Food-based interventions to mitigate household food insecurity in Canada: A systematic review

INTRODUCTION: Household food insecurity (HFI) is a persistent and important public health and policy concern within Canada that continues to be widespread in the face of economic uncertainties and inflation. The objective of this systematic review was to synthesize the evidence on food-based interventions that could reduce HFI in Canada. 

METHODS: Studies that assessed a food-based intervention that might reduce food insecurity and measured HFI were included, regardless of whether that was the primary purpose of the study. Four databases were searched up to 19 February 2025. Screening of abstracts and full texts, data extraction, assessments of risks of bias and certainty of the evidence were conducted independently by two reviewers. PROSPERO CRD42021254450. RESULTS: Exposure to food voucher programs may reduce HFI, but exposure to food box, community gardening, school food, hunting and fishing, and food charity programs may have little to no effect on HFI. The rate of utilization of food banks by food-insecure households may be low and depends upon food insecurity level and population group. 

CONCLUSION: Food charities may be a last resort for those in need of short-term access to emergency food (i.e. populations experiencing homelessness). However, given the pervasive nature of HFI as a marker of deprivation, it is unlikely that food-based responses will have a major impact on overall HFI, which is primarily an economic problem. A more comprehensive public policy approach to mitigate HFI is likely required. Participating in food box, community gardening, school food, hunting and fishing and food charity programs may have little to no effect on household food insecurity (HFI) (low certainty). Participating in food voucher programs may reduce HFI (low to moderate certainty). Food-insecure households’ utilization of food banks is likely low and depends on the severity of food insecurity and the population group (low to moderate certainty). The rate and frequency of food bank utilization is likely high among people experiencing homelessness and particularly youth (moderate to high certainty), but these interventions are unlikely to reduce HFI in the long term. A comprehensive public policy approach that addresses economic deprivation is likely more effective at reducing HFI (moderate certainty) than food-based interventions. eng