Peer-reviewed article

Single-mother households and risk of poor dietary quality among schoolchildren: results from a nationwide survey.

Rahman N, Takahashi YK, Ishitsuka K, Piedvache A, Sampei M et al. · 28 Jul 2026

Abstract

Background The COVID-19 pandemic prompted lifestyle changes and increased parental stress and food insecurity, raising concern for single-parent households. This study investigates disparities in schoolchildren's diet quality in single-parent and two-parent households in Japan before, during and after the April 2020 state of emergency, considering financial status and parental meal preparation skills. Methods Data from a nationwide cross-sectional study conducted in December 2020 were analysed. A stratified two-stage cluster sampling design was used to select households with fifth-grade and eighth-grade students. Parents reported their child's dietary intake before, during and after the state of emergency and their knowledge about food. 'Poor dietary quality' was defined as failing to consume any of the following food categories at least twice a day: 'milk and dairy products', 'meat, fish or eggs', 'vegetables' and 'fruits'. Multilevel modified Poisson models were used to estimate prevalence risk ratios and differences in dietary quality. Results Among 1534 parents, single-mother households exhibited higher risk of poor dietary quality during and after the state of emergency (univariate prevalence differences 13.4% (95% CI 3.5% to 23.2%) and 8.3% (95% CI 1.8% to 14.8%), respectively) compared with two-parent households. This difference persisted after adjusting for child sex and grade but substantially diminished after accounting for food literacy and financial status. No significant increase was observed in single-father households. Conclusion Single-mother households, marked by lower food literacy and income, experience a higher prevalence of poor dietary quality. Targeted support is crucial to improve diet quality in single-mother households compared with their two-parent counterparts.