How the COVID-19 Pandemic Relates to Planning, Selecting, and Preparing Healthier Foods: An Observational Study in 38 Countries Worldwide

Background: Time, money, and stress are well-known factors influencing food behaviours. Seeing as the COVID-19 crisis affected finances, stress, and time perceptions, changes regarding planning, selecting, and preparing healthier foods were evaluated in 38 countries worldwide. Methods: A cross-sectional online survey using validated instruments (N=37 207, M age 36·7 SD 14·8, 77% women) was conducted in 38 countries between April 14th and June 25th 2020. Hierarchical multiple regression analyses were used to assess the influence of psychological distress, financial stress, and perceptions of time availability, alongside economic and social restrictions, on self-perceived changes in planning, selecting, and preparing healthier foods. Analyses were run separately for men and women, weighted by country, and controlled for sociodemographic variables. Findings: Small increases ( p< 0·0001) in planning (4·7 SD 1·3, 4.9 SD 1·3), selecting (3·6 SD 1·7, 3·7 SD 1·7), and preparing (4·6 SD 1·2, 4·7 SD 1·3) healthier foods were found for women and men. Perceived time availability and working from home were associated with positive changes ( p< 0·0001). Psychological distress acted as a barrier for women, and an enabler for men ( p< 0·0001). Financial distress acted as a barrier and enabler for men and women, depending on other sociodemographic variables ( p< 0·0001).Interpretation: Food literacy improvement is possible worldwide. At the onset of the COVID-19 crisis, perceptions of greater time availability and working from home related to increases in planning, selecting, and preparing healthier foods. Psychological distress and financial stress were barriers and enablers to food literacy. Funding: Research Foundation Flanders, Flanders Innovation & Entrepreneurship/ Flanders’ FOOD.Declaration of Interests: The authors declare that they have no conflict of interest.Ethics Approval Statement: The Ethics Committee for the Social Sciences and Humanities of the University of Antwerp approved the study protocol.