Table 2.

Results from multinomial logistic regression models assessing self-reported impacts of the COVID-19 pandemic on food behaviors, food security, and overall diet healthfulness among respondents of the International Food Policy Study (N = 20,554)¹

	Has the COVID-19 pandemic affected how often you eat food prepared away from home?		Has the COVID-19 pandemic affected how often you have food delivered from a restaurant?		Has the COVID-19 pandemic affected how often you buy groceries online (for delivery or pick-up)?		Has the COVID-19 pandemic affected how often you buy groceries from convenience/corner stores?		Has the COVID-19 pandemic affected whether your household has had enough food to eat?		Compared to before the COVID-19 pandemic, my overall diet is …
	I eat a lot less/a little less2	I eat a little more/a lot more2	I have a lot less/a little less2	I have a little more/a lot more2	I buy a lot less/a little less2	I buy a little more/a lot more2	I buy a lot less/a little less2	I buy a little more/a lot more2	A little3	A lot3	A lot less healthy/A little less healthy4	A little more healthy/A lot more healthy4
	AOR(99% CI)	AOR(99% CI)	AOR(99% CI)	AOR(99% CI)	AOR(99% CI)	AOR(99% CI)	AOR(99% CI)	AOR(99% CI)	AOR(99% CI)	AOR(99% CI)	AOR(99% CI)	AOR(99% CI)
Country5
Australia	0.28 (0.24–0.34)6	0.64 (0.49–0.84)6	0.64 (0.54–0.76)6	0.62 (0.51–0.76)6	0.35 (0.29–0.43)6	0.44 (0.36–0.52)6	0.41 (0.34–0.49)6	0.28 (0.22–0.34)6	0.27 (0.23–0.32)6	0.25 (0.19–0.33)*	1.03 (0.84–1.26)	0.64 (0.54–0.76)6
Canada	0.51 (0.42–0.63)6	0.85 (0.63–1.13)	0.94 (0.79–1.12)	0.84 (0.68–1.04)	0.37 (0.30–0.46)6	0.51 (0.42–0.61)6	0.51 (0.42–0.61)6	0.21 (0.17–0.27)6	0.27 (0.22–0.32)6	0.24 (0.18–0.33)6	1.20 (0.98–1.47)	0.56 (0.47–0.67)6
Mexico	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]
United Kingdom	0.52 (0.43–0.63)6	0.83 (0.63–1.09)	0.96 (0.81–1.14)	0.89 (0.73–1.09)	0.45 (0.36–0.55)6	1.03 (0.87–1.21)	0.78 (0.65–0.93)6	0.82 (0.68–1.00)	0.25 (0.21–0.29)6	0.23 (0.18–0.31)6	1.24 (1.02–1.52)6	0.62 (0.52–0.73)6
United States	0.49 (0.40–0.59)6	1.28 (0.98–1.67)	0.81 (0.69–0.97)6	1.10 (0.91–1.35)	0.43 (0.35–0.52)6	0.90 (0.76–1.06)	0.70 (0.59–0.83)6	0.46 (0.38–0.57)6	0.41 (0.35–0.49)6	0.59 (0.46–0.76)6	1.14 (0.94–1.39)	0.65 (0.55–0.77)6
Age
18–29 years	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]
30–44 years	0.86 (0.73–1.01)	0.60 (0.49–0.74)6	0.98 (0.85–1.13)	0.71 (0.60–0.83)6	0.96 (0.81–1.14)	1.12 (0.97–1.29)	1.05 (0.90–1.21)	0.84 (0.71–0.99)6	0.78 (0.67–0.90)6	0.99 (0.79–1.24)	0.81 (0.69–0.95)6	0.89 (0.77–1.03)
45–59 years	0.85 (0.72–1.00)6	0.33 (0.26–0.42)6	0.86 (0.74–0.99)6	0.37 (0.31–0.44)6	0.83 (0.69–0.99)6	0.71 (0.61–0.83)6	0.88 (0.75–1.02)	0.55 (0.46–0.66)6	0.45 (0.38–0.52)6	0.50 (0.39–0.64)6	0.62 (0.52–0.73)6	0.80 (0.69–0.93)6
≥60 years	0.91 (0.78–1.08)	0.25 (0.19–0.32)6	0.71 (0.61–0.83)6	0.21 (0.17–0.26)6	0.82 (0.67–1.00)	0.66 (0.56–0.77)6	0.86 (0.73–1.01)	0.40 (0.32–0.50)6	0.22 (0.19–0.26)6	0.20 (0.14–0.28)6	0.46 (0.38–0.55)6	0.70 (0.59–0.82)6
Sex
Female	1.32 (1.19–1.45)6	1.03 (0.88–1.20)	1.14 (1.03–1.25)6	0.98 (0.87–1.11)	0.97 (0.86–1.10)	1.25 (1.13–1.38)6	1.04 (0.94–1.15)	1.01 (0.89–1.15)	0.95 (0.85–1.06)	0.91 (0.76–1.08)	1.54 (1.37–1.73)6	1.20 (1.09–1.33)6
Male	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]
Ethnicity7
Majority group	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]
Minority group	1.38 (1.19–1.59)6	1.36 (1.13–1.65)6	1.39 (1.22–1.58)6	1.29 (1.10–1.50)6	1.65 (1.41–1.92)6	1.08 (0.94–1.23)	1.45 (1.27–1.65)6	1.59 (1.35–1.87)6	1.58 (1.38–1.80)6	1.68 (1.36–2.07)6	1.04 (0.89–1.21)	1.27 (1.12–1.45)6
Education level8
Low	0.56 (0.50–0.63)6	0.50 (0.42–0.60)6	0.79 (0.71–0.89)6	0.55 (0.48–0.64)6	0.94 (0.81–1.09)	0.55 (0.49–0.62)6	0.76 (0.67–0.86)6	0.67 (0.58–0.78)6	1.02 (0.90–1.16)	1.12 (0.91–1.38)	0.75 (0.65–0.86)6	0.55 (0.48–0.62)6
Medium	0.74 (0.66–0.85)6	0.69 (0.57–0.84)6	0.87 (0.77–0.99)6	0.70 (0.60–0.81)6	0.88 (0.74–1.04)	0.73 (0.64–0.83)6	0.87 (0.77–1.00)6	0.75 (0.64–0.89)6	1.03 (0.90–1.19)	1.28 (1.02–1.60)6	0.90 (0.78–1.05)	0.73 (0.64–0.83)6
High	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]
BMI
Underweight (<18.5 kg/m2)	0.85 (0.62–1.18)	0.70 (0.44–1.11)	0.90 (0.66–1.22)	1.00 (0.72–1.41)	1.31 (0.92–1.86)	1.06 (0.78–1.45)	1.08 (0.79–1.48)	1.36 (0.95–1.96)	1.05 (0.77–1.45)	1.59 (0.98–2.57)6	1.15 (0.82–1.61)	0.82 (0.59–1.13)
Normal weight (18.5–24.9 kg/m2)	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]
Overweight (25.0–29.9 kg/m2)	1.04 (0.92–1.18)	1.17 (0.97–1.42)	1.07 (0.95–1.21)	1.04 (0.90–1.21)	1.02 (0.87–1.19)	0.93 (0.82–1.06)	0.97 (0.85–1.10)	0.98 (0.83–1.14)	0.86 (0.75–0.98)6	0.79 (0.63–1.00)	1.50 (1.29–1.75)6	1.10 (0.97–1.25)
Obesity (≥30 kg/m2)	1.04 (0.91–1.20)	1.286 (1.03–1.58)	1.08 (0.95–1.24)	1.08 (0.92–1.28)	1.03 (0.86–1.23)	0.95 (0.82–1.10)	1.07 (0.93–1.24)	1.03 (0.86–1.24)	0.88 (0.76–1.03)	0.78 (0.61–1.00)6	2.01 (1.71–2.37)6	1.15 (1.00–1.33)
Missing	0.70 (0.59–0.82)6	0.80 (0.63–1.03)	0.93 (0.79–1.10)	0.79 (0.65–0.96)6	1.06 (0.87–1.29)	0.77 (0.65–0.92)6	0.90 (0.76–1.07)	0.85 (0.69–1.05)	1.25 (1.05–1.49)6	1.59 (1.22–2.06)6	1.06 (0.87–1.29)	0.74 (0.62–0.88)6
Income adequacy9
High	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]
Low	1.16 (1.02–1.32)6	0.92 (0.76–1.12)	1.16 (1.03–1.31)6	0.96 (0.83–1.11)	1.10 (0.95–1.27)	0.81 (0.71–0.92)6	1.15 (1.01–1.30)6	0.97 (0.83–1.13)	4.63 (4.09–5.23)6	8.75 (7.31–10.49)6	2.08 (1.82–2.37)6	0.95 (0.83–1.08)
COVID-19 illness status
No	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]
Yes–confirmed by test	1.58 (1.11–2.24)6	1.71 (1.12–2.62)6	1.71 (1.28–2.27)6	1.64 (1.19–2.25)6	2.65 (1.96–3.58)6	1.59 (1.20–2.11)6	2.05 (1.55–2.71)6	1.83 (1.34–2.49)6	1.91 (1.42–2.58)6	2.91 (1.93–4.38)6	1.83 (1.32–2.53)6	1.94 (1.47–2.56)6
I believe I had COVID-19, but was not tested	1.10 (0.86–1.42)	1.19 (0.85–1.65)	1.20 (0.97–1.49)	1.29 (1.00–1.67)	1.20 (0.92–1.56)	1.13 (0.91–1.41)	1.17 (0.94–1.46)	1.36 (1.05–1.76)6	2.07 (1.67–2.58)6	2.48 (1.79–3.43)6	1.20 (0.93–1.56)	1.23 (0.99–1.54)
COVID-19 impacts on food security
A little	1.80 (1.57–2.06)6	2.37 (1.96–2.87)6	1.96 (1.74–2.22)6	1.80 (1.56–2.08)6	2.69 (2.32–3.12)6	1.82 (1.61–2.07)6	2.38 (2.10–2.69)6	2.92 (2.50–3.41)6	—	—	2.00 (1.73–2.30)6	1.44 (1.27–1.63)6
A lot	1.78 (1.40–2.27)6	2.91 (2.16–3.92)6	2.50 (2.03–3.07)6	2.34 (1.85–2.96)6	3.68 (2.92–4.63)6	2.70 (2.20–3.32)6	3.09 (2.51–3.81)6	4.69 (3.71–5.93)6	—	—	3.48 (2.81–4.33)6	2.45 (1.98–3.04)6
Not at all/don't know	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	[ref]	—	—	[ref]	[ref]

¹Abbreviations: AOR, adjusted odds ratio; COVID-19, coronavirus disease 2019.

²Participants reporting that they [eat/have/buy] “a lot less/a little less” or “a little more/a lot more” compared with “no difference/don't know.”

³Participants reporting that the COVID-19 pandemic affected whether their household had enough food to eat by “a little” or “a lot” compared with “not at all/don't know.”

⁴Participants reporting that their overall diet is “a lot less healthy/a little less healthy” or “a little more healthy/a lot more healthy” compared to before the COVID-19 pandemic, compared with “no difference/don't know.”

⁵Full cross-country comparisons are provided in Supplemental Table 3.

⁶ P < 0.01.

⁷Ethnicity categories as per census questions asked in each country: 1) in Australia, majority indicates the participant only speaks English at home and minority indicates the participant speaks a language besides English at home; 2) in Canada, the United Kingdom, and the United States, majority indicates the participant is White race and minority indicates the participant is of other ethnicity; and 3) in Mexico, majority indicates the participant is nonindigenous and minority indicates they are indigenous.

⁸Participants were asked, “what is the highest level of formal education that you have completed?” Responses were categorized as low (completed secondary school or less), medium (some postsecondary qualifications), or high (university degree or higher) according to country-specific criteria.

⁹Participants were asked, “thinking about your total monthly income, how difficult or easy is it for you to make ends meet?” Response options were very easy, easy, and neither easy nor difficult, which were all categorized as high income adequacy, and difficult and very difficult, which were categorized as low income adequacy.