The coronavirus disease 2019 (COVID-19) pandemic has drastically altered food shopping behaviors, and the resulting economic recession has caused a spike in food insecurity. Since food insecurity is associated with poor diet, especially low intake of fruits and vegetables, food-insecure individuals may disproportionately experience negative health impacts related to poor diet during the pandemic. To assess the relationship between food security status and fruit and vegetable intake during the COVID-19 pandemic, we conducted an online survey of adult residents of the US state of Michigan in June of 2020. Among the 484 survey respondents, 36.2% were classified as food-insecure. Food-insecure respondents consumed fruits and vegetables fewer times per day than food-secure respondents and were more likely to report decreasing their consumption of any type of fruits and vegetables (total, fresh, frozen, and canned) since the pandemic started. For those who reduced their purchase of fresh fruit and vegetable, reasons included poor quality, poor availability, high price, reduced store trips, and concerns of contamination. These findings highlight the need for adequate food assistance during the COVID-19 pandemic and in future pandemics, as well as public health messages that promote healthy eating.

Background The COVID-19 pandemic profoundly affected food systems including food security. Understanding how the COVID-19 pandemic impacted food security is important to provide support, and identify long-term impacts and needs. Objective The National Food Access and COVID research Team (NFACT) was formed to assess food security over different U.S. study sites throughout the pandemic, using common instruments and measurements. This study present results from 18 study sites across 15 states and nationally over the first year of the COVID-19 pandemic. Methods A validated survey instrument was developed and implemented in whole or part through an online survey of adults across the sites throughout the first year of the pandemic, representing 22 separate surveys. Sampling methods for each study site were convenience, representative, or high-risk targeted. Food security was measured using the USDA six-item module. Food security prevalence was analyzed using analysis of variance by sampling method to statistically significant differences. Results Respondents (n = 27,168) indicate higher prevalence of food insecurity (low or very low food security) since the COVID-19 pandemic, as compared to before the pandemic. In nearly all study sites, there is higher prevalence of food insecurity among Black, Indigenous, and People of Color (BIPOC), households with children, and those with job disruptions. The findings demonstrate lingering food insecurity, with high prevalence over time in sites with repeat cross-sectional surveys. There are no statistically significant differences between convenience and representative surveys, but statistically higher prevalence of food insecurity among high-risk compared to convenience surveys. Conclusions This comprehensive study demonstrates higher prevalence of food insecurity in the first year of the COVID-19 pandemic. These impacts were prevalent for certain demographic groups, and most pronounced for surveys targeting high-risk populations. Results especially document the continued high levels of food insecurity, as well as the variability in estimates due to survey implementation method. Summary Multi-site assessment demonstrates widespread food insecurity during COVID-19, especially on households with children, job loss, and Black, Indigenous, People of Color across multiple survey methods.

Background: Past research examining times of crisis has suggested that limited social and economic resources may lead to disparities, which can have serious ramifications for food security and lasting effects on child nutrition. To date, it is unknown how changes related to COVID-19 may influence child dietary outcomes, especially for vulnerable populations.Methods: Families (n¼33) completed 3, 24-hour dietary recalls and validated questionnaires to assess food security and child diet quality (HEI). Measures were conducted Winter 2019 (pre-COVID-19) and Fall 2020 (during COVID-19). Families were predominantly Hispanic (83.6%), married (78.8%), welleducated (76.1%) and some had children diagnosed with ADHD (44%).Descriptive statistics, one-way ANOVA, and t-tests were analyzed using SPSS V26.0. Results were considered significant at p<0.05.Results: Approximately 27% of families experienced some level of food insecurity during the pandemic. In food secure households, the mean HEI was reduced from 60.48 (SD¼12.27) in 2019 to 54.10 (SD¼10.74) in 2020. In food insecure households, the mean HEI was reduced from 62.13 (SD¼14.28) to 61.38 (SD¼7.15). However, differences between food secure and insecure households were not significant. Overall, child HEI scores were significantly reduced during the pandemic compared to pre-pandemic (t¼2.58,p¼0.015). Children significantly increased sodium consumption (t¼2.12,p¼0.041) and marginally increased saturated fat consumption (t¼1.92,p¼0.063). Conclusion:Overall, child diet quality was reduced during the pandemic, especially for food secure children. More research is needed to see the longterm effects of the pandemic on child dietary quality.

Background. The COVID-19 pandemic profoundly affected food systems including food security. Understanding how the COVID-19 pandemic impacted food security is important to provide support, and identify long-term impacts and needs. Objective. Our team- the National Food Access and COVID research Team (NFACT) was formed to assess food security over different U.S. study sites throughout the pandemic, using common instruments and measurements. Here we present results from 18 study sites across 15 states and nationally over the first year of the COVID-19 pandemic. Methods. A validated survey instrument was developed and implemented in whole or part across the sites throughout the first year of the pandemic, representing 22 separate surveys. Sampling methods for each study site were convenience, representative, or high-risk targeted. Food security was measured using the USDA six-item module. Food security prevalence was analyzed using analysis of variance by sampling method to statistically significant differences. Results. In total, more than 27,000 people responded to the surveys. We find higher prevalence of food insecurity (low or very low food security) since the COVID-19 pandemic, as compared to before the pandemic. In nearly all study sites, we find higher prevalence of food insecurity among Black, Indigenous, and People of Color (BIPOC), households with children, and those with job disruptions. We also demonstrate lingering food insecurity, with high or increased prevalence over time in sites with repeat surveys. We find no statistically significant differences between convenience and representative surveys, but statistically higher prevalence of food insecurity among high-risk compared to convenience surveys. Conclusions. This comprehensive multi-study site effort demonstrates higher prevalence of food insecurity since the beginning of the COVID-19 pandemic, which in multiple survey sites continues throughout the first year of the pandemic. These impacts were prevalent for certain demographic groups, and most pronounced for surveys targeting high-risk populations.

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