Socio-ecological factors linked with changes in adults' dietary intake in Los Angeles County during the peak of the COVID-19 pandemic.

OBJECTIVE: Comprehensive studies examining longitudinal predictors of dietary change during the COVID-19 pandemic are lacking. Based on an ecological framework, this study used longitudinal data to test if individual, social, and environmental factors predicted change in dietary intake during the peak of the COVID-19 pandemic in Los Angeles (L.A.) County, and examined interactions among the multilevel predictors.

DESIGN: We analyzed two survey waves (e.g., baseline and follow-up) of the Understanding America Study (UAS), administered online to the same participants 3 months apart. The surveys assessed dietary intake and individual, social, and neighborhood factors potentially associated with diet. Lagged multilevel regression models were used to predict change from baseline to follow-up in daily servings of fruits, vegetables, and sugar-sweetened beverages.

SETTING: Data were collected in October 2020 and January 2021, during the peak of the COVID-19 pandemic in L.A. County.

PARTICIPANTS: 903 adults representative of L.A. County households.

RESULTS: Individuals who had depression, less education, or who identified as Non-Hispanic Black or Hispanic reported unhealthy dietary changes over the study period. Individuals with smaller social networks, especially low-income individuals with smaller networks, also reported unhealthy dietary changes. After accounting for individual and social factors, neighborhood factors were generally not associated with dietary change.

CONCLUSIONS: Given poor diets are a leading cause of death in the U.S., addressing ecological risk factors that put some segments of the community at risk for unhealthy dietary changes during a crisis should be a priority for health interventions and policy.