The International Food Information Council (IFIC) is keenly interested in public perceptions of topics related to health, nutrition, food safety, and agriculture. IFIC's signature consumer research effort, the annual Food & Health Survey, has captured the opinions, behaviors, and beliefs of the American population on these topics since 2006.
Although there have been other notable shifts in the consumer landscape for the past 16 years, the COVID-19 pandemic has created a universally significant disruption to American lifestyles, including our behaviors and perspectives around food. This article offers an overview of the results of the 2021 Food & Health Survey,1 conducted in the shadow of a global pandemic, and aims to assess both general consumer trends and how COVID-19 has shaped the way we think about our food choices.
METHODS
The 2021 IFIC Food & Health Survey was conducted online between March 23 and March 31, among 1014 Americans, ages 18 to 80 years. Results of this and previous surveys were weighted to ensure that they are reflective of the American public as seen in the most recent US Census Bureau and the US Bureau of Labor Statistics' Current Population Survey2 available at the time of survey fielding (ie, weighting in the 2021 Food & Health Survey was based on the 2020 Current Population Survey). Specifically, results were weighted by age, education, gender, race/ethnicity, and region.
RESULTS
Eating and Shopping Habits in the Wake of COVID-19
The 2020 Food & Health Survey3 and 2021 Food & Health Survey1 were fielded during the COVID-19 global pandemic, which provided an opportunity to capture self-reported changes in food-related behaviors that have accompanied this massively disruptive period. Although it is clear that most Americans are still experiencing shake-ups to their prepandemic behaviors, a pull back toward "normalcy" may be occurring. Marking a shift in behaviors compared with the onset of the pandemic in spring 2020, the overall percentage of people who reported a COVID-19-related change in their eating and food preparation patterns in 2021 was lower than in 2020 (72% vs 85%, respectively). This finding is reflected in the fact that fewer people reported changes to many specific food-related behaviors in the 2021 Survey compared with the 2020 Survey, including cooking at home more frequently (47% in 2021 vs 60% in 2020), snacking more (18% vs 32%), washing fresh produce more (22% vs 30%), and thinking about food more often (13% vs 27%). At the same time, the percentage reporting behaviors such as eating healthier than usual (20% vs 22%) and getting more meals delivered/picking up take-out (14% in both years) remained stable between 2020 and 2021.
Even in the face of changes to everyday life necessitated by the pandemic, public interest in ascribing to specific diet trends and eating patterns remains high. In 2021, 39% reported that they had followed a specific eating pattern or diet within the past year, which was not statistically significantly different from those who said the same in the 2020 Survey (43%). In 2021, the most frequently reported diets or eating patterns were "calorie counting" (10% of survey participants), "clean eating" (9%), and "intermittent fasting" (8%). Evidence-based diets such as the Mediterranean diet and Dietary Approaches to Stop Hypertension diet were not as commonly followed (4% and 2%, respectively). Reports of following a "ketogenic or high-fat diet" decreased from 2020 (5% vs 8%).
Snacking Trends
Self-reported snacking frequency was steady from 2020 to 2021, with nearly 6 of 10 (58%) reporting that they snack at least once per day. Favorite times of day for a snack are late afternoon (3-5 PM) and late evening (8-11 PM). Nearly half of survey respondents said they reach for a snack during these periods (47% and 46%, respectively). Overall, even more so than seeking nutritional benefits, snacking seems to be driven by the desire to satisfy hunger or thirst, wanting a treat, or wanting something salty or sweet.
Snacking habits vary greatly by age. Younger people are more likely to snack throughout the day. In comparison with those 65 years and older, people younger than 35 years are more than twice as likely to snack in the late morning/early afternoon, 6 times more likely in the early morning, and 10 times more likely late at night. Thirty-seven percent of this youngest age group report snacking after 11 PM.
In the 2021 Survey, participants were not given a definition for a "snack." Instead, they were asked how they differentiate snacks from meals. The most common way that a differentiation is made is by time of day, with nearly one-third (32%) agreeing that meals are eaten at a particular time of day and eating in between those times is considered a snack. For many, food type is another important element in differentiating between meals and snacks. More than one-fifth (22%) of survey participants viewed some foods inherently as snacks, whereas others are considered meals. However, the caloric content seems to be less relevant than the amount of food. Whereas 1 in 5 (20%) said that quantity of food is a determining factor, fewer (5%) indicated that they use the number of calories consumed to decide whether something is a meal or a snack.
Consumption of Select Nutrients and Sweeteners
The IFIC Food & Health Survey offers a look at how eating habits evolve over time by inquiring about consumption patterns of certain foods, food components, and nutrients. Sources of protein have undergone notable changes in terms of public interest, consumption, and the variety of products available. In 2021, more than 6 in 10 (62%) said they try to consume protein in their diet and nearly 1 in 4 (24%) reported eating a greater amount of protein from plant sources than they did the year before. Similar percentages said they are eating more seafood (23%) and more poultry/eggs (22%); however, a higher percentage (28%) reported eating more poultry/eggs in 2020. Compared with 2020, fewer people said they are eating less red meat for the past year (26% vs 32% in 2020).
More than half of 2021 Survey participants reported that they try to consume fiber (56%), vitamin D (56%), and calcium (52%). Whereas fiber and calcium are more often sought from foods than from beverages or supplements, dietary supplements are on par with foods as the most commonly reported sources of vitamin D. These findings are supportive of recent data from the National Center for Health Statistics, which showed that vitamin D is the second most common dietary supplement used by adults in the United States, trailing only a multivitamin.4 National Center for Health Statistics data also found that calcium ranks as the fifth most common type of supplement used by US adults ages 40 to 59 years and is the fourth most common in those 60 years and older.
Turning next to trends in dietary sweeteners, consumption of added sugars has declined during the last 2 decades, but current intake remains higher than recommended.5 In the 2021 Survey, 72% reported trying to limit or avoid sugars in their diet, down from a peak of 80% in 2019 (Table 1). Since 2017, the Food & Health Survey has shown that people take several actions to limit or avoid sugars, with "drinking water instead of caloric beverages" consistently being the top strategy.1,3,6-8
Although reducing added sugar consumption is a common dietary goal and low/no-calorie sweeteners provide sweetness without sugar, fewer people in the 2021 Survey reported a preference for low/no-calorie sweeteners (23%) than reported a preference for sugar (28%). Recent Food & Health Surveys have also found that low/no-calorie sweeteners were less likely than sugar to be used to sweeten a food or beverage.1,3,6-8 One potential factor involved may be low awareness of the US Food and Drug Administration's role in reviewing the safety data on low/no-calorie sweeteners for use in the US food supply. In the 2021 Survey, more than one-third were unsure or said that no US authority is responsible for reviewing the safety of low-calorie sweeteners (25% and 8%, respectively) and 29% said that safety review is the responsibility of food and beverage companies/manufacturers, whereas only 31% said it was the US government's responsibility. It is plausible that increasing knowledge and understanding of the rigorous safety review process undertaken by the US Food and Drug Administration for these ingredients may reduce public concerns about the safety of low/no-calorie sweeteners.
Eating for Health Benefits
Food contributes to our well-being in countless ways, including physical health. Yet, some people are more intentional about their food choices than others. In 2021, 1 in 5 respondents (20%) reported actively seeking health benefits from foods, whereas the majority (60%) said they try to eat healthy without seeking specific health benefits. Health benefits are not a factor in food choice for approximately 1 in 10 (12%).
Nearly three-quarters of survey participants selected at least 1 health benefit that they seek from foods or nutrients, with the most commonly selected top choices being weight loss/weight management (22%), energy/less fatigue (14%), heart/cardiovascular health (11%), and digestive health (10%) (Figure 1). The high priority placed on weight loss and/or weight management has consistently been reported in the Food & Health Survey since 2016.1,3,6-9
The COVID-19 pandemic has led many people to consider the role of lifestyle factors, such as diet, on overall health and disease risk. For this reason, it may not be surprising that most 2021 Food & Health Survey participants (66%) were interested in learning more about how food and nutrients impact immune health. Indeed, throughout the pandemic, many Americans have been looking for foods or specific ingredients to help support immunity.10 However, of those who seek health benefits from food, only 5% selected "immune function" as their top benefit (Figure 1).
Shifts in Shopping Behaviors
One of the most notable changes accelerated by the COVID-19 pandemic is the rise in online grocery shopping. In the 2021 Food & Health Survey, 42% said they shop online for groceries at least monthly (up from 33% in 2020 and 27% in 2019). Similarly, 20% reported shopping online at least weekly (vs 11% in 2020 and 13% in 2019). Younger consumers, African Americans, and parents, in particular, tend to grocery shop online more frequently than others. Similar observations have been consistently and extensively noted in reports from both IFIC and other consumer insights groups.11-13
COVID-19 Concerns: Food Safety and Food Access
When the 2021 Food & Health Survey was fielded in March 2021, cases of COVID-19 were precipitously declining in the United States from their peak in January 2021.14 Even so, nearly 4 in 10 participants remained concerned about COVID-19 exposure while shopping in person at the grocery store (39% concerned) and from cooks and chefs at restaurants (37% concerned). Less concern was reported about exposure from farmers and food manufacturers who produce the food we buy (28% concerned). Concerns were disproportionately present among different subpopulation groups. African Americans were more likely than non-Hispanic Whites, and parents with children younger than 18 years were more likely than those without, to be concerned about being exposed to COVID-19 in all 3 previous scenarios.
In addition to worries about COVID-19 exposure in food settings, food access was top-of-mind for many. Survey participants who were African American, between the ages of 18 and 34 years, and those with an annual household income of less than $75 000 were more likely than their counterparts to agree with statements such as "I have purchased less healthy food options than I would otherwise because I don't have enough money to purchase healthier food options" and "I have delayed purchasing food or purchased less food because of other expenses like rent or utility bills," although overall agreement with both statements was significantly less than in 2018's Food & Health Survey.6 However, in contrast to these overall results, African Americans reported increased incidence of each of these markers of food insecurity compared with 2018.
Of those who had often or sometimes experienced markers of food insecurity during the past year, 3 in 4 (75%) reported that COVID-19 contributed somewhat or significantly to the food insecurity they faced.
Knowledge and Use of the Dietary Guidelines for Americans and MyPlate
A wealth of evidence-based nutrition and health information stems from the Department of Health and Human Services and the US Department of Agriculture (USDA) related to the Dietary Guidelines for Americans (DGA).5 Published every 5 years since 1980, the DGA is widely available and free to access. In 2011, the USDA unveiled MyPlate to help Americans visualize and build healthy meals that align with DGA recommendations. Although diet quality in the United States has shown signs of improvement during the last decade, adherence to DGA recommendations remains low.5
The IFIC Food & Health Survey has assessed familiarity with the DGA in 2010, 2020, and 2021.1,3,15 In 2021, nearly half of all respondents (46%) reported knowing "a lot" or "a fair amount" about the DGA, a significant increase from 2020 (41%) and a 2-fold increase since 2010 (23%). Compared with older generations, younger adults are more familiar with the DGA in 2021-59% of those ages 18 to 34 years reported that they know "a lot" or "a fair amount" about them. A similar percentage (59%) of parents with children younger than 18 years also reported this level of DGA knowledge.
An important question to consider is whether familiarity with the DGA influences the likelihood of meeting its recommendations. The 2021 Food & Health Survey results identify a correlation between knowledge of the DGA and the promotion of healthy habits and choices. In fact, roughly half of those surveyed (53%) who reported ease with figuring out which foods are healthy also reported knowing "a lot" or "a fair amount" about the DGA versus one-third of the survey participants who reported knowing "very little" or have "never heard" of the DGA. Awareness of how to eat healthy is one of the most cited benefits that knowledge of the DGA helps people achieve, with adults ages 65 to 80 years being more likely to report this than their younger counterparts (78% vs 55%).
The IFIC Food & Health Survey has tracked familiarity with USDA's MyPlate graphic each year since 2016 (Table 2).1,3,6-9 Recognition of the MyPlate graphic remained steady from 2016 to 2021, with 37% and 41% saying they know "a lot" or "a fair amount" about it, respectively. In 2021, certain population subgroups reported greater recognition, including younger adults and parents with children younger than 18 years.
Motivators of Food Purchases
Understanding food and beverage purchase motivations has been a goal of IFIC's Food & Health Survey since it was first conducted in 2006. Every year since its inception, the Survey has asked participants to rank the impact of "convenience," "healthfulness," "price," and "taste" on their food and beverage purchasing decisions. In the 2011 Survey,16 "sustainability" was added as a fifth factor to consider. Although the percentage reported for each factor has fluctuated from year to year, "taste" has been the leading purchase driver since 2006, followed by "price," "healthfulness," and "convenience" (Figure 2). However, compared with 2020, significantly fewer people indicated that taste greatly impacted their purchasing decisions in 2021 (82% vs 88% in 2020).
Sustainability is a widely discussed issue in many facets of American life, and yet, "sustainability" has consistently ranked at the bottom of the list of food and beverage purchase drivers since its inclusion in 2011. In the 2019 Survey,8 "sustainability" was modified to "environmental sustainability," with no effect on the rank order. In 2019, 27% reported that environmental sustainability greatly impacted their purchasing decisions; this increased to 34% in 2020. No statistically significant difference was observed between 2020 and 2021 (31%).
Label Descriptions and Perceptions of Healthfulness
Food and beverage labels provide an ever-increasing amount of information on nutritional content, ingredients, and manufacturing practices. For many, labeling is an important part of the decision-making process for foods and beverages: roughly half of 2021 Survey participants often or always pay close attention to labels whether shopping in person (52%) or online (46%). These descriptions on packaging can be highly influential on perceptions of healthfulness. When presented with a scenario in which 2 products are nutritionally identical but differ in their descriptive labels, more people perceive products to be less healthy if they are described as a "bioengineered food/containing bioengineered ingredients" (compared with those that are not labeled as such) or contain artificial ingredients (Figure 3). Conversely, a product with a label description of "all-natural," "plant-based food," "having a small carbon footprint," or having "clean ingredients" is considered healthier than a product that does not share this information on its label.
Defining "Healthy"
"Healthy" is often a subjective term, and the application of its meaning to individual foods may differ from healthy eating patterns. Survey participants were asked how they define a "healthy food" and a "healthy eating pattern" in the 2016 and 2021 Food & Health Surveys. In 2016, perceptions of what constitutes a "healthy food" took on a somewhat negative tone, primarily identified as foods featuring the absence of certain components, such as fat or sugar.6 In 2021, the definition of a "healthy food" swung in a more positive direction, characterized more frequently by the presence of certain items such as fruits, vegetables, and specific nutrients (27% in 2021 up from 17% in 2016) and the food being "good for you" (25% in 2021 vs 18% in 2016). Overall, the 2021 Survey found that a "healthy eating pattern" is most defined by 3 attributes: "eating appropriate portion sizes at each meal," "avoiding processed foods," and "the right mix of different foods."
Food Production Methods
The Food & Health Survey also gives American consumers an opportunity to share opinions on food production methods and their influence on food and beverage purchase decisions. In the 2021 Survey, more than 4 in 10 reported it was important for them to know that the food they purchase was produced with animal welfare in mind (45%), whether the food or its ingredients are bioengineered (43%), that the food was produced using farming technologies to reduce the impact on natural resources (40%), and that the food manufacturer has a commitment to reducing their carbon footprint (41%). The importance of these factors was viewed differently by certain demographics. For example, women were more likely than men to consider animal welfare and whether food or its ingredients are bioengineered to be important. Those with household incomes higher than $35 000 per year viewed animal welfare, whether a food or its ingredients are bioengineered, and farming technologies that reduced impact on natural resources as important. African Americans and parents with children younger than 18 years were more likely to say that all 4 factors were important.
Environmental and Social Sustainability
With connections between personal and planetary health becoming more prominent, many consumers believe that their individual food and beverage purchases impact the environment. Approximately 4 in 10 (42%) in the 2021 Survey felt that their choices have either a moderate or significant impact on the environment, and slightly more than half (53%) agreed that if it were easier to understand the actual environmental impact of their food choices, it would have a greater influence on the choices they make. Those who believed that their individual choices impact the environment also perceived certain foods and beverages to be more detrimental than others (Figure 4). For example, survey participants believed that meat and poultry have the most negative impact on the environment, followed by bottled beverages, seafood, frozen foods, and dairy. Other food items such as grains, nuts/seeds, and protein from plant sources are perceived to have a gentler impact on the environment.
For the first time, the 2021 Food & Health Survey included questions about elements of social sustainability (defined in the Survey as "fair and equitable treatment of food workers"). Nearly 6 in 10 (59%) said that it is important that the foods they purchase or consume are produced in ways that are committed to treating food workers fairly and equitably. For those who said that this was important to them, ease of finding information on the issue was mixed: 44% said that information on the fair and equitable treatment of workers was at least somewhat easy to find, whereas 48% said it was at least somewhat difficult. Parents, African Americans, people with a college degree, and those who made an effort on social/food issues in 2020 place more importance on the fair and equitable treatment of workers; these groups also reported that it is easier to find information on this topic compared with their counterparts.
CONCLUSION
The results of the 2021 Food & Health Survey demonstrate both shifts in the consumer landscape and consistencies holding fast for the past 16 years. This work also offers a glimpse into how the COVID-19 pandemic has impacted consumer perspectives and behaviors when it comes to food. Although some aspects of life may be pulling back toward prepandemic patterns, it is clear that others-such as protein consumption and online shopping-are rapidly changing.
Results from the 2021 Survey and those conducted in previous years can be helpful for food and nutrition professionals to understand past and present knowledge, sentiments, and the influence of various factors on food and beverage purchasing and consumption decisions in the United States. Future IFIC Food & Health Surveys will continue to capture insights and document the evolution of American food opinions, behaviors, and beliefs. Along with consumer-friendly information and resources for health professionals, IFIC's consumer research findings can be accessed free of charge at http://foodinsight.org.
REFERENCES