Food Insecurity and Less Frequent Cooking Dinner at Home Are Associated with Lower Diet Quality in a National Sample of Low-Income Adults in the United States during the Initial Months of the Coronavirus Disease 2019 Pandemic.

BACKGROUND: Food insecurity is a critical public health problem in the United States that has been associated with poor diet quality. Cooking dinner more frequently is associated with better diet quality. OBJECTIVE: This study aimed to examine how food insecurity and dinner cooking frequency are associated with diet quality during the initial months of the coronavirus disease 2019 pandemic. DESIGN: This cross-sectional study analyzed data from a national web-based survey (June 23 to July 1, 2020). PARTICIPANTS/SETTING: Participants were 1,739 low-income (<250% of the federal poverty level) adults in the United States. MAIN OUTCOME MEASURES: The outcome was diet quality, measured by the Prime Diet Quality Score (PDQS-30D). The PDQS-30D is a food frequency questionnaire-based, 22-component diet quality index. STATISTICAL ANALYSES PERFORMED: Food security status (high, marginal, low, or very low) and frequency of cooking dinner (7, 5 to 6, 3 to 4, or 0 to 2 times/week) were evaluated in relation to PDQS-30D scores (possible range = zero to 126) in age- and sex and gender-, and fully adjusted linear regression models. Postestimation margins were used to predict mean PDQS-30D score by food security status and dinner cooking frequency. The interaction between food security status and frequency of cooking dinner was also tested. RESULTS: Overall, the mean PDQS-30D score was 51.9 ± 11 points (possible range = zero to 126). The prevalence of food insecurity (low/very low) was 43%, 37% of the sample cooked 7 times/week and 15% cooked 0 to 2 times/week. Lower food security and less frequent cooking dinner were both associated with lower diet quality. Very low food security was associated with a 3.2-point lower PDQS-30D score (95% CI -4.6 to -1.8) compared with those with high food security. Cooking dinner 0 to 2 times/week was associated with a 4.4-point lower PDQS-30D score (95% CI -6.0 to -2.8) compared with cooking 7 times/week. The relationship between food insecurity and diet quality did not differ based on cooking dinner frequency. CONCLUSIONS: During the initial months of the coronavirus disease 2019 pandemic food insecurity and less frequently cooking dinner at home were both associated with lower diet quality among low-income Americans. More research is needed to identify and address barriers to low-income households' ability to access, afford and prepare enough nutritious food for a healthy diet.

Restaurant dining during the COVID-19 pandemic among adults with low-income in the United States.

The COVID-19 pandemic caused widespread non-essential business closures in the U.S., which may have disproportionately impacted food consumption in lower-income communities, in part due to reduced access to healthy and affordable foods, as well as occupations that may have required working outside the home. The aims of this study were to examine restaurant dining behaviors (including drive-through, takeout, and delivery) at fast-food and non-fast-food (i.e., fast casual and full-service ['other']) restaurants and the impact on diet quality among racially/ethnically diverse low-income adults during the early months of the pandemic. Participants completed an online survey using CloudResearch regarding restaurant dining behaviors in the past week (during June 2020) and during a typical week prior to the pandemic. Diet quality was measured using the Prime Diet Quality Score (PDQS). Surveys from 1,756 low-income adults (incomes <250% of the Federal Poverty Level) were analyzed using chi-squared tests to examine differences in demographic characteristics among those dining at restaurants during the pandemic, as well as to examine differences in dining frequency compared with prior to COVID-19. Negative binomial regressions were used to examine the mean frequency of eating food from fast-food and other restaurants, adjusted for socio-demographic characteristics. This study found reductions in fast-food and other restaurant dining compared with prior to COVID-19, although overall restaurant consumption remained high with over half of participants reporting fast-food consumption in the week prior (average consumption of twice per week). Greater fast-food consumption was associated with poorer diet quality. In conclusion, while fast-food consumption was slightly lower during the pandemic, the overall high levels observed among socioeconomically disadvantaged adults remains concerning, highlighting the continued need for initiatives and policies to encourage greater access to and consumption of affordable and healthier foods.

Disordered eating in college women: associations with the mother-daughter relationship and family weight-related conversations.

PURPOSE: Extensive work in the field has found multiple risk factors of disordered eating among women; however, there is limited research regarding the associations of maternal influence and family weight-related conversations during childhood with eating disorder psychopathology later in adulthood. Thus, the purpose of this study was to explore how the mother-daughter relationship and family weight-related conversations may influence the development of disordered eating in college-aged women. METHODS: A diverse sample of 551 college-aged women completed an online survey with instruments that assessed disordered eating risk (dependent variable) with the following independent variables: aspects of the mother-daughter relationship (maternal regard and responsibility) and family weight-related conversations (emphasis on maternal weight, appearance weight control, and parent weight talk). Mediation analysis was performed using hierarchical regression analyses to examine the influence of maternal factors in combination with family weight-related conversations with disordered eating risk. RESULTS: Using hierarchical regression analyses, aspects of the mother-daughter relationship were significantly associated with risk of disordered eating. However, this significant relationship was diminished in the presence of family weight-related conversations. Furthermore, a test of the mediation suggests that family weight-related conversations may act as a pathway for influencing perceived maternal factors in the development of disordered eating. CONCLUSIONS: Findings illustrate the important role mothers may have in shaping their daughters eating attitudes and behaviors. Future disordered eating prevention programs and interventions may consider developing strategies in educating parents on conversations regarding weight. LEVEL OF EVIDENCE: Descriptive cross-sectional study, Level V.