Changes in Dietary Behaviours during the COVID-19 Outbreak Confinement in the Spanish COVIDiet Study

A study of diet in older community-dwelling adults in the UK during the COVID-19 pandemic: Findings from the Southampton Longitudinal Study of Ageing (SaLSA)

Introduction

Adequate nutrition is important for health in later life. Older adults are especially vulnerable to adverse outcomes following infection by COVID-19 and have commonly spent a disproportionate time within their own homes to reduce risk of infection. There are concerns that advice to shield may have led to malnutrition as older adults may modify daily routines including usual shopping habits. The aims of this study were to report self-reported pandemic-related changes in diet and examine lifestyle and medical correlates of these changes in older UK community-dwelling adults.

Methods

We recruited 491 participants from the city of Southampton, UK. Participants completed a postal questionnaire in summer/autumn 2021, over a year after the first UK national lockdown was announced. The questionnaire ascertained demographic and lifestyle factors, in addition to number of comorbidities, nutrition risk scores, and presence of frailty. Associations between these participant characteristics in relation to self-reported changes in diet quality (lower, similar or higher when compared to before the first lockdown) were examined using ordinal logistic regression.

Results

Median (lower quartile, upper quartile) age was 79.8 (77.0, 83.7) years. Overall, 11 (4.9%) men and 25 (9.4%) women had poorer diet quality compared to before the first UK lockdown. The following participant characteristics were associated with increased risk of being in a worse category for change in diet quality after adjustment for sex: lower educational attainment (p = 0.009); higher BMI (p < 0.001); higher DETERMINE (a malnutrition assessment) score (p = 0.004); higher SARC-F score (p = 0.013); and self-reported exhaustion in the previous week on at least 3 days (p = 0.002).

Conclusions

Individuals at higher nutritional risk were identified as reporting increased risk of deterioration in diet quality during the pandemic. Further investigation of the factors leading to these changes, and an understanding of whether they are reversible will be important, especially for future pandemic management.

The Medium-Term Changes in Health-Related Behaviours among Spanish Older People Lifestyles during Covid-19 Lockdown

OBJECTIVES

The aim was to evaluate general changes and investigate the association between diet quality, physical activity (PA), and sedentary time (ST) during COVID-19 lockdown and the subsequent 7-month changes in health-related behaviours and lifestyles in older people.

PARTICIPANTS

1092 participants (67-97y) from two Spanish cohorts were included.

DESIGN

Telephone-based questionaries were used to evaluate health-related behaviours and lifestyle. Multinomial logistic regression analyses with diet quality, PA, and ST during lockdown as predictors for health-related behaviours changes post-lockdown were applied.

RESULTS

Diet quality, PA, and ST significantly improved post-lockdown, while physical component score of the SF-12 worsened. Participants with a low diet quality during lockdown had higher worsening of post-lockdown ST and anxiety; whereas those with high diet quality showed less likelihood of remaining abstainers, worsening weight, and improving PA. Lower ST was associated with a higher likelihood of remaining abstainers, and worsening weight and improving social contact; nevertheless, higher ST was linked to improvement in sleep quality. Lower PA was more likely to decrease alcohol consumption, while higher PA showed the opposite. However, PA was more likely to be associated to remain abstainers.

CONCLUSIONS

Despite improvements in lifestyle after lockdown, it had health consequences for older people. Particularly, lower ST during lockdown seemed to provide the most medium-term remarkable lifestyle improvements.

Changes in home cooking and culinary practices among the French population during the COVID-19 lockdown

In March 2020, the COVID-19 pandemic led to a strict lockdown in France for 2 months, drastically changing the daily life of the population. We investigated changes in perceived diet quality and cooking practices during the lockdown in comparison with the preceding period. Between June 9 and 30, 2020, 2422 participants were recruited and completed a questionnaire regarding the evolution of their overall diet and cooking habits during the lockdown. Descriptive analyses showed that 41.5% of participants described dietary changes with a similar proportion reporting positive or negative changes (22.0% and 19.5%, respectively). The exceptional circumstances of the lockdown provided a positive opportunity for some people to improve their diet quality by spending more time cooking (54.8% of those reporting a positive change) or eating more fresh products, including fruits and vegetables (47.4%). By contrast, other participants reported a decline in their diet quality, mainly caused by poorer dietary choices due to the consumption of comfort food (50.3% of those reporting a negative change), snacking (40.1%), or food supply issues (35.9%). The lockdown led to a massive rise in home cooking with 42.0% of all participants cooking more frequently (vs 7.0% cooking less), as barriers such as time constraints were reduced. Using multivariate analyses, we found that this change in cooking frequency varied among population subgroups, especially in regard to financial situation, as individuals in financial difficulty tended to cook less. As home cooking has already been linked to better diet quality and thus health status, our results suggest that the lockdown increased social health inequalities. An adequate public health response is therefore needed to support nutritionally vulnerable populations.

Dietary Patterns and Changes in Weight Status Among Chinese Men and Women During the COVID-19 Pandemic

Aims: To identify dietary patterns during the coronavirus disease-2019 (COVID-19) pandemic and to examine their association with changes in weight status in the Chinese population.

Methods: The 2020 China COVID-19 cross-sectional survey is an anonymous 74-item survey administered via social media across 31 provinces in mainland China between April and May 2020. Dietary data were assessed by a Food Frequency Questionnaire and the changes in weight status were self-reported. Exploratory factor analysis using the principal component analysis method was applied to identify dietary patterns. The multinomial regression models were conducted, and forest plots were used to present the associations between dietary patterns and changes in weight status.

Results: Of a total of 10,545 adults (aged ≥18 years), more than half of participants reported to have weight gain, with 18.6% of men and 16.3% of women having weight gain >2.5 kg. Approximately 8% of participants reported to have weight loss, with 2.1% of men and 2.5% women having weight loss >2.5 kg. Two dietary patterns, namely, the modern and prudent dietary patterns, were identified during the COVID-19 pandemic. The modern dietary pattern was loaded heavily with soft drinks, fried foods, pickles, and inversely with fresh vegetables. The prudent dietary pattern was characterized by high intake of fresh fruits, vegetables, and inversely with soft drinks and fried food. The modern dietary pattern was positively associated with weight gain in men and women, while the prudent dietary pattern was negatively associated with both weight gain and loss in men and women during the COVID-19 pandemic.

Conclusion: Dietary patterns during COVID-19 are significantly associated with the changes in weight status, which may subsequently increase the risk of diet-related non-communicable disease among the Chinese population.

Impact of Nationwide Lockdowns Resulting from The First Wave of the COVID-19 Pandemic on Food Intake, Eating Behaviours and Diet Quality: A Systematic Review

The lockdowns resulting from the first wave of the COVID-19 pandemic impacted deeply on all life activities, including diet. We performed a systematic review to investigate changes in food intake, eating behaviours and diet quality during lockdown as compared to before. A literature search was performed using three electronic databases from inception until June 13, 2021. Observational studies evaluating changes in general populations during the COVID-19 pandemic lockdown were eligible. Out of 1,963 studies achieved from the search strategy, 95 met inclusion criteria (85 on adults, 10 on children/adolescents), and the majority were of high quality (72.6%). Most of the studies were web-based surveys using convenience sampling, mainly focused on variations in the consumption of foods and eating behaviours during lockdown, whereas only 15 studies analysed diet quality through dietary indices. On the basis of the definition of a healthful diet as reflected by a traditional Mediterranean diet, an increase in recommended foods such as fruit and vegetables, legumes, cereals and olive oil was observed, although a sharp decrease in fish intake and an increase in dairy products were documented. Accordingly, a reduction in foods that should be eaten less frequently was reported, namely, red and processed meat. However, a higher consumption of unhealthy foods (e.g., snacks and sweets) was also observed. Results indicated improved diet quality in Europe, especially among Mediterranean countries, with the exception of France, while a switching to poor nutrient patterns was observed in Colombia and Saudi Arabia. Analyses of eating behaviours suggest an increase in food intake, number of daily meals and snacking. In conclusion, changes in intake of major food groups, apart from fish intake, were in line with the definition of a traditional Mediterranean diet, indicating a consistent moderate improvement of dietary habits worldwide. This review protocol was registered at https://www.crd.york.ac.uk/prospero/ as CRD42020225292.

Association between positive psychological traits and changes in dietary behaviour related to first COVID-19 lockdown: A general population-based study

Background

The spread of the coronavirus disease (COVID-19) led many countries to implement lockdown measures, which resulted in changes in dietary behaviours that could persist over the long term and have associated health consequences. Psychological traits may impact these changes given their known association with dietary behaviours. We aimed to investigate in a population-based study, whether positive psychological traits were associated with changes of snacking behaviour and food consumption observed during the first COVID-19 lockdown period.

Design

In 2016, levels of optimism, resilience, self-esteem, satisfaction with life, mindfulness and mastery were assessed in 33,766 adults of the French NutriNet-Santé cohort. Snacking and food group consumption were assessed in April–May 2020. Association between psychological traits and changes (no change, increase, decrease) in snacking and food group consumption were assessed using logistic regressions. Multiple correspondence analysis followed by ascending hierarchical classification were used to derive clusters of dietary behaviours. Covariance analyses were used to compare mean scores of psychological traits between clusters. Analyses were adjusted for sociodemographic and lifestyle characteristics, anxiety and depressive symptomatology.

Results

Participants with higher levels of optimism, resilience, self-esteem, satisfaction with life, mindfulness or mastery were less likely to change their snacking behaviour and food group consumption of various food groups. Individuals with lower levels were more likely to make changes, with either unhealthy (e.g., less fruits and vegetables, more processed meat) or healthy (e.g., more pasta/rice (whole-grain)) changes. Overall, individuals showed higher levels of positive psychological traits in the “no change” cluster, followed by the “healthy” and the “unhealthy” cluster (all P < 0.05).

Conclusions

Individuals with higher levels of optimism, resilience, self-esteem, satisfaction with life, mindfulness or mastery were less impacted by the lockdown in terms of dietary behaviours.

Changes in Eating Habits and Physical Activity after COVID-19 Pandemic Lockdowns in Italy

The introduction of lockdowns and other containment measures during the COVID-19 pandemic substantially altered people’s lifestyle and dietary behavior. Several studies evaluated the short-term effects of these measures; yet reports on long-term consequences are scarce. We sought to address this gap in the literature by analyzing dietary and lifestyle data collected at an obesity center in Rome, Italy. The Italian region of Lazio was hit hard by the pandemic. To evaluate the potential health impacts, we compared the pre- and post-lockdown data of 118 individuals. Contrary to the common belief that lockdown had adverse effects solely on people’s dietary habits, we observed a significantly increased consumption of raw vegetables, whole grains, and water in our study sample. Favorable effects, however, were also accompanied by adverse trends, such as a higher prevalence of sleeping difficulties. Our data emphasize that the lockdowns associated with the pandemic also influenced participants’ social behavior, with less individuals reporting eating out or in company. Our study highlights the substantial impact of lockdowns on many dimensions of life. As such, it is of utmost importance in the critical evaluation of such stringent containment measures.

Nutrient modulation of viral infection-implications for COVID-19

The coronavirus disease 2019 (COVID-19) pandemic has put focus on the importance of a healthy immune system for recovery from infection and effective response to vaccination. Several nutrients have been under attention because their nutritional statuses showed associations with the incidence or severity of COVID-19 or because they affect several aspects of immune function. Nutritional status, immune function, and viral infection are closely interrelated. Undernutrition impairs immune function, which can lead to increased susceptibility to viral infection, while viral infection itself can result in changes in nutritional status. Here, we review the roles of vitamins A, C, D, and E, and zinc, iron, and selenium in immune function and viral infection and their relevance to COVID-19.

Changes in the behavioural determinants of health during the COVID-19 pandemic: gender, socioeconomic and ethnic inequalities in five British cohort studies

BACKGROUND

The COVID-19 pandemic is expected to have far-reaching consequences on population health. We investigated whether these consequences included changes in health-impacting behaviours which are important drivers of health inequalities.

METHODS

Using data from five representative British cohorts (born 2000-2002, 1989-1990, 1970, 1958 and 1946), we investigated sleep, physical activity (exercise), diet and alcohol intake (N=14 297). We investigated change in each behaviour (pre/during the May 2020 lockdown), and differences by age/cohort, gender, ethnicity and socioeconomic position (childhood social class, education attainment and adult financial difficulties). Logistic regression models were used, accounting for study design and non-response weights, and meta-analysis used to pool and test cohort differences in association.

RESULTS

Change occurred in both directions-shifts from the middle part of the distribution to both declines and increases in sleep, exercise and alcohol use. Older cohorts were less likely to report changes in behaviours while the youngest reported more frequent increases in sleep, exercise, and fruit and vegetable intake, yet lower alcohol consumption. Widening inequalities in sleep during lockdown were more frequent among women, socioeconomically disadvantaged groups and ethnic minorities. For other outcomes, inequalities were largely unchanged, yet ethnic minorities were at higher risk of undertaking less exercise and consuming lower amounts of fruit and vegetables.

CONCLUSIONS

Our findings provide new evidence on the multiple changes to behavioural outcomes linked to lockdown, and the differential impacts across generation, gender, socioeconomic circumstances across life, and ethnicity. Lockdown appeared to widen some (but not all) forms of health inequality.

Lifestyle changes and mental health during the COVID-19 pandemic: A repeated, cross-sectional web survey

BACKGROUND

This study aimed to compare self-reported changes on lifestyle behaviors during two phases of the COVID-19 pandemic in Spain, and to evaluate clinical and sociodemographic factors associated with lifestyles.

METHODS

Two cross-sectional web surveys were conducted during lockdown (April 15-May 15, 2020) and seven months later (November 16-December 16, 2020). Lifestyle behaviors were self-reported by a multidimensional scale (SMILE-C). Two separate samples of respondents were analyzed. A multivariate regression model was performed to evaluate the association of SMILE-C scores with demographic and clinical variables.

RESULTS

The sample comprised, 3412 participants from the first survey (S1) and in the S1 and 3635 from the second (S2). SMILE-C score decreased across surveys (p < 0.001). The rates of positive screenings for depression and anxiety were similar between the surveys, whereas those for alcohol abuse decreased (p < 0.001). Most participants in S2 reported that their lifestyle had not changed compared to those before the pandemic. Variables independently associated with an unhealthier lifestyle were working as an essential worker, lower educational level, previous mental disease, worse self-rated health, totally/moderate changes on diet, sleep or social support, as well as positive screenings for alcohol abuse, anxiety and depression.

LIMITATIONS

The cross-sectional design and recruitment by non-probabilistic methods limit inferring causality and the external validity of the results.

CONCLUSIONS

Overall lifestyle worsened seven months after the lockdown in Spain. Several demographic and clinical factors were associated with lifestyle scores. The contribution of common mental disorders to unhealthier lifestyles should be considered in order to prevent the negative impact of the pandemic.

Homemade food, alcohol, and body weight: Change in eating habits in young individuals at the time of COVID-19 Lockdown

BACKGROUND

The 2019 coronavirus disease (COVID-19) lockdown has caused significant changes in everyday life. This study evaluated the effect of the COVID-19 quarantine on dietary and alcohol consumption habits and body weight of Italian university students.

MATERIALS AND METHODS

An online cross-sectional survey was carried out among university students than 18 years in July 2020. The online self-administered questionnaire included demographic and anthropometric data (reported weight and height), weight, and dietary habits changes during of the COVID-19 lockdown.

RESULTS

A total of 520 respondents have been included in the study. A total of 393 (~76%) were female, 3.8% was obese, and the mean age was 23 ± 4 years. Numerous students reported a change in their eating habits during the lockdown with an increase in consumption of chocolate (40%), ice cream, and desserts (34%), but most of all an increase of homemade bread and pasta (60%), pizza (47%), and homemade sweets (55%). The students also reported an increase of vegetables, fresh fruit, legumes, eggs, and coffee, but also of processed meat, fried foods, cheeses, butter, and sweet beverage, and a reduction in alcohol intake. The weight gain was observed in 43.8%, and males have greater weight gain than females (57% vs. 46%, respectively; P = 0.04). A greater increase in body weight was observed in obese as compared to those with normal weight (77% vs. 44%, respectively; P < 0.001).

CONCLUSIONS

Our data highlighted the need for dietary guidelines to prevent weight gain during the period of self-isolation, especially targeting those with overweight and obesity.

Perceived Diet Quality, Eating Behaviour, and Lifestyle Changes in a Mexican Population with Internet Access during Confinement for the COVID-19 Pandemic: ESCAN-COVID19Mx Survey

Perceived changes in diet quality, emotional eating, physical activity, and lifestyle were evaluated in a group of Mexican adults before and during COVID-19 confinement. In this study, 8289 adults answered an online questionnaire between April and May 2020. Data about sociodemographic characteristics, self-reported weight and height, diet quality, emotional eating, physical activity, and lifestyle changes were collected. Before and after confinement, differences by sociodemographic characteristics were assessed with Wilcoxon, Anova, and linear regression analyses. Most participants were women (80%) between 18 and 38 years old (70%), with a low degree of marginalisation (82.8%) and a high educational level (84.2%); 53.1% had a normal weight and 31.4% were overweight. Half (46.8%) of the participants perceived a change in the quality of their diet. The Diet Quality Index (DQI) was higher during confinement (it improved by 3 points) in all groups, regardless of education level, marginalisation level, or place of residence (p < 0.001). Lifestyle changes were present among some of the participants, 6.1% stopped smoking, 12.1% stopped consuming alcohol, 53.3% sleep later, 9% became more sedentary, and increased their screen (43%) as well as sitting and lying down time (81.6%). Mexicans with Internet access staying at home during COVID-19 confinement perceived positive changes in the quality of their diet, smoking, and alcohol consumption, but negative changes in the level of physical activity and sleep quality. These results emphasise the relevance of encouraging healthy lifestyle behaviours during and after times of crisis to prevent the risk of complications due to infectious and chronic diseases.

The Prevalence of ''Food Addiction'' during the COVID-19 Pandemic Measured Using the Yale Food Addiction Scale 2.0 (YFAS 2.0) among the Adult Population of Poland

The announcement of the coronavirus pandemic by the World Health Organization (WHO), ongoing restrictions and isolation led to a break with the daily routine, and suspension of social contacts, but also imposed new challenges on the population related to maintaining healthy eating habits. The purpose of the study was to assess the prevalence of “food addiction” (FA) during the COVID-19 pandemic in Poland in relation to several variables including depression. The method of analysis was a questionnaire containing original questions and the Yale Food Addiction Scale 2.0 (YFAS). A total of 1022 Polish residents aged 18–75 participated in the study (N = 1022; 93.7% women, 6.3% men). The prevalence of FA during the COVID-19 pandemic measured with the YFAS 2.0 scale was 14.1%. The average weight gain during the pandemic in 39% of respondents was 6.53 kg. Along with the increase in the value of the BMI index, the intensity of “food addiction” increased in the study group. People with depression had statistically significantly more FA symptoms than healthy people. This work may motivate future research to evaluate the association and potential overlap of “food addiction” and problem eating behaviors during the pandemic and the obesity problem.

Impacts of COVID-19 on changing patterns of household food consumption: An intercultural study of three countries

In light of COVID-19's effects on individuals' social, economic, political, and psychological values, this paper aims to investigate the pandemic's role in possible changes to people's food consumption and meal habits in three countries, namely China, Portugal, and Turkey. The sample includes individuals from the three countries, exploratory factor analysis and non-parametric tests were used to test the differences. Results suggest that coronavirus has played a strong part in altering households' food consumption and meal habits within these countries. The pandemic has particularly led to greater consumption of fresh fruits and vegetables and spending more time eating meals at home. Portugal appears to be consuming more seafood, bread, and butter whereas China features higher consumption of rice and meat products; Turkey is consuming more meat and eggs. The study closes with a set of recommendations for the society and future research.

Associations between Perceived Social Eating Norms and Initiation and Maintenance of Changes in Dietary Habits during the First COVID-19 Lockdown in France

Changes in dietary habits of the French population have been reported during the national lockdown that was enforced due to the COVID-19 pandemic. This study investigated whether perceived social eating norms were associated with the initiation and maintenance of dietary changes that took place as a result of lockdown. An online study collected information on (1) changes in consumption implemented during the lockdown and the maintenance of these changes, and (2) perceptions about changes in consumption implemented during lockdown by household members, relatives out of home, and the general population. The changes in consumption were classified as foods to increase or to decrease according to French national recommendations. The perception of changes to dietary habits by household members and relatives out of home was related to the changes made by individuals for each of the food categories (all p < 0.05) but not to the perception of changes made the general population. Increased consumption of foods to increase was more likely to be maintained when there was a positive perception of the changes made by household members (p = 0.03). These results highlight the influence of the perception of social eating norms, especially by household members and relatives, on the implementation of dietary changes during lockdown and suggest that social eating norms can have a lasting influence.

Changes in fast food intake in Iranian households during the lockdown period caused by COVID-19 virus emergency, National Food and Nutrition Surveillance

Background

Fast foods, though very popular, are commonly known as unhealthy foods. However, coronavirus pandemic may have influenced on food choices of the general population. This study investigated the changes in fast food consumption during epidemic lockdown 2020.

Materials and Methods

This study was part of a nationwide survey having been conducted using a web‐based electronic self‐administered questionnaire. The questionnaire link was extensively distributed among the whole population both through popular social media platforms and by nutrition and health workers of health offices and medical universities of all provinces. The questionnaire included questions about socio‐demographic characteristics, changes in frequency of fast food consumption as compared with before pandemic, and the reasons for these changes.

Results

A total of 21,290 households took part in the study of whom 89.8% were male‐headed, and almost 74% were from urban areas. Decrease in fast food consumption was reported by 74.8%, while increase in fast food consumption was reported by 2% of the households during the COVID‐19 quarantine. Among those who decreased their fast food consumption, about 82% had completely omitted them from their food baskets. Fear of contamination of fast foods by coronavirus and increase in the number of people at home were the most and the least frequent reasons for decreasing fast food consumption, respectively.

Conclusion

Fast food consumption has dramatically decreased during the lockdown period in Iranian households. Though it may be considered a pleasant offshoot of disastrous COVID‐19 epidemic, the foods replaced fast foods in Iranian households and the overall health consequences warrant further studies.

Effects of COVID-19 lockdown on the dietary habits and lifestyle in a population in southern Spain: a cross-sectional questionnaire

Background/Objective

Few studies have assessed the effect of lockdown on physical activity and eating behaviours in a population from the Autonomous Community of Andalusia in southern Spain. The aim of our study was to describe the effect of COVID-19 pandemic home lockdown on eating habits and lifestyle in the Andalusian population.

Subjects/Methods

A cross-sectional observational study was carried out on a population from southern Spain, Andalusian population. An online questionnaire was shared through social networks and snowball sampling. A total of 1140 people filled in the questionnaire. The questionnaire consisted of 34 items classified into three sections: sociodemographic data, work and leisure activities and questions on food consumption. Each item offered pre- and post-lockdown information.

Results

The participants were classified into three age groups: 18–35, 36–65 and over 65. Statistically significant differences were found between the three groups, with the younger age group undergoing greater changes, increasing their physical activity and consumption of fresh food, and decreasing both their consumption of fast food at home and alcohol intake.

Conclusions

These findings suggest that, in the current social and health crisis, the citizens of southern Spain have become aware of the importance of maintaining an appropriate lifestyle to remain healthy, particularly the younger population with less well-consolidated habits.

Adjustments in Food Choices and Physical Activity during Lockdown by Flemish Adults

Background: On Wednesday 18/03/2020 Belgium was placed in lockdown in order to curb the spread of COVID-19. Lockdown can lead to loneliness, boredom, anger, anxiety and depression, which in turn have an influence on food choices and physical activity (PA). This study aims to map the adjustments in food choices and PA by Flemish adults during lockdown. Methods: Chi square tests were performed to investigate the relationship between adjustments in food choices, PA and demographic variables. Results: A total of 1.129 respondents filled in the online questionnaire, aged between 18 and 81 years. The healthiest food choices were made by respondents living alone during lockdown, whilst people cohabiting with others increased their PA significantly. Moreover, the dietary adjustments of adults living with children evolved more favourably to healthier choices then those cohousing with other adults. However, respondents living with other adults showed a more favourable pattern regarding adjustments in PA. The strongest increase in sedentary behaviour was observed in students. Conclusions: This study shows the impact of lockdown on both PA and food choices, where healthier adjustments were observed in PA and respondents were prone to consume unhealthier food.

Changes in Ultra-Processed Food Consumption and Lifestyle Behaviors Following COVID-19 Shelter-in-Place: A Retrospective Study

Ultra-processed food (UPF) consumption poses a potential risk to public health and may be related to shelter-in-place orders. This study utilized the level of food processing as a lens by which to examine the relationships between diet, weight change, and lifestyle changes (including cooking, snacking, and sedentary activity) that occurred during regional shelter-in-place orders. This study used a cross-sectional, retrospective survey (n = 589) to assess baseline demographics, changes in lifestyle behaviors using a Likert scale, and changes in dietary behaviors using a modified food frequency questionnaire from mid-March to May 2020; data were collected in the California Bay Area from August to October 2020. Foods were categorized by level of processing (minimally processed, processed, and ultra-processed) using the NOVA scale. Stepwise multiple linear regression and univariate linear regression models were used to determine the associations between these factors. Increased snacking was positively associated with a change in the percent of the calories derived from UPF and weight gain (β = 1.0, p < 0.001; β = 0.8 kg, p < 0.001) and negatively associated with the share of MPF calories consumed (β = −0.9, p < 0.001). These relationships have public health implications as interventions designed around decreased snacking may positively impact diet and weight management and thereby mitigate negative health outcomes.

Effect of COVID-19 Pandemic-Induced Dietary and Lifestyle Changes and Their Associations with Perceived Health Status and Self-Reported Body Weight Changes in India: A Cross-Sectional Survey

Home confinement during the COVID-19 pandemic is accompanied by dramatic changes in lifestyle and dietary behaviors that can significantly influence health. We conducted an online cross-sectional survey to assess COVID-19 pandemic-induced dietary and lifestyle changes and their association with perceived health status and self-reported body weight changes among 1000 Indian adults in early 2021. Positive improvements in dietary habits, e.g., eating more nutritious (85% of participants) and home-cooked food (89%) and an increase in overall nutrition intake (79%), were observed. Sixty-five percent of participants self-reported increased oat consumption to support immunity. There were some negative changes, e.g., more binge eating (69%), eating more in between meals (67%), and increasing meal portion size (72%). Two-thirds of participants reported no change in lifestyles, whereas 21 and 23% reported an increase, and 13 and 10% reported a decrease in physical activity and sleep, respectively. Overall, 64 and 65% of participants reported an improvement in perceived health and an increase in body weight during the COVID-19 period compared to pre-COVID-19, respectively. The top motivations for improving dietary habits included improving physical and mental health and building immunity. In conclusion, the overall perceived health was improved and there was an increase in self-reported body weight in most participants during COVID-19. Diet emerged as the most crucial determinant for these changes.

Depression, dietary intake, and body image during coronavirus disease 2019 quarantine in Peru: An online cross-sectional study

Objective:

The coronavirus disease 2019 affects the psychological well-being of populations. In the same way, it can be a potential threat to body image. The aim of the study was to explore associations between depressive symptoms, dietary intake, and body image during coronavirus disease 2019 quarantine.

Methods:

An online cross-sectional study was conducted in 589 Peruvian adults, 297 men (50.4%) and 292 women (49.6%). The mean age was 30.2 ± 9.4 years (range: 18–59 years). Participants completed three questionnaires, including a food frequency questionnaire, the Body Shape Questionnaire, and the Patient Health Questionnaire-9. Moreover, sociodemographic data were collected. The data were analyzed using the statistical software IBM SPSS version 24, and the chi-square test was used. A significance level of 5% was considered.

Results:

A total of 37.7% and 43.6% of the women reported depressive symptoms and dissatisfaction with body image, respectively. Depressive symptoms were associated with dietary intake and dissatisfaction with body image (p < 0.05). Dissatisfaction with body image was associated with dietary intake (p < 0.01).

Conclusions:

Depressive symptomatology plays an important role in the dietary intake and body image of the study population. It is suggested to address these factors through the implementation of health campaign programs and personalized therapeutic interventions.

Changes in Dietary Patterns and Clinical Health Outcomes in Different Countries during the SARS-CoV-2 Pandemic

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to an excess in community mortality across the globe. We review recent evidence on the clinical pathology of COVID-19, comorbidity factors, immune response to SARS-CoV-2 infection, and factors influencing infection outcomes. The latter specifically includes diet and lifestyle factors during pandemic restrictions. We also cover the possibility of SARS-CoV-2 transmission through food products and the food chain, as well as virus persistence on different surfaces and in different environmental conditions, which were major public concerns during the initial days of the pandemic, but have since waned in public attention. We discuss useful measures to avoid the risk of SARS-CoV-2 spread through food, and approaches that may reduce the risk of contamination with the highly contagious virus. While hygienic protocols are required in food supply sectors, cleaning, disinfection, avoidance of cross-contamination across food categories, and foodstuffs at different stages of the manufacturing process are still particularly relevant because the virus persists at length on inert materials such as food packaging. Moreover, personal hygiene (frequent washing and disinfection), wearing gloves, and proper use of masks, clothes, and footwear dedicated to maintaining hygiene, provide on-site protections for food sector employees as well as supply chain intermediates and consumers. Finally, we emphasize the importance of following a healthy diet and maintaining a lifestyle that promotes physical well-being and supports healthy immune system function, especially when government movement restrictions ("lockdowns") are implemented.

Has COVID-19 Changed the Lifestyle and Dietary Habits in the Spanish Population after Confinement?

Since 2020, the world has been immersed in a change in lifestyle (social, lifestyle, nutri-tion and physical activity patterns), due to the appearance of COVID-19 and the strict mobility measures which were implemented to prevent its spread. All these changes had a nutritional impact on people, modifying their dietary guidelines. This cross-sectional study was carried out to assess whether dietary habits, lifestyle, and adherence to the Mediterranean diet among the Spanish adult population (25-65 years old) during confinement was modified during the post-confinement period, using an e-survey through social networks, involving 510 subjects. A decrease in the intake of ultra-processed products, with a correlation between weekly food delivery orders at home and the consumption of salty snacks, sugary drinks, and processed pastries was also recorded. Most of the subjects performed physical exercise on a regular basis, maintaining the body weight in half of the participants. During the post-confinement period a substantial proportion of the population had healthy lifestyle and dietary habits, including the adequate consumption of fruits, vegetables and legumes; adequate time was spent preparing meals and the population did not regularly order food at home, which in the long term, reduced the risk of several diseases.

A Year Following the Onset of the COVID-19 Pandemic: Existing Challenges and Ways the Food Industry Has Been Impacted

The COVID-19 pandemic has created significant impacts for nearly all industrial and societal sectors in the world. As closures and social distancing mandates were implemented to help control the spread of the novel coronavirus designated as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the food industry was immensely affected. This review explores the effects of the COVID-19 pandemic on the food supply chain from a multi-disciplinary viewpoint and provides perspectives on the consequences on food safety and food security, a risk assessment on human–animal interactions, and considers logistical/protocol adjustments required for the food industry. While foodborne transmission of the novel coronavirus SARS-CoV-2 is not a significant factor for food safety as direct transmission of the virus through food products is not evident, food security has been significantly affected by the COVID-19 pandemic. The pandemic threatens food accessibility, especially for vulnerable populations of people, through its effects on food cost and infrastructure, food distribution and public transit access, and social inequities. Currently, global interest for COVID-19 is focused on human health and rightfully so, but adverse effects on the food supply chain are already evident and will likely continue to occur for several years after the pandemic is over, let alone if other global health pandemics of this magnitude surface in upcoming years. Uncertainties over the novel coronavirus have interrupted global trade and supply chains. The pandemic has underlined the importance of a robust and resilient food system, which presents an unprecedented challenge for competent authorities in upcoming years.

The future of human malnutrition: rebalancing agency for better nutritional health

The major threat to human societies posed by undernutrition has been recognised for millennia. Despite substantial economic development and scientific innovation, however, progress in addressing this global challenge has been inadequate. Paradoxically, the last half-century also saw the rapid emergence of obesity, first in high-income countries but now also in low- and middle-income countries. Traditionally, these problems were approached separately, but there is increasing recognition that they have common drivers and need integrated responses. The new nutrition reality comprises a global ‘double burden’ of malnutrition, where the challenges of food insecurity, nutritional deficiencies and undernutrition coexist and interact with obesity, sedentary behaviour, unhealthy diets and environments that foster unhealthy behaviour. Beyond immediate efforts to prevent and treat malnutrition, what must change in order to reduce the future burden? Here, we present a conceptual framework that focuses on the deeper structural drivers of malnutrition embedded in society, and their interaction with biological mechanisms of appetite regulation and physiological homeostasis. Building on a review of malnutrition in past societies, our framework brings to the fore the power dynamics that characterise contemporary human food systems at many levels. We focus on the concept of agency, the ability of individuals or organisations to pursue their goals. In globalized food systems, the agency of individuals is directly confronted by the agency of several other types of actor, including corporations, governments and supranational institutions. The intakes of energy and nutrients by individuals are powerfully shaped by this ‘competition of agency’, and we therefore argue that the greatest opportunities to reduce malnutrition lie in rebalancing agency across the competing actors. The effect of the COVID-19 pandemic on food systems and individuals illustrates our conceptual framework. Efforts to improve agency must both drive and respond to complementary efforts to promote and maintain equitable societies and planetary health.

Influence of the COVID-19 Lockdown on the Physical and Psychosocial Well-being and Work Productivity of Remote Workers: Cross-sectional Correlational Study

BACKGROUND

Lockdowns imposed during the COVID-19 pandemic have impacted the living and working habits of millions of people, with potentially important implications for their physical, mental, and social well-being.

OBJECTIVE

The primary objective of this study was to investigate the impact of the COVID-19 pandemic on remote workers who were not directly affected by COVID-19.

METHODS

This was a correlational cross-sectional study (with an additional qualitative component) of 184 remote workers surveyed during the first COVID-19 lockdown in the United Kingdom. Standard measures of mental health (Kessler-6 Distress Scale), productivity (Brief Instrument to Assess Workers' Productivity During a Working Day), and physical activity (International Physical Activity Questionnaire) were used, and respondents were further surveyed on changes to their dietary, exercise, smoking, drinking, and socialization habits to produce a well-being change index.

RESULTS

The results revealed associations between sedentary behavior and poorer mental health (τ b=0.14) and between poorer mental health and low work productivity (τ b=-0.39). However, both positive and negative lifestyle changes were reported; a self-reported increase in well-being (with respect to diet, exercise, smoking, alcohol consumption, and socialization) since the start of the pandemic was associated with both better mental health (τ b=-0.14) and better work productivity (τ b=0.14). Of note, among respondents without a mental health diagnosis (137/184, 74.4%), we observed rates of moderate (76/137, 55.5%) and severe (17/137, 12.4%) psychological distress, which were markedly higher than those reported in large prepandemic studies; moreover, 70.1% (129/184) of our respondents reported more sedentary behavior, 41% (69/168) increased their alcohol consumption, and 38.6% (71/184) increased their overall food intake. However, 46% (75/163), 44.8% (39/87) and 51.8% (57/110) of respondents reported spending more time walking and engaging in more moderate and vigorous exercise, respectively. Qualitative analysis revealed many positive adaptations to lockdowns (eg, decreased commuting expenses, flexibility) but also a number of structural obstacles to remote working (eg, lack of support and high expectations from employers, childcare duties).

CONCLUSIONS

These findings may be of practical importance for policy makers and employers in a world in which work involves long-term remote or hybrid employment arrangements; strategies to promote more sustainable remote working are discussed.

The fishing and seafood sector in the time of COVID-19: Considerations for local and global opportunities and responses

This article provides an overview of the impact of the COVID-19 pandemic on the fishing sector over the world, including several economic, social, environmental, and health challenges that the fisheries have had to face during the early days of the health crisis, and some of them still continue today. These problems, in short, are translated into a decrease in seafood demand, loss of jobs, changes in food consumption habits, economic losses, or increased vulnerability of the industry. As a consequence, governments have been forced to implement regulations and measures in support of this sector. However, a positive aspect of the pandemic also stands out, the opportunity to transform the food system to be greener, more inclusive, and resilient against future shocks.

Impact of COVID-19 confinement on eating behaviours across 16 European countries: The COVIDiet cross-national study

We aimed to evaluate the changes in eating behaviours of the adult population across 16 European countries due to the COVID-19 confinement and to evaluate whether these changes were somehow related to the severity of the containment measures applied in each country. An anonymous online self-reported questionnaire on socio-demographic characteristics, validated 14-items Mediterranean diet (MedDiet) Adherence Screener (MEDAS) as a reference of a healthy diet, eating and lifestyle behaviours prior to and during the COVID-19 confinement was used to collect data. The study included an adult population residing in 16 European countries at the time of the survey. Aggregated Stringency Index (SI) score, based on data from the Oxford COVID-19 Government Response Tracker, was calculated for each country at the time the questionnaire was distributed (range: 0-100). A total of 36,185 participants completed the questionnaire (77.6% female, 75.2% with high educational level and 42.7% aged between 21 and 35 years). In comparison to pre-confinement, a significantly higher adherence to the MedDiet during the confinement was observed across all countries (overall MEDAS score prior to- and during confinement: 5.23 ± 2.06 vs. 6.15 ± 2.06; p < 0.001), with the largest increase seen in Greece and North Macedonia. The highest adherence to MedDiet during confinement was found in Spain and Portugal (7.18 ± 1.84 and 7.34 ± 1.95, respectively). Stricter contingency restrictions seemed to lead to a significantly higher increase in the adherence to the MedDiet. The findings from this cross-sectional study could be used to inform current diet-related public health guidelines to ensure optimal nutrition is followed among the population, which in turn would help to alleviate the current public health crisis.

The impact of COVID-19 on alternative and local food systems and the potential for the sustainability transition: Insights from 13 countries

The COVID-19 pandemic has been a major stress test for the agri-food system. While most research has analysed the impact of the pandemic on mainstream food systems, this article examines how alternative and local food systems (ALFS) in 13 countries responded in the first months of the crisis. Using primary and secondary data and combining the Multi-Level Perspective with social innovation approaches, we highlight the innovations and adaptations that emerged in ALFS, and how these changes have created or supported the sustainability transition in production and consumption systems. In particular, we show how the combination of social and technological innovation, greater citizen involvement, and the increased interest of policy-makers and retailers have enabled ALFS to extend their scope and engage new actors in more sustainable practices. Finally, we make recommendations concerning how to support ALFS’ upscaling to embrace the opportunities arising from the crisis and strengthen the sustainability transition.

A lifespan perspective of structural and perceived social relationships, food insecurity, and dietary behaviors during the COVID-19 pandemic

Physical distancing and economic impacts of the COVID-19 pandemic may influence dietary behaviors. Using a parallel mixed method design, we examined the relationships between structural and perceived social relationships on dietary behaviors across the adult lifespan and by food security status. A representative sample of 360 adults (18-78 years old) living in the United States were recruited through Prolific Academic to complete an online cross-sectional survey. Participants provided data about demographics, food insecurity, structural and perceived social relationships, diet quality, and unhealthy snacking at the onset of the pandemic. Participants responded to open-ended questions about perceived changes in social connections and dietary behavior since COVID-19. Quantitative findings indicated food insecure emerging and older adults were at highest risk for low diet quality and frequent unhealthy snacking. Friend support was associated with higher diet quality. Qualitative findings suggested overall decreases in social connection and changes in dietary behavior, with food insecure adults describing decreases in diet quality. Participants who reported increases in emotional eating also reported decreases in social connection. Findings suggest the pandemic may exacerbate inequalities, particularly among food insecure emerging and older adults. Scaling up preventive interventions to increase social connection and reduce food insecurity during unprecedented challenges may promote healthier dietary behaviors now and in the long-term.

Relationship Between Dietary Variety and Frailty in Older Japanese Women During the Period of Restriction on Outings Due to COVID-19

Objective

This study investigated the relationship between diet and frailty in community-dwelling older adults during the period of restriction on outings due to COVID-19. A population of 322 women aged 65 years or older living in the community was recruited for the study, of whom 253 were analyzed.

Method

A mail survey was carried out in May 2020, targeting adults aged 65 years or older. The survey included questions regarding sex, age, height, weight, and social participation. Dietary variety score and frailty score were also calculated.

Results

Mean age for the 253 participants was 80.0±6.4 years. Dietary variety score and frailty score were significantly correlated under linear regression analysis (β :-0.224, P < 0.001). In multivariate regression analysis, these factors remained significantly correlated in Model 2 , which was adjusted for age (β :-0.229, P < 0.001), and Model 3, which was adjusted for age, BMI, and other confounding factors (β :-0.208, P = 0.001).

Conclusion

Diet was correlated with frailty in older adults living in the community during the period of restriction on outings due to COVID-19.

Qualitative Research on Solving Difficulties in Maintaining Continuity of Food Supply Chain on the Meat Market during the COVID-19 Pandemic

Although the pandemic phenomenon is not the first of its kind in human history, the common feature of COVID-19 is its rapid impact on the global economy. The challenge for the national economy on the world stage is to maintain a continuous food supply. The scientific purpose of the study is to report, analyze and evaluate backgrounds, causes of instabilities and their effects of the COVID-19 pandemic on supply and demand side of the meat market in the United States of America, China and Russia. The practical purpose of the study is to present implemented measures and recommendations on how to return to meat market equilibrium. In the theoretical part of the study, the revised public source of information coming from well-known organizations such as: EC, FAO, OECD, and WB, are used. In the practical part of the manuscript, qualitative research on the People’s Republic of China, Russian Federation, and the United States of America, along with semi-structured in-depth interviews with experts and Ishikawa diagram are presented. The primary data come from authors’ own research and collection of multiple sources. The article indicates the use of qualitative systematic review, supported by a creation of a prototype of the issues of maintaining continuity of the food supply chain during the COVID-19 pandemic in the secondary sources, intensified by a keyword search. The results of the research are diverse and oriented toward the needs of the analyzed meat markets. In the case of the People’s Republic of China, the solution is to develop a system of subsidies and preferential rates for the use of rail transport in exports. In the case of Russia, the solution is to provide support to the meat and poultry farmers for cold storage of slaughtered animals. In the case of the USA, the solution is to develop technical and technological facilities in order to speed up the supply chain between local livestock with meat and poultry farmers. Moreover, the outcomes indicate that sustainability of the food supply chain needs well-thought-out support on agri-food supply production.

Consumers’ Trust in Greek Traditional Foods in the Post COVID-19 Era

We are entering a new, unprecedented global economic and social era following the COVID-19 pandemic, in which there will be opportunities and threats for the goods and services provided. Traditional foods (TFs) could have their chances in the new food chain which will be developed, as long as they become the food of choice for the consumers of the future. This paper investigates consumers’ trust in Greek TFs, and northwest Greek TFs, in order to assess their potential consumption in the new economy. Trust was tested using the variables of safety, healthiness, sustainability, authenticity and taste, assessing consumers’ confidence and satisfaction with the TFs, their raw materials, and the technologies used for their production. A self-response questionnaire survey was carried out in May and June 2021 on a sample of 548 participants through the Google platform. In order to analyze the data, basic descriptive statistical tools were used, combined with crosstabs and chi-square tests. The results show that the participants trust the Greek TFs because they “strongly agree” by an average of 20%, and “agree” by an average of 50% that they are safe, healthy, sustainable, authentic and tasty. A similar pattern was recorded for the regional northwest Greek TFs as well. These results indicate that TFs could be the food of choice because they bear consumers’ trust in the coming “new normality”, where trust will be a major factor of choice for the purchase of goods and services.

The effect of COVID-19 pandemic and quarantine period on physical activity and dietary habits of college-aged students

The coronavirus disease 2019 (COVID-19) pandemic led to sudden extreme changes in lifestyle, potentially causing adverse changes in physical activity, sedentary behavior, and dietary habits. The objective of the study was to investigate the effects of COVID-19 quarantine on physical activity, dietary habits, and food insecurity among college students who were impacted by the quarantine periods and campus closures. The findings of the study will provide preliminary evidence on dietary, physical activity, and sedentary behavior changes induced by the pandemic among college students.

Participants (n ​= ​403) completed a cross-sectional self-report online questionnaire, evaluating the physical activity, sedentary behavior, and dietary behaviors before- and during-COVID-19 campus closures (March–May 2020). Sociodemographic and descriptive information was also obtained from each participant. Wilcoxon signed-rank test was used to assess changes in physical activity, sedentary behavior, and dietary habits. McNemar's test was used to compare food insecurity changes. Data were presented as median and interquartile range.

A total of 291 participants who met the inclusion criteria were enrolled in the study (college-aged, 18–24 years). Physical activity decreased at vigorous (2 days/week to 1 day/week, p ​< ​0.001), moderate (4 days/week to 1 day/week, p ​< ​0.001), and light (4 days/week to 2 days/week, p ​< ​0.001) intensity levels, while sedentary behavior increased (4 ​h/day to 7 ​h/day, p ​< ​0.001) from pre-to during-COVID-19 quarantine period. Frequencies of meals at home and alcohol consumption increased (Z ​= ​−3.911 and Z ​= ​−4.022, p ​< ​0.001), while frequency of fruit consumption decreased (Z ​= ​−2.116, p ​< ​0.001) from pre-to during-COVID-19 quarantine period. Daily alcohol intake also increased during COVID-19 quarantine period (Z ​= ​−4.442, p ​< ​0.001). Lastly, the percentage of individuals reporting food insecurity significantly increased during COVID-19 quarantine (p ​< ​0.001).

College-aged students in quarantine significantly decreased physical activity participation and increased sedentary behavior. Changes in dietary habits were observed, including increased meals at home, alcohol consumption, and decreased fruit consumption. Food insecurity also doubled among college-aged students during quarantine. Public health strategies to attenuate these changes in lifestyle habits should be implemented during a global pandemic.

COVID-19 Self-quarantine and Weight Gain Risk Factors in Adults

PURPOSE OF REVIEW

The COVID-19 pandemic is associated with weight gain in certain individuals. This review highlights the risk factors for weight gain during COVID-19 self-quarantine in adults.

RECENT FINDINGS

Among those who have gained weight during COVID-19 self-quarantine, self-reported body weight has increased between .5 and 1.8 kg (± 2.8 kg) after just 2 months of quarantine. Identified risk factors for weight gain during COVID-19 self-quarantine are the following: increased sedentary behaviors, decreased physical activity, increased snacking frequency (particularly after dinner), increased alcohol intake, decreased water intake, emotional eating, decreased sleep quality, and being overweight/obese. Having identified risk factors for weight gain during the COVID-19 pandemic, practitioners and researchers should devise plans to assist those who have gained weight to re-learn weight management/weight loss strategies.

Influence of the confinement that occurred in Spain due to the SARS-CoV-2 virus outbreak on adherence to the Mediterranean diet

Introduction

The Mediterranean diet (MDiet), reduces morbidity and mortality. The lockdown that took place in Spain between the months of March and May 2020 may have led to behavioural changes. The aim of the present study was to assess adherence to the MDiet at the end of the lockdown period and to compare it with the situation prior to it.

Methods

Data were obtained by means of two online questionnaires, one at the beginning of lockdown and the other at the end, completed by adults from the Spanish population, who responded anonymously and voluntarily. The assessment of adherence to the MDiet was carried out using two questionnaires: Mediterranean Diet Adherence Screener (MEDAS) and modified PREDIMED, which contained 14 questions each. Other variables included were: age, gender, body mass index (BMI), Autonomous Community of origin, home living conditions, and level of studies achieved. At the end of the lockdown period, the comparison was made using the Student t statistic and the McNemar test.

Results

A total of 207 people (137 women) participated, with a mean age 51.3 ± 12.4 years, age range: 20−83 years. After lockdown, BMI remained unchanged (initial 24.55 ± 3.7 kg/m² and final 24.57 ± 3.7 kg/m², P = .752), as well as fish consumption (initial 51.2%) and 60.9% at the end, P = .003) mainly due to the women and adherence to the Mdiet. The mean total score of MEDAS increased with 10.6 ± 2.0 at the beginning, and 10.57 ± 2.0 at the end; P = .001). This also occurred with the modified PREDIMED (9.47 ± 2.1 at the beginning and 9.93 ± 2.1 at the end, P < .001). Similarly, the proportion of participants that had a score classified as high at the beginning increased at the end of lockdown: from 80.7% initially in MEDAS to 87.9% at the end, P = .021, and from 68.6% initially in modified PREDIMED to 75.8% at the end, P = .037.

Conclusions

In the study sample, during lockdown there were no changes in BMI, but there were increases in fish consumption and adherence to the MDiet.

Influence of the confinement that occurred in Spain due to the SARS-CoV-2 virus outbreak on adherence to the Mediterranean diet

INTRODUCTION

The Mediterranean diet (MDiet) reduces morbidity and mortality. The lockdown that took place in Spain between the months of March and May 2020 may have led to behavioural changes. The aim of the present study was to assess adherence to the MDiet at the end of the lockdown period and to compare it with the situation prior to it.

METHODS

Data were obtained by means of 2online questionnaires, one at the beginning of lockdown and the other at the end, completed by adults from the Spanish population, who responded anonymously and voluntarily. The assessment of adherence to the MDiet was carried out using 2questionnaires: Mediterranean Diet Adherence Screener (MEDAS) and modified PREDIMED, which contained 14 questions each. Other variables included were: age, gender, body mass index (BMI), autonomous community of origin, home living conditions, and level of studies achieved. At the end of the lockdown period, the comparison was made using the Student t statistic and the McNemar test.

RESULTS

A total of 207 people (137 women) participated, with a mean age 51.3±12.4 years, age range: 20-83 years. After lockdown, BMI remained unchanged (initial 24.55±3.7kg/m2 and final 24.57±3.7kg/m2, P=.752), as well as fish consumption (initial 51.2%) and 60.9% at the end, P=.003), mainly due to the women, and adherence to the Mdiet. The mean total score of MEDAS increased with 10.16±2.0 at the beginning, and 10.57±2.0 at the end; P=.001). This also occurred with the modified PREDIMED (9.47±2.1 at the beginning and 9.93±2.1 at the end, P<.001). Similarly, the proportion of participants that had a score classified as high at the beginning increased at the end of lockdown: from 80.7% initially in MEDAS to 87.9% at the end (P=.021) and from 68.6% initially in modified PREDIMED to 75.8% at the end (P=.037).

CONCLUSIONS

In the study sample, during lockdown there were no changes in BMI, but there were increases in fish consumption and adherence to the MDiet.

Eating Competence among Brazilian Adults: A Comparison between before and during the COVID-19 Pandemic

The coronavirus pandemic started a worldwide emergency, and tight preventive actions were necessary to protect the population, changing individuals' daily habits. Dwelling and working at home can change dietary habits, affect food choice and access, as well as the practice of physical activity. In this regard, this study's goal was to compare eating competence (EC) among Brazilian adults before and during the coronavirus pandemic, using the Brazilian version of the eating competence Satter inventory (ecSI2.0™BR) with the "retrospective post-then-pre" design. This cross-sectional study was performed from 30 April to 31 May 2021 among a convenience sample of the Brazilian adult population using an online platform (Google® Forms). In the studied sample (n = 302 in which 76.82% were females), EC total score lowered during the pandemic (31.69 ± 8.26 vs. 29.99 ± 9.72; p < 0.005), and the decrease was worst after the beginning of the pandemic among those who reported weight gain, decreased the consumption of fruit and vegetables, and increased the consumption of sugary beverages. The contextual skill component seems relevant in this scenario, where our life and routines were changed entirely, demonstrating that the ability to manage the food context is essential, especially when sanitary and economic situations represent a new challenge.

The Relationship between Adults' Perceptions, Attitudes of COVID-19, Intuitive Eating, and Mindful Eating Behaviors

In total, 1224 Turkish adults (27.5 ± 9.6 years; 80.6% female) answered sociodemographic questions, and three instruments: Mindful Eating Questionnaire (MEQ), Intuitive Eating Scale-2 (IES-2), and COVID-19 Perception and Attitude Scale. Women's perceptions and attitudes toward COVID-19 indicated higher concerns than men (p < .001). It was found that IES-2 scores of all subjects increased as body mass index (BMI) decreased and education level increased (p < .001; p = .033, respectively). During the social isolation of COVID-19, the MEQ scores of married couples and those who did not eat take-out foods were higher (p = .027; p = .006, respectively). Interestingly, it was found that as the BMI of the subjects increased, their MEQ scores increased (p < .001). The COVID-19 pandemic, which has social and economic consequences, has a great impact on human health and causes sudden lifestyle changes through social distance and isolation at home. Although social isolation during the epidemic is a necessary precaution to protect public health, the results of this study support that it causes changes in intuitive eating, and mindful eating behaviors.

Challenges in Feeding Children Posed by the COVID-19 Pandemic: a Systematic Review of Changes in Dietary Intake Combined with a Dietitian's Perspective

PURPOSE OF REVIEW

To examine the evidence that the dietary quality of children changed between the period preceding the COVID-19 pandemic and the first year during the pandemic.

RECENT FINDINGS

A systematic review of the evidence for dietary changes occurring as a result of the pandemic-related restrictions, in Part I of this article, yielded 38 original research articles. These articles had conflicting results, some describing improvements in overall quality and some describing deteriorations. As a whole the studies were characterized by a low study quality, and children were poorly represented. Taken together, these studies do not provide enough evidence to draw conclusions about whether dietary habits changed or not as a result of the pandemic. However, in a wider, narrative review of the psychosocial changes occurring as a result of the COVID-19 pandemic, and the known associations of these factors with a dietary intake in Part II, we conclude that there is a reason to expect that the dietary quality of children might have been adversely affected by the COVID-19 pandemic. One the one hand, the literature fails to provide conclusive evidence on changes in the dietary quality of children resulting from the COVID-19 pandemic. On the other hand, the broader literature supports the hypothesis that children's dietary quality will have declined during the pandemic. Taken together, we urgently need more high-quality research on children's changes in dietary intake occurring over the pandemic. This will provide important information on whether any potential long-term consequences of such changes, if they exist, need to be examined and ameliorated.

Industrial Animal Farming and Zoonotic Risk: COVID-19 as a Gateway to Sustainable Change? A Scoping Study

The threat of zoonoses (i.e., human infectious diseases transmitted from animals) because of industrial animal farming may be receiving less attention in society due to the putative wildlife origin of COVID-19. To identify societal responses to COVID-19 that do address or affect the risk of future zoonoses associated with industrial animal farming, the literature was screened for measures, actions, proposals and attitudes following the guidelines of a scoping review. Forty-one articles with relevant information published between 1 January 2020 and 30 April 2021 were identified directly or indirectly via bibliographies from 138 records retrieved via Google Scholar. Analysis of relevant content revealed ten fields of policy action amongst which biosecurity and change in dietary habits were the dominant topics. Further searches for relevant records within each field of policy action retrieved another eight articles. Identified responses were furthermore classified and evaluated according to groups of societal actors, implying different modes of regulation and governance. Based on the results, a suggested policy strategy is presented for moving away from food production in factory farms and supporting sustainable farming, involving the introduction of a tax on the demand side and subsidies for the development and production of alternative meat.

Trends in Food Preferences and Sustainable Behavior during the COVID-19 Lockdown: Evidence from Spanish Consumers

The COVID-19 pandemic poses a threat to global food security, and it changes consumers' food buying and consumption behavior. This research not only investigates trends in Spanish consumers' general food shopping and consumption habits during the lockdown, but also investigates these trends from the perspective of sustainable purchasing. Specifically, total food consumption (C), food expenditure (E), and purchase of food with sustainable attributes (S) were measured. Data were collected from a semi-structured questionnaire which was distributed online among 1203 participants. The logit models showed that gender, age, employment status, and consumers' experiences were associated with total food consumption and expenditure during the lockdown. In addition, consumers' risk perceptions, shopping places, trust level in information sources, and risk preference were highly essential factors influencing consumers' preferences and sustainable behavior. Consumers' objective knowledge regarding COVID-19 was related to expenditure. Furthermore, family structure only affected expenditure, while income and place of residence influenced food consumption. Mood was associated with expenditure and the purchase of sustainable food. Household size affected purchasing behavior towards food with sustainable attributes. This research provides references for stakeholders that help them to adapt to the new COVID-19 situation.

The impact of Corona pandemic on consumer's food consumption: Vulnerability of households with children and income losses and change in sustainable consumption behavior

The ongoing corona crisis affected many people worldwide by restrictions in their everyday lives. The question arises to what extent the pandemic has accelerated diet trends or general differences in food consumption between different population groups. For this purpose, an online-survey was carried out in order to determine the effects of the corona lockdown on food consumption, shopping behaviour and eating habits in Germany. The aspects of sustainability and health were given special consideration in this study, reflecting people choices of healthier and more environmentally conscious foods. This study demonstrates that the corona pandemic has a significant impact on consumers’ eating habits. More food was eaten, and more convenience products such as ready-made meals and canned food with a longer shelf life were purchased. The consumption of alcohol and sweets has also increased. In return, there was a reduced consumption of fresh fruits and vegetables. The findings reveal that families who are financially affected by the pandemic represent a vulnerable group. With the ongoing pandemic, possible lockdowns, corona-related closings of schools and kindergartens, severe health consequences are expected long term, especially for this population group.

Changes in Selected Food Groups Consumption and Quality of Meals in Japanese School Children during the COVID-19 Pandemic

In 2020, a state of emergency was declared to control the devastating impact of coronavirus, leading to temporary school closures in Japan, meaning that school lunches were not provided to the majority of schoolchildren. Using questionnaires completed by participants' guardians, we examined the relationship between household income and the quality of meals in Japanese schoolchildren before, during, and after the state of emergency. Participants (1111 children, 10-14 years old) were chosen to form a nationally representative sample of the Japanese population. "Well-balanced dietary intake" was defined as the intake of (i) meat, fish, or eggs and (ii) vegetables. The desired prevalence was defined as equal to or more than twice a day. Household income was divided into quartiles. "Well-balanced dietary intake" was lower in all households during the state of emergency compared with before. The proportion of those with a "well-balanced dietary intake" at least twice a day was notably low in both Q3 and Q4 during the state of emergency compared with before the declared state of emergency; relative risk increase (95% CI) were Q1: -19.0% (-19.6% to -18.4%), p < 0.001, Q2: -21.3% (-22.1% to -20.6%) p < 0.001, Q3: -25.4% (-26.1% to -24.7%), p < 0.001, and Q4: -34.8% (-35.6% to -34.0%), p < 0.001. The interaction p (vs. Q1) of Q2, Q3, and Q4 were all <0.001. Guardians from low-income households had significantly higher rates of having less: time, psychological room, and financial position to prepare meals during the state of emergency. Our results suggest that schoolchildren's quality of meals worsened during the state of emergency, especially in low-income households, because school lunches were not provided.

Association of Healthy Diet with Recovery Time from COVID-19: Results from a Nationwide Cross-Sectional Study

The world is still in need of an effective therapy to treat coronavirus disease-19 (COVID-19). This cross-sectional study was conducted on COVID-19 survivors in Saudi Arabia to investigate the influence of a healthy diet on the recovery time from COVID-19. A questionnaire was developed to assess participants' dietary habits, based on the 2015 Dutch food-based dietary guidelines. A total of 738 COVID-19 survivors participated in the study, of whom 237 (32.1%) were hospitalized for COVID-19 treatment while 501 (76.9%) were not hospitalized, and 320 (43.4%) were females and 418 (56.6%) were males. Overall, no significant difference was noted in healthy diet score between males and females; however, this score was significantly lower for Saudis compared to non-Saudis. Among the non-hospitalized patients, eating a more healthy diet was associated with a shorter duration of recovery (p < 0.05) and was significantly affected by gender (15.8 ± 9.3 male vs. 12.1 ± 8.9 female; p < 0.001) and marital status (12.1 ± 8.4 singles vs. 13.7 ± 9.3 married vs. 16.1 ± 11.8 divorced; p < 0.05). In contrast, no significant correlation was found with age or BMI. In this study, a more healthy diet was associated with a shorter duration of recovery from COVID-19. However, further studies are needed to thoroughly investigate the relationship between diet and recovery time from COVID-19.

Changes in ultra-processed food consumption during the first Italian lockdown following the COVID-19 pandemic and major correlates: results from two population-based cohorts

OBJECTIVE

To evaluate changes in ultra-processed food (UPF) intake and its major correlates during the first Italian lockdown (9 March-3 May 2020).

DESIGN

Retrospective observational study.

SETTING

Italy.

PARTICIPANTS

We analysed 2992 subjects (mean age 57·9 ± 15·3 years, 40·4 % men). Individual participant data were pooled from two retrospective cohorts: (1) The Moli-LOCK cohort consists of 1501 adults, a portion of the larger Moli-sani study (n 24 325; 2005-2010) who were administered a phone-based questionnaire to assess lifestyles and psychological factors during confinement and (2) the Analysis of Long Term Risk of Covid-19 Emergency is a web-based survey of 1491 individuals distributed throughout Italy who self-responded to the same questionnaire by using Google forms.UPF was defined according to NOVA classification based on degree of food processing. An UPF score was created by assigning 1 point to increased consumption, -1 to decreased and 0 point for unchanged intakes of nineteen food items, with higher values indicating an increase in UPF during confinement.

RESULTS

Overall, 37·5 % of the population reported some increase in UPF (UPF score ≥1). Adults were more likely to decrease UPF (multivariable regression coefficient β = -1·94; 95 % CI -2·72, -1·17 for individuals aged >75 years as compared with 18-39 years) as did individuals from southern Italian regions as compared with Northern inhabitants (β = -1·32; 95 % CI -1·80, -0·84), while UPF lowering associated with increased exercise (β = -0·90; 95 % CI -1·46, -0·35) and weight loss (β = -1·05; 95 % CI -1·51, -0·59) during confinement.

CONCLUSIONS

During the first Italian lockdown, about 40 % of our population switched to unfavourable eating as reflected by increased UPF intake and this may have long-term effects for health.

Psycho-social and behavioral impact of COVID-19 on middle-aged and elderly individuals: A qualitative study

BACKGROUND

COVID-19 may seem to have an impact on middle-aged and elderly people. However, not much is known about the lived experiences of middle-aged and elderly people during this pandemic. The study aims to explore psychosocial and behavioral impact of COVID-19 on the lives of these individuals.

MATERIALS AND METHODS

Three focus group discussions and seven in-depth interviews were conducted. A format to guide discussions and interviews was made to bring uniformity across groups and participants. Participants were recruited through purposive and snowball sampling techniques. Discussions were recorded and transcribed verbatim. Thematic analysis method was used to extract key conceptual themes.

RESULTS

There were 12 male and 10 female participants included, with a mean age of 62.2 years. Five subcategories identified were: Fear and anxiety, household confinement, lifestyle modification, preventive practices, and coping strategies. These sub-categories formed three major categories-psychological, social, and behavioral which ultimately led to the emergence of the main theme that is, COVID-19 effects on the life of middle-aged and older individuals.

CONCLUSION

Middle-aged and elderly people are affected in many ways due to COVID-19. Addressing the psycho-social and behavioral problems can help in the better adjustment to tide over the pandemic.

The impact of COVID-19 quarantine on dietary habits and physical activity in Saudi Arabia: a cross-sectional study

Background

The COVID-19 pandemic has forced governments around the world to impose strict hygiene and national lockdown measures, which in turn has changed the dietary and lifestyle habits of the world’s population. Thus, the aim of this study is to evaluate whether dietary and physical activity behaviors of Saudi Arabia’s adult population changed during the COVID-19 quarantine.

Methods

An electronic questionnaire which assessed changes in body weight, dietary habits, and physical activity of Saudi Arabia’s adult population (n = 2255) during the COVID-19 quarantine was distributed on social media between June and July 2020. To test the differences between changes in dietary and physical activity behaviors in relation to changes in body weight a Chi-square test was used.

Results

Over 40 and 45% of participants reported eating and snacking more, respectively, which led to weight gain in around 28%. Most participants reported that they consumed home-cooked (73%) and healthy meals (47%), while only 7% reported that they consumed foods from restaurants. Feelings of boredom and emptiness (44%) and the availability of time for preparing meals (40%) were the main reasons for changing dietary habits. Honey (43%) and vitamin C (50%) were the most consumed immune-boosting food and dietary supplement, respectively. COVID-19 also had a negative impact on physical activity, lowering the practice in 52% subjects, which was associated with significant weight gain (p < 0.001).

Conclusion

Assessing the changes to the population’s dietary habits and physical activity during the lockdown will help predict the outcome of the population’s future health and wellbeing after the pandemic.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11540-y.

The Effects of COVID-19 on the Eating Habits of Children and Adolescents in Italy: A Pilot Survey Study

Nutrition during childhood and adolescence is very important for growth and can have long-term health implications. The COVID-19 lockdown caused significant changes in everyday life, including in children and adolescents. This study evaluated the effects of the first COVID-19 lockdown on eating habits and body weight in children and adolescents. An online cross-sectional survey was carried out among the parents of children (5-9 years) and adolescents (10-14 years) living in Italy. The online self-administered questionnaire included demographic and anthropometric data (reported weight and height) weight and dietary habit changes during the COVID-19 lockdown in Italy (March to June 2020). A total of 439 participants were included. We found a change in eating habits with an increase in consumption of sweet packaged snacks (34%) and processed meat (25%), as well as bread, pizza and bakery products (47%). We also found an increase in vegetable, fresh fruit and legume intake (19%), and a reduction in sweet beverage and candy intake. A total of 59.7% of the participants reported body weight gain, with adolescents gaining more than children (67% vs. 55%, p = 0.010, respectively). In children, body weight gain was associated with a change in body height and increased consumption of dairy products and sweet packaged snacks, while in adolescents it was associated with an increased intake of comfort foods and processed meat. Our data highlighted the need to carefully monitor eating behaviors to avoid the establishment of unhealthy eating habits and prevent obesity in children and adolescents during periods of self-isolation.