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Nielsen et al. (in press)
This paper is not the copy of record and may not exactly replicate the final, authoritative
version of the article. Please do not copy or cite without authors' permission. The reference
to the final article is:
Nielsen, D. E., Karamanoglu, I., Han, H. Y., Labonté, K., & Paquet, C. (in press). Food values,
food purchasing, and eating-related outcomes among a sample of Quebec adults during the
COVID-19 pandemic. Canadian Journal of Dietetic Practice and Research.
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Nielsen et al. (in press)
Food values, food purchasing, and eating-related outcomes among a sample of Quebec
adults during the COVID-19 pandemic
Daiva E Nielsen1, Irem Karamanoglu1, Hannah Yang Han1, Katherine Labonté1, and Catherine
Paquet2
Author Affiliations: 1School of Human Nutrition, McGill University, Montreal, Canada, 2Faculté
des sciences de l'administration. Laval University, Quebec, Canada
Corresponding Author: Daiva E Nielsen, School of Human Nutrition, McGill University, MS2-
035, 21,111 Lakeshore Rd, Ste. Anne de Bellevue, QC, Canada, H9X 3V9. Tel. +1-514-398-
7677; E-mail: daiva.nielsen@mcgill.ca
Sources of Support: McGill Social Sciences and Humanities Research Council (SSHRC)
Institutional Grant and the McGill Interdisciplinary Initiative in Infection and Immunity (MI4)
Conflict of Interest and Funding Disclosure: The authors have no conflicts of interest.
Number of Figures: 1
Number of Tables: 3
Running title: Food values during the COVID-19 pandemic
Key words: Food values, Food purchasing, Food skills, COVID-19 pandemic
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Nielsen et al. (in press)
Abstract
Purpose: This investigation evaluated food values, food purchasing, and other food and eating-
related outcomes during the COVID-19 pandemic in Quebec, Canada. The role of stress in eating
outcomes was also examined.
Methods: An online household survey was conducted among Quebec adults aged ≥18 years
(n=658). Changes in outcomes during as compared to before the pandemic were evaluated using
descriptive statistics and thematic analysis of free text responses. Eating outcomes by daily stress
level (low, some, high) were assessed using Cochran-Armitage test for trend.
Results: Most respondents reported increased importance and purchasing of local food products
(77% and 68%, respectively) and 60% reported increased grocery spending (mean ± standard
deviation: 28% ± 23%). Respondents with higher daily stress level had a higher frequency of
reporting eating more than usual compared to before the pandemic (low stress 21%, some stress
34%, high stress 39%, p-trend <0.0001). Free text responses described more time spent at home
as a reason for eating more than usual.
Conclusions: To support healthy eating during and post-pandemic, dietitians should consider
patients’ mental/emotional wellbeing and time spent at home. Moreover, support of local food
products may provide opportunities to promote healthy eating, sustainability, and post-pandemic
resiliency of food systems.
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Nielsen et al. (in press)
Introduction
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The COVID-19 pandemic has changed daily life around the globe. Restrictions to control the
2
spread of the SARS-CoV-2 virus, such as working from home and closure of non-essential
3
services (including schools), have had extensive unintended socioeconomic impacts [1, 2].
4
Quebec was the Canadian epicentre at the start of the pandemic and the province imposed a
5
lockdown between March 13 – May 4, 2020 (see Supplementary Material for further resources
6
on the timeline of the pandemic in Quebec). Residents were instructed to remain home and limit
7
trips for essential items, such as food. The first wave of the pandemic in Quebec began to
8
subside in late May 2020 and public health restrictions were eased during the provincial
9
deconfinement period (i.e. easing out of the lockdown) that began in the summer.
10
Individual behaviours and perceptions related to food are important to evaluate during the
11
COVID-19 pandemic, as the unique societal experiences of social distancing and isolation likely
12
impacted complex factors connected to food intake including food access and psychosocial
13
determinants of eating (for example, stress [3]). Current evidence on eating behaviours during
14
the pandemic are mixed with both positive and negative impacts being reported, often within the
15
same study sample [4-10]. However, while previous investigations have evaluated diet quality
16
and intake, important practical and psychosocial considerations that can influence eating
17
behaviour have been largely unexplored, including grocery spending, food skills, food values,
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desire to eat, and stress. Due to the unprecedented nature of the COVID-19 pandemic,
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investigations of the broader set of factors connected to food and eating are warranted.
20
We previously reported a reduction in the frequency of in-store grocery shopping and
21
increased use of online grocery ordering during the first wave of the pandemic among a sample
22
of Quebec households that responded to an online survey [11, 12]. This present investigation
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Nielsen et al. (in press)
aimed to evaluate reported changes in food-related (food values, food skills, and grocery
24
spending) and eating-related (desire to eat and eating amount) outcomes during the pandemic as
25
compared to 2019 among participants who responded to a follow-up survey. Since stress has
26
been consistently linked with eating behaviour [3], we also assessed respondent stress level and
27
hypothesized that those with higher reported stress would report greater changes in their desire to
28
eat and eating amount during the pandemic.
29
Methods
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Detailed methods for the survey have been reported elsewhere [11]. Briefly, an open online
31
survey was initially conducted during the lockdown period in Quebec in May 2020. Participants
32
were recruited through radio and digital media advertisements, social media campaigning, e-mail
33
listservs, and word of mouth. A follow-up survey was collected in August 2020, after the
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provincial deconfinement period and prior to the onset of the pandemic’s second wave. The
35
surveys were developed by the research team, comprised of nutrition and food environment
36
investigators, and were available in English and French. The follow-up survey consisted of up to
37
36 questions, depending on the number of applicable follow-up questions. However, the present
38
report is focused on results from 15 questions (two open-ended) that queried the outcomes of
39
interest to this analysis (see Supplementary File for Survey Questions). Ethics approval was
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obtained from the McGill University Faculty of Agriculture and Environmental Sciences
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Research Ethics Board (#20-05-021). As per ethics requirements, all questions were optional.
42
Thus, minor variations in sample sizes across questions occur due to non-response.
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Changes in food values (Survey Q1; “more important”, “less important”, “no change”)
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were assessed using the 11 items from Lusk and Briggeman’s food values scale, which has been
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validated against grocery scanner data of food purchasing among a consumer panel of
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Nielsen et al. (in press)
households in the United States of America [13, 14]. Two additional items of interest to the
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present investigation were included (purchasing from local retailers and food product brand).
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Changes in food product purchasing (Q2; “purchased more”, “purchased less”, “no change”)
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were evaluated using 21 food categories commonly found in grocery scanner data [15, 16].
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Weekly grocery budget in 2019 (Q3) was assessed using increments of $50 based on the most
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recent Statistics Canada estimate of household food spending (approximately $119/week in
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2016) [17]. Grocery budget change since the start of the pandemic was assessed with
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“decreased”, “did not change”, or “increased” options (Qs 4-5).
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Survey items also evaluated changes in desire to eat (Qs 6-8), food skills in the household
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(Qs 9-11; definition provided on survey [18, 19]), eating amount (Q12; “eat more than you
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usually do”, “eat less than you usually do”, “no change”), and food interests/actions (Q13)
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(response options for Qs 6-11 and Q13: “increased”, “decreased”, “no change”). Follow-up
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questions were included for the desire to eat (Q7) and food skills (Q10) items to identify reasons
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for reported changes, which included 16 options such as stress, emotions, time, motivation, and
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media influences (social or other). Moreover, two open-ended questions were included for
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respondents to describe reasons for changes in their own words (Q8 and Q11). Stress was
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evaluated with two items from the 2020 Canadian Community Health Survey (Annual
63
Component) (Qs 14-15): 1) a 5-point scale on daily stress level and 2) an 8-item sources of stress
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question [20]. Items evaluating changes in outcomes were framed with the text “Compared to the
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year before COVID-19 (2019)…”.
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Statistical analysis
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Descriptive statistics were calculated to report frequency (%) of responses using available data
68
per survey item and mean and standard deviation for change in grocery budget. For comparisons
69
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Nielsen et al. (in press)
by stress level, the 5-point scale on daily stress was collapsed into three levels (Not at all
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stressful and Not very stressful: “Low stress”; A bit stressful: “Some stress”; Quite a bit stressful
71
and Extremely stressful: “High stress”). Cochran-Armitage test for trend was used to compare
72
patterns of responses for changes in eating outcomes by the 3-level stress variable. Free text
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responses to open-ended items were evaluated by two investigators (DEN and KL) using
74
thematic analysis [21]. Responses were read several times by DEN to identify themes with an
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inductive approach and propose categories. KL reviewed and both together developed a coding
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frame and finalized categories. DEN performed categorization, which KL reviewed. Review of
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the initial categorization yielded 94% consensus. Discrepancies were discussed and 100%
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consensus was achieved. Themes that were unique from the list of options provided and that
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were reported by ≥5 respondents are presented in the results.
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Results
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Among 1056 participants who consented to being contacted for follow-up, n=658 (62%)
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consented to this survey and n=633 responded to the last question (96% completion).
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Characteristics of the present sample aligned with those of the respondents who completed the
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baseline survey [11]. Respondents were primarily females residing in large urban areas with mid-
85
to-high household incomes. The majority were married/common-law and the most prevalent
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household size was three or more individuals (Table 1). Most participants reported that their
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days were a bit stressful and one quarter reported high stress. Work, health, and family were the
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most frequently reported sources of stress (Supplementary Table S1).
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Food values, purchasing and spending
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Compared to 2019, the food values that were most selected as gaining importance were
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purchasing food from local retailers (77%) and country of origin of food products (68%) (Table
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2). Safety, environmental impact, price, ethical impact, naturalness, and brand of food products
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were also selected as gaining importance, but to a lesser extent (23-48%). The remaining food
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values were relatively unchanged (nutritional value, convenience, taste, appearance, and
95
tradition). The most noticeable reported change in food product purchasing compared to 2019
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was for local food products (65% purchased more), while changes to all other food products
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were mixed. Subsets of respondents reported more purchasing (32-40%) of frozen/shelf-stable
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items (canned or dried goods, baking products, alcohol, chips or other salty snacks, frozen fruits
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and vegetables) and some reported less purchasing (17-26%) of fresh and frozen prepared meals,
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meat products, sweet snacks and desserts, and carbonated beverages with sugar (Table 2). The
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most selected weekly grocery budget in 2019 was $100-$149/week and most participants (60%)
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reported that their grocery spending increased compared to 2019 (Table 3). Among those who
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reported an increase, the mean ± standard deviation increase in food spending was 28% ± 23%
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(range: 5%-175%, mode: 20%).
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Eating, food skills, and food interests
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Compared to 2019, 28% of participants reported an increase in their desire to eat and
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32% said they eat more than they usually do compared to 2019 (Table 3). The most selected
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factors (item response frequency >40%) that reportedly played a role in increased desire to eat
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were more comfort/enjoyment of food, stress, boredom, emotions, and anxiety (Figure 1 and
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Supplementary Table S2). Free text analysis revealed four additional themes, which were being
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at home and around food more often, increased cravings/snacking, a need to eat all meals with
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children who were at home, and health consciousness. See Supplementary Table S3 for
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selected free text responses from each theme. Eight percent of respondents reported that their
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desire to eat decreased and 12% reported that they eat less than they usually do. The most
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selected factors (item response frequency >40%) for a decreased desire to eat were stress,
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anxiety, and decreased motivation to cook (Supplementary Table S4). Free text analysis
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revealed health consciousness as an additional theme (Supplementary Table S3).
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Thirty nine percent of respondents reported that food skills in their household had
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increased compared to 2019, while only 2% reported that food skills had decreased (Table 3).
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The most selected factors (>40%) related to increase in food skills were more time to prepare
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food, increased motivation to cook, more comfort/enjoyment of food, and more interest in food
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(Supplementary Table S2). Free text analysis revealed six additional themes, which were
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increased family participation, fear of virus exposure/reduced shopping frequency, reducing food
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waste, health consciousness, sourcing local foods/gardening, and closure of restaurants
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(Supplementary Table S3). Among the small proportion of participants who reported that food
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skills had decreased, the most common selected factors (>40%) were stress, decreased
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motivation to cook, emotions, and food prices (Supplementary Table S4). Free text analysis
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revealed one additional theme, which was greater use of prepared foods.
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Participants also reported changes to their food-related interests and actions. While
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interest in growing food, cooking, baking, and use of online grocery ordering increased among
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some (37-43%), desire to go grocery shopping for fun, desire to eat at sit-down restaurants, and
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"fill in" grocery trips (to buy a small number of ingredients/items) decreased (58-70%)
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(Supplementary Table S5).
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Eating-related outcomes by stress level
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Significant differences in eating-related outcomes were observed by stress level. The frequency
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of reporting an increased desire to eat compared to before the pandemic significantly increased
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with stress level (low stress: 18%, some stress: 28%, high stress: 38%, p-trend <0.0001). The
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frequency of reporting a decreased desire to eat also significantly increased with stress level,
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although proportions were lower (low stress: 4%, some stress: 8%, high stress: 13%, p-trend
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<0.0001). The same significant observations were present for eating amount with 21%, 34%, and
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39% (low, some, and high stress groups, respectively) reporting that they eat more than they
142
usually do compared to 2019 and 9%, 11%, and 16% reporting that they eat less than they
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usually do (p-trend <0.0001).
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Discussion
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Among a sample of predominantly female adults in Quebec who responded to a follow-up
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survey, changes were reported in food and eating-related outcomes compared to before the
147
pandemic. One of our most noticeable observations was the increased importance of purchasing
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food from local retailers. Support for local economies, including local food systems, has been
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reported globally during the pandemic [22, 23]. While local food systems promote sustainability
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and can provide access to healthy foods, they may also be important for building post-pandemic
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resiliency in food systems [24, 25]. In addition to purchasing more local food products, many
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respondents reported purchasing more baking products, alcoholic beverages, and frozen/shelf-
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stable products. A Consumer Price Index analysis of Canadian food purchases in the early
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months of the pandemic also reported increased purchasing of non-perishable products and
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baking products [26]. Most respondents reported an increase in their household food spending,
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which has been observed in other Canadian investigations [27, 28]. Increased food spending may
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be due to several factors including increased time spent at home, higher food prices [27], and
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potentially purchasing more food for a household reserve in the event of required self-isolation,
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an observation that we previously reported from our baseline data [11].
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Our respondents reported increased interests in growing food and cooking/baking
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compared to before the pandemic. However, certain interests/actions in food procurement
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reportedly decreased, including small “fill-in” grocery trips and desire to eat at sit-down
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restaurants. These observations likely reflect adherence to stay-at-home directives, but also
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concerns of virus exposure in grocery stores and restaurants. Indeed, many participants in our
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study reported increased activity in ordering online groceries and take-out food (either by phone,
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online, or mobile app). Consumer concerns of virus transmission in grocery stores and food
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safety during the pandemic have been reported in other survey investigations conducted in
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Canada and internationally (e.g. India) [29, 30]. While, to our knowledge, no reports exist of
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virus transmission among patrons of food retailers, the impact of the pandemic on the food
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service sector has been profound. In 2020, approximately 30% of Canadian expenditures on food
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away from home shifted to grocery store spending [31]. Restaurants coped in part by adjusting
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operations to take-out and delivery services and it is anticipated that prioritizing take-away
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services may prevail even post-pandemic [32].
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Stress appeared to be linked to both reported increases and decreases in desire to eat and
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amount eaten (though more frequently linked to reported increases in these outcomes). This
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observation aligns with the recognized complexity between stress and eating, which can lead to
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both over- and undereating [33]. Indeed, other research has reported mixed observations of both
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healthful and unhealthful dietary outcomes during the pandemic within the same study sample
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[6-10]. Among our sample, comfort/enjoyment of food, stress, and boredom were the most
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frequently reported reasons for increased desire to eat, and thematic analysis revealed other
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reasons such as being home and around food frequently and needing to prepare all meals for
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children at home. These results give novel insight into possible reasons for changes in eating
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behaviour during the pandemic and should be considered by dietetics professionals in their
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practice or research.
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Food skills have been positively associated with diet quality [34, 35], thus the reported
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increase in household food skills could hold benefits for individuals and families. We also
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observed a theme that food skills and meal planning were used to minimize food waste, since
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many respondents indicated they had reduced their grocery shopping frequency. More time and
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more motivation to prepare food were common factors for the report of increased food skills.
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Although more research is needed, we speculate that cooking could have been used as a coping
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strategy during points of the pandemic with stricter restrictions, given the limited abilities for
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interactions and activities outside of the home. Indeed, positive attitudes toward home cooking
193
during the pandemic have been reported internationally. An online survey conducted in the
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United Kingdom among a representative sample of adults reported that nearly 75% of
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respondents enjoyed cooking at home over the year 2020 [36], and cooking was reported to be
196
related to pleasure and relaxation during a pandemic lockdown in Turkey [37]. However, some
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individuals may grow fatigued from the increased need to cook and turn to consuming prepared
198
foods, which we observed among a small proportion of our respondents. It is interesting to note
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that some respondents selected media exposures (social or other media) as a reason for increased
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food skills, but few reported media exposures as a reason for changes in eating outcomes. Future
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considerations of links between media exposures, food preparation and intake are warranted, as
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time spent on social media has increased during the pandemic [38, 39]. While exposure to food
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marketing on social media is gaining recognition as a factor that may influence eating behaviour
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among youth [40, 41], its relevance for adult food choices is also an emerging area for
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investigation [42].
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Our investigation is not without limitations. First, recruitment of representative samples
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of the population are challenging with open online surveys. Indeed, our sample was comprised
208
primarily of women and thus is not representative of the province of Quebec. The self-reported
209
nature of the data is another limitation. The accuracy and/or reliability of survey responses may
210
be impacted by response bias, recall bias, and social desirability bias. Lastly, although our
211
investigation included subjective aspects of eating, we did not measure dietary intake and thus
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cannot infer whether reported changes were healthful or less healthful. Notwithstanding the
213
above, social media campaigns to assist with recruitment are increasingly being recognized for
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their effectiveness in accessing low prevalence and hard-to-reach populations and have been
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reported to be advantageous for surveys conducted during the pandemic [43, 44]. Moreover, our
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study design required the household’s primary grocery shopper to be the respondent. The large
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proportion of female respondents may reflect observations that women are more likely to take on
218
responsibilities for food budgeting, purchasing and preparation within a household [45]. Women
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also have been reported to be more knowledgeable about a household’s food situation,
220
potentially being more suitable respondents for household food surveys [46]. Lastly, our findings
221
align with previous reports about food purchasing in Canada during the pandemic and existing
222
knowledge regarding the complexity between stress and eating, increasing our confidence in our
223
observations.
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Relevance to Practice
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Given the global trend for increased importance of supporting local economies, dietitians and
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nutrition professionals in various sectors (clinical practice, public health, and research/education)
227
may wish to engage with local food providers to promote healthy eating, sustainability, and post-
228
pandemic resiliency in food systems. Increased household food skills could hold benefits for
229
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Nielsen et al. (in press)
individuals and families, though dietitians can contribute to communicating strategies that reduce
230
fatigue of food preparation. Finally, given our observations of stress and time spent at home
231
being linked to reports of increased eating and desire to eat, practicing dietitians should inquire
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about patients’ mental/emotional wellbeing and time spent at home. Where indicated,
233
counselling on strategies for regulating food intake and stress management can be provided.
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Table 1 Respondent characteristics
Characteristic
n (%)†
Age group (years)
18-39
223 (34%)
40-59
278 (42%)
60 and older
155 (24%)
Total
656
Gender
Woman
597 (91%)
Man
58 (9%)
Prefer to specify
3 (<1%)
Total
658
Language
French
383 (58%)
English
275 (42%)
Total
658
Total household income
<$20,000
26 (4%)
$20,000-$49,999
100 (15%)
$50,000-$99,000
251 (39%)
$100,000-$149,999
150 (23%)
$150,000 or more
123 (19%)
Total
650
Marital status
Never married
120 (18%)
Married/Common-law
452 (69%)
Separated/Divorced/Widowed
84 (13%)
Total
656
Urban vs. rural
Large population center
482 (77%)
Medium population center
38 (6%)
Small population center
36 (6%)
Rural
74 (12%)
Total
630
Household size
Single individual
140 (22%)
2 individuals
229 (36%)
3 or more individuals
274 (43%)
Total
643
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Children at home*
No
312 (57%)
Yes
235 (43%)
Total
547
Thinking about the amount of
stress in your life, would you say
that most of your days are...?†
Not at all stressful
31 (5%)
Not very stressful
151 (24%)
A bit stressful
293 (46%)
Quite a bit Stressful
143 (22%)
Extremely stressful
22 (3%)
Total
640
†Percentages may not total to 100% due to rounding.
*The response rate for this question is 83%; thus, results should be interpreted with caution.
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Table 2 Changes in importance of food-related factors and food purchasing during the
pandemic compared to 2019 (pre-pandemic).
Food Value†
More
Important
No Change
Less
Important
Total
Responses
Purchasing food from local
retailers
500 (77%)
135 (21%)
11 (2%)
646
Country of origin of the
food products
440 (68%)
198 (31%)
10 (2%)
648
Safety of the food products
312 (48%)
341 (52%)
1 (<1%)
654
Environmental impact of the
food products
265 (41%)
360 (55%)
25 (4%)
650
Price of the food products
249 (38%)
331 (51%)
71 (11%)
651
Ethical impact of the food
products
226 (35%)
406 (62%)
18 (3%)
650
Naturalness of the food
products
192 (30%)
448 (69%)
7 (1%)
647
Food product brand
148 (23%)
475 (73%)
27 (4%)
650
Nutritional value of the food
products
124 (19%)
518 (79%)
11 (2%)
653
Convenience of preparing
the food products
102 (16%)
486 (74%)
65 (10%)
653
Taste of the food products
68 (10%)
573 (88%)
12 (2%)
653
Appearance of the food
products
60 (9%)
569 (87%)
25 (4%)
654
Tradition associated with
food products
58 (9%)
565 (87%)
24 (4%)
647
Food Product
Purchased
More
No Change
Purchased
Less
Total
Responses
Local food products
415 (65%)
216 (34%)
10 (2%)
641
Canned or dried goods
254 (40%)
366 (57%)
22 (3%)
642
Baking products (e.g. flour,
sugar)
239 (37%)
364 (57%)
40 (6%)
643
Alcoholic beverages
234 (36%)
330 (51%)
79 (12%)
643
Frozen fruits and vegetables
219 (34%)
383 (60%)
40 (6%)
642
Chips or other salty snacks
208 (32%)
360 (56%)
75 (12%)
643
Fresh fruits and vegetables
203 (32%)
399 (62%)
41 (6%)
643
Meat alternatives
150 (23%)
458 (72%)
31 (5%)
639
Bread products
136 (21%)
423 (66%)
85 (13%)
644
Candy, chocolate or other
sweet snacks
119 (19%)
404 (63%)
118 (18%)
641
Dairy products
96 (15%)
513 (80%)
35 (5%)
644
Meat products
89 (14%)
442 (69%)
106 (17%)
637
Carbonated beverages
(without sugar)
88 (14%)
471 (74%)
81 (13%)
640
Dairy alternatives
86 (14%)
516 (81%)
35 (5%)
637
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Breakfast cereals
77 (12%)
503 (79%)
60 (9%)
640
Frozen prepared foods
70 (11%)
433 (68%)
136 (21%)
639
Water (plain)
63 (10%)
515 (81%)
61 (10%)
639
Fresh prepared foods
62 (10%)
453 (71%)
126 (20%)
641
Juice
62 (10%)
515 (81%)
61 (10%)
638
Prepared cakes/desserts
54 (8%)
421 (66%)
165 (26%)
640
Carbonated beverages (with
sugar)
30 (5%)
488 (76%)
123 (19%)
641
†Food-related factors are comprised of Lusk and Briggeman’s 11 food values and two additional
items (purchasing food from local retailers and food product brand).
Percentages may not total to 100% due to rounding.
Results are listed in descending order by “More Important” and “Purchased More”, respectively.
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Table 3 Reported changes to grocery budget, desire to eat, eating amount, and household
food skills during the pandemic, compared to 2019 (pre-pandemic).
Survey Questions
n (%)†
What was your household’s weekly budget for grocery shopping in 2019 (i.e. the year
BEFORE COVID-19)?
Under $50 per week
13 (2%)
$50-$99 per week
144 (23%)
$100-$149 per week
207 (33%)
$150-200 per week
139 (22%)
$200-$250 per week
79 (13%)
Over $250 per week
49 (8%)
Total
631
Please indicate how your household’s weekly budget for grocery shopping changed
since the start of the COVID-19 epidemic in Quebec.
Increased
387 (60%)
No change
216 (34%)
Decreased
39 (6%)
Total
642
Compared to the year before COVID-19 (2019), how has your desire to eat changed?
Increased
177 (28%)
No change
413 (64%)
Decreased
51 (8%)
Total
641
Since the start of COVID-19, would you say you…
Eat more than you usually do
204 (32%)
Eat less than you usually do
75 (12%)
No change in how much you eat
361 (56%)
Total
640
Compared to the year before COVID-19 (2019), how have food skills in your
household changed?
Increased
249 (39%)
No change
380 (59%)
Decreased
14 (2%)
Total
643
†Percentages may not total to 100% due to rounding
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56% 55% 54%
49%
45%
40%
34%
20%
74%
47%
20% 21%
53%
41%
29%
0%
20%
40%
60%
80%
Increased Desire to Eat Increased Food Skills
Figure 1. Most frequently selected reasons for reporting increased desire to eat and
increased household food skills during the pandemic, compared to 2019 (pre-pandemic).
Full results as n (%) are reported in Supplementary Table S2, including for the remaining reasons
provided in the questions that were reported at a frequency of <20%.
†Option provided on increased food skills question only.
‡Option provided on increased desire to eat question only.
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Supplementary Material for “Food values, food purchasing, and eating-related outcomes among
a sample of Quebec adults during the COVID-19 pandemic.”
Table of Contents
Page Number
Item
2
Supplementary information on timeline of COVID-19 pandemic in Quebec,
Canada.
3
Table S1 Most important contributors to stress in day-to-day life.
4
Table S2 Complete results on reasons for reporting increased desire to eat
and increased household food skills during the pandemic, compared to
2019 (pre-pandemic).
5
Table S3 Themes emerging from open-ended responses for changes in
desire to eat and household food skills during the pandemic.
8
Table S4 Reasons for reporting decreased desire to eat and decreased
household food skills during the pandemic, compared to 2019 (pre-
pandemic).
9
Table S5 Changes to food-related interests and actions during the
pandemic, compared to 2019 (pre-pandemic).
10
Copy of survey questionnaire
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For additional details on the timeline of COVID-19 responses in Quebec, please see the
following sources:
https://montreal.ctvnews.ca/covid-19-in-quebec-a-timeline-of-key-dates-and-events-1.4892912
https://cdn-contenu.quebec.ca/cdn-contenu/sante/documents/Problemes_de_sante/covid-
19/Plan_deconfinement/Planification_deconfinement_conditionnel_pandemie_covid19.pdf?1590
425091
https://inspq.qc.ca/covid-19/donnees/ligne-du-temps
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Table S1 Most important contributors to stress in day-to-day life
Thinking about stress in your day-to-day life, what
would you say is the most important thing
contributing to feelings of stress you may have?†
n (%)†
Work
187 (29%)
Health
105 (16%)
Family
104 (16%)
Time pressures / not enough time
67 (11%)
Financial concerns
58 (9%)
Other‡
62 (10%)
None
30 (5%)
School work
24 (4%)
Total
637
†Percentages may not total to 100% due to rounding.
‡Free text analysis revealed that the majority of responses to “Other (please specify)” were of
stress being related to the pandemic (e.g. adjusting to working from home, isolation,
homeschooling, travel restrictions, and fear of contracting the virus).
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Table S2 Complete results on reasons for reporting increased desire to eat and increased household food skills during the
pandemic, compared to 2019 (pre-pandemic).
Factor
Increased Desire to Eat
(reported by n=177)
Factor
Increased Food Skills
(reported by n=249)
More comfort/enjoyment of food
100 (56%)
†More time to prepare food
185 (74%)
Stress
98 (55%)
Increased motivation to cook
132 (53%)
Boredom
95 (54%)
More comfort/enjoyment of
food
117 (47%)
Emotions
87 (49%)
More interest in food
103 (41%)
‡Anxiety
80 (45%)
Food prices
73 (29%)
Increased motivation to cook
70 (40%)
Boredom
53 (21%)
More interest in food
61 (34%)
Stress
50 (20%)
Food prices
35 (20%)
Social media influence
37 (15%)
‡Depression
26 (15%)
Loss of income
31 (12%)
Decreased motivation to cook
17 (10%)
Emotions
27 (11%)
Social media influence
14 (8%)
Media influence (TV, radio, or
non-social media websites)
13 (5%)
Loss of income
8 (5%)
Decreased motivation to cook
9 (4%)
Media influence (TV, radio, or
non-social media websites)
8 (5%)
Gain of income
8 (3%)
Gain of income
3 (2%)
†Less time to prepare food
5 (2%)
Less comfort/enjoyment of food
4 (2%)
Less comfort/enjoyment of food
4 (2%)
Less interest in food
0
Less interest in food
2 (1%)
Values are n (%). Respondents were instructed to select all factors that applied. Thus, total responses for each outcome sum to greater
than the original sample size.
Results are listed in descending order for each outcome.
‡The options “Anxiety” and “Depression” appeared on the desire to eat question only, as they were deemed less relevant for the food
skills question.
†The options “More time to prepare food” and “Less time to prepare food” appeared as possible reasons for the food skills question
only, as they were deemed less relevant for the desire to eat question.
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Table S3 Themes emerging from open-ended responses for changes in desire to eat and household food skills during the
pandemic.
Theme
Sample Responses
Increased Desire to Eat
Being at home and around food more often
“My office is across from my kitchen, therefore it's much simpler to go and
snack whereas at work I'm limited to what I bring.”
“Being around food all the time as compared to the office made for more
snacks”
Cravings/snacking
“Increased access and desire to snack; increased desire for easy already
prepared snacks.”
“Ate a lot more chocolate! Bought bars of chocolate and eat one a week.
Previously ate one a month.”
A need to eat all meals with children who were at
home
“We have been home for about 4 months and eating was an important activity
of the day. With the children, it is imperative to eat at every meal.”
“More desire and time to cook and the need to cook all the meals, for the
whole family at home every day. Sometimes when the children are not there,
meals are lighter, more eaten on the go.”
Health consciousness
“Leaning more towards freshly made foods and meals and buying locally. Less
prepackaged food, less drive-thru, less dining out”
“I feel like eating more healthy foods and whenever possible less industrialized.
Sweets replaced by fruits, snacks replaced by veggies, eggs, corn and popcorn.”
Decreased Desire to Eat
Health consciousness
“During the pandemic, my husband and I decided to make our lifestyle
healthier so all the change in our food basket is for this reason. I want to lose
weight and started eating mindfully, avoiding emotional eating, and increasing
physical activity.”
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“Was more concerned about strengthening my immune system. Therefore
eating less junk food.”
Increased Food Skills
Family participation
“Learned to be more creative with food we had, learning to cook as a family.”
“Taught all 3 school-aged children how to bake bread from scratch and make
them each responsible for one dinner a week.”
Fear of virus exposure/reduced shopping
frequency
“Some things we were used to were unavailable or we were trying to be safe
and not eat in the very beginning like take-out, so we cooked more.”
“Unable to access groceries since we're high risk and there's no affordable
delivery option near us. We've had to make do on very little food and stretch it
as far as it could go.”
Reducing food waste
“We made more efforts not to waste any food, which took more time and
learning new skills.”
“Web search to better plan meals and use foods without wasting them.”
Health consciousness
“I’ve become more aware of the food choices that I make vs how I feel after
eating, which increased my motivation to cook more at home and select quality
foods.”
“We have decreased consumption of red meat, sugar, white bread, salty
snacks. We bake in the oven or grill the food, no frying. Intake of vegetables
with each meal, more protein in each meal, and more water.”
Sourcing local foods/gardening
“We grew an urban garden and my partner developed baking skills.”
“We are more aware of foods produced close to home, which are often
products that we did not cook before, therefore we are discovering new
recipes!”
Closure of restaurants
“We cook more complex meals at home due to the fact that we don't go to the
restaurant.”
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“Willingness to try new recipes, even if they fail, with restaurants out of reach,
cooking at home is the only option for variety.”
Decreased Food Skills
Prepared foods
“I hardly cook anymore I lack energy and motivation. Fortunately I buy home-
style prepared meals that are healthy (many vegetables and rice) without
addition of additive so that helps me a lot.”
“Not motivated to cook well rounded meals. Annoyed with having to prepare
more meals as everyone is at home all the time. Started buying more
readymade or more snack items..”
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Table S4 Reasons for reporting decreased desire to eat and decreased household food skills during the pandemic, compared to
2019 (pre-pandemic).
Factor
Decreased Desire to Eat
(reported by n=51)
Factor
Decreased Food Skills
(reported by n=14)
Decreased motivation to cook
21 (41%)
Stress
10 (71%)
Stress
21 (41%)
Decreased motivation to cook
9 (64%)
‡Anxiety
21 (41%)
Emotions
8 (57%)
Less interest in food
19 (37%)
Food prices
6 (43%)
Food prices
17 (33%)
†Less time to prepare food
4 (29%)
Loss of income
13 (25%)
Boredom
4 (29%)
Less comfort/enjoyment of food
13 (25%)
Less interest in food
3 (21%)
Emotions
12 (24%)
Less comfort/enjoyment of food
2 (14%)
‡Depression
9 (18%)
†More time to prepare food
2 (14%)
Boredom
9 (18%)
Loss of income
2 (14%)
Increased motivation to cook
6 (12%)
More interest in food
1 (7%)
More comfort/enjoyment of food
4 (8%)
More comfort/enjoyment of
food
1 (7%)
Media influence (TV, radio, or
non-social media websites)
2 (4%)
Increased motivation to cook
1 (7%)
More interest in food
2 (4%)
Social media influence
1 (7%)
Social media influence
1 (2%)
Media influence (TV, radio, or
non-social media websites)
1 (7%)
Gain of income
0
Gain of income
0
Values are n (%). Respondents were instructed to select all factors that applied. Thus, total responses for each outcome sum to greater
than the original sample size.
Results are listed in descending order for each outcome.
‡The options “Anxiety” and “Depression” appeared on the desire to eat question only, as they were deemed less relevant for the food
skills question.
†The options “More time to prepare food” and “Less time to prepare food” appeared as possible reasons for the food skills question
only, as they were deemed less relevant for the desire to eat question.
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Table S5 Changes to food-related interests and actions during the pandemic, compared to 2019 (pre-pandemic).
Interest/Action
Increased
No Change
Decreased
Total Responses
Interest in growing food
277 (43%)
353 (55%)
7 (1%)
637
Interest in cooking
258 (40%)
330 (52%)
51 (8%)
639
Interest in baking
245 (38%)
345 (54%)
48 (8%)
638
Use of online grocery ordering
234 (37%)
360 (57%)
42 (7%)
636
Desire to eat take-out food
163 (26%)
308 (48%)
167 (26%)
638
Ordering take-out food by telephone or
online (not mobile app)
162 (26%)
380 (60%)
90 (14%)
632
Interest in nutrition
161 (25%)
469 (73%)
9 (1%)
639
Use of mobile app take-out food
ordering (e.g. UberEats, Skip the Dishes)
118 (19%)
433 (69%)
78 (12%)
629
Desire to eat at sit-down restaurants
61 (10%)
169 (27%)
406 (64%)
636
"Fill in" grocery trips (to buy a small
number of ingredients/items)
52 (9%)
203 (34%)
345 (58%)
600
Desire to go grocery shopping for fun
39 (6%)
152 (24%)
446 (70%)
637
Values are n (%). Percentages may not total to 100% due to rounding.
Results are listed in descending order by “Increased”.
