The impact of food aid interventions on food insecurity, diet quality and mental health in households with children in high-income countries: a systematic review

Objective: Households with children accessing food aid in high-income countries are often food insecure. We aimed to review the evidence on food aid interventions in households with children and impact on food insecurity, diet quality and mental health.Design: A systematic search was conducted using Web of Science, MEDLINE, CINAHL and PsycINFO. Articles published from January 2008 to July 2022 including cross-sectional, cohort and interventional studies in high-income countries were eligible.Setting: Food aid is defined as the use of interventions providing free food items by community and/or charitable organisations.Participants: Two-parent, lone parent or households with a primary caregiver with at least one child <= 18 years.Results: From a total of 10 394 articles, nine were included. Food banks, mobile pantry combined with a free meal for children, backpack provision during school term and food parcel home delivery interventions were evaluated. Food bank models offering additional support such as community programmes, health and social services, cooking classes and free meals for children, client-choice-based models and programmes providing convenient access were associated with improved food security and diet quality (increased intake of wholegrains, fruit and vegetables). One study reported an improvement in mental health and food bank access at the end of 18 months but not at earlier timepoints and one study reported no change in parents' mental health.Conclusions: Accessing food aid was linked to improved diet quality and reduced food insecurity in some studies. Allowing clients to choose food items and providing support services were most effective.