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Muscogiuri G, Kohler L, Parra O, Soltani L, Spegman D, Coletta D, Mandarino LJ. Longitudinal study of the impact of the COVID-19 pandemic on diet and physical activity among Latinos of Mexican ancestry. J Transl Med 2024; 22:342. [PMID: 38594708 PMCID: PMC11005240 DOI: 10.1186/s12967-024-05007-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 02/18/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic caused societal disruption in the United States and most of the world, affecting many aspects of life, including healthcare and health-related behaviors such as diet, food security, and physical activity. Communities with economic and health disparities may have been particularly affected. This study was undertaken to determine how conditions in the early pandemic (January, 2021-February, 2022) affected Latino patients of Mexican Ancestry at high risk of type 2 diabetes mellitus who participated in El Banco por Salud biobank project in Tucson, Arizona. METHODS Baseline, prepandemic measurements were available in 17, 21, and 60 patients with normal hemoglobin A1c (HbA1c), prediabetes, and type 2 diabetes, respectively. RESULTS People with healthy HbA1c were significantly younger, less obese, and had higher HDL cholesterol. HbA1c was unaffected by the pandemic in any group. Triglycerides, total and HDL cholesterol levels fell in all groups during the pandemic. Physical activity levels in all groups were remarkably low, with most reporting no engagement in any voluntary physical activity. Engagement in physical activity or its enjoyment was lower in patients with diabetes and prediabetes than in younger, less obese patients. Major diet differences were between men and women and were present before the pandemic. Women consumed significantly more vegetables, fruit, and salad than men. The only pandemic-related change in diet was a drop in egg consumption, possibly explaining the fall in total cholesterol. CONCLUSION Societal disruption during the COVID-19 pandemic had minimal effects on adverse health-related behaviors, cardiometabolic risk, or changes in glycemic control in a Latino community with diabetes and healthcare disparities in the Southwest US.
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Affiliation(s)
- Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia e Andrologia, Università degli Studi Di Napoli Federico II, Naples, Italy
- Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University Federico II, Naples, Italy
- Division of Endocrinology, Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Lindsay Kohler
- Department of Health Promotion Sciences, College of Public Health, University of Arizona, Tucson, AZ, USA
- Center for Disparities in Diabetes, Obesity, and Metabolism, University of Arizona Health Sciences, University of Arizona, Tucson, AZ, USA
- Pima County Department of Public Health, Tucson, AZ, USA
| | - Oscar Parra
- Center for Disparities in Diabetes, Obesity, and Metabolism, University of Arizona Health Sciences, University of Arizona, Tucson, AZ, USA
| | | | | | - Dawn Coletta
- Division of Endocrinology, Department of Medicine, University of Arizona, Tucson, AZ, USA
- Center for Disparities in Diabetes, Obesity, and Metabolism, University of Arizona Health Sciences, University of Arizona, Tucson, AZ, USA
- Department of Physiology, University of Arizona, Tucson, AZ, USA
| | - Lawrence J Mandarino
- Division of Endocrinology, Department of Medicine, University of Arizona, Tucson, AZ, USA.
- Center for Disparities in Diabetes, Obesity, and Metabolism, University of Arizona Health Sciences, University of Arizona, Tucson, AZ, USA.
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Chacón V, Chung M, Folta SC, Hennessy E, Macfarlane H, Roberto CA, Tovar A, Wilson NLW, Economos CD. The longitudinal association between caregivers' perceived competence and autonomy and children's dietary consumption before and 10 months into the COVID-19 pandemic. Appetite 2024; 195:107205. [PMID: 38242361 DOI: 10.1016/j.appet.2024.107205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/21/2024]
Abstract
The COVID-19 pandemic has been stressful, potentially affecting caregivers' feeding choices. Caregivers play a role in shaping children's diets, yet few studies have explored how their competence and autonomy, defined by the Self-Determination Theory, impact children's diets. We examined the relationship between caregivers' autonomy and competence and their feeding practices before and during the first year of the pandemic. A national convenience sample of caregivers with 3-12-year-old children completed an online survey during two time-periods. Questions adapted from the Intrinsic Motivation Inventory measured perceived competence and autonomy for feeding fruits and vegetables (F/V) and limiting sugar-sweetened beverages (SSBs) and desserts. National Health and Nutrition Examination Survey Dietary Screener questions measured children's consumption of F/V, SSBs, and desserts. Paired t-tests examined how child consumption and caregiver's perceived competence and autonomy changed, and logistic regressions examined whether caregivers' competence and autonomy predicted the change in child consumption and if changes in competence and autonomy were associated with changes in child consumption. Caregivers (n = 597) were mostly Black/African American (33.0%) or Latina/o/x (42.7%) and older than 30 years (84.1%). Children's consumption did not change overall, but caregivers' competence for feeding F/V increased, and their competence for limiting SSBs and desserts decreased. Caregiver competence and autonomy before COVID-19 did not predict child dietary consumption during the pandemic. However, change in competence was a significant predictor of the change in child consumption of F/V [OR (95%CI): 0.70 (0.57, 0.86)]. The association between caregiver's perceived competence for feeding F/V and child consumption remained positive and significant in both periods [OR (95%CI) pre and during COVID: 2.09 (1.69, 2.57) - 2.40 (1.88, 3.06)]. This study can inform behavioral interventions supporting caregivers' competence and autonomy around feeding choices.
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Affiliation(s)
- Violeta Chacón
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA.
| | - Mei Chung
- Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA
| | - Sara C Folta
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA
| | - Erin Hennessy
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA
| | - Hannah Macfarlane
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA
| | - Christina A Roberto
- Department of Medical Ethics & Health Policy, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive Blockley Hall, Philadelphia, PA, 19104-4884, USA
| | - Alison Tovar
- Department of Behavioral and Social Sciences, Center for Health Promotion and Health Equity, Brown School of Public Health, Brown University, Providence, RI 02912 USA
| | - Norbert L W Wilson
- Duke Divinity School, Sanford School of Public Policy, and Director of the World Food Policy Center, Duke University, Durham, NC, 27708, USA
| | - Christina D Economos
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA
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Woods N, Seabrook JA, Schaafsma H, Burke S, Tucker T, Gilliland J. Dietary Changes of Youth during the COVID-19 Pandemic: A Systematic Review. J Nutr 2024; 154:1376-1403. [PMID: 38408731 PMCID: PMC11007747 DOI: 10.1016/j.tjnut.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/24/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has taken the lives of millions and disrupted countless more worldwide. Simply living through the pandemic has had drastic effects on the health of citizens. Diet, an important aspect of health, has been uniquely affected by the pandemic, although these changes have not been sufficiently studied among youth. OBJECTIVES The objective of this systematic review was to investigate dietary changes of youth during COVID-19. METHODS A prespecified literature review was conducted using MEDLINE, EMBASE, Scopus, and CINAHL to identify studies from January 2020 to May 2023 that assessed dietary changes among youth aged ≤20 y compared with before the pandemic. Only quantitative observational studies that were published in English were included. Two authors completed all screening/study selection independently, with disagreements being resolved via discussion. Data extraction was completed by 1 author. Dietary changes were categorized into food groups and habits for analysis purposes. RESULTS In total, 67 studies met inclusion criteria. Most studies used recall to assess changes (48/67; 71.6%). Most studies found an increase in fruits and vegetables (24/46; 52.2%), grain products (6/11; 54.5%), meat, poultry, and eggs (4/8, 50.0%), diet quality indices and/or overall dietary assessments (7/13, 53.8%), and the frequency of snacking (9/12; 75.0%), whereas generally finding a decrease in ultraprocessed foods (32/53; 60.4%), compared with before the COVID-19 pandemic. Mixed findings or primarily no changes were found for fish and aquatic products, legumes, beans, seeds and nuts, milk and milk products, breakfast consumption, and nutrient intake. CONCLUSIONS Mostly favorable dietary changes appear to have occurred among youth during COVID-19, although there were several mixed findings and unclear takeaways among the foods and habits under study. The heterogeneity of defining food groups was a noted limitation in the current review.
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Affiliation(s)
- Nicolas Woods
- School of Health Studies, the University of Western Ontario, London, Ontario, Canada; Human Environments Analysis Laboratory, the University of Western Ontario, London, Ontario, Canada; Health and Rehabilitation Sciences, Faculty of Health Sciences, the University of Western Ontario, London, Ontario, Canada.
| | - Jamie A Seabrook
- Human Environments Analysis Laboratory, the University of Western Ontario, London, Ontario, Canada; Department of Epidemiology & Biostatistics, the University of Western Ontario, London, Ontario, Canada; School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Paediatrics, the University of Western Ontario, London, Ontario, Canada.
| | - Holly Schaafsma
- School of Health Studies, the University of Western Ontario, London, Ontario, Canada; Human Environments Analysis Laboratory, the University of Western Ontario, London, Ontario, Canada; Health and Rehabilitation Sciences, Faculty of Health Sciences, the University of Western Ontario, London, Ontario, Canada.
| | - Shauna Burke
- School of Health Studies, the University of Western Ontario, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada.
| | - Trish Tucker
- Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; School of Occupational Therapy, the University of Western Ontario, London, Ontario, Canada.
| | - Jason Gilliland
- School of Health Studies, the University of Western Ontario, London, Ontario, Canada; Human Environments Analysis Laboratory, the University of Western Ontario, London, Ontario, Canada; Department of Epidemiology & Biostatistics, the University of Western Ontario, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Paediatrics, the University of Western Ontario, London, Ontario, Canada; Department of Geography and Environment, the University of Western Ontario, London, Ontario, Canada; Health and Rehabilitation Sciences, Faculty of Health Sciences, the University of Western Ontario, London, Ontario, Canada.
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Duncan MJ, Belita E, Amores A, Riazi NA, Carsley S, Vanderloo LM, Carson V, Chaput JP, Faulkner G, Leatherdale ST, Patte KA. Changes in breakfast and water consumption among adolescents in Canada: examining the impact of COVID-19 in worsening inequity. BMC Nutr 2024; 10:27. [PMID: 38317176 PMCID: PMC10840267 DOI: 10.1186/s40795-024-00831-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND To assess whether changes in breakfast and water consumption during the first full school year after the emergence of the COVID-19 pandemic varied based on sex/gender, race/ethnicity, and socioeconomic status among Canadian adolescents. METHODS Prospective annual survey data collected pre- (October 2019-March 2020) and post-COVID-19 onset (November 2020-June 2021) the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary behaviour (COMPASS) study. The sample consisted of 8,128 students; mean (SD) age = 14.2 (1.3) years from a convenience sample of 41 Canadian secondary schools. At both timepoints self-reported breakfast and water consumption were dichotomized as daily or not. Multivariable logistic generalized estimating equations with school clustering were used to estimate differences in maintenance/adoption of daily consumption post-COVID-19 based on demographic factors, while controlling for pre-COVID-19 behaviour. RESULTS Adjusted odds ratios (AOR) with 95% confidence intervals are reported. Females (AOR = 0.71 [0.63, 0.79]) and lower socioeconomic status individuals (AORLowest:Highest=0.41 [0.16, 1.00]) were less likely to maintain/adopt daily breakfast consumption than male and higher socioeconomic status peers in the 2020-2021 school year. Black identifying individuals were less likely than all other racial/ethnic identities to maintain/adopt plain water consumption every day of the week (AOR = 0.33 [0.15, 0.75], p < 0.001). No significant interaction effects were detected. CONCLUSIONS Results support the hypothesis that changes in nutritional behaviours were not equal across demographic groups. Female, lower socioeconomic status, and Black adolescents reported greater declines in healthy nutritional behaviours. Public health interventions to improve adherence to daily breakfast and water consumption should target these segments of the population. TRIAL REGISTRATION Not a trial.
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Affiliation(s)
- Markus J Duncan
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada.
| | - Emily Belita
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Angelica Amores
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
| | - Negin A Riazi
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada
| | - Sarah Carsley
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON, M5G 1V2, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Room 500, Toronto, ON, M5T 3M7, Canada
| | - Leigh M Vanderloo
- ParticipACTION, 77 Bloor St. W., Suite 1205, Toronto, ON, M5S 1M2, Canada
- School of Occupational Therapy, Western University, 1201 Western Rd., London, ON, N6G 1H1, Canada
| | - Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 8840 114 St., Edmonton, AB, T6G 2H9, Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children?s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
- Department of Pediatrics, University of Ottawa, 75 Laurier Ave. East, Ottawa, ON, K1N 6N5, Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Lower Mall Research Station, 2259 Lower Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
| | - Karen A Patte
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada
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Gunther C, Banna J, Jones BL, Park C, Reicks M, Richards R, Schier H, Topham GL, Wong SS, Anderson AK, Ballejos M, Hopkins LC, Lora KR, Monroe-Lord L. Adolescent Independent Eating Occasions, Dietary Intake, and Parenting Practices During the COVID-19 Pandemic: A Qualitative Study of Parents and Adolescents From Households With Low Income. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:634-643. [PMID: 37422758 DOI: 10.1016/j.jneb.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 04/28/2023] [Accepted: 05/01/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVE Examine how experiencing the coronavirus disease 2019 (COVID-19) pandemic influenced adolescent independent eating occasions (iEOs) and iEO-related parenting practices from the perspective of parents and adolescents METHODS: Cross-sectional remote interviews were conducted for this basic qualitative research study. Participants were a purposive sample of multiracial/ethnic adolescents aged 11-14 years and their parents from households with low income (n = 12 dyads) representing 9 US states. The main outcome measures were iEOs and iEO-related parenting practices. Data were analyzed using directed content analysis. RESULTS About half of the parents indicated that their adolescents had more iEOs during the COVID-19 pandemic and that there were changes in the types of foods consumed during iEOs. In contrast, most adolescents indicated their iEOs had not changed remarkably in frequency or foods consumed since the onset of the pandemic. Most parents reported no change in how they taught their adolescents about healthy food, the rules for foods/beverages permitted during iEOs, or how they monitored what their adolescents ate during iEOs; adolescent reports were in general agreement. Most parents indicated that family members were home together more often during the pandemic, which increased cooking frequency. CONCLUSIONS AND IMPLICATIONS The effect of the COVID-19 pandemic on adolescents' iEOs varied, and the parenting practices used to influence iEOs remained stable during the pandemic. Families experienced having more time together and cooking at home more often.
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Affiliation(s)
- Carolyn Gunther
- Martha S. Pitzer for Women, Children, and Youth, College of Nursing, The Ohio State University, Columbus, OH.
| | - Jinan Banna
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI
| | - Blake L Jones
- Department of Psychology, Brigham Young University, Provo, UT
| | - Catherine Park
- Department of Biochemistry and Molecular Biology, Oregon State University, Corvallis, OR
| | - Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, Minneapolis, MN
| | - Rickelle Richards
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT
| | - Heather Schier
- Department of Human Sciences, The Ohio State University, Columbus, OH
| | - Glade L Topham
- Department of Applied Human Sciences, Kansas State University, Manhattan, KS
| | - Siew Sun Wong
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR
| | - Alex K Anderson
- Department of Nutritional Sciences, University of Georgia, Athens, GA
| | | | - Laura C Hopkins
- Department of Public Health and Prevention Science, Baldwin Wallace University, Berea, OH
| | - Karina R Lora
- Department of Exercise and Nutrition Sciences, The George Washington University, Washington, DC
| | - Lillie Monroe-Lord
- Center for Nutrition, Diet and Health, University of the District of Columbia, Washington, DC
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Galván M, Hernández-Cabrera J, López-Rodríguez G, Bustos N, García-Cruz R, Guzmán-Saldaña R, Alzate-Yepes T, Galván-Valencia O. Perceptions of food environments in the school and at home during Covid-19: An online cross-sectional study of parents, teachers and experts from Latin America. PLoS One 2023; 18:e0287747. [PMID: 37384611 PMCID: PMC10309603 DOI: 10.1371/journal.pone.0287747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/13/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND The high prevalence of overweight and obesity in children from Latin America (LA) have been related to obesogenic food environments. Besides, the negative effects of the Covid-19 pandemic should also be considered. The objective of this research was to describe and compare the perceptions of parents, teachers, and experts in LA of food environments at home and school that favor healthy habits in schoolchildren in pre Covid-19 stage and during the pandemic. METHODS This study used a survey self-reporting regarding conditions at home and the school favoring healthy habits, for three profiles: parents, primary school teachers, and experts. A fisher exact test was used to establish the difference between the response categories between countries and profiles. Logistic regression models were used to determine the probability of response in the levels of importance adjusted for sex and nationality. RESULTS Information from 954 questionnaires was reported: 48.4% experts, 32.0% teachers, and 19.6% parents. There were differences in the perception of food environments at school between profiles (p<0.001). In multivariate logistic regression models, experts and teachers were 20% more likely to give greater importance to elements of the food environment at school compared to parents (p<0.001). CONCLUSIONS Our findings showed that parents were less likely to perceive important elements of the school food environment compared to experts and teachers. Interventions are required to improve healthy eating environments that consider children's interpersonal mediators.
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Affiliation(s)
- Marcos Galván
- Interdisciplinary Health Sciences Research Center, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
- Interdisciplinary Network of Experts in School Environments in Latin America, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
| | - Jhazmín Hernández-Cabrera
- Interdisciplinary Health Sciences Research Center, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
- Interdisciplinary Network of Experts in School Environments in Latin America, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
| | - Guadalupe López-Rodríguez
- Interdisciplinary Health Sciences Research Center, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
- Interdisciplinary Network of Experts in School Environments in Latin America, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
| | - Nelly Bustos
- Interdisciplinary Network of Experts in School Environments in Latin America, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
- Nutrition and Food Technology Institute, University of Chile, Santiago, Chile
| | - Rubén García-Cruz
- Interdisciplinary Health Sciences Research Center, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
- Interdisciplinary Network of Experts in School Environments in Latin America, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
| | - Rebeca Guzmán-Saldaña
- Interdisciplinary Health Sciences Research Center, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
- Interdisciplinary Network of Experts in School Environments in Latin America, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
| | - Teresita Alzate-Yepes
- Interdisciplinary Network of Experts in School Environments in Latin America, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
- School of Nutrition and Dietetics, University of Antioquia, Medellín, Colombia
| | - Oscar Galván-Valencia
- Interdisciplinary Network of Experts in School Environments in Latin America, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
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Bekelman TA, Trasande L, Law A, Blackwell CK, Jacobson LP, Bastain TM, Breton CV, Elliott AJ, Ferrara A, Karagas MR, Aschner JL, Bornkamp N, Camargo CA, Comstock SS, Dunlop AL, Ganiban JM, Gern JE, Karr CJ, Kelly RS, Lyall K, O’Shea TM, Schweitzer JB, LeWinn KZ. Opportunities for understanding the COVID-19 pandemic and child health in the United States: the Environmental influences on Child Health Outcomes (ECHO) program. Front Pediatr 2023; 11:1171214. [PMID: 37397146 PMCID: PMC10308998 DOI: 10.3389/fped.2023.1171214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Objective Ongoing pediatric cohort studies offer opportunities to investigate the impact of the COVID-19 pandemic on children's health. With well-characterized data from tens of thousands of US children, the Environmental influences on Child Health Outcomes (ECHO) Program offers such an opportunity. Methods ECHO enrolled children and their caregivers from community- and clinic-based pediatric cohort studies. Extant data from each of the cohorts were pooled and harmonized. In 2019, cohorts began collecting data under a common protocol, and data collection is ongoing with a focus on early life environmental exposures and five child health domains: birth outcomes, neurodevelopment, obesity, respiratory, and positive health. In April of 2020, ECHO began collecting a questionnaire designed to assess COVID-19 infection and the pandemic's impact on families. We describe and summarize the characteristics of children who participated in the ECHO Program during the COVID-19 pandemic and novel opportunities for scientific advancement. Results This sample (n = 13,725) was diverse by child age (31% early childhood, 41% middle childhood, and 16% adolescence up to age 21), sex (49% female), race (64% White, 15% Black, 3% Asian, 2% American Indian or Alaska Native, <1% Native Hawaiian or Pacific Islander, 10% Multiple race and 2% Other race), Hispanic ethnicity (22% Hispanic), and were similarly distributed across the four United States Census regions and Puerto Rico. Conclusion ECHO data collected during the pandemic can be used to conduct solution-oriented research to inform the development of programs and policies to support child health during the pandemic and in the post-pandemic era.
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Affiliation(s)
- Traci A. Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Leonardo Trasande
- Department of Pediatrics, Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, United States
| | - Andrew Law
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Courtney K. Blackwell
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Lisa P. Jacobson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Theresa M. Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Amy J. Elliott
- Avera Research Institute, Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, United States
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Judy L. Aschner
- Departments of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ, United States
| | - Nicole Bornkamp
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Sarah S. Comstock
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, United States
| | - Anne L. Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Jody M. Ganiban
- Department of Psychological and Behavioral Sciences, The George Washington University, Washington, DC, United States
| | - James E. Gern
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Catherine J. Karr
- Departments of Pediatrics & Occupational and Environmental Health Sciences, University of Washington, Seattle, WA, United States
| | - Rachel S. Kelly
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Kristen Lyall
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - T. Michael O’Shea
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Julie B. Schweitzer
- Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, United States
| | - Kaja Z. LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
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Dhammawati F, Fagerberg P, Diou C, Mavrouli I, Koukoula E, Lekka E, Stefanopoulos L, Maglaveras N, Heimeier R, Karavidopoulou Y, Ioakimidis I. Ultra-Processed Food vs. Fruit and Vegetable Consumption before and during the COVID-19 Pandemic among Greek and Swedish Students. Nutrients 2023; 15:nu15102321. [PMID: 37242204 DOI: 10.3390/nu15102321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/04/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has impacted children's lifestyles, including dietary behaviors. Of particular concern among these behaviors is the heightened prevalence of ultra-processed food (UPF) consumption, which has been linked to the development of obesity and related non-communicable diseases. The present study examines the changes in (1) UPF and (2) vegetable and/or fruit consumption among school-aged children in Greece and Sweden before and during the COVID-19 pandemic. METHODS The analyzed dataset consisted of main meal pictures (breakfast, lunch, and dinner) captured by 226 Greek students (94 before the pandemic and 132 during the pandemic) and 421 Swedish students (293 before and 128 during the pandemic), aged 9-18, who voluntarily reported their meals using a mobile application. The meal pictures were collected over four-month periods over two consecutive years; namely, between the 20th of August and the 20th of December in 2019 (before the COVID-19 outbreak) and the same period in 2020 (during the COVID-19 outbreak). The collected pictures were annotated manually by a trained nutritionist. A chi-square test was performed to evaluate the differences in proportions before versus during the pandemic. RESULTS In total, 10,770 pictures were collected, including 6474 pictures from before the pandemic and 4296 pictures collected during the pandemic. Out of those, 86 pictures were excluded due to poor image quality, and 10,684 pictures were included in the final analyses (4267 pictures from Greece and 6417 pictures from Sweden). The proportion of UPF significantly decreased during vs. before the pandemic in both populations (50% vs. 46%, p = 0.010 in Greece, and 71% vs. 66%, p < 0.001 in Sweden), while the proportion of vegetables and/or fruits significantly increased in both cases (28% vs. 35%, p < 0.001 in Greece, and 38% vs. 42%, p = 0.019 in Sweden). There was a proportional increase in meal pictures containing UPF among boys in both countries. In Greece, both genders showed an increase in vegetables and/or fruits, whereas, in Sweden, the increase in fruit and/or vegetable consumption was solely observed among boys. CONCLUSIONS The proportion of UPF in the Greek and Swedish students' main meals decreased during the COVID-19 pandemic vs. before the pandemic, while the proportion of main meals with vegetables and/or fruits increased.
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Affiliation(s)
- Friska Dhammawati
- Innovative Use of Mobile Phones to Promote Physical Activity and Nutrition Across the Lifespan (the IMPACT) Research Group, Department of Biosciences and Nutrition, Karolinska Institutet, 14152 Stockholm, Sweden
| | - Petter Fagerberg
- Innovative Use of Mobile Phones to Promote Physical Activity and Nutrition Across the Lifespan (the IMPACT) Research Group, Department of Biosciences and Nutrition, Karolinska Institutet, 14152 Stockholm, Sweden
| | - Christos Diou
- Department of Informatics and Telematics, Harokopio University of Athens, 177 78 Athens, Greece
| | - Ioanna Mavrouli
- Innovative Use of Mobile Phones to Promote Physical Activity and Nutrition Across the Lifespan (the IMPACT) Research Group, Department of Biosciences and Nutrition, Karolinska Institutet, 14152 Stockholm, Sweden
| | | | - Eirini Lekka
- 2nd Obstetrics and Gynaecology Dept, Center of Woman Digital Health, Medical School, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Leandros Stefanopoulos
- 2nd Obstetrics and Gynaecology Dept, Center of Woman Digital Health, Medical School, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
- Image and Video Processing Laboratory, Department of Electrical and Computer Engineering, Northwestern University, Evanston, IL 60208, USA
| | - Nicos Maglaveras
- 2nd Obstetrics and Gynaecology Dept, Center of Woman Digital Health, Medical School, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | | | - Youla Karavidopoulou
- Laboratory of Medical Informatics, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Ioannis Ioakimidis
- Innovative Use of Mobile Phones to Promote Physical Activity and Nutrition Across the Lifespan (the IMPACT) Research Group, Department of Biosciences and Nutrition, Karolinska Institutet, 14152 Stockholm, Sweden
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ÓhAiseadha C, Quinn GA, Connolly R, Wilson A, Connolly M, Soon W, Hynds P. Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population Health and Health Inequalities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5223. [PMID: 37047846 PMCID: PMC10094123 DOI: 10.3390/ijerph20075223] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/05/2023] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
Since the start of the COVID-19 pandemic in early 2020, governments around the world have adopted an array of measures intended to control the transmission of the SARS-CoV-2 virus, using both pharmaceutical and non-pharmaceutical interventions (NPIs). NPIs are public health interventions that do not rely on vaccines or medicines and include policies such as lockdowns, stay-at-home orders, school closures, and travel restrictions. Although the intention was to slow viral transmission, emerging research indicates that these NPIs have also had unintended consequences for other aspects of public health. Hence, we conducted a narrative review of studies investigating these unintended consequences of NPIs, with a particular emphasis on mental health and on lifestyle risk factors for non-communicable diseases (NCD): physical activity (PA), overweight and obesity, alcohol consumption, and tobacco smoking. We reviewed the scientific literature using combinations of search terms such as 'COVID-19', 'pandemic', 'lockdowns', 'mental health', 'physical activity', and 'obesity'. NPIs were found to have considerable adverse consequences for mental health, physical activity, and overweight and obesity. The impacts on alcohol and tobacco consumption varied greatly within and between studies. The variability in consequences for different groups implies increased health inequalities by age, sex/gender, socioeconomic status, pre-existing lifestyle, and place of residence. In conclusion, a proper assessment of the use of NPIs in attempts to control the spread of the pandemic should be weighed against the potential adverse impacts on other aspects of public health. Our findings should also be of relevance for future pandemic preparedness and pandemic response teams.
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Affiliation(s)
- Coilín ÓhAiseadha
- Department of Public Health, Health Service Executive, D08 W2A8 Dublin, Ireland
| | - Gerry A. Quinn
- Centre for Molecular Biosciences, Ulster University, Coleraine BT52 1SA, UK
| | - Ronan Connolly
- Independent Scientist, D08 Dublin, Ireland
- Center for Environmental Research and Earth Sciences (CERES), Salem, MA 01970, USA
| | - Awwad Wilson
- National Drug Treatment Centre, Health Service Executive, D02 NY26 Dublin, Ireland
| | - Michael Connolly
- Independent Scientist, D08 Dublin, Ireland
- Center for Environmental Research and Earth Sciences (CERES), Salem, MA 01970, USA
| | - Willie Soon
- Center for Environmental Research and Earth Sciences (CERES), Salem, MA 01970, USA
- Institute of Earth Physics and Space Science (ELKH EPSS), H-9400 Sopron, Hungary
| | - Paul Hynds
- SpatioTemporal Environmental Epidemiology Research (STEER) Group, Environmental Sustainability & Health Institute, Technological University, D07 H6K8 Dublin, Ireland
- Irish Centre for Research in Applied Geoscience, University College Dublin, D02 FX65 Dublin, Ireland
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10
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Tovar A, Fox K, Gans KM, Markham Risica P, Papandonatos GD, Ramirez A, Gorin AA, von Ash T, Jennings E, Bouchard K, McCurdy K. Results from the Strong Families Start at Home/Familias Fuertes Comienzan en Casa: feasibility randomised control trial to improve the diet quality of low-income, predominantly Hispanic/Latinx children. Public Health Nutr 2023; 26:1-15. [PMID: 36691686 PMCID: PMC10131154 DOI: 10.1017/s1368980023000174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/21/2022] [Accepted: 01/13/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To describe the feasibility, acceptability and results of Strong Families Start at Home, a 6-month pilot trial of a home-based food parenting/nutrition intervention. DESIGN Pilot randomised controlled trial. SETTING Participants received six visits with a community health worker trained in motivational interviewing (three home visits, three phone calls); an in-home cooking or reading activity; personalised feedback on a recorded family meal or reading activity; text messages and tailored printed materials. PARTICIPANTS Parents and their 2-5-year-old child were randomised into intervention (responsive food parenting practices/nutrition) or control (reading readiness) groups. RESULTS Parents (n 63) were mostly mothers (90 %), Hispanic/Latinx (87 %), born outside the USA (62 %), with household incomes <$25 k (54 %). Despite delivery during COVID-19, 63 % of dyads were retained at 6 months. The intervention was delivered with high fidelity. All parents in the intervention group (n 24) expressed high levels of satisfaction with the intervention, which produced positive treatment effects for whole and total fruit component Healthy Eating Index-2015 scores (point estimate (PE) = 2·14, 95 % CI (0·17, 1·48); PE = 1·71, 95 % CI (0·16, 1·47), respectively) and negative treatment effects for sodium (PE = -2·09, 95 % CI (-1·35, -0·04)). Positive treatment effects also resulted for the following food parenting practices: regular timing of meals and snacks (PE = 1·08, 95 % CI (0·61, 2·00)), reducing distractions during mealtimes (PE = -0·79, 95 % CI (-1·52, -0·19)), using food as a reward (PE = -0·54, 95 % CI (-1·35, -0·04)) and providing a supportive meal environment (PE = 0·73, 95 % CI (0·18, 1·51)). CONCLUSION Given the continued disparities in diet quality among low-income and diverse families, continued efforts to improve child diet quality in fully powered intervention trials are needed.
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Affiliation(s)
- Alison Tovar
- Department of Behavioral and Social Sciences, Brown School of Public Health, Box G-121S Rm 813, Providence, RI02912, USA
| | - Katelyn Fox
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Kim M Gans
- Department of Behavioral and Social Sciences, Brown School of Public Health, Box G-121S Rm 813, Providence, RI02912, USA
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Patricia Markham Risica
- Department of Behavioral and Social Sciences, Brown School of Public Health, Box G-121S Rm 813, Providence, RI02912, USA
| | | | - Andrea Ramirez
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Amy A Gorin
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Tayla von Ash
- Department of Behavioral and Social Sciences, Brown School of Public Health, Box G-121S Rm 813, Providence, RI02912, USA
| | - Ernestine Jennings
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Kelly Bouchard
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Karen McCurdy
- Department of Human Development and Family Science, University of Rhode Island, Kingston, RI, USA
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Johnson AN, Clockston RLM, Fremling L, Clark E, Lundeberg P, Mueller M, Graham DJ. Changes in Adults' Eating Behaviors During the Initial Months of the COVID-19 Pandemic: A Narrative Review. J Acad Nutr Diet 2023; 123:144-194.e30. [PMID: 36075551 PMCID: PMC9444582 DOI: 10.1016/j.jand.2022.08.132] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 08/20/2022] [Accepted: 08/31/2022] [Indexed: 11/18/2022]
Abstract
Factors such as regulations and health concerns shifted daily habits, including eating behaviors, during the early months of the coronavirus disease 2019 (COVID-19) pandemic. This comprehensive narrative review synthesizes research on eating behavior changes during the early months of the pandemic (February to June 2020), including changes in amount, rate, and timing of food consumption, types and healthfulness of foods consumed, the occurrence of other specified eating behaviors (eg, restrained eating or binging), and reasons for eating (eg, stress or cravings), among adults. A literature search using three EBSCOhost databases and Google Scholar was conducted to identify relevant articles made available in 2020. A total of 71 articles representing 250,715 individuals from more than 30 countries were reviewed. Findings show eating behaviors changed little during the early COVID-19 pandemic for most participants. Among those whose eating behaviors changed, increases in both intake and frequency of eating meals and snacks were more common than decreases. Findings on timing of eating and healthfulness of food consumed showed mixed results. However, when changes occurred in the type of food consumed, increases were more common for snacks, homemade pastries, white bread/pasta, legumes, and fruits/vegetables; decreases were more common for meats, seafood/fish, frozen foods, fast food, dark breads/grains, and dark leafy green vegetables. During the pandemic, binging, uncontrolled eating, and overeating increased, meal skipping decreased, and restrictive eating had mixed findings. Changes in factors such as emotions and mood (eg, depression), cravings, and environmental factors (eg, food insecurity) were related to changes in eating behaviors. Findings can inform clinical practitioners in efforts to mitigate disruptions to normal, healthy eating patterns among adults both in and outside of global health catastrophes.
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Affiliation(s)
- Ashlie N Johnson
- Department of Psychology, Linfield University, McMinnville, Oregon.
| | | | - Lindsey Fremling
- Department of Psychology, Colorado State University, Fort Collins, Colorado
| | - Emma Clark
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado
| | - Pamela Lundeberg
- Department of Psychology, Colorado State University, Fort Collins, Colorado
| | - Megan Mueller
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, Colorado
| | - Dan J Graham
- Department of Psychology, Colorado State University, Fort Collins, Colorado
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Zhu L, Kim EJ, González E, Fraser MA, Zhu S, Rubio-Torio N, Ma GX, Yeh MC, Tan Y. Reducing Liver Cancer Risk through Dietary Change: Positive Results from a Community-Based Educational Initiative in Three Racial/Ethnic Groups. Nutrients 2022; 14:4878. [PMID: 36432564 PMCID: PMC9698707 DOI: 10.3390/nu14224878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/28/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
Dietary behaviors and alcohol consumption have been linked to liver disease and liver cancer. So far, most of the liver cancer awareness campaigns and behavioral interventions have focused on preventive behaviors such as screening and vaccination uptake, while few incorporated dietary aspects of liver cancer prevention. We implemented a community-based education initiative for liver cancer prevention among the African, Asian, and Hispanic populations within the Greater Philadelphia and metropolitan New York City areas. Data from the baseline and the 6-month follow-up surveys were used for the assessment of changes in dietary behaviors and alcohol consumption among participants. In total, we recruited 578 participants through community-/faith-based organizations to participate in the educational workshops. The study sample included 344 participants who completed both baseline and follow-up survey. The Hispanic subgroup was the only one that saw an overall significant change in dietary behaviors, with the Mediterranean dietary score increasing significantly from 30.000 at baseline survey to 31.187 at 6-month follow-up assessment (p < 0.05), indicating a trend towards healthier dietary habit. In the African Americans participants, the consumption scores of fruits and poultry increased significantly, while vegetables and red meats decreased. In Asian Americans, the consumption of non-refined cereals, red meats, and dairy products decreased. Alcohol consumption decreased significantly among Hispanics while it did not change significantly among the other two communities. This community-based educational initiative generated different impacts in the three populations, further highlighting the needs for more targeted, culturally tailored efforts in health promotion among these underprivileged communities.
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Affiliation(s)
- Lin Zhu
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
- Department of Urban Health and Population Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
| | - Ellen Jaeseon Kim
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
| | - Evelyn González
- Office of Community Outreach, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA 19111, USA
| | | | - Steven Zhu
- Pennsylvania United Chinese Coalition, Philadelphia, PA 19107, USA
| | | | - Grace X. Ma
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
- Department of Urban Health and Population Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
| | - Ming-Chin Yeh
- Nutrition Program, Hunter College, City University of New York, New York, NY 10017, USA
| | - Yin Tan
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
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13
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Lashkarbolouk N, Mazandarani M, Pourghazi F, Eslami M, Khonsari NM, Ghonbalani ZN, Ejtahed HS, Qorbani M. How did lockdown and social distancing policies change the eating habits of diabetic patients during the COVID-19 pandemic? A systematic review. Front Psychol 2022; 13:1002665. [PMID: 36211913 PMCID: PMC9540372 DOI: 10.3389/fpsyg.2022.1002665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundAfter the declaration of the COVID-19 pandemic, governments established national lockdowns and social distancing as an effective plan to control this disease. As a result of the lockdown policies, diabetic patients` access to food products, medication, and routine follow-ups is disrupted, making it difficult for them to control their disease.MethodsInternational databases, including PubMed/Medline, Web of Science, and Scopus, were searched until April 2022. All observational studies included assessing the impact of lockdown and social distancing on eating habits (as primary outcome), and glycemic and anthropometric indices (as secondary outcomes) of diabetic patients during the COVID-19 pandemic. The Newcastle-Ottawa Quality Scale was used to assess the quality rating of the studies.ResultsOverall, 22 studies were included in this systematic review, the results of which varied in different communities. In most studies, consumption of grains, fruits, and vegetables was reported to increase. On the other hand, consumption of snacks and sweets was reported to increase in other surveys. During the COVID-19 lockdown, most diabetic patients preferred to cook meals at home, using less takeout, fast foods, and alcoholic drinks. Although the patients mostly improved their eating habits, the glycemic and anthropometric indices were contradictory in different studies. Studies showed that the eating habits of diabetic patients vary from country to country, even in some cases and studies done in the same country showed different results. For example, all the studies done in Japan showed an increase in the consumption of snacks and sweets, leading to weight gain in the patients. However, conflicting results in eating habits have been observed in studies conducted in India.ConclusionThe lockdown policies have led to a beneficial change in the eating habits of diabetic patients to consume more fruits and vegetables and reduce the consumption of animal protein products and alcoholic beverages. While some diabetic patients have increased consumption of snacks and sweets, leading to a disturbance in their glycemic and anthropometric indices control. Understanding the consequences of lockdown and social distancing of the diabetic patient during the COVID-19 pandemic can help public health authorities make better recommendations to improve glycemic control.
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Affiliation(s)
- Narges Lashkarbolouk
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Mazandarani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Pourghazi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maysa Eslami
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Zahra Nouri Ghonbalani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Hanieh-Sadat Ejtahed,
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Mostafa Qorbani,
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14
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van den Broek N, Larsen JK, Verhagen M, Burk WJ, Vink JM. Adolescents' food intake changes during the COVID-19 pandemic: The moderating role of pre-pandemic susceptibility, COVID-19 related stressors, and the social food context. EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2022; 20:616-634. [PMID: 37377464 PMCID: PMC10292123 DOI: 10.1080/17405629.2022.2115999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/22/2022] [Indexed: 11/03/2022]
Abstract
Although insight in how adolescents' food intake is affected by the COVID-19 pandemic is critical, knowledge is limited. Hence, this longitudinal study (N = 691, Mage = 14.30, SDage = 0.62; 52.5% female) investigated changes in adolescents' unhealthy (sugar-sweetened beverages, sweet snacks, savoury snacks) and healthy (fruit and vegetables) food intake (in total, obtained from home, and from outside the home) from pre-pandemic (Spring 2019) to the first lockdown (Spring 2020) and to six months later (Fall 2020). Moreover, several moderating factors were assessed. Results showed that the intake of unhealthy and healthy food in total and obtained from outside the home decreased during the lockdown. Six months later, unhealthy food intake returned to pre-pandemic levels, while healthy food intake remained lower. COVID-19 stressful life events and maternal food intake further qualified these longer-term changes in intake of sugar-sweetened beverages and fruit and vegetables, respectively. Future work is warranted to elucidate longer-term COVID-19 effects on adolescents' food intake.
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Affiliation(s)
- Nina van den Broek
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Junilla. K. Larsen
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Maaike Verhagen
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - William J. Burk
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Jacqueline M. Vink
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
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15
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Bekelman TA, Dong Y, Elliott AJ, Ferrara A, Friesen K, Galarce M, Gilbert-Diamond D, Glueck DH, Hedderson MM, Hockett CW, Karagas MR, Knapp EA, Lucchini M, McDonald JC, Sauder KA, Dabelea D. Health Behavior Changes during the COVID-19 Pandemic: A Longitudinal Analysis among Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159220. [PMID: 35954577 PMCID: PMC9368377 DOI: 10.3390/ijerph19159220] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/20/2022] [Accepted: 07/25/2022] [Indexed: 12/04/2022]
Abstract
This longitudinal study compared children’s health behaviors before the COVID-19 pandemic versus during the pandemic. This analysis examined the association between individual-level characteristics and health behavior change. Four prospective cohort studies in the Environmental influences on Child Health Outcomes (ECHO) Program contributed data. Children aged 4−12 years and their caregivers were recruited in California, Colorado, North Dakota, and New Hampshire. Dietary intake, physical activity, screen time, and sleep duration were assessed with questionnaires pre-pandemic and during the pandemic. The final sample included 347 children: 47% female and 62% non-Hispanic White. Compared with pre-pandemic, weekday screen time duration was higher during the pandemic (3.0 vs. 4.5 h, p < 0.001). Unadjusted increases in screen time duration differed by race and ethnicity: 1.3 h/day for non-Hispanic White children, 2.3 h/day for Hispanic children, and 5.3 h/day for non-Hispanic Black children. Overall, no changes occurred in sugar-sweetened beverage (SSB) intake (p = 0.26), discretionary food intake (p = 0.93), and physical activity (p = 0.15). Sleep duration increased by 30 min among children who did not meet sleep recommendations pre-pandemic. Child sex and maternal education level were not associated with health behavior change. The pandemic may have exacerbated disparities in some health behaviors. Families may need support to re-establish healthy routines.
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Affiliation(s)
- Traci A. Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (K.F.); (D.H.G.); (K.A.S.); (D.D.)
- Correspondence:
| | - Yanan Dong
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (Y.D.); (E.A.K.)
| | - Amy J. Elliott
- Avera Research Institute, Sioux Falls, SD 57108, USA; (A.J.E.); (C.W.H.)
- Department of Pediatrics, School of Medicine, University of South Dakota, Sioux Falls, SD 57108, USA
| | - Assiamira Ferrara
- Kaiser Permanente Northern California Division of Research, Oakland, CA 94612, USA; (A.F.); (M.G.); (M.M.H.); (J.C.M.)
| | - Kaylyn Friesen
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (K.F.); (D.H.G.); (K.A.S.); (D.D.)
| | - Maren Galarce
- Kaiser Permanente Northern California Division of Research, Oakland, CA 94612, USA; (A.F.); (M.G.); (M.M.H.); (J.C.M.)
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Medicine and Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA; (D.G.-D.); (M.R.K.)
| | - Deborah H. Glueck
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (K.F.); (D.H.G.); (K.A.S.); (D.D.)
- Department of Pediatrics, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
| | - Monique M. Hedderson
- Kaiser Permanente Northern California Division of Research, Oakland, CA 94612, USA; (A.F.); (M.G.); (M.M.H.); (J.C.M.)
| | - Christine W. Hockett
- Avera Research Institute, Sioux Falls, SD 57108, USA; (A.J.E.); (C.W.H.)
- Department of Pediatrics, School of Medicine, University of South Dakota, Sioux Falls, SD 57108, USA
| | - Margaret R. Karagas
- Department of Epidemiology, Medicine and Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA; (D.G.-D.); (M.R.K.)
| | - Emily A. Knapp
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (Y.D.); (E.A.K.)
| | - Maristella Lucchini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032, USA;
| | - Julia C. McDonald
- Kaiser Permanente Northern California Division of Research, Oakland, CA 94612, USA; (A.F.); (M.G.); (M.M.H.); (J.C.M.)
| | - Katherine A. Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (K.F.); (D.H.G.); (K.A.S.); (D.D.)
- Department of Pediatrics, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (K.F.); (D.H.G.); (K.A.S.); (D.D.)
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Mayra ST, Kandiah J, McIntosh CE. COVID-19 and health in children and adolescents in the US: A narrative systematic review. PSYCHOLOGY IN THE SCHOOLS 2022; 60:PITS22723. [PMID: 35572171 PMCID: PMC9088696 DOI: 10.1002/pits.22723] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/05/2022] [Accepted: 04/11/2022] [Indexed: 12/11/2022]
Abstract
In the United States, the Coronavirus Disease 2019 (COVID-19) pandemic necessitated nationwide closures of kindergarten through twelfth grade (K-12) schools. Stay-at-home orders and social distancing mandates were also implemented to mitigate the spread of COVID-19. The purpose of this systematic review was to synthesize the existing literature on how COVID-19 impacted K-12 students' eating patterns, physical activity, and sleep in the United States. Utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search was conducted between October and December 2021. Inclusion criteria were studies focused on COVID-19 and eating patterns, physical activity, and sleep in students enrolled in K-12 schools since March 2020. International studies were excluded. Mixed findings were observed for eating patterns whereby the consumption of unhealthful savory and sweet items and healthful snacks (e.g., fruit and vegetables) increased. Reductions in physical activity and disrupted sleep routines were also observed. Heterogeneity in methodological procedures may limit the generalizability of these findings. In the United States, preliminary data suggest that select health-promoting behaviors were negatively impacted by the COVID-19 pandemic. Given that prolonged unhealthful eating patterns, physical inactivity, and poor sleep contribute to chronic disease risk, initiatives that increase health-promoting behaviors are warranted.
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Affiliation(s)
- Selicia T. Mayra
- Department of Nutrition and Health ScienceBall State UniversityMuncieIndianaUSA
| | - Jayanthi Kandiah
- Department of Nutrition and Health ScienceBall State UniversityMuncieIndianaUSA
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[A cohort-comparison of food intake, lifestyle and social-emotional health of adolescents before and during the corona crisis]. TSG : TIJDSCHRIFT VOOR GEZONDHEIDSWETENSCHAPPEN 2022; 100:40-48. [PMID: 35281369 PMCID: PMC8902735 DOI: 10.1007/s12508-022-00331-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/04/2022] [Indexed: 11/17/2022]
Abstract
De coronacrisis kan beschouwd worden als een ‘natuurlijk experiment’ waarin de sociale context aanzienlijk is veranderd. Het is nog grotendeels onbekend hoe jongeren daarop reageren en welke gedragingen veranderen. We hebben een cohortvergelijking gemaakt van derdeklassers (N = 177, Mleeftijd = 15,00) van de middelbare school vóór de coronacrisis (voorjaar 2019) met een qua demografische kenmerken vergelijkbare groep derdeklassers (N = 188, Mleeftijd = 14,95) tijdens de eerste lockdown (voorjaar 2020). We vergeleken de domeinen eetgedrag, leefstijl en sociaal-emotionele gezondheid tussen beide cohorten en keken naar de samenhang binnen en tussen domeinen voor beide cohorten. De consumptie van zoete snacks thuis, alcoholgebruik en eenzaamheid waren in het coronacohort hoger dan vóór de coronacrisis (niet significant na correctie). De consumptie van fruit thuis, van suikerhoudende dranken en ongezonde snacks buitenshuis, en matige en zware fysieke activiteit kwamen minder voor tijdens de lockdown. Relatietevredenheid met ouders, geluksgevoel en stress door school waren lager vergeleken met het cohort vóór de lockdown. Roken, stress thuis en relatietevredenheid met beste vriend(in) waren in beide cohorten even hoog. Het patroon van samenhang binnen en tussen de domeinen verschilde. Verder onderzoek moet uitwijzen hoe veerkrachtig jongeren op de langere termijn zijn en welke jongeren ondersteuning nodig hebben om terug te veren.
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Eating Behaviour Changes during the COVID-19 Pandemic: A Systematic Review of Longitudinal Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111130. [PMID: 34769648 PMCID: PMC8582896 DOI: 10.3390/ijerph182111130] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/13/2021] [Accepted: 10/20/2021] [Indexed: 12/11/2022]
Abstract
Eating behaviour is a complex construct that is liable to be modified by external factors. Due to the outbreak of coronavirus disease 2019 (COVID-19), many restrictive measures were carried out with the aim of reducing the impact of this disease. As a result, lifestyles were disrupted, which could affect eating behaviours. The aim of this systematic review of longitudinal studies was to assess changes in eating behaviour during the COVID-19 pandemic by establishing a comparison of eating behaviours before and after the outbreak of the pandemic. This study followed the PRISMA guidelines (PROSPERO: CRD42020203246), whereas to assess the quality of the studies, the Newcastle-Ottawa Quality Assessment Scale (NOS) was applied. Out of a set of 826 studies, 23 were included in this systematic review. The main findings provided information about a shift towards modified eating behaviours, characterized by an increased snack frequency and a preference for sweets and ultra-processed food rather than fruits, vegetables, and fresh food. Additionally, an increased alcohol consumption was found among different countries. Consequently, adherence to healthy diets decreased. These findings are relevant to future policies and strategies to assess nutrition in cases of alarming situations such as the current COVID-19 pandemic.
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