The results of this study show a clear trend toward more unhealthy consumption behaviors and dietary habits of young adults during the COVID-19 pandemic. The overall consumption of junk food significantly increased, over a third gained weight, and about two-thirds reported less healthy eating habits overall, unhealthier snack consumption, and more emotional eating. These results echo findings from other studies both in the United States and in other wealthy nations that have found associations between the pandemic and dietary deterioration[4, 11–17, 27].
The previous neglect of a focus on the young adult demographic in this growing literature, aside from rare exceptions[27], was a primary motivation for the current study. As we have argued, the abrupt and unprecedented degree of change experienced at a formative stage of life makes this group important to understand on its own. Another aim was to investigate socioeconomic differences, given the widening inequalities induced by the pandemic. Group level differences by household income followed a clear pattern. Lower-income participants were disproportionately represented among those who reported unhealthy consumption and behaviors while the opposite was true for upper-income participants. While both groups reported more negative, than positive, changes, when there were positive changes, such as less reliance on fast foods and consuming more home-cooked food from scratch, upper-income participants were disproportionately represented among those who reported them.
The differences we found may be explained, in part, by the defining characteristics of the American class divide during COVID-19. Affluent Americans have been more likely to remain employed, work from home, and not suffer income decline while lower-income Americans have disproportionately suffered job loss, financial strain, and housing precariousness. Among lower-income Americans still working, they have been more likely to work outside the home than their upper-income counterparts, and often in two or more job while facing risk of exposure to the virus [43, 44]. The economic impact has been especially harsh for young workers who are disproportionately employed in entry level service sectors where job losses were particularly severe [29]. These disparate class-based experiences may help explain dietary inequities.
Cooking at home, for instance, requires planning, time, investment in raw products, and a modicum of stability[45], requirements that the affluent may have enhanced capacity to meet during the pandemic and the lower-income may have decreased capacity to meet. This study’s finding that home-based cooking from scratch significantly increased, and reliance on fast food significantly decreased only among upper-income participants, indicates that the pandemic’s positive influences on healthy eating[18, 21, 22] may be a silver lining enjoyed primarily by the more privileged. On the other hand, a reliance on pre-prepared, processed, convenience and/or fast foods may better correlate with the circumstances of those with less stable, downward spiraling lives, as they are cheap, readily available, and calorie dense. In a recent study involving focus groups, lower-income women reported that barriers to healthy eating included cost, convenience, and preparation time. This team of authors also noted that comfort foods may be used by as a coping mechanism for the multiple stressors and anxieties in their lives[46]. Geography may play a role, too. Lower-income households are already more likely to reside in food deserts and mirages where access to foods high in nutrition is limited[47, 48] In this way, the results of this study support existing research on how socioeconomic status impacts dietary practices[49, 50] while contributing evidence on how the pandemic may exacerbate nutritional inequities.
Lower-income participants’ disproportionate representation in several other unhealthy trends is additional cause for concern. While alarming numbers reported gaining weight and sedentary lifestyle during the pandemic, the proportions were much more severe among those from lower-income households. When more than one in two lower-income young adults report gaining weight during the pandemic (versus one in four among upper-income participants), it suggests a class-based vulnerability to a host of metabolic diseases associated with unhealthy weight gain, such as type 2 diabetes, dyslipidemia and hypertension, all of which have been shown to downgrade immune responses, and make one more vulnerable to infections and less responsive to antivirals and vaccinations[4, 51–53]. The Center for Disease Control and Prevention (CDC) has identified obesity and increased BMI as a risk factor for COVID-19 related illnesses, regardless of age[54]. Even more disturbing is that lower-income Americans already have higher rates of obesity than their more affluent counterparts, a disparity that has long been recognized[55, 56].
Studies have shown that the increased risk to obesity during the pandemic is due to a sustained positive energy balance with reduced energy exposure[10]. Since junk foods are generally energy dense, and nutritionally lacking, it likely poses a threat to those reporting an increase in its consumption, especially in conjunction with a sedentary or low active lifestyle. The positive relationship between activity levels and healthy eating behaviors, irrespective of household income level, is an important finding, as it suggests that all socioeconomic groups benefit from the positive influence of an active lifestyle on healthy eating behaviors. The fact that more lower income than upper income participants reported being sedentary during the lockdown suggests a need for promoting and ensuring opportunities for active lifestyle among the low income who may not have the same access to pandemic-safe recreational facilities, including parks, sports arenas, and home-based equipment.
The prevalence of food insecurity found in this study and lower-income participants’ disproportionate representation in it, corresponds with what is already known about the pandemic’s influence on food accessibility. Food insecurity was heightened during the pandemic, becoming a catastrophic problem associated with panic, hoarding, and other alarming behaviors, while afflicting the most economically vulnerable [57]. The fact that half of lower-income participants in this study struggled with getting enough to eat at least once or twice during the first few months of the pandemic and that more than 10 percent did not have enough to eat on a regular basis, is deeply concerning. On the other hand, it should not be missed that nearly a quarter of upper-income participants reported struggling with getting enough to eat at least once or twice during the pandemic, and for more than 5%, it was a regular occurrence. It is clear, that even though income background is significantly correlated with food insecurity, it does not make anyone immune from the perils of hunger and malnutrition[47].
It is important to emphasize that both lower- and upper-income participants in this study reported worsened financial circumstances during the pandemic. This reflects the ways in which economic losses have impacted a broad swath of the American population. On the other hand, it is also important to note that significantly more lower-income participants reported that their financial situation negatively impacted their diet. This may indicate one of the ways in which pandemic related economic losses impacted the daily lives of lower-income groups more severely. In a TIAA survey conducted during the pandemic it was found that more than half of individuals who make less than $50,000 per year have never created an emergency fund[58]. This finding follows what studies have always shown, that the wealthier you are, the more equipped you are to absorb emergencies, and the poorer you are, the less you have to fall back on, and the more vulnerable you are to a downward spiral where diet is often the first casuality[59].
Most generally, the widening socioeconomic disparities in society at large that have been caused by the COVID-19 pandemic appear to be reflected in the dietary inequities found in this study. The pandemic has impacted dietary composition, eating practices and weight change in primarily negative ways, but the lower-income are disproportionately represented in these unhealthy trends while the opposite is true for upper-income participants. It is important for public health policies aimed at improving the well-being of the U.S. population to be cognizant of these income-based inequities and how they reflect “differential access to the resources required to access high-quality diets and physical activity”[55]. Solutions should be geared toward reshaping fiscal, social and physical environments, rather than relying solely on behavioral interventions[55, 60].