adherence to the Mediterranean Diet among New Zealand Adults: The NZ MED Cross-Sectional Study

There is increasing evidence that adherence to a Mediterranean dietary pattern reduces the incidence of diet-related diseases. To date, the habitual dietary intake of New Zealand (NZ) adults has not been examined in relation to its alignment with a Mediterranean-style dietary pattern. This study aimed to define the habitual dietary patterns, nutrient intakes, and adherence to the Mediterranean Diet in a sample of 1012 NZ adults (86% female, mean age 48 ± 16 years) who had their diabetes risk defined by the Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK). Dietary intakes were collected using a validated semi-quantitative NZ food frequency questionnaire, and dietary patterns were identified using principal component analysis. Reported intakes from the FFQ were used in conjunction with the Mediterranean-Style Dietary Pattern Score (MSDPS) to determine adherence to a Mediterranean dietary pattern. Mixed linear models were used to analyze the association between dietary patterns and MSDPS with demographics, health factors, and nutrient intakes. Two distinct dietary patterns were identified: Discretionary (positive loadings on processed meat, meat/poultry, fast food, sweet drinks, and sugar, sweets, and baked good) and Guideline (positive loadings on vegetables, eggs/beans, and fruits). Adherence to dietary patterns and diet quality was associated with age and ethnicity. Dietary patterns were also associated with sex. Adherence to a Mediterranean dietary pattern defined by the MSDPS was low, indicating that a significant shift in food choices will be required if the Mediterranean Diet is to be adopted in the NZ population.

Food practices adaptation: Exploring the coping strategies of low-socioeconomic status families in times of disruption

COVID-19 impact on global and national food systems, along with associated physical restrictions, lockdowns, and school closures, have led to dramatic changes in families' everyday food practices. Our research explored the way food practices adapted and emerged, allowing families to cope with the disruption caused by COVID-19. We recruited 18 low socio-economic status families with primary school children across the United Kingdom and New Zealand to partake in two interviews, a survey, and the use of an ethnographic app. Analysis illuminates that this disruption triggered the emergence of three practices that were necessary to carry on and mitigate the impact of disrupted food practices; 'asking for help', 'planning' and 'research and experimentation'. As a way to deal with disruption to their food practices, many participants called on the support of the community, including the use of food banks and the sharing of food. Participants discussed the way they had to plan their food, which often involved the expansion of practices formerly enacted to a small degree, such as curation of online shopping lists and stockpiling. Food research and experimentation also emerged as largely new practices, such as freezing foods, learning new recipes online (YouTube), experimenting with new ingredients and recipes. As such, for some participants, experimentation and research transformed cooking practices into leisure practices. The findings have practical implications for policy makers and non-governmental organisations, such as providing formal support that is accessible while reducing any associated stigma. Designing interventions that integrate planning routines within food practices can help build skills (e.g., bulk cooking and freezing) which can be vital during disruptions, aiding families to cope with the difficulties and aftermath of sudden and large-scale disruption, such as a pandemic.

Eating Choices—The Roles of Motivation and Health Literacy: A Cross-Sectional Study

Food choices are determined by intrinsic and extrinsic product characteristics, biological and physiological features, psychological factors, and situational and socio-cultural factors. Self-determination theory offers the explanation of health behavior change identifying motivations located along a continuum of autonomy. Another approach to the motivations guiding health behaviors, including food choices, relies on distinguishing thematic categories. Health motivations seem to be an obvious determinant of health behaviors, but final decisions regarding health are also the effect of other types of motivations such as economic, cultural, or emotional. The role of marketing pressure in modern society is perceived to be an important source of motivation for purchasing food and other products. The Motivation–Opportunity–Ability (MOA) framework was initially proposed in order to explain the processing of brand information from advertisements and was later expanded to other areas, including health and nutritional behaviors. The aim of this study was the analysis of determinants of food choices. We have developed a common regression model including six categories of motivations addressed by the Eating Motivations Scale and three health literacy types corresponding with element of ability from the MOA framework, adjusted for socio-demographic factors, health status, and the use of the Internet and TV. The analysis was performed on data from a computer-assisted web-based interviewing (CAWI) survey among 2008 adult Internet users completed in May 2022. The uni- and multivariate linear regression models were developed with the Index of Unhealthy Food Choices (IUFC), calculated based on the responses to items asking about the frequency of the consumption of twelve food categories. Univariate modeling revealed that IUFC is significantly associated with health, food, and e-health literacies and with five out of six eating motivations. However, the multivariate regression model yielded significant associations only for eating motivations but not for the three literacy scores. Health motivation was negatively associated with IUFC (B, standard error (SE): 0.83, 0.07; 95% confidence interval (95% CI): 0.98–0.69), but positively with emotional (B, SE: 0.22, 0.04; 95% CI: 0.14–0.3), economic (B, SE: 0.41, 0.08; 95% CI: 0.25–0.56), and marketing (B, SE: 0.62, 0.08; 95% CI: 0.47–0.78) motivations. Our findings suggest that motivations guiding food choices may prevail over the element of ‘ability’ distinguished in the frameworks and models that explain people’s behaviors, including behaviors relating to health. Thus, it is essential to emphasize development of appropriate motivations and not only to provide knowledge and skills. Furthermore, one should also remember motivations other than health motivations when searching for the determinants of health behaviors.

Household Mealtimes During the 2020 COVID-19 Lockdown in Aotearoa New Zealand: The Influence of Household Type and Psychological Distress

COVID-19 lockdown meant disruptions to daily routines for households in Aotearoa New Zealand. The research presented here investigates how mealtimes changed for people living in New Zealand during the first COVID-19 lockdown in mid-2020 and sought to determine if household composition type and psychological distress impacted the frequency of engaging in several mealtime behaviors. The COVID Kai Survey collected data using an anonymous, online survey and asked questions on sociodemographic characteristics including household composition, frequency of engaging in different mealtime behaviors before and during lockdown, and psychological distress, which was measured using the Kessler 6 screening tool. The findings of this study shows an increase in the perceived importance of mealtimes (n = 807, 26.9% before lockdown, n = 1,154, 38.5% during lockdown) and an increase in the proportion of the survey respondents who stated that they frequently ate meals at the dinner table (n = 1,343, 44.8% before lockdown, n = 1,481, 49.4% during lockdown). There was a decrease, across all household composition types, in the proportion of respondents who ate out frequently at a restaurant or café (n = 878, 29.3% before lockdown, n = 5, 0.2% during lockdown, P < 0.001). The use of meal kits, e-dining, and eating meals in front of screens is also presented and discussed. All results are discussed with reference to Aotearoa New Zealand’s stringent lockdown restrictions. Respondents who experienced psychological distress during lockdown were 1.47 times more likely to consider mealtimes an important part of their day and respondents living in households with one adult and at least one child who also experienced psychological distress were 5.95 times more likely to eat dinner at the dinner table than those who did not report psychological distress. Findings of this study further the understanding of the wider societal impact of COVID-19 lockdown on everyday life.