Table 3.
The characteristics and findings of the seven quantitative studies that were included in the systematic review which investigated the impact or association of food banks on the food insecurity or diet intake of food bank users (objective 2)
| Study characteristics | Population | Methodology | Outcomes | Key findings | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Citation | Location | Study design | Sample size | Aims/intervention | Data collection and analysis | Food parcel | Food security | Diet | Other | ||
| Cheyne et al. (2020) 83 | USA, Oakland, California Food pantries (prepackaged) | Pre–post | Food banks: n = 12 Food bank users: n = 192 | Mean age (SD): 48.5 (12.7) years Female: 174 (90.6%) Condition: food bank user with prediabetes | To assess effectiveness of food bank‐based intervention at improving food insecurity, diet intake and diabetes risk Intervention: monthly food parcels, text‐based health promotion education; engagement messages | Participants completed survey at baseline and at 6 months χ 2test; t‐test; Fisher exact tests | NA | USDA 6‐item | Food groups: FRESH foods survey | Physical activity, general health, BMI, engagement in the intervention | Food security: after 6 months, percentage of participants reporting food insecurity decreased from 68.8% to 62.5% (Pearson χ 2 = 72.6, p < 0.001). Food groups: from pre–post, frequency of consumption of fruits and vegetables, whole grains, green salad, potatoes, nonfried vegetables, and cooked beans significantly increased, whereas consumption of sweetened drinks, fried potatoes, candy/chocolate, cookies and cakes significantly decreased (p ≤ 0.05). Other: minutes of physical activity per week increased 95.6–145.1 (paired t‐test = 4.05, p < 0.001). Percentage reporting health status as poor or fair declined 73.9–60.1% (Fisher exact = 39.19, p < 0.001). Mean BMI (32.4 kg/m2) did not change |
| Ferrer et al. (2019) 84 | USA Food bank (prepackaged) | RCT | Food banks: n = 1 Food bank users: n = 58 (29 control, 29 intervention) | Age (mean): 34–72 (54) years Female: 36 (62%) Condition: HbA1c >9% and food insecure | To assess whether a food bank–primary care collaboration improves food security and diabetes control Intervention: 2× weekly provision of fresh and canned food parcels; nutrition education conducted by a dietitian; health worker visits | Outcome measurement at baseline and at 6 months Kernel density plots | NA | NA | Dietary quality: STC‐Diet | HbA1c, BMI | Dietary quality: mean STC‐Diet increased by 2.47 points (21‐point scale) in intervention (95% CI = 1.42–3.52; Cohen's d = 1.10, p < 0.001). No significant difference in the STC‐Diet in the controls. Other: mean baseline BMI and HbA1c were 32 kg/m2 and 11%, respectively. Both decreased more in the intervention group, but differences were only significant for the outcome HbA1c, which decreased −3.09% (95% CI = −4.04 to −2.13; Cohen's d = −0.516, p = 0.012) |
| Liu et al. (2019) 85 | USA,Indiana Food pantries (pre‐packaged and client choice) | Cross‐sectional | Food banks: n = 27 Food bank users: n = 270 | Mean age (SEM): 45.7 (0.9) years Female: 149 (67%) | To determine the associations between food bank use and food security status with BMI, diet quality and chronic disease | Food bank user survey, interviewer assisted 24‐h diet recallχ 2 test; least‐squares means; logistic regression | NA | USDA 18‐item | Dietary quality: ASA24‐2014 for HEI‐2010 total and component scores | Frequency food bank use (> once a month; < once a month), BMI, self‐reported chronic disease; BMI; chronic disease | Dietary quality: visiting food banks > once a month showed significantly greater HEI‐2010 total (44.1 [SD 3.9] vs. 38.9 [SD 3.7], p = 0.03), and greater protein component score (4.7 [SD 0.4] vs. 4.3 [SD 0.4], p = 0.05), compared with visiting foodbanks < once a month). Food security was not associated with HEI‐2010 |
| Mousa and Freeland‐Graves (2019) 59 | USA, Central Texas Food pantries (pre‐packaged) | Cross‐sectional | Food banks: n = 10 Food bank users: n = 112 | Mean age (SD): 50.91 (1.17) Female: 75 (67%) | To assess impact of 2× monthly food parcels on the total nutrient intake of foodbank users | Interview; FFQ to measure past months nutrient and food intake Daily nutrient intake of base diet, food parcel and total diet estimated. Percentage of nutrients and food groups in total diet and from food parcels. Compared with USA adult DRIs and ‘Choose MyPlate’ t‐tests | NA | NA | Nutrients and energy: E, C, P, F, Sf, Uf, Tf, Ch, Fi, S, Va, Vd, Ve, Vk, Vc, Th, Ri, Ni, Vb6, Fo, Vb12, Ca, Po, Mg, Fe, Zn, Cu, Ma, Se, Na, and K Food groups: ‘choose MyPlate’ | Weight and monthly value ($) of food parcel items (per person and household) | Nutrients and energy: base diets were below DRIs for C, Fi, F and all vitamins and minerals, except Vb12 and Na, which exceeded DRIs. After food parcels, total daily diet exceeded DRIs of E, P, F, Ch, Th, Ri, Ni, Vb6, Fo, Po Vb12, Zn, Cu, Ma, Se, and Na. After food parcels, significant increases in: E, C, P, F, Ch, Fi, S, Va, Vk, Vc, Ni, Fo, Vb12, Ca, Po, Mg, Fe, Zn Se Na, and K (p < 0.05) Food parcels provided >40% of DRI for: macronutrients, E, Fi, Vc, Ri, Vb6, Vb12, Fe, Zn, Na, Po, Cu, and Se Food groups: food parcels provided >50% of whole grains, fruit, vegetable, dairy, protein, and meat portions, contributing significantly to total diet (p ≤ 0.05). Total diets lacked whole grains and dairy |
| Neter et al. (2020) 86 | Netherlands Food banks (prepackaged) | RCT | Food banks: n = 3 Food bank users: n = 163 (56 control, 28 − snacks, 25 + FV, 54 − snacks + FV) | Mean age (SD): 45.1 (10.8) years Female: 111 (68.1%) | To assess if improving the diet quality of food parcels positively impacts diet intake Intervention: crossover RCT of 10 possible sequences. Weekly provision of food parcels (control parcel,a −snacks, +FV, −snacks +FV) in two consecutive 4‐week periods | Baseline socio‐demographic questionnaire and 24‐h diet recall using USDA MPM at baseline, 4 weeks (T1)and 8 weeks (T2) Multi‐level linear regression analysis | NA | NA | Nutrients and energy: E, P, F, Sf, S, Fi, Vc, Na, and KFood groups: fruit and vegetables; grains, flour, rice; nuts, seeds, and snacks; pastry and cookies; pulses; sugar, candy, sweet filling, and sweet sauces | NA | Nutrients and energy: In +FV and −snacks + FV, mean daily C, S, fi were significantly higher, whereas F was significantly lower, compared with controls (p < 0.05). In −snacks + FV, mean daily Vc and K were significantly higher compared with controls and −snacks (p < 0.05). Food groups: mean daily intake of fruit was significantly greater in + FV and −snacks + FV interventions compared with controls. Intake of vegetables was significantly higher in −snacks + FV compared with controls Intake of pulses was significantly higher in −snacks than controls and −snacks + FV (p < 0.05) |
| Philip et al. (2018) 82 | Israel Food pantries (prepackaged) | Cross‐sectional | Food banks: n = 16 Food parcels: n = 90 Food bank users: n = 105 | Mean age (SD): 52.1 (14.5) years Female: 81 (77.1%) | To assess the nutritional quality of food parcels and the association between food parcel quality and their users’ dietary quality | Telephone survey with food bank users; staff‐reported food parcel items Based on weekly parcel provision and controlled for household size, age and gender. Compared with USA RDAs Univariate analysis; χ 2 test; t‐test; one‐way ANOVA | Nutrients: E, P, Fi, Ca, Fe, Mg, Va, Ve, Vd, Vc, Th, Ri, Ni, pa, vb6, Fo, and Vb12. Nutritional quality: HPS; NDS Food groups: fruits and vegetables | NA | Dietary quality: FFQ to devise HPS; NDS | Percentage of parcels meeting weekly household dietary requirements | Food parcel nutrition (objective 1): nutrients and energy: mean parcels provided 29.6% E, 54.9% P, and 49.9% Fi recommendations. 1.1%, 11.1%, 11.1% of parcels met household E, P, and Fi requirements, respectively. Mean parcels exceeded Va, Ri, Fo, and Vb12 recommendations, but were insufficient in Ca, Fe, Ve, Vd, Th, Ni, Pa, and Vb6. No parcels met weekly household Vd and Ca requirements Nutritional quality: mean parcel HPS and NDS were 20 (SD 20.3) and 0.3 (SD 0.3), respectively. Mean parcels provided 36.4% of recommended total portions and 14.4% of parcels met household portion guidelines Food groups: mean parcels provided 87% of recommended fruit and vegetable portions, with 25% of parcels meeting fruit and vegetable portions Food bank effectiveness (objective 2): dietary quality: food parcel nutritional quality (HPS) positively correlated with diet quality (NDS), both before and after adjusting for gender, marital status, and country of birth (Standardized: β = 0.22, p = 0.03. Overall model R 2 = 0.18, F = 4.65, p < 0.01) |
| Seligman et al. (2018) 87 | USA Food pantries (pre‐packaged) | RCT | Food banks: n = 27 Food bank users: n = 568 (285 intervention, 285 control) | Mean age (±SD): 55 (±11.4) years Female: 384 (68.3%) Condition: food bank user with HbA1c ≥7.5% | To investigate the effectiveness of a foodbank‐based diabetes intervention Intervention: diabetes self‐management education; 2× monthly food parcels Randomised into intervention or waitlist control | Participant survey and HbA1c at baseline and 6 months χ 2test; t‐test; Wilcoxon rank sums test | NA | USDA 6‐item | Food groups: fruit, vegetable, and sugar intake (California health interview survey) | Food instability; HbA1c; self‐management; satisfaction | Food insecurity: at baseline, 75.5% of participants were food insecure. Intervention participants had significant improvements in food security compared with controls (60% vs. 69.4%, RR = 0.85, 95% CI = 0.73, 0.98, p = 0.03) Food groups: intervention participants had significant increase in fruit and vegetable servings compared with controls (4.2 vs. 3.9, RD = 0.34; 95% CI = 0.34, 0.34, p = 0.04). No significant differences in sugar intake Other: food instability significantly decreased in interventions, compared with controls (54.9% vs. 70.2%, RD = 0.34; 95% CI = 0.34, 0.34, p = 0.01). No other outcomes differed; 80% preferred the food parcel compared with usual food offered |
Note: Choose MyPlate: developed by USDA to determine serving size equivalents for food groups (vegetables, fruits, refined and whole grains, milk and dairy products, beans and meat, and empty calories (solid fats, added sugars and alcohol). 59 HEI‐2010: higher scores indicate better diet quality. HEI‐2010 total score is the sum of 12 component scores. 85 HPS: adherence to “Basic Healthy Food Basket Guidelines” established by the Government of Israel's National Nutritional Security Council and Ministry of Health. These guidelines define adequate portion sizes for each of five healthy food groups (whole grains, fruits, vegetables, protein‐rich foods, fats and oils) and the recommended daily portions according to RR age and sex. HPS is a food‐based score. Division of total healthy portions by total energy is meant to account for unhealthy foods in the diet so HPS score increases as healthy portions in the diet increases but decreases with increasing total energy intake. The higher the score the higher the quality of food or diet. 82 NDS: degree to which the diet achieves the RDA for macronutrients and micronutrients, divided by the overall energy density of the food. A score of 1 indicates a food or diet that provides 100% of the RDA at the required energy intake; a score <1 indicates some degree of deficiency, and a score higher than 1 indicates possible excess. 82 Nutrient and energy outcomes key: E (energy), P (protein), C (carbohydrate), F (fat), Sf (saturated fat), Uf (unsaturated fat), Tf (trans fat), Ch (cholesterol), Fi (fibre), S (sugar), Sa (salt), K (potassium), Na (sodium) Ca (calcium), Fe (iron), Mg (magnesium), Po (phosphorus), I (iodine), Zn (zinc), Cu (copper), Se (selenium), Va (vitamin A), Ve (vitamin E), Vd (vitamin D), Vc (vitamin C), Vk (vitamin K), Th (Thiamine), Ri (Riboflavin), Ni (niacin), Ma (manganese), pa (pantothenic acid), vb6 (vitamin B6), Fo (folate), Vb12 (vitamin B12), FV (fruit and vegetables). STC‐Diet: 7‐item diet assessment for intake of: fruit/vegetables, fast food, chicken/fish/beans, chips/crackers, soda, sweets, and butter. Items are scored 1–3 and a higher score indicates better diet quality.. 84 USDA MPM: developed for collecting interviewer‐administered 24‐h recalls and includes multiple passes through the 24‐h of the previous day, during which respondents receive cues to help them remember and describe foods and drinks they consumed. Interviewers also asked participants whether the recall day was a normal day regarding dietary intake (yes/no) and a portion size photo booklet assisted in portion‐size estimation of foods and drink consumed. 86 USDA 6‐item: questions are about the food eaten in your household in the last 12 months. 83
Abbreviations: ASA24‐2014, automated self‐administered 24‐h recall version 2014 85 ; BMI, body mass index; CI, confidence interval; DRI, dietary reference intake; HEI‐2010, Healthy Eating Index‐2010; HPS, healthy portions score; NA, not applicable for the study or this systematic review; NDS, nutrient density score; RD, risk difference; RDA, recommended daily allowance; RCT, randomised controlled trial; RR, relative risk; SEM, standard error of the mean; SD, standard deviation; STC‐Diet, starting the conversion‐Diet; USDA MPM, USDA five‐step multiple‐pass method (MPM); USDA 6‐item, the United States Department of agriculture 6‐item questionnaire for food security.
Control parcel (standard food bank specific food parcel with additional non‐food items [e.g. personal care products, blanket]). −Snacks (standard food bank specific food parcel in which unhealthy snacks [e.g. chocolate, cookies, potato chips]) were replaced by staple foods (e.g. pasta, rice), with additional non‐food items (e.g. personal care products, blanket), +FV (standard food bank specific food parcel plus recommended daily amount of fruit [2] and vegetables [200 g] for all household members for 7 days), −snacks + FV (standard food bank specific food parcel in which unhealthy snacks [e.g. chocolate, cookies, potato chips]) were replaced by staple foods (e.g. pasta, rice) plus the recommended daily amount of fruit (2) and vegetables (200 g) for all household members for 7 days. 86