Jenkins Rosemary H, Vamos Eszter P, Taylor-Robinson David, Millett Christopher, Laverty Anthony A
Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, Charing Cross Campus; The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK.
Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Waterhouse Building Block B, 2nd Floor, Liverpool, L69 3BX, UK.
Int J Behav Nutr Phys Act. 2021 Apr 29;18(1):57. doi: 10.1186/s12966-021-01125-8.
The 2008 Great Recession significantly impacted economies and individuals globally, with potential impacts on food systems and dietary intake. We systematically reviewed evidence on the impact of the Great Recession on individuals' dietary intake globally and whether disadvantaged individuals were disproportionately affected.
We searched seven databases and relevant grey literature through June 2020. Longitudinal quantitative studies with the 2008 recession as the exposure and any measure of dietary intake (energy intake, dietary quality, and food/macronutrient consumption) as the outcome were eligible for inclusion. Eligibility was independently assessed by two reviewers. The Newcastle Ottawa Scale was used for quality and risk of bias assessment. We undertook a random effects meta-analysis for changes in energy intake. Harvest plots were used to display and summarise study results for other outcomes. The study was registered with PROSPERO (CRD42019135864).
Forty-one studies including 2.6 million people met our inclusion criteria and were heterogenous in both methods and results. Ten studies reported energy intake, 11 dietary quality, 34 food intake, and 13 macronutrient consumption. The Great Recession was associated with a mean reduction of 103.0 cal per adult equivalent per day (95% Confidence Interval: - 132.1, - 73.9) in high-income countries (5 studies) and an increase of 105.5 cal per adult per day (95% Confidence Interval: 72.8, 138.2) in middle-income countries (2 studies) following random effects meta-analysis. We found reductions in fruit and vegetable intake. We also found reductions in intake of fast food, sugary products, and soft drinks. Impacts on macronutrients and dietary quality were inconclusive, though suggestive of a decrease in dietary quality. The Great Recession had greater impacts on dietary intake for disadvantaged individuals.
The 2008 recession was associated with diverse impacts on diets. Calorie intake decreased in high income countries but increased in middle income countries. Fruit and vegetable consumption reduced, especially for more disadvantaged individuals, which may negatively affect health. Fast food, sugary products, and soft drink consumption also decreased which may confer health benefits. Implementing effective policies to mitigate adverse nutritional changes and encourage positive changes during the COVID-19 pandemic and other major economic shocks should be prioritised.
2008年大衰退对全球经济和个人产生了重大影响，可能对食品系统和饮食摄入产生影响。我们系统地回顾了关于大衰退对全球个人饮食摄入的影响以及弱势群体是否受到不成比例影响的证据。
我们检索了七个数据库以及截至2020年6月的相关灰色文献。以2008年衰退为暴露因素、以任何饮食摄入指标（能量摄入、饮食质量以及食物/宏量营养素消费）为结果的纵向定量研究均符合纳入标准。由两名评审员独立评估纳入资格。使用纽卡斯尔渥太华量表进行质量和偏倚风险评估。我们对能量摄入的变化进行了随机效应荟萃分析。采用收获图展示和总结其他结果的研究结果。该研究已在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42019135864）注册。
41项研究（涉及260万人）符合我们的纳入标准，在方法和结果方面均存在异质性。10项研究报告了能量摄入情况，11项报告了饮食质量，34项报告了食物摄入情况，13项报告了宏量营养素消费情况。随机效应荟萃分析结果显示，在高收入国家（5项研究），大衰退与成人当量每日平均减少103.0千卡（95%置信区间：-132.1，-73.9）相关；在中等收入国家（2项研究），大衰退与成人每日平均增加105.5千卡（95%置信区间：72.8，138.2）相关。我们发现水果和蔬菜摄入量减少。我们还发现快餐、含糖产品和软饮料的摄入量减少。对宏量营养素和饮食质量的影响尚无定论，但提示饮食质量有所下降。大衰退对弱势群体的饮食摄入影响更大。
2008年衰退对饮食产生了多种影响。高收入国家的卡路里摄入量下降，而中等收入国家的卡路里摄入量增加。水果和蔬菜的消费量减少，尤其是对处境更为不利的个人而言，这可能对健康产生负面影响。快餐、含糖产品和软饮料的消费量也减少，这可能带来健康益处。应优先实施有效政策，以减轻新冠疫情大流行及其他重大经济冲击期间的不良营养变化，并鼓励积极变化。
