The COVID-19 pandemic emergency has caused major disruption to our physical and social environments, and there are likely to be knock-on effects on our food habits. This blog will discuss a mixed-methods study that is exploring how different aspects of our food habits could have been affected by the pandemic and its consequences.
Habits are defined in psychology as “cue-response associations in memory that are acquired slowly through repetition of an action in a stable circumstance”. This definition applies to any habit developed in our daily lives but in relation to the food we eat, this means that food habits become automated through repeated consumption of foods in the same contexts (i.e. where we are, what we’re doing, who we’re with, etc.) over time. Inevitably this can make changing eating habits in stable environments difficult, hence the difficulty experienced by many when trying to move to a healthier diet.
How is the pandemic affecting our food ‘lives’?
As we will all have experienced, our food ‘lives’ have been markedly impacted by the COVID-19 pandemic in a variety of ways. During the early stages of the lockdown, how we shopped and the food we could purchase were affected by supply chain difficulties and panic buying, and the need for social distancing within stores.
As a consequence, some products were largely unobtainable during the first weeks of lockdown, whereas others had dramatically reduced choice, for example, due to the closure of delicatessen counters in store. In addition, the disruption to our normal practice resulting from the need to adhere to social distancing guidance in shops, looks set to be with us for some time.
With many people working from home, furloughed due to the lockdown, or experiencing other employment-related challenges, the social context of food purchase and consumption has also radically altered. For many people, most, if not all, meals are being eaten in the home and alone or only with household members, according to personal domestic circumstances.
What effect are all these changes having on our overall diet? – The foods we’re eating, their variety, nutritional content, how much we’re eating and when and where we are eating it, and with whom?
Gathering data – repurposing our habitual diet study
To assess how COVID-19 has affected our interactions with food, we could ask people to record their food consumption and relate how they think their habits have changed as a result of the pandemic. But this approach suffers from the potential to ‘lead the witness’ into looking for differences that might not exist.
A better approach is to contact people who have already filled out food and drink diaries prior to the COVID-19 outbreak and ask them to complete an identical diary during lockdown. Each volunteer would therefore be acting as their own control – comparing their COVID-19 diaries with baseline pre-COVID-19 times.
The HABIT research study
In our ongoing research, we established a HABIT study with around 120 adult volunteers living in the Aberdeen area. The study addressed dietary sugar intake and routes to support beneficial changes in habits through a repeated exposure intervention. This intervention asked volunteers to remove sugar from components of their habitual diet either completely, partially or by substitution of sweetener, for a period of 12 weeks.
Although this study is not directly relevant to the COVID-19 pandemic and accompanying lockdown, the volunteers also filled out a 7-day food and drink diary prior to being randomised to a study group. These diaries provide a robust assessment of food choice and nutritional intake under ‘normal’ conditions which can act as a baseline (in the same individuals) for life in the COVID-19 era under social isolation conditions.
The lockdown restrictions have effectively removed people from the relatively stable contexts within which dietary (and other) habits are formed and sustained. This provides an opportunity to further examine the maintenance of habits over time, using a ‘natural experiment’ design generated by the COVID-19 pandemic.
Extending our research
In addition to replicating the food and drink diaries to provide a ‘before and after’ picture, which also affords us the option to develop a longitudinal picture of dietary habits and nutritional intakes as the pandemic and our response to it develops, we have also introduced a short questionnaire and an interview into the protocol.
The questionnaire examines individual experiences during the COVID-19 pandemic including the purchasing and consumption of different food groups, along with perspectives of snack consumption and of the three main meals of the day – their variety, frequency, timing, healthiness, portion size, and social context.
The semi-structured interview lasting about half an hour and asks questions about diet during the time period since COVID-19 social distancing restrictions were put in place in Scotland, to provide more understanding of the reasons behind changes in habit, dietary choices and eating patterns. It focuses on the reasons behind perceived changes in food consumption, what routines have changed, the effects of those changes on eating habits, and the likelihood that acquired habits will be sustained once we return to something closer to normal routines.
All these components of the study are designed to provide a comprehensive understanding of our food habits resulting from the COVID-19 health crisis and can be carried out remotely by email and video link.
What do we hope to find out?
In the context of the COVID-19 pandemic, this research is addressing whether dietary habits have changed as a result of the changes in social and environmental context associated with COVID-19 restrictions.
We are seeking to learn how social restrictions and pressure on the food supply chain have impacted on nutritional intake, calibrated against dietary advice such as the Eatwell Guide.
We are also generating important longitudinal information on the extent to which diets, dietary choices and nutrition are being affected by the COVID-19 restrictions and food supply chain pressures.
Building in flexibility in an evolving situation
In order to efficiently react to an ongoing and evolving situation during the COVID-19 restrictions, we have also obtained participants’ permission to return to them to repeat the diaries and questionnaire in the future as the Scottish Government exit strategy unfolds and where significant and general changes in the restrictions arise (e.g. working from home instructions are lifted).
Repurposing and extending the HABIT study in the early stages of the COVID-19 epidemic, with the ability to recontact our volunteers as the crisis develops, will help to provide important granularity to descriptions of how our food experiences have been affected by the epidemic and its consequences, and how we have adapted.
In conjunction with important data relating to the supply chain, shopping habits and consumer behaviour etc., this study may provide a useful insight to support planning for, and mitigation of future crises.