Household food insecurity in Canada early in the COVID-19 pandemic.

BACKGROUND: Food insecurity linked to insufficient income is an important determinant of health. Whether the COVID-19 pandemic has exacerbated levels of food insecurity in Canada, particularly among vulnerable groups, is unclear. This study estimated the proportion of Canadians reporting experience of household food insecurity six to nine months into the COVID-19 pandemic, and drew comparisons with pre-pandemic levels. DATA AND METHODS: Data on household food security status during the pandemic came from the population-based cross-sectional Canadian Community Health Survey (CCHS) collected from September to December 2020. Analyses were based on 26,831 respondents aged 12 and older residing in the 10 provinces. The Household Food Security Survey Module was used to categorize respondents' household food security status within the previous 12 months as food secure or marginally, moderately or severely insecure. The percentage of Canadians reporting some experience of household food insecurity was estimated for the overall population and for various sociodemographic groups. T-tests were used to draw comparisons with pre-pandemic rates from the 2017/2018 CCHS. RESULTS: In fall 2020, 9.6% of Canadians reported having experienced some level of food insecurity in their household in the prior 12 months, which is lower than the estimate of 12.6% from 2017/2018. Overall estimates were also lower in fall 2020 when examined within levels of household food insecurity (i.e., marginal, moderate or severe). The percentage of Canadians reporting experience of household food insecurity was either unchanged or lower than in 2017/2018 among sociodemographic groups vulnerable to experiencing income-related food insecurity, including renters and those with lower levels of education. INTERPRETATION: During the second wave of the COVID-19 pandemic in fall 2020, about 1 in 10 Canadians aged 12 and older reported experience of food insecurity in their household in the previous 12 months. This proportion was lower compared with 2017/2018, both overall and among several groups at higher risk of food insecurity. Monitoring household food insecurity will continue to be important during the COVID-19 pandemic and throughout the years of recovery ahead.

Eating away from home in Canada: impact on dietary intake.

BACKGROUND: Public health measures related to the COVID-19 pandemic have upended the way Canadians eat and shop for food. Since the pandemic began, many Canadians have reported consuming food away from home (FAFH) less often. FAFH tends to be less healthful than food prepared at home. Little is known about patterns of Canadians' FAFH consumption before the pandemic. This study used 2015 national-level nutrition data, the most recent available, to characterize patterns of FAFH consumption and selected markers of dietary intake. DATA AND METHODS: National-level food intake data came from the first 24-hour dietary recall provided by 20,475 respondents aged 1 or older to the 2015 Canadian Community Health Survey-Nutrition. Mean daily intakes of selected food subgroups and nutrients, adjusted for total energy intake, were compared between those who had consumed any food in a restaurant on the previous day and those who had not. Estimates were generated overall and for eight age and sex groups. RESULTS: In 2015, overall, 21.8% of Canadians had consumed FAFH in a restaurant on the previous day. Eating out was most common among males aged 19 to 54 (27.7%) and least common among young children aged 1 to 5 (8.4%). Compared with Canadians who had not eaten out on the previous day, those who had eaten out had consumed, on that day, fewer servings of whole fruit; whole grains; dark green and orange vegetables; other vegetables (excluding potatoes); milk and fortified soy-based beverages; and legumes, nuts and seeds, on average. Those who had eaten out had consumed, on average, less fibre and total sugar, and more total fat, saturated fat and sodium on that day. There were few differences for meat and poultry, fish and seafood, and protein intake. DISCUSSION: On the day that Canadians ate out in a restaurant, their dietary intake was generally less favourable than that of Canadians who did not eat out. If Canadians continue to eat at home more and to consume less FAFH, as early pandemic-period reports suggest, then results can be used to gauge the potential dietary implications of these shifts.

Food insecurity and mental health during the COVID-19 pandemic.

BACKGROUND: Food insecurity has been linked to adverse mental health outcomes. This study assessed the association between household food insecurity and self-perceived mental health status and anxiety symptoms among Canadians in the early months of the COVID-19 pandemic. DATA AND METHODS: The Canadian Perspectives Survey Series 2 collected cross-sectional data from May 4 to 10, 2020, on Canadians aged 15 years or older residing in the ten provinces. The brief six-item Household Food Security Survey Module was used to measure participants' households as food secure or marginally, moderately or severely food insecure within the previous 30 days. Logistic regression was used to assess associations between food security status and self-perceived fair or poor mental health and moderate or severe anxiety symptoms, adjusting for sociodemographic covariates. RESULTS: Approximately one in seven Canadians (14.6%) lived in a household that experienced some level of food insecurity. Of these individuals, 9.3% reported recently accessing free food from a community organization. About one in five Canadians self-perceived their mental health as fair or poor (22.0%), or self-reported moderate or severe anxiety symptoms (18.2%). With covariate adjustment, individuals in households with moderate food insecurity had nearly three times higher odds of reporting fair or poor mental health, and moderate or severe anxiety symptoms, compared with individuals in food-secure households. Among those with severe food insecurity, adjusted odds ratios were 4.0 (95% confidence interval [CI]: 2.0 to 7.9) for fair or poor mental health, and 7.6 (95% CI: 3.9 to 14.7) for moderate or severe anxiety symptoms. DISCUSSION: In the early period of the COVID-19 epidemic in Canada, household food insecurity was independently associated with poorer mental health outcomes. Monitoring both food insecurity and mental health will be important as the COVID-19 pandemic continues.

Change in vegetable and fruit consumption in Canada between 2004 and 2015

BACKGROUND: Eating plenty of vegetables and fruits on a daily basis is the foundation of a healthy diet. This study investigated patterns in Canadians'vegetable and fruit consumption in 2015 and compared these with 2004 data. DATA AND METHODS: The 2015 Canadian Community Health Survey (CCHS) - Nutrition and the 2004 CCHS - Nutrition (Cycle 2.2) provided nationally representative 24-hour dietary recall data on Canadians'vegetable and fruit intakes. The frequency of consumption and the average quantity of daily intake for total vegetables, fruits and subgroups were calculated overall and by age and sex group for each survey year. The National Cancer Institute's methodology was used to assess the distribution of usual total vegetable and fruit intake and how it relates to recommendations in the 2007 Canada's Food Guide. RESULTS: Overall, Canadians reported consuming fewer total servings of vegetables and fruits in 2015 (4.5 average daily servings) than in 2004 (5.3 average daily servings). Lower total fruit intakes were explained by significantly lower intakes of fruit juice across nearly all age and sex groups, resulting in a decline of 0.3 average total daily fruit servings in the overall population. Lower vegetable consumption was largely driven by lower intakes of potatoes and, to a lesser extent, lettuce. Intakes of whole fruits and other vegetables remained largely unchanged. In both years, the majority of Canadians did not usually consume the number of total vegetable and fruit servings recommended for their age and sex group in the 2007 Canada's Food Guide. DISCUSSION: Canadians reported consuming fewer vegetables and fruits in 2015 compared with 2004. This was largely driven by substantially lower consumption of fruit juice and, to a lesser extent, potatoes. These findings can serve as valuable baseline data to assess any changes in patterns of vegetable and fruit consumption in Canada.

Health-related concerns and precautions during the COVID-19 pandemic: A comparison of Canadians with and without underlying health conditions.

BACKGROUND: The risk of experiencing adverse outcomes from the coronavirus disease 2019 (COVID-19), such as hospitalization, admission to intensive care units and death, is elevated for older individuals and those with certain underlying health conditions including diabetes, chronic conditions affecting lungs, heart or kidneys, and a compromised immune system. DATA AND METHODS: Data collected between March 29 and April 3, 2020 from the Canadian Perspectives Survey Series 1: Impacts of COVID-19 (n=4,627) were used to estimate the prevalence of underlying health conditions, health concerns and precautionary behaviours among Canadians aged 15 or older living in the provinces. Multivariate analyses examined associations between these variables after accounting for age, sex and education. RESULTS: Close to 1 in 4 Canadians (24%) had an underlying health condition that increased their risk of adverse outcomes from COVID-19. Overall, 36% of the population were very or extremely concerned about the impact of COVID-19 on their own health. Individuals with underlying health conditions had higher odds (odds ratio: 2.0, 95% confidence interval: 1.6 to 2.5) of being highly concerned than those without these conditions, after adjustment for demographic characteristics. High percentages of Canadians took precautions to reduce the risk of infection regardless of whether or not they had underlying health conditions. DISCUSSION: Health status was associated with higher levels of concern for one's own health in the early period of the COVID-19 pandemic. Most Canadians were taking precautions recommended by public health authorities to protect themselves and others.