Out-of-home food environment and the COVID-19 pandemic: an interrupted time-series analysis in England 2019–2021

In response to the COVID-19 pandemic, the UK government introduced three waves of national lockdowns and other measures to limit the spread of the virus between 2020 and 2021. A key component of these national lockdowns required the out-of-home food sector, such as restaurants and pubs, to operate only as takeaways. The aim of this study was to investigate the impact of COVID-19 on the out-of-home food environment in England. Using monthly data collected at the local authority level between March 2019 to December 2021, we employed an interrupted time-series approach to analyze the trends of eight different types of food outlets: (1) fast food/sandwich shop; (2) pub/night club/bar; (3) restaurant/café/canteen; (4) supermarket; (5) mobile caterer; (6) other catering premise, (7) fast food chains, and (8) non-chained hot food outlets. Our findings suggest that the COVID-19 pandemic had heterogeneously impacted on different types of food outlets. After the easing of restrictions only restaurants, mobile caterers, pubs, and supermarkets grew, whereas fast food outlets and mobile caters did not. However, when looking at chained and non-chained fast food outlets, non-chained food outlets were more responsive to government policy during the pandemic such as the Eat Out To Help Out scheme, whereas after restrictions eased, chained outlets grew at a faster rate compared to their non-chained counterparts, but all fast food outlets had lower growth than before the pandemic. It is important to understand how the food environment is evolving and changing especially in relation to shocks such as the COVID-19 pandemic. The food environment has a direct and indirect impact on the economy and population health. Thus, it is of great value to understand how it is changing and when and where there is a role for government intervention.