The COVID-19 pandemic has dramatically increased food insecurity in the United States (US). The objective of this study was to understand the early effects of the COVID-19 pandemic among low-income adults in the US as social distancing measures began to be implemented. On 19–24 March 2020 we fielded a national, web-based survey (53% response rate) among adults with <250% of the federal poverty line in the US (N = 1478). Measures included household food security status and COVID-19-related basic needs challenges. Overall, 36% of low-income adults in the US were food secure, 20% had marginal food security, and 44% were food insecure. Less than one in five (18.8%) of adults with very low food security reported being able to comply with public health recommendations to purchase two weeks of food at a time. For every basic needs challenge, food-insecure adults were significantly more likely to report facing that challenge, with a clear gradient effect based on severity of food security. The short-term effects of the COVID-19 pandemic are magnifying existing disparities and disproportionately affecting low-income, food-insecure households that already struggle to meet basic needs. A robust, comprehensive policy response is needed to mitigate food insecurity as the pandemic progresses.

Objective: To examine national patterns in cooking frequency and diet quality among adults in the USA, overall and by weight-loss intention.Design: Analysis of cross-sectional 24 h dietary recall and interview data. Diet quality measures included total kilojoules per day, grams of fat, sugar and carbohydrates per day, fast-food meals per week, and frozen/pizza and ready-to-eat meals consumed in the past 30 d. Multivariable regression analysis was used to test associations between frequency of cooking dinner per week (low (0–1), medium (2–5) and high (6–7)), dietary outcomes and weight-loss intention.Setting: The 2007–2010 National Health and Nutrition Examination Survey.Subjects: Adults aged 20 years and over (n9569).Results: In 2007–2010, 8 % of adults lived in households in which someone cooked dinner 0–1 times/week and consumed, on an average day, 9627 total kilojoules, 86 g fat and 135 g sugar. Overall, compared with low cookers (0–1 times/week), a high frequency of cooking dinner (6–7 times/week) was associated with lower consumption of daily kilojoules (9054v. 9627 kJ,P=0·002), fat (81v. 86 g,P=0·016) and sugar (119v. 135 g,P<0·001). Individuals trying to lose weight consumed fewer kilojoules than those not trying to lose weight, regardless of household cooking frequency (2111v. 2281 kJ/d,P<0·006).Conclusions: Cooking dinner frequently at home is associated with consumption of a healthier diet whether or not one is trying to lose weight. Strategies are needed to encourage more cooking among the general population and help infrequent cookers better navigate the food environment outside the home.

Objective: To examine the association between cooking frequency and Healthy Eating Index (HEI)-2015, overall and by income, among US adults.Design: Cross-sectional analysis using multivariable linear regression models to examine the association between cooking frequency and total HEI-2015 score adjusted for sociodemographic variables, overall and stratified by income.Setting: Nationally representative survey data from the USA.Participants: Adults aged ≥20 years (with 2 d of 24 h dietary recall data) obtained from the 2007 to 2010 National Health and Nutrition Examination Survey (n 8668).Results: Compared with cooking dinner 0–2 times/week, greater cooking frequency was associated with higher HEI-2015 score overall (≥7 times/week: +3·57 points, P < 0·001), among lower-income adults (≥7 times/week: +2·55 points, P = 0·001) and among higher-income adults (≥7 times/week: +5·07 points, P < 0·001). Overall, total HEI-2015 score was higher among adults living in households where dinner was cooked ≥7 times/week (54·54 points) compared with adults living in households where dinner was cooked 0–2 times/week (50·57 points). In households in which dinner was cooked ≥7 times/week, total HEI-2015 score differed significantly based on income status (lower-income: 52·51 points; higher-income: 57·35 points; P = 0·003). Cooking frequency was associated with significant differences in HEI-2015 component scores, but associations varied by income.Conclusions: More frequent cooking at home is associated with better diet quality overall and among lower- and higher-income adults, although the association between cooking and better diet quality is stronger among high-income adults. Strategies are needed to help lower-income Americans consume a healthy diet regardless of how frequently they cook at home.

Purpose: To understand associations between food insecurity and depression, anxiety, and stress during the COVID-19 pandemic among low-income adults in the United States. Methods: During March 19–24, 2020, we fielded a national, web-based survey (53% response rate) among low-income adults (<250% of the federal poverty line) in the United States (N=1,476). Food security status was measured using the 18-question USDA Household Food Security Module. Multivariable-adjusted logistic regression models examined the association between food insecurity and psychological distress outcomes and COVID-19-specific worries. Qualitative data from an open-response question were also analyzed. Results: More than one-third of low-income adults screened positive for depression (33%), anxiety (39%), and high stress (39%). Greater food insecurity was associated with a dose–response relationship with all psychological distress outcomes (all outcomes p-trend <0.001) and COVID-19-specific worries (all outcomes p-trend <0.001). Compared to food-secure adults, adults with very low food security were more likely to screen positive for depression (odds ratio [OR] 7.72; 95% confidence interval [CI]: 5.52–10.80), anxiety (OR 6.19; 95% CI: 4.51–8.51), and high perceived stress (OR 10.91; 95% CI: 7.78–15.30). Very low food security was also associated with increased worries about the effect of COVID-19 on one's health (OR 2.56; 95% CI: 1.90–3.45), income (OR 5.18; 95% CI: 3.78–7.06), and ability to feed one's family (OR 9.24; 95% CI: 6.61–12.92). Conclusions: The COVID-19 pandemic is negatively associated with the mental health of low-income adults in the United States, with disproportionate associations among adults experiencing food insecurity. These disparities have the potential to increase mental health disparities over the long term.

American Journal of Public Health (AJPH) from the American Public Health Association (APHA) Food Insecurity During COVID-19: An Acute Crisis With Long-Term Health Implications, an article from American Journal of Public Health, Vol 110 Issue 12