Food insecurity and its association with changes in nutritional habits among adults during the COVID-19 confinement measures in Belgium

Objective: To assess food insecurity and its association with changes in nutritional habits among Belgian adults during confinement due to COVID-19. Design: Three cross-sectional online health surveys were conducted during March-May 2020. Multinomial logistic regression models were used to determine associations between self-reported changes in fruit, vegetable, soft drink and sweet and salted snack consumption or weight as dependent variables and food insecurity indicators as independent variables, adjusted for gender, household composition, educational attainment and household income. Setting: Belgium. Participants: In total, 8640 adults recruited by convenience sampling. Results: About 10 center dot 4 % of Belgians often or sometimes feared food shortages, 5 center dot 0 % were often or sometimes short of food without money to buy more and 10 center dot 3 % often or sometimes could not afford to eat a healthy diet during confinement. These percentages were highest among single-parent families (26 center dot 7, 14 center dot 4 and 23 center dot 4 %, respectively). Adults who often or sometimes feared that food would run out during confinement had significantly higher odds of decreased v. unchanged fruits (3 center dot 53; 95 % CI = 2 center dot 06, 6 center dot 05) and vegetables (5 center dot 42; 95 % CI = 2 center dot 90, 10 center dot 11) consumption and significantly higher odds of increased v. unchanged soft drink consumption (3 center dot 79; 95 % CI = 2 center dot 20, 6 center dot 54). Similar results were found for adults who often or sometimes ran out of food and for adults who often or sometimes were not able to afford a healthy diet. Conclusion: Food insecurity during the COVID-19 confinement measures in Belgium was associated with adverse changes in most dietary behaviours. A strong government response is needed to tackle malnutrition and food insecurity to protect public health from ongoing and future pandemics.