key: cord-0914463-2mtn10h1 authors: Theobald, Claire; White, Alex title: British Nutrition Foundation Healthy Eating Week 2020 – insights into the effect of COVID‐19 on eating and activity habits of adults and children in the UK date: 2021-06-04 journal: Nutr Bull DOI: 10.1111/nbu.12500 sha: 611568a5047baa363ac3d9527920e4423f1e2def doc_id: 914463 cord_uid: 2mtn10h1 This article provides an overview of the British Nutrition Foundation's Healthy Eating Week in 2020. Included is a summary of the Week, including resources developed, activities undertaken by participants, the results of two surveys of the impact of the COVID‐19 pandemic on the healthy eating habits and physical activity levels of children and adults in the UK and an evaluation of the Week, along with details for future plans. The British Nutrition Foundation Healthy Eating Week (BNF HEW) is an annual event, designed to bring the UK together for a dedicated Week, focussing on key health messages and promoting healthy habits (Ballam, 2016 (Ballam, , 2017 . The eighth consecutive BNF HEW was run in 2020. The Week was originally planned to take place in June 2020, but due to the COVID-19 pandemic, which resulted in a national lockdown in March 2020 and schools being closed from March until September 2020 (except to a small number of key worker children), the Week was moved to 28 September to 4 October 2020 to enable greater participation. In place of the Week in June, BNF Healthy Eating Week @ home (BNF HEW @ home) was run to support nurseries, schools, universities and workplaces during the lockdown. Given the drastic changes that were seen in the world in 2020 through the coronavirus pandemic and the subsequent impact on daily life, it was important to investigate the changes this brought about to the healthy eating and activity habits of the general public as part of this year's BNF HEW. The effects of the pandemic on perceived health were, therefore, explored through two surveys conducted as part of BNF HEW @ home and BNF HEW 2020, looking at how the healthy eating habits and physical activity levels of both children and adults had been impacted by the COVID-19 pandemic. For both BNF HEW @ home 2020 and BNF HEW 2020, there were significant differences in the way the Weeks were able to run compared with BNF HEW in previous years, which were explored through an evaluation conducted after the two Weeks. British Nutrition Foundation Healthy Eating Week gives a focal point during the school calendar to promote health and encourage children and young people to make healthier choices. As part of the Week, the British Nutrition Foundation provides nurseries, schools, universities and workplaces with engaging and relevant resources and activities, to help motivate children, young people and adults to consider, and make improvements to, their health, diet and physical activity. The Week supports health and wellbeing initiatives and whole-school approaches to food and physical activity within schools and nurseries, and supports employee or student health programmes within universities and workplaces. This article explores how the COVID-19 pandemic impacted BNF HEW in 2020 and whether there were any beneficial changes that can be carried through to subsequent years. To support schools and workplaces during the lockdown and offer something in place of the postponed BNF HEW 2020, a special, virtual event, BNF HEW @ home, ran from 22 to 28 June 2020. This enabled schools and workplaces who had scheduled the Week into their annual planning to take part in a range of activities, designed to support learning or working from home. The purpose of this was to provide useful, engaging activities that pupils and adults could use to support their health, while they were learning and working from home. A survey of 2067 UK adults was commissioned for BNF HEW @ home and was conducted by YouGov on behalf of the British Nutrition Foundation from 3 to 4 June 2020 (Figure 1 ). Over a quarter (27%) of respondents felt they had been eating less healthily during lockdown, 50% stated their habits had not changed and 22% reported they were eating more healthily than usual. Of those reporting that they were eating less healthily, 63% attributed 'boredom' and 45% attributed 'stress, anxiety and tiredness' as being one of their main reasons. With relation to activity, 32% reported that they were sitting down a lot more and 29% stated they were less active than usual (British Nutrition Foundation, 2020a) . BNF HEW @ home was resourced with a collection of materials, organised around daily themes, in the same way as the annual BNF HEW. Although there was no formal registration for BNF HEW @ home, the Week was widely promoted including on the British Nutrition Foundation's websites and social media. People of all ages were encouraged to take part in the range of health challenges at home, or in nurseries, schools, universities or workplaces, where social distancing measures allowed. The resources were available via the website (www.nutri tion.org.uk), and there was also a news article on Food -a fact of life (www.fooda facto flife.org.uk) to promote the Week. The themes for BNF HEW @ home were as follows: Eat well, Eat more wholegrains, Have 5 A DAY, Drink plenty, Move more, Be mind kind and Make a change. The resources provided included information on each of the challenges, links to supporting resources and information on Food -a fact of life and nutrition.org.uk, videos to complement and support learning around the challenges, recipes and 'cook-a-long' cooking videos. Remote home learning resources that corresponded to each of the challenges were also highlighted to further support pupils learning from home. Two cook-a-longs were made available from Monday to Friday via the Food -a fact of life YouTube channel, released as either a live stream or a pre-recorded video. In total, the ten cook-a-longs were viewed over 3000 times. Across the Week, there were a combined 53 906 users on the nutrition.org.uk and foodafactoflife. org.uk websites, with 31 750 resources downloaded. One thousand six hundred and two people viewed the 'Get cooking with BNF' page on nutrition.org.uk, and 417 people viewed the news article on Food -a fact of life. The BNF HEW @ home resources remained on the British Nutrition Foundation website and the Food -a fact of life YouTube channel throughout the year to allow them to be used whenever best suited users. The British Nutrition Foundation Healthy Eating Week took place between 28 September and 4 October 2020. The Week received 6538 registrations, 5094 of which were from nurseries and schools, representing participation from just over 1 million children and young people. This was a slight increase from the 4770 registrations from nurseries and schools received in 2019. There were 1444 registrations from universities and workplaces, representing participation from just over 300 000 adults, which was fewer than the 2173 registrations in 2019 and possibly due to the impact of workplace closures as a result of the COVID-19 pandemic. The British Nutrition Foundation was once again honoured that its Patron, HRH The Princess Royal, attended a celebratory event, at Hinckley Parks Primary, Leicestershire on 1 October 2020. The event, that followed strict and well-planned social distancing measures due to the pandemic, provided an opportunity for F I G U R E 1 A summary of the survey results from BNF Healthy Eating Week @ home [Colour figure can be viewed at wileyonlinelibrary.com] The Princess Royal to talk to children at the school and find out about their plans for the Week, including focaccia and pizza making, vegetable bingo, circuits to exercise specific body parts and tasting activities ( Figure 2 ). For 2020, seven health challenges were provided, so that it also covered the weekend for the first time. The seven health challenges for 2020 were as follows: Eat more wholegrains, Vary your veg, Drink plenty, Move more, Be mind kind, Get active together and Eat together. These challenges were chosen as they explored a range of topics, looking at not only healthy eating, hydration and activity, but also mental health and the importance this plays in our overall health and wellbeing. While the British Nutrition Foundation assigned one day of the Week to each of the seven challenges, this was not prescriptive, and the Week could be tailored to the individual needs of each organisation. Before the Week, registered schools were invited to participate in an online survey (British Nutrition Foundation, 2020b). The rationale for the survey was to gather a snapshot of the beliefs and attitudes of children and young people about eating and activity behaviours after the March 2020 lockdown; fruit and vegetable consumption; and eating and being active with others ( Figure 3 ). In total, the survey was completed by 1082 respondents, comprising 324 primary children (age 7 years upward), 405 secondary students and 352 adults, across the UK. The survey was conducted from 1 to 15 September 2020 and at the start of the Week, a press release was published outlining the results. The questions were multiple-choice and differentiated by age. The survey indicated that children reported that they felt 'more healthy', and 'more active' on returning to school than they did during lockdown. Over half (56%) of primary schoolchildren and 50% of secondary school students surveyed said that they were 'more active' back at school, with only 11% reporting to being 'less active'. Fifty per cent of primary schoolchildren and 26% of secondary school students reported feeling better or healthier back at school than during lockdown. Over a quarter of adults (27%) said they felt healthier after lockdown restrictions were eased, although almost one third (29%) of adults stated they were less active post-lockdown than before the first lockdown started in March. The survey also investigated the extent to which adults and secondary school students turned to 'comfort' foods and drinks throughout the first lockdown period. It found that 46% of adults and 43% of secondary school students reported that they had consumed more chocolate when feeling tired, stressed, bored or anxious throughout the COVID-19 outbreak. Forty-one per cent of adults and 35% of secondary school students reported that they consumed more cakes or biscuits; 33% of adults and 41% of secondary school students reported that they ate more crisps; and 13% of adults and 28% of secondary school students reported that they had drunk more sugary drinks. Thirty-five per cent of all adults reported that they consumed more alcohol when feeling tired, stressed, bored or anxious during the first lockdown. However, some were eating more healthily, with 37% of secondary students and 18% of adults reporting to eating more fruit, and 21% of secondary students and 12% of adults reporting to eating more vegetables when feeling tired, stressed, bored or anxious. Primary schoolchildren were also asked to report their three favourite vegetables, with carrots the most popular (68%), followed by beetroot (36%), cauliflower (32%) and cucumber (31%). However, 10% of primary schoolchildren and 7% of secondary school students reported that, if they could, they would eat no vegetables at all. As has been the case in previous years, a range of free resources, supporting each of the health challenges, was developed to help nurseries, schools, universities and workplaces plan, run and celebrate BNF HEW. A set of seven printed posters were sent to the first 6000 registrants and regular email updates, highlighting resources for the Week and offering ideas and tips of how to tackle the challenges, were send to registrants, both leading up to the Week and each day throughout the Week ( Figure 4 ). A range of resources was also provided to support the different audiences with the health challenges. Those for nurseries and schools were published on the Food -a fact of life and those for universities and workplaces on the www.nutri tion.org.uk website ( Figure 5 ) and were highlighted to registrants via the email newsletters. All resources were devised, so that they could be used throughout the school year, not just during Healthy Eating Week, giving greater flexibility of use. They remained on both websites throughout the year to allow nurseries, schools, universities and workplaces that were unable to run the Week in September to use them when needed. The general resources for pupils included a challenge guide (Figure 6 ), poster ( Figure 6) , icon, tracker, ideas sheet and challenge video for each of the seven challenges alongside a participation certificate, BNF HEW bunting, a series of 'tutor time activities' (presentations and worksheets). The challenge resources included a series of worksheets, activities and presentations to support the learning around each challenge theme, along with highlighted resources and recipes from elsewhere on the site that were linked to the theme. The cooking resources included a cooking video and recipe for each of the ten cooking sessions that ran during the Week (discussed in further detail in the next section). During the Week, 51 051 resources were downloaded from the Food -a fact of life website, over double the mean number of resources downloaded per week across the year (25 480), and the 10 131 resources downloaded on the first day of BNF HEW was the most on a single day throughout 2020. Overall, there were 15 891 users of the Food -a fact of life site during BNF HEW 2020. On the nutrition.org.uk website, the resources provided for universities and workplaces included a challenge poster, guide and icon, an activities ideas video for each challenge, and further links to resources on the British Nutrition Foundation website to support learning around each challenge. There were 40 613 users of the British Nutrition Foundation site, with 7034 resource downloads, during BNF HEW 2020. The combined downloads across both sites of 58 085 in 2020 were considerably more than the 10 082 downloads for the 2019 HEW. A similar number of combined users visited the two websites in 2020 (56 504 users) compared with 2019 (60 264 users). The British Nutrition Foundation worked with the Week's Official Supporters to produce a series of online cooking activities. Teachers and pupils were invited to participate in the cooking activities that were pre-recorded and released as YouTube premier videos each day. These were watched over 2000 times on YouTube, and it is estimated that at least half of the cooking session video views during the Week were a class of pupils (approximately 30), so the sessions could have been watched by around 30 000 viewers. There were also three 30-minute webinars to support the three challenges: Eat more wholegrains, Vary your veg and Eat together. The webinars highlighted the key aspects of each challenge and explored in more depth the reasons why these challenges were important. To date, these webinars have had over 1100 views on YouTube. Challenge videos were also produced for each of the seven health challenges, highlighting some of the key points from each challenge guide. These were viewed collectively over 5300 times. All webinars and cooking sessions were recorded and kept on YouTube and the Food -a fact of life website, for future use as learning resources. The British Nutrition Foundation also promoted the online training courses available on the www.nutri tion. training website and promoted the free eating well in lockdown course, which has since been updated F I G U R E 3 A summary of the survey results from BNF Healthy Eating Week [Colour figure can be viewed at wileyonlinelibrary.com] to the keeping well at home course (British Nutrition Foundation, 2020c). BNF HEW received coverage at a regional and national level. Print coverage included mentions in The Times, The Daily Telegraph and The Daily Star. BNF HEW 2020 achieved coverage with a combined print and online circulation of 13 146 900 and a total estimated audience of 41 760 680. The media relations programme that achieved this coverage included a launch press release and the development of an embargoed press release (British Nutrition Foundation, 2020a), which revealed the results of the BNF HEW survey mentioned above. However, the coverage was less than that achieved by BNF HEW 2019, which had a total media coverage circulation of 28 320 938 and a total estimated reach of 78 863 122. This probably reflects the amount of coverage dominated by the pandemic in 2020. Nurseries, schools, universities and workplaces also engaged with BNF HEW via social media, with Twitter the main site used, sharing how they were completing the challenges and inspiring others with their achievements. This year, the British Nutrition Foundation produced a social media messaging guide, providing ideas for tweets and daily messages for the Week's participants to share via their social media platforms and websites. Tweets were promoted on Twitter through @Foodafactoflife and @BNFEvents using the hashtag #BNFHEW20. Compared with the start of the academic year (w/c 7 September 2020), during BNF HEW (28 September -4 October 2020), there was a 408% increase in likes and a 537% increase in retweets on the @BNFEvents Twitter page and a 254% increase in likes and a 237% increase in retweets on the @Foodafactoflife Twitter page. After BNF HEW 2020, all participants were invited to provide feedback via an online survey. One hundred and seventeen responses were received from nurseries and schools, and 107 responses were received from universities and workplaces. This figure was lower than in previous years, with the lower survey engagement possibly due to the pandemic and pressures faced by schools and workplaces. Overall, 91% of nurseries and schools and 88% of universities and workplaces responded that they were likely to take part in BNF HEW next year. When asked to rate the satisfaction with the resources available for BNF HEW, 80% of nurseries and schools, and 82% of universities and workplaces responded that they were satisfied or very satisfied with the resources provided. The three health challenges that were reported to be most commonly covered by respondents, across both surveys, were as follows: Drink plenty, Vary your veg and Move more. In nurseries and schools, the most common activities undertaken during the week were physical activity sessions, providing vegetables to pupils and healthy eating sessions. In universities and workplaces, the most common activities were physical activity and healthy eating sessions. When asked for the highlights from the Week, overall, responses from universities and workplaces were positive and participants enjoyed the resources, particularly the posters. People also mentioned one or more specific health challenge that they enjoyed, with the most common being the Vary your veg and Be mind kind challenges. A few people had issues relating to COVID-19, particularly the restrictions of working from home, but overall the responses were positive and wide-ranging. In response to the same question, teachers often cited pupils' engagement with and enjoyment of the Week, along with the resources, posters and assemblies. The activities and challenge themes were also reported to be widely enjoyed, with particular emphasis given to the Vary your veg and Move more challenges. A number of organisations reported that the planning and running of the Week were impacted by the restrictions placed upon them by the COVID-19 pandemic, with only 17% of nurseries and schools and 21% of universities and workplaces reporting that they were able to continue as originally planned. The most cited reasons for not being able to run the Week as planned were, for schools, reduced activity sessions due to social distancing measures (55%) and not being able to cook/run tasting sessions (48%), and for universities and workplaces, reduced time to carry out the activities (47%) and staff working from home (29%). In 2020, the COVID-19 pandemic meant that the Week was run differently, with teachers reporting that there were unique challenges that reduced the opportunities for running the physical activity and practical activities. For many organisations, 2020 would have been the first BNF HEW with their employees working from home and there was an added pressure reported by many organisations that there was less time to carry out the activities. For schools, the majority of pupils were working from home for HEW @ home and even by September and BNF HEW 2020, many schools reported additional barriers brought on by the COVID-19 pandemic that impacted the way the Week was run. However, despite these difficulties, more schools took part in the week and downloaded more resources than in 2019. Time will tell whether these differences will continue moving forwards for 2021, but BNF HEW will continue to run in whatever capacity it is able to. The British Nutrition Foundation is proud to run BNF HEW, which provides a platform to promote and celebrate healthy lifestyles. The Week has become a focal point during the year for nurseries, schools, universities and workplaces to promote health. Our ambition is to work with more organisations and extend the Week further in 2021, despite the continuing pandemic. BNF HEW 2021 will run from 14 to 18 June 2021. The authors received no direct financial contribution towards the production of this article. Funding to support the British Nutrition Foundation's charitable aims and objectives comes from a range of sources including membership, donations and project grants from food producers and manufacturers, retailers and food service companies. Further information about the British Nutrition Foundation's activities and funding can be found at www.nutrition.org.uk/aboutbnf/ ORC I D Alex White https://orcid.org/0000-0001-9098-4602 British nutrition foundation healthy eating week 2016 British nutrition foundation healthy eating week 2017 Many children feel healthier and are more active since the return to school BNF survey reveals stress, anxiety, tiredness and boredom are the main causes of unhealthy eating habits in lockdown Keeping well at home British Nutrition Foundation Healthy Eating Week 2020 -insights into the effect of COVID-19 on eating and activity habits of adults and children in the UK BNF HEW 2020 was developed by the British Nutrition Foundation and supported by the Agriculture & Horticulture Development Board (AHDB), Quorn Foods, Asda, Nestlé Cereals, Old El Paso, innocent drinks and Waitrose & Partners. This support enabled the British Nutrition Foundation to provide free printed resources to schools, as well as create and develop other online materials and activities freely available during the BNF HEW. The British Nutrition Foundation was grateful for the advice received from the Charlie Waller Trust on the Be mind kind challenge.