A lifespan perspective of structural and perceived social relationships, food insecurity, and dietary behaviors during the COVID-19 pandemic.

Physical distancing and economic impacts of the COVID-19 pandemic may influence dietary behaviors. Using a parallel mixed method design, we examined the relationships between structural and perceived social relationships on dietary behaviors across the adult lifespan and by food security status. A representative sample of 360 adults (18-78 years old) living in the United States were recruited through Prolific Academic to complete an online cross-sectional survey. Participants provided data about demographics, food insecurity, structural and perceived social relationships, diet quality, and unhealthy snacking at the onset of the pandemic. Participants responded to open-ended questions about perceived changes in social connections and dietary behavior since COVID-19. Quantitative findings indicated food insecure emerging and older adults were at highest risk for low diet quality and frequent unhealthy snacking. Friend support was associated with higher diet quality. Qualitative findings suggested overall decreases in social connection and changes in dietary behavior, with food insecure adults describing decreases in diet quality. Participants who reported increases in emotional eating also reported decreases in social connection. Findings suggest the pandemic may exacerbate inequalities, particularly among food insecure emerging and older adults. Scaling up preventive interventions to increase social connection and reduce food insecurity during unprecedented challenges may promote healthier dietary behaviors now and in the long-term.