ABSTRACT
Objectives While there is evidence that the early lockdown due to COVID-19 pandemic may have had small positive impacts on several populations’ dietary habits, the longer term effects remain largely unknown. The aim of this study was to document changes in diet quality over the two years of the COVID-19 pandemic in adults from the Province of Québec, Canada. We hypothesized that diet quality remained unchanged since the onset of the pandemic. Methods Data are from the NutriQuébec project, a web-based cohort destined to study temporal changes in dietary habits among adults in the Province of Quebec, Canada. We retained 1922 participants (85% female, mean age 50.4 ± 15.4 years) who completed questionnaires before March 12, 2020 including validated web-based 24-h dietary recalls. Among those, 918 completed the questionnaires during the first pandemic year (March 2020- February 2021) and 572 recompleted the questionnaires during the second year (March 2021-February 2022). The study outcome was temporal changes in diet quality measured by the newly developed Healthy Eating Food Index (HEFI-2019), which measures adherence to the recommendations on healthy food choices in the 2019 Canadian Food Guide (CFG), on a scale of 80 points. Temporal changes in HEFI-2019 score were assessed using mixed models adjusted for sex, age, census metropolitan area, marital status, education, occupation, smoking and social and material deprivation index. Results The mean pre-pandemic HEFI-2019 score in this cohort was 47.3/80 points (95%CI 45.9 to 48.7). There was no change in the mean HEFI-2019 score during the first year of the pandemic (+0.1 point, 95% CI −0.5 to 0.7) but a small reduction during year 2 (−1.2 points, 95% CI −1.9 to −0.5). The reduction in the HEFI-2019 score at year 2 compared with the pre-pandemic values was mostly seen in September 2021 (−1.4 points vs. September 2019;95%CI −2.4 to −0.3) and February 2022 (−1.5 point vs. February 2020;95%CI −2.2 to −0.2). Conclusions Contrary to our hypothesis, diet quality in this longitudinal cohort study of adult men and women has slightly deteriorated during the second year of COVID-19. These results are specific to the NutriQuébec sample. The longer-term impact of the pandemic on diet quality needs to be confirmed in other longitudinal cohorts. Funding Sources Ministère de la santé et des services sociaux du Québec.
ABSTRACT
BACKGROUND: The impact that the coronavirus disease 2019 (COVID-19)-related early lockdown has had on dietary habits of the population and on food insecurity is unknown. OBJECTIVE: The aim of this study was to document the change in diet quality and in food insecurity observed during the COVID-19-related early lockdown. We hypothesized that the lockdown was associated with a deterioration in overall diet quality and an increase in food insecurity. METHODS: Data are from a COVID-19 subsample of NutriQuébec, a web-based cohort destined to study temporal changes in dietary habits among adults in Quebec, Canada. Participants completed questionnaires before (between June 2019 and February 2020) and during (April to May 2020) early lockdown, including a validated web-based 24-h recall (n = 853) and a questionnaire on food security (n = 922). Primary study outcomes were temporal changes in diet quality measured by the Healthy Eating Index (HEI)-2015 and in the prevalence of food insecurity. RESULTS: There was a small increase in the HEI-2015 during the COVID-19 early lockdown compared with baseline (+1.1 points; 95% CI: 0.6, 1.5), mostly due to small improvements in the intakes of whole grains, greens and beans, refined grains, total vegetables, total dairy, seafood and plant proteins, added sugar, and total protein subscores of the HEI-2015. Exploratory analyses suggested that individuals aged 18-29 y (+3.6 points; 95% CI: 2.4, 4.7), participants with lower education (+1.9 points; 95% CI: 1.3, 2.6), or with obesity (+3.8 points; 95% CI: 2.7, 4.8) showed particularly important increases in the HEI-2015. The prevalence of food insecurity was reduced from 3.8% at baseline to 1.0% during the early lockdown (prevalence ratio = 0.27; 95% CI: 0.08, 0.94). CONCLUSIONS: Contrary to our hypotheses, diet quality has slightly improved and prevalence of food insecurity was reduced in this sample of adults from Quebec during the COVID-19-related early lockdown. These results may be generalizable only to relatively healthy populations.