Changes in eating behaviors according to household income in adolescents during the COVID-19 pandemic: findings from the Korea National Health and Nutrition Examination Survey

OBJECTIVES: To assess social inequalities in changes in dietary behaviors among adolescents during the coronavirus disease 2019 (COVID-19) pandemic, we compared changes in dietary behavior indicators by household income. METHODS: Using cross-sectional data from the 2019 and 2020 Korea National Health and Nutrition Examination Survey, the prevalence of dietary behaviors in adolescents (12–18 years old) was estimated and changes in dietary behaviors during the COVID-19 pandemic were evaluated. We assessed changes in dietary behaviors with a household income (as a measure of socioeconomic status, SES) disparity. RESULTS: During the COVID-19 pandemic, the average consumption of vegetables decreased and food insecurity worsened. Adolescents were more likely to skip breakfast than before COVID-19 (33.1 and 37.4%). Soft drink consumption also increased in 2020 from 2019 (7.6 and 14.8%), especially among boys. Average sugar intake and sodium intake showed a tendency to decrease only in girls, but there was no significant difference according to SES level. Skipping breakfast was particularly evident in the low-SES group, and the difference according to household income level (high vs. low) was greater during COVID-19 than before. The prevalence of soft drink consumption increased significantly in the low-SES group, but the rate of increase did not differ by SES level. CONCLUSIONS: We found that the social disparity in skipping breakfast was further aggravated during the COVID-19 pandemic. To reach a better understanding of the dietary behaviors of adolescents, continuous monitoring is necessary.