Associations between food-related concerns, food security status, and food support use: a secondary analysis of the...

Household food insecurity has previously been associated with psychological distress, and subsequently, poorer diet quality. Further understanding of this relationship is required to improve nutritional outcomes, with food-related concerns suggested as one potential mechanism. Therefore, the current pre-registered (https://osf.io/zd3ak) study conducted cross-sectional secondary analyses of Wave 6 (October 2022-January 2023) of the Food and You 2 survey administered in adults aged 16 years and over across England, Wales, and Northern Ireland (N = 2315), to explore the differential prevalence of food-related concerns in people experiencing food insecurity. Exploratory analyses also identified characteristics of food support users (food bank or social supermarket; N = 467) and quantified associations between food support use and the same food-related concerns. People experiencing marginal (OR = 1.43, p = 0.02) and low food security (OR = 1.51, p = 0.02) (relative to high food security) were significantly more concerned about food prices, but this association was not seen in people experiencing very low food security. Both food bank and social supermarket use were predicted by very low food security (food bank OR = 6.05, p < 0.001; social supermarket OR = 2.40, p = 0.02) and having a long-term health condition (food bank OR = 3.91, p = 0.00; social supermarket OR = 3.17, p = 0.00). Food bank users were less concerned about healthy eating (OR = 0.33, p = 0.00) whereas social supermarket users were less concerned about food prices (relative to non-users) (OR = 0.40, p = 0.01). Food-related concerns, particularly regarding food prices, are differentially associated with food security status and food support use. Findings could support specific interventions to promote better diet quality and improve health and wellbeing in populations experiencing food insecurity.