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      Pandemic-related financial hardship and disparities in sugar-sweetened beverage consumption and purchasing among San Francisco Bay Area residents during COVID-19

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          Highlights

          • Financial hardship among a sample of San Francisco Bay Area residents increased since COVID-19.

          • People with financial hardship reported consuming more sugar-sweetened beverages.

          • No increased purchasing of sugar-sweetened beverages overall since COVID-19.

          • People with new financial hardship increased purchasing of regular soda.

          Abstract

          Some reports suggest that the COVID-19 pandemic resulted in shifts to unhealthier diets. These unhealthier diets may include sugar-sweetened beverages (SSBs), which strongly contribute to diabetes and other chronic diseases. Using cross-sectional surveys in the San Francisco Bay Area, California, USA we sought to assess self-reported SSB consumption during the pandemic’s shelter-in-place and self-reported changes in SSB purchasing from before to during the pandemic’s shelter-in-place, stratifying by indices of pandemic-related financial hardship. Nearly 60% of our diverse sample (N = 943) reported that it was harder to pay for basics (like food and utilities) during shelter-in-place. Among those who found it harder to pay for basics and received financial assistance during shelter-in-place, we found a ten-fold higher frequency of daily SSB consumption compared to those not facing new financial hardship (2.76 [95% CI: 1.78, 3.74] versus 0.30 [95% CI: 0.23, 0.37] times/day). There were no statistically significant increases in reported purchasing of any SSB, but those with new financial hardship during shelter-in-place reported greater purchasing of regular soda relative to those with no new hardship (0.20 on a 3-point scale [95% CI: 0.03, 0.37]). Our findings suggest that new hardship may increase unhealthy behaviors and worsen existing disparities in SSB consumption. Such disparities are a reminder of the urgent need to reduce economic inequity and improve the quality of our emergency food system in order to mitigate the impact of public health crises like the COVID-19 pandemic.

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          Most cited references15

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          Food Insecurity and COVID-19: Disparities in Early Effects for US Adults

          The COVID-19 pandemic has dramatically increased food insecurity in the United States (US). The objective of this study was to understand the early effects of the COVID-19 pandemic among low-income adults in the US as social distancing measures began to be implemented. On 19–24 March 2020 we fielded a national, web-based survey (53% response rate) among adults with <250% of the federal poverty line in the US (N = 1478). Measures included household food security status and COVID-19-related basic needs challenges. Overall, 36% of low-income adults in the US were food secure, 20% had marginal food security, and 44% were food insecure. Less than one in five (18.8%) of adults with very low food security reported being able to comply with public health recommendations to purchase two weeks of food at a time. For every basic needs challenge, food-insecure adults were significantly more likely to report facing that challenge, with a clear gradient effect based on severity of food security. The short-term effects of the COVID-19 pandemic are magnifying existing disparities and disproportionately affecting low-income, food-insecure households that already struggle to meet basic needs. A robust, comprehensive policy response is needed to mitigate food insecurity as the pandemic progresses.
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            Trends in Beverage Consumption Among Children and Adults, 2003-2014

            This study aimed to provide the most recent national estimates for beverage consumption among children and adults in the United States.
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              Consumption patterns of sugar-sweetened beverages in the United States.

              Few previous studies have investigated consumption distributions of sugar-sweetened beverages (SSBs) over time and individual-level associations despite recent interest in SSBs regarding obesity control. To assess consumption patterns and individual-level associations. Trend and cross-sectional analyses of 24-hour dietary recall data and demographic characteristics and socioeconomic status (SES) drawn from National Health and Nutrition Examination Survey (1999-2000, 2001-2002, 2003-2004, 2005-2006, and 2007-2008) data. Children (aged 2 to 11 years, n=8,627), adolescents (aged 12 to 19 years, n=8,922), young adults (aged 20 to 34 years, n=5,933), and middle-aged and elder adults (aged ≥35 years, n=16,456). Age-stratified regression analyses for SSBs overall and by subtypes. The prevalence of heavy total SSB consumption (≥500 kcal/day) increased among children (4% to 5%) although it decreased among adolescents (22% to 16%) and young adults (29% to 20%). Soda was the most heavily consumed SSB in all age groups except for children. Prevalence of soda consumption decreased, whereas heavy sports/energy drink consumption tripled (4% to 12%) among adolescents. Black children and adolescents showed higher odds of heavy fruit drink consumption (odds ratios 1.71 and 1.67) than whites. Low-income children had a higher odds of heavy total SSB consumption (odds ratio 1.93) and higher energy intake from total SSBs and fruit drinks (by 23 and 27 kcal/day) than high-income children. Adolescents with low- vs high-educated parents had higher odds of heavy total SSB consumption (odds ratio 1.28) and higher energy intake from total SSBs and soda (by 27 and 21 kcal/day). Low vs high SES was associated with a higher odds of heavy consumption of total SSBs, soda, and fruit drinks among adults. Prevalence of soda consumption fell, but consumption of nontraditional SSBs rose. Heterogeneity of heavy consumption by SSB types across racial/ethnic subpopulations and higher odds of heavy SSB consumption among low-SES populations should be considered in targeting policies to encourage healthful beverage consumption. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Prev Med Rep
                Preventive Medicine Reports
                2211-3355
                08 March 2022
                April 2022
                08 March 2022
                : 26
                : 101759
                Affiliations
                [a ]School of Public Health, University of California, Berkeley, CA, USA
                [b ]Division of General Internal Medicine at San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA
                [c ]Center for Vulnerable Populations at San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA
                Author notes
                [* ]Corresponding author.
                Article
                S2211-3355(22)00066-3 101759
                10.1016/j.pmedr.2022.101759
                8917297
                35287282
                74053fb8-d846-4a3f-8fb5-cdda73d9f705
                © 2022 The Author(s)

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 24 September 2021
                : 4 March 2022
                : 6 March 2022
                Categories
                Regular Article

                sugar-sweetened beverages,health behavior,diet,financial stress

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