Table 2.

Summary of Study Findings by Outcome

Author & Year	Exposure	Main results (only statistically significant findings described; see Additional File 2 for full details)
		Energy Intake	Dietary Quality	Food Intake	Macronutrient intake	Socio-economic differences and impacts on children
Alves, 2019 [69]	Commencement of Great Recession	n/a	n/a	Soup, fish, fruits and vegetables significantly decreased; legumes significantly increased.	n/a	Legumes increased only among the low and medium educated; soup intake decreased only among the least educated, fish decreased only amongst those with medium education.
Antelo, 2017 [68]	Unemployment rates	n/a	n/a	Unemployment was associated with a decrease in expenditure on bread, cereals, rice and pasta; meat; fish; milk, cheese and eggs; fruits; vegetables, pulses, potatoes and other root crops; and sugar, jam, honey, chocolate, sweets and ice cream.	n/a	n/a
Asgeirsdottir, 2014 [67]	Commencement of Great Recession	n/a	n/a	Daily sugared soft drink, daily sweets, weekly fast food, daily fruit and daily vegetables decreased	n/a	n/a
Asgeirsdottir, 2016 [66]	Commencement of Great Recession	n/a	n/a	Daily sugared soft drink, daily sweets, weekly fast food, daily fruit and decreased.	n/a	n/a
Bartoll, 2015 [65]	Commencement of Great Recession	n/a	n/a	Reduction in fruits, vegetables, meats, and cold meats.	n/a	Vegetable consumption decreased only for women without a qualification, fruit decreased most for the unemployed and those with lowest education. Meat consumption decreased the most among men and women with the lowest education.
Bonaccio, 2014 [64]	Commencement of Great Recession	Calorie intake decreased.	Adherence to Mediterranean Diet and antioxidant score decreased.	Animal proteins and fats increased, vegetarian proteins and fats decreased.	Carbohydrate intake and fibre intake decreased. Protein, fats, and saturated fats increased.	Mediterranean Diet adherence highest in those with higher wealth score and education.
Brinkman, 2010 [63]	Changes in food prices	n/a	Diet quality and diversity decreased in all three countries.	n/a	n/a	n/a
Colman, 2018 [61]	Unemployment	n/a	n/a	Becoming nonemployed and unemployed was associated with decreased consumption of fast food.	n/a	n/a
Çırakli 2019 [62]	Commencement of Great Recession	n/a	n/a	Annual per capita vegetable and fruit consumption increased.	Sugar consumption increased.	n/a
Dave, 2012 [60]	Unemployment rates	n/a	Higher state unemployment was associated with decreased dietary quality.	Higher state unemployment was associated with decreased consumption of fruits, fruit juice, carrots and green salad and vegetables, as well as significantly increased snacks.	n/a	Lower education was associated with lower consumption of fruits, fruit juice, carrots, green salad and vegetables. Lower education was associated with higher consumption of snacks, hamburgers, hot dogs, French fries, fried chicken and doughnuts.
Di Pietro, 2018 [59]	Unemployment rates	n/a	n/a	Higher unemployment rate was associated with decreased probability of consuming at least 5 portions of fruit and vegetables per day and increased probability of eating snacks high in salt every day.	n/a	n/a
Díaz-Méndez 2019 [58]	Commencement of Great Recession	n/a	n/a	Fruit, vegetables, meat, fish, and sweets consumption decreased.	n/a	Lower social class and education level, and higher unemployment, associated with lower fruit consumption. Unemployment associated with lower fish consumption.
Duquenne, 2014 [57]	Change over time	n/a	n/a	Recession had limited impact on consumption of pasta, potatoes, olive oil, rice, bread, vegetables, milk, and fruits (component 1). There was a bigger impact on beef, sheep and goat, pork, cold cuts, chicken, fish, sweets, cheese and feta consumption, with more than 60% of households changing their behaviour (component 2).	n/a	Generally those more affected by Great Recession had a lower income and greater decrease in monthly income, and higher unemployment.
Filippidis, 2014 [55]	Commencement of Great Recession	n/a	n/a	Significant decrease in consuming five portions of fruits and vegetables per day.		Decrease in consuming 5 portions of fruits & vegetables greater in those of lower socio-economic status.
Filippidis, 2017 [56]	Commencement of Great Recession	n/a	n/a	No significant change in low fruit and vegetable consumption (two or less portions).	n/a	n/a
Florkowski, 2012 [54]	Commencement of Great Recession	n/a	n/a	Expenditure share from pasta, bread, seafood, offal, barley, pork, chicken, milk, farmers’ cheese, hard cheese, eggs, margarine, vegetable oil, animal fats, citrus and apples increased. Expenditure share from freshwater fish, potatoes and sugar decreased.	Sugar consumption decreased.	Generally those below average income spent less on the different food types. Observed changes were the same but with a lower start and end level of consumption.
Foscolou, 2017 [53]	Commencement of Great Recession	n/a	Adherence to Mediterranean Diet decreased after 2009.	n/a	n/a	n/a
García-Mayor, 2020 [70]	Commencement of Great Recession	n/a	n/a	Daily fruit, vegetables, pastries and sweets, and sugar-sweetened beverages decreased.	n/a	Lower fruit and vegetable intake for those of lower social class, also a greater decrease in pastries and sweets of those of lower SEP.
Griffith, 2016a [51]	Commencement of Great Recession	Calories purchased and energy density decreased.	Healthy Eating (HEI) score increased.	Share of calories from fruit, grains, poultry and fish, prepared sweets and desserts, and confectionary increased; vegetables, red meat and nuts, fats and oils, eating out and fast food and drinks decreased.	Carbohydrates, sugar, fibre and saturated fats increased and protein and salt decreased.	Middle income individuals decreased their calories purchased the most. Working low income individuals improved their HEI score the most. Households with children reduced expenditure and calories the most; households with pre-school children increased their HEI score the most.
Griffith, 2016b [52]	Commencement of Great Recession	n/a	n/a	Fruit and vegetables, dairy, meat, fish, eating out and fast food, soft drink and confectionary consumption decreased.	n/a	n/a
Griffith, 2013 [50]	Commencement of Great Recession	Calorie density increased.	Dietary quality decreased over the recession.	Decrease in calorie share from fruit and vegetables.	Saturated fat, sugar, and protein consumption increased.	Calorie density increased most in single parents and families of two adults with young children. HEI was lowest for single pensioners. Households with children increased protein consumption the most but decreased calories from vegetables the most.
Hasan, 2019 [49]	Commencement of Great Recession	Calorie intake per day increased over the recession.	Household Dietary Diversity Score and number of food groups consumed increased while Food Consumption Score decreased.	Consumed rice and calories from non-rice grain, pulses, high value and low value pulses, fruits, proteins, low value fish and other items increased, while calorie intake from high value fish decreased.	No change in calorie intake from protein.	Higher education was associated with higher Household Dietary Diversity Score and Food Consumption Score; lower calories from rice and grain and higher calories from other grains and protein.
Iannotti, 2011 [48]	Actual vs. expected price changes	Calories decreased in general.	n/a	n/a	n/a	Considerable differences in by wealth score; lower wealth associated with fewer calories consumed.
Jofre-Bonet, 2016 [47]	Unemployment rates, commencement of Great Recession	n/a	n/a	Vegetable consumption increased and fruit consumption decreased.	n/a	n/a
Kim, 2019 [46]	Local indicators	n/a	n/a	Decrease in median household income was associated with decreased fruit and vegetable availability in the home.	n/a	Higher socio-economic status associated with higher availability of fruit and vegetables in the home.
Kotelnikova, 2017 [45]	Commencement of Great Recession	n/a	n/a	Food expenditure in the previous week on bread, cereals, and canned food; fresh vegetables; fresh meat and fish; milk and dairy products; and berries and other fresh fruits decreased.	n/a	n/a
Kuhns, 2014 [44]	Commencement of Great Recession	n/a	USDA score for dietary quality increased.	n/a	n/a	n/a
Marcotte-Chenard, 2019 [43]	Commencement of Great Recession	Calories decreased for men and women.	n/a	n/a	Protein, carbohydrate, sodium and sugar intake decreased in men and women. Fats significantly decreased in women only.	n/a
Martin-Prevel, 2012 [42]	Commencement of Great Recession	n/a	n/a	Tubers/roots, green leafy vegetables, eggs and vitamin A (VA)-rich oil (red palm oil) increased. VA -rich vegetables and tubers, other vegetables, VA-rich fruits, other fruits, offal, meat, fish, legumes/ nuts/ seeds, milk/ dairy products and oils/fats decreased.	Sugar consumption decreased.	n/a
Mattei, 2017 [41]	Commencement of Great Recession	n/a	n/a	No significant impact on foods assessed	n/a	n/a
Mohseni-Cheraglou, 2016 [40]	Currency devaluation or banking distress	Growth rates for calorie intake per day decrease during economic crises with or without recessions.	n/a	n/a	Growth rates for protein intake per day decrease during economic crises with or without recessions.	n/a
Ng, 2014 [39]	Commencement of Great Recession	Mean calories consumed per day decreased in adults and children.	n/a	Increase in unemployment rate associated with increased calories from consumer packaged goods and beverages.	n/a	n/a
Norte, 2019 [38]	Commencement of Great Recession	n/a	Odds of poor diet increased for the less affluent.	n/a	n/a	Increased odds of poor diet higher for those in unskilled work or with lower education.
Nour, 2019 [37]	Commencement of Great Recession	n/a	n/a	Recession not significantly associated with fruit and vegetable consumption.	n/a	n/a
Rajmil, 2013 [36]	Commencement of Great Recession	n/a	n/a	Junk food consumption decreased for families with maternal primary education level.	n/a	Junk food consumption decreased more for families with lower maternal primary education level.
Regidor, 2019 [35]	GDP	n/a	n/a	Fruit and vegetable consumption increased.	n/a	n/a
Shabnam, 2016 [34]	Commencement of Great Recession	n/a	n/a	Vegetable, wheat and wheat flour, rice, milk and milk products, legumes, fats and oils and sugar increased. Fruit consumption decreased.	Price elasticity for carbohydrates, fats, and proteins decreased.	Greater impact on low income families.
Smed, 2017 [33]	Consumer Confidence Index (CCI)	n/a	n/a	Canned and processed fish, fresh fish, fresh fruit, poultry, processed meat, sliced meat, fats, cheese, dairy and sugar products significantly increase with increased CCI (so decreased during recession). Pork and snacks significant decrease with increased CCI (so increased during recession).	Total fat, saturated fats, and protein increase with increased CCI. Added sugar and carbohydrates decreased with increased CCI.	n/a
Todd, 2014 [32]	Commencement of Great Recession	n/a	More likely to rate dietary quality as excellent or very good in 2009–2010 compared to 2007–2008.	No significant change in total snacks consumed but did find a significant decrease in snacks eaten away from home. Decrease in calories from fast food.	Percentage calories from fat and saturated fat, fibre intake, and cholesterol intake decreased.	n/a
Todd, 2017 [31]	Commencement of Great Recession	n/a	n/a	No significant change in total snacks consumed but did find a significant decrease in snacks eaten away from home. Decrease in calories from fast food.	Saturated fat, fibre, and cholesterol intake decreased.	n/a
Yang, 2019 [30]	Commencement of Great Recession	n/a	n/a	Decreases in beef and pork expenditure, with income differences. Increase in eggs and no change in dried beans.	n/a	For lower incomes households, pork expenditure decreased over time while fish, seafood, and dairy expenditure increased over time. For higher income households, beef expenditure decreased while eggs and dairy products increased over time. For middle income households, bean expenditure increased over time.