Exploring changes in body image, eating and exercise during the COVID-19 lockdown: A UK survey

'I've learned a lot about myself this year': Young student women's perceptions of their cumulative use of digital fitness technologies across the Covid-19 pandemic

Many young women turned to digital fitness technologies (DFT) to support their health and wellbeing during the covid-19 pandemic. The present study explores young student women's retrospective perceptions of their cumulative engagement with DFT, across periods of restriction and easing (March 2020-2021). Seventeen UK-based women (Age M = 20.29, SD = 1.72); Ethnicity White = 94.12% participated in one-on-one interviews using an adapted scroll-back technique. Data was analysed using narrative-informed reflexive thematic analysis. Three themes were developed: My lockdown #fitnesstransformation: DFT as information and inspiration, My unrealistic expectations: DFT as a source of comparison and concern and My new body positive and resilient self: DFT as a catalyst to self-development. Themes highlight how perceptions of DFT changed over time as a consequence of repeat engagement, sociocultural context and psychological meaning-making. Crucially, findings underscore the importance of examining the collective and cumulative effects of DFT engagement on health and wellbeing, both positive and negative.

Cognitive reappraisal moderates the protective effect of body satisfaction on mental health and wellbeing in adults: A prospective study during COVID-19 lockdown

BACKGROUND

Body satisfaction is associated with mental health and well-being in adults. However, prospective studies are needed to better understand its protective effects, and in whom these are most beneficial. This study investigated body satisfaction as a predictor of depressive symptoms, generalised anxiety, and well-being in a representative Australian sample collected during the initial COVID-19 lockdown. Two emotion regulation strategies - cognitive reappraisal and expressive suppression - were also tested as moderating variables.

METHODS

The sample comprised 684 adults aged 19 to 87 years who completed three primary waves of data spanning two months [Wave 3 (W3), W4 and W7] from the Australian National COVID-19 Mental Health, Behaviour and Risk Communication Survey.

RESULTS

Hierarchical multiple regression models controlling for demographic and COVID-19 risk factors, as well as W3 for each outcome variable, indicated that W3 body satisfaction predicted greater W7 well-being, and fewer W7 depressive symptoms and greater W7 well-being in participants reporting low levels of W4 cognitive reappraisal. No moderation for W4 expressive suppression was observed, nor predictive relationships between W3 body satisfaction and W7 anxiety.

LIMITATIONS

The two-month follow-up period precludes conclusions relating to the longer-term protective effects of body satisfaction within and beyond the pandemic context. Examination of focal relationships in clinical samples, and inclusion of broader indices of body image, emotion regulation and mental health, is needed in future studies.

CONCLUSIONS

Findings suggest body satisfaction warrants attention in community well-being promotion in adults, and may be particularly beneficial for those lack adaptive emotion regulation strategies.

Impact of Antenatal Care Modifications on Gestational Diabetes Outcomes During the COVID-19 Pandemic

BACKGROUND

Many of the adverse outcomes of gestational diabetes mellitus (GDM) are linked to excessive fetal growth, which is strongly mediated by the adequacy of maternal glycemic management. The COVID-19 pandemic led to a rapid adoption of virtual care models. We aimed to compare glycemic management, fetal growth, and perinatal outcomes before and during the COVID-19 pandemic.

METHODS

A retrospective cohort study was conducted between 2017 and 2020. Singleton pregnancies complicated by GDM were included in the study. The cohort was stratified into "before" and "during" COVID-19 subgroups, using March 11, 2020, as the demarcation time point. Women who began their GDM follow-up starting March 11, 2020, and thereafter were allocated to the COVID-19 era, whereas women who delivered before the demarcation point served as the pre-COVID-19 era. The primary outcome was the rate of large-for-gestational-age (LGA) neonates. Secondary outcomes included select maternal and neonatal adverse outcomes.

RESULTS

Seven hundred seventy-five women were included in the analysis, of which 187 (24.13%) were followed during the COVID-19 era and 588 (75.87%) before the COVID-19 era. One hundred seventy-one of the 187 women (91.44%) followed during COVID-19 had at least 1 virtual follow-up visit. No virtual follow-up visits occurred before the COVID-19 era. There was no difference in the rate of LGA neonates between groups on both univariate (5.90% vs 7.30%, p=0.5) and multivariate analyses, controlling for age, ethnicity, parity, body mass index, gestational weight gain, chronic hypertension, smoking, and hypertensive disorders in pregnancy (adjusted odds ratio [aOR] 1.11, 95% confidence interval [CI] 0.49 to 2.51, p=0.80). In the multivariate analysis, there was no difference in composite neonatal outcome between groups (GDM diet: aOR 1.40, 95% CI 0.81 to 2.43, p=0.23; GDM medical treatment: aOR 1.20, 95% CI 0.63 to 2.43, p=0.5).

CONCLUSIONS

After adjusting for differences in baseline variables, the combined virtual mode of care was not associated with a higher rate of LGA neonates or other adverse perinatal outcomes in women with GDM. Larger studies are needed to better understand the specific impact of virtual care on less common outcomes in pregnancies with GDM.

COVID-19 pandemic impact among adolescents with eating disorders referred to Italian psychiatric unit

PROBLEM

The COVID-19 pandemic has triggered or exacerbated eating disorders (EDs), especially in adolescents. This study examined the prevalence of admissions of patients with EDs at the Child and Adolescent Psychiatry Unit from the pre-COVID-19 pandemic to March 2023 and explored the differences in dimensions of ED's symptomatology according to the year of access.

METHODS

We included 174 children and adolescents, 94.3% females and 5.7% males, with a diagnosis of ED (Mage  = 14.87; SD = 1.72). The Eating Disorder Inventory-3 (EDI-3), the Body Uneasiness Test (BUT) and Youth Self Report ASEBA (YSR) were assessed. A one-way analysis of variance test was performed.

FINDINGS

EDs' hospitalization prevalence was higher in the years 2020 and 2021 compared to pre-COVID-19 and the year 2022. Considering the ED psychopathology (EDI-3), findings showed a higher score in the dimension of the push to thinness, body dissatisfaction, asceticism, and fear of maturity in the year 2021 compared to pre-pandemic. Regarding the discomfort related to the image of one's own body (BUT), results showed an increase in the global severity index in the year 2022 compared to pre-pandemic and in weight phobia in the year 2021 compared to the year 2020. Concerning the internalizing symptoms (YSR), a tendency was found for withdrawal/depression, with higher levels in the year 2022 compared to the year 2020.

CONCLUSIONS

Our study highlighted the increase of different types of EDs symptomatology related to concerns about weight, especially 2 and 3 years after the outbreak of the pandemic, on which the literature is still scarce, especially in the Italian context.

Healthcare providers' perspectives on implementing a brief physical activity and diet intervention within a primary care smoking cessation program: a qualitative study

BACKGROUND

Post-smoking-cessation weight gain can be a major barrier to quitting smoking; however, adding behavior change interventions for physical activity (PA) and diet may adversely affect smoking cessation outcomes. The "Picking up the PACE (Promoting and Accelerating Change through Empowerment)" study assessed change in PA, fruit/vegetable consumption, and smoking cessation by providing a clinical decision support system for healthcare providers to utilize at the intake appointment, and found no significant change in PA, fruits/vegetable consumption, or smoking cessation. The objective of this qualitative study was to explore the factors affecting the implementation of the intervention and contextualize the quantitative results.

METHODS

Twenty-five semi-structured interviews were conducted with healthcare providers, using questions based on the National Implementation Research Network's Hexagon Tool. The data were analyzed using the framework's standard analysis approach.

RESULTS

Most healthcare providers reported a need to address PA and fruit/vegetable consumption in patients trying to quit smoking, and several acknowledged that the intervention was a good fit since exercise and diet could improve smoking cessation outcomes. However, many healthcare providers mentioned the need to explain the fit to the patients. Social determinants of health (e.g., low income, food insecurity) were brought up as barriers to the implementation of the intervention by a majority of healthcare providers. Most healthcare providers recognized training as a facilitator to the implementation, but time was mentioned as a barrier by many of healthcare providers. Majority of healthcare providers mentioned allied health professionals (e.g., dieticians, physiotherapists) supported the implementation of the PACE intervention. However, most healthcare providers reported a need for individualized approach and adaptation of the intervention based on the patients' needs when implementing the intervention. The COVID-19 pandemic was found to impact the implementation of the PACE intervention based on the Hexagon Tool indicators.

CONCLUSION

There appears to be a need to utilize a flexible approach when addressing PA and fruit/vegetable consumption within a smoking cessation program, based on the context of clinic, the patients' it is serving, and their life circumstances. Healthcare providers need support and external resources to implement this particular intervention.

NAME OF THE REGISTRY

Clinicaltrials.gov.

TRIAL REGISTRATION NUMBER

NCT04223336.

DATE OF REGISTRATION

7 January 2020 Retrospectively registered. URL OF TRIAL REGISTRY RECORD: https://classic.

CLINICALTRIALS

gov/ct2/show/NCT04223336 .

Impact of COVID-19 on negative body image: Evidence based on social media data

Body experiences and conditions bear close relations to social development and human well-being. However, no consensus has been reached regarding the impact of coronavirus disease 2019 on negative body image. Investigating a reliable relationship between COVID-19 and negative body image, we developed a dictionary of negative body image to obtain panel data on body image for 31 Chinese provinces/municipalities/autonomous regions. We compared negative body image before and after the pandemic and explored the impact of pandemic severity. The prevalence of negative body image decreased following the outbreak and remained at a relatively low level for two years. After controlling regional and temporal effects, we verified epidemic severity as an important predictor of the decline in negative body image. The findings suggest that the public is likely to accept their physical appearances during lockdown due to changes in lifestyle and the fear of mortality. This research has important implications for gaining insights into the dynamic transformation of public negative body image under the influence of catastrophic public health events.

How does COVID-19-related social media usage influence disordered eating? A daily diary study among Chinese adults during lockdown

BACKGROUND

Despite previous studies highlighting the benefits of social media use during the COVID-19 pandemic, particularly under lockdown, limited research has identified the potential detrimental consequences of social media use during lockdown. Therefore, the purpose of this study is to examine the effects of social media on mental health in particular situations and the mechanisms underlying these effects.

METHODS

A daily diary protocol was adopted. A total of 96 adults (Mage = 25.90 ± 8.32 years) were recruited from Xi'an, Shaanxi Province, China. COVID-19-related social media use, psychological distress, COVID-19-related stress and anxiety, and disordered eating were measured each day for a week. Multilevel path analyses for the nested data were conducted.

RESULTS

Daily COVID-19-related social media use was positively related to daily disordered eating (r = .13 p < .001). Furthermore, the multilevel path analysis showed that psychological distress and COVID-19-related stress and anxiety mediated the relationship between COVID-19-related social media use and disordered eating at the within-person level. However, only COVID-19-related-anxiety mediated the relationship at the between-person level.

CONCLUSIONS

Our findings contribute to the understanding of social media's impact during lockdown and provide implications for social media users, social media platform providers, mental health professionals, and governments regarding the correct and sustainable use of social media during the COVID-19 pandemic and in future public health emergencies.

COVID-19-related anxiety and trauma symptoms predict decreases in body image satisfaction in children

The present study investigated short-term longitudinal effects of COVID-19-related trauma and separation, social, and generalized anxiety symptoms on children's body image satisfaction. Participants were 247 Canadian children (121 boys, 123 girls) aged between 7 and 12 years (M = 9.04). Two cohorts of parents were recruited to complete a questionnaire at two time points on their children's body image satisfaction and COVID-19-related trauma and anxiety symptoms. The first cohort (n = 136 children) was recruited in Summer 2020 and the second cohort (n = 111 children) was recruited in Winter 2021. For each cohort, follow-up surveys were completed approximately five months later, therefore covering an entire year with both cohorts. Multilevel regression analyses showed that children's trauma and anxiety at Time 1 predicted significant decreases in body image satisfaction at Time 2. Older children were especially at risk of decreased body image satisfaction as a result of their COVID-19-related trauma, social anxiety and generalized anxiety symptoms. Younger girls were susceptible to decreased body image satisfaction as a result of their separation anxiety symptoms. Given that children's body image dissatisfaction is a precursor to the development of eating disorders, these findings shed light on potential targets for early intervention with children who are at-risk of developing such difficulties.

EDIFY (Eating Disorders: Delineating Illness and Recovery Trajectories to Inform Personalised Prevention and Early Intervention in Young People): project outline

EDIFY (Eating Disorders: Delineating Illness and Recovery Trajectories to Inform Personalised Prevention and Early Intervention in Young People) is an ambitious research project aiming to revolutionise how eating disorders are perceived, prevented and treated. Six integrated workstreams will address key questions, including: What are young people's experiences of eating disorders and recovery? What are the unique and shared risk factors in different groups? What helps or hinders recovery? How do the brain and behaviour change from early- to later-stage illness? How can we intervene earlier, quicker and in a more personalised way? This 4-year project, involving over 1000 participants, integrates arts, design and humanities with advanced neurobiological, psychosocial and bioinformatics approaches. Young people with lived experience of eating disorders are at the heart of EDIFY, serving as advisors and co-producers throughout. Ultimately, this work will expand public and professional perceptions of eating disorders, uplift under-represented voices and stimulate much-needed advances in policy and practice.

Family body culture, disordered eating and mental health among young adult females during COVID-19

Different family interactions related to body weight and shape may co-occur and represent a broader 'family body culture'. This may be important in the context of COVID-19 due to a heightened focus on body weight/shape, and many young adults living back with their families. This study aimed to, first, explore relationships between different family body-related interactions to assess the presence of a family body culture, and second, explore relationships between aspects of family body culture, disordered eating and mental health among young adult females during the COVID-19 pandemic. Participants were 233 females aged 18-25 years who completed measures of family body culture (family fat talk; family weight concern; family weight teasing), disordered eating, anxiety and depression. Results showed all aspects of family body culture were significantly, positively related. Engaging in fat talk with family members (self fat talk) was a key correlate of disordered eating, anxiety and depression. Family concern with weight was also significantly associated with disordered eating. Findings suggest that among some families there is a more problematic family body culture with a greater importance placed on body weight and shape through various body-related interactions. Additionally, findings highlight two key aspects of family body culture related to disordered eating and wellbeing among young adult females. Specifically, vocalising critical remarks about one's own body when with family and an environment that may indirectly communicate a high importance of body weight and shape (e.g., via dieting). These should be considered in future family interventions to support healthy eating behaviours.

A Cytomegalovirus (CMV) Case Study to Promote Interprofessional Learning (IPL) Between Audiology and Biomedical Science Students in Higher Education

Modern and effective patient care requires specialist healthcare professionals working together. Interprofessional learning (IPL) seeks to provide opportunities for different healthcare disciplines to learn with, from and about each other. This study focused on the delivery and evaluation of a cytomegalovirus (CMV) case study workshop to facilitate IPL between two Health and Care Professions Council (HCPC) regulated courses: Biomedical Science and Audiology. The 2 h online workshop consisted of 1) defining the roles, responsibilities and skills of the two healthcare professions, 2) the structure of the Biomedical Science and Audiology departments, 3) routes to HCPC registration, 4) core curriculum of both degree programmes and 5) interpreting interdisciplinary data related to a CMV patient case. The workshop was interactive, with the virtual learning environment promoting peer discussions and the use of online polling. Student responses were collected through an online questionnaire. A total of 108 respondents completed a post-event survey and Mann-Whitney U tests revealed there were no significant differences in the responses between the two student cohorts in response to each of the survey statements (p > 0.05). A total of 82.4% of students agreed that they need to know the role of other healthcare professionals for their future practice, whilst 84.2% agreed that the CMV case study was a good format to facilitate effective IPL. A total of 93.5% of respondents recognised the importance of both professions in diagnosing a patient with CMV. Thematic analysis identified four common themes, including appreciation of shared roles, recognition of similarities in registration pathways, working together to provide holistic patient care and the role of clinicians in the patient journey. This novel collaboration between Biomedical Science and Audiology facilitated effective IPL whilst meeting the interprofessional education HCPC requirements. Collaborative working is an essential component of delivering effective patient care and allied healthcare degrees need to provide opportunities within their curriculum to foster this. We hope this study encourages other higher education institutes to expand and develop their current IPL activities to include a broader spectrum of healthcare courses.

Preparing for the next pandemic by understanding the impact of COVID-19 mitigation measures on patients with eating Disorders: observations from an inpatient setting

OBJECTIVE

The COVID-19 pandemic overwhelmed eating disorder (ED) services worldwide. Data suggests a worsening of psychopathology and an increased request for specialised treatments. Still, the studies are mostly based on experimental protocols with underpowered short-term opportunistic experimental designs. Thus, this study aims to assess the clinical and psychological differences between patients admitted to a specialised ED Unit before and after the COVID-19 breakout.

METHODS

Consecutive patients admitted from June 2014 to February 2022 in a specialised EDs Unit were enrolled. A total sample of 498 individuals was enrolled in this retrospective study, collecting demographic and psychopathological data at admission.

RESULTS

An increase in the admission of patients with anorexia nervosa has been reported, with lower age and higher levels of specific and general psychopathology, especially linked to body uneasiness.

CONCLUSIONS

Results are put into the context of the preparation for the next pandemic that may require similar mitigation measures as COVID-19 to ensure the impact on existing and new patients. Covering an extended period with validated tools, our results might help psychiatric services to reassess their treatment pathways after the pandemic, helping clinicians to delineate future treatment interventions.KEYPOINTSAfter the COVID-19 breakdown, there was an increase in the admission of patients with anorexia nervosa to specialised services.More severe psychopathology was not accompanied by lower body mass index.Specialised eating disorders services should face sudden changes in patients' requests for treatment.Understanding the impact of the Covid-19 pandemic and the resulting mitigation measures taken can lead to better preparations for the next pandemic.

Exploring the reciprocal associations between body appreciation, body image flexibility, and body acceptance by others in the context of the COVID-19 pandemic in Germany: Results from cross-lagged panel analyses among women and men

The COVID-19 pandemic provided a context associated with negative consequences for body image and eating behavior. However, little is known about what factors helped to mitigate these consequences and build a positive body image. Previous research pointed to the significance of body image flexibility and perceived body acceptance by others in predicting body appreciation. However, as most of the studies have been cross-sectional, causal relationships are poorly understood. This longitudinal study tested the reciprocal association between body appreciation, body image flexibility, and perceived body acceptance by others during the COVID-19 pandemic in Germany. We analyzed data from a large community sample consisting of 1436 women and 704 men who were invited to complete the study measures (BAS-2, BI-AAQ-5, BAOS-2) at three time points, each approximately six months apart. Latent cross-lagged panel analyses revealed that greater T1 body appreciation predicted an increase in T2 body image flexibility among both genders, while for women, we additionally observed reciprocal effects between T2 and T3. Among both genders, we further found that greater body appreciation predicted increased perceived body acceptance by others over both measurement intervals (but not vice versa). Our findings are discussed in light of pandemical constraints during the studies' assessments.

The Impact of the First and Second Wave of the COVID-19 Pandemic on Eating Symptoms and Dysfunctional Eating Behaviours in the General Population: A Systematic Review and Meta-Analysis

BACKGROUND

The aim of this systematic review and meta-analysis was to examine the prevalence of feeding and eating disorder (FED) symptoms or dysfunctional eating behaviours (DEB) in the general population during the COVID-19 outbreak.

METHOD

We searched eligible articles in biomedical databases from 1 January 2020 to 31 March 2022. Prevalence rates of FED or DEB changes between pre-pandemic and pandemic time and correlation with psychological distress were pooled with a meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I2) statistics. A total of 186 studies with 406,076 participants met the inclusion criteria.

RESULTS

The more prevalent FED or DEB during the COVID-19 outbreak were: body image concerns (52%, 95% CI 0.38, 0.66), binge eating (40%, 95% CI 0.25, 0.55), and overeating (40%, 95% CI = 0.32-0.48). Pooled data of longitudinal studies (k = 8) only showed a significant difference in the prevalence of weight gain from pre-pandemic to the pandemic time. Finally, increased levels of psychological distress (k = 35) positively correlated with some ED symptoms.

CONCLUSION

This meta-analysis evidenced a negative impact of the pandemic on eating symptoms and DEB in the general population.

[Diet and body weight at the beginning of the COVID-19 pandemic in Mexico]

Background

Weight changes in adults have strong repercussions on people's health status. During the COVID-19 pandemic, these changes could be more evident due to the mandatory confinement, as well as eating habits and lifestyle. In this study, changes in diet and body weight in Mexican population at the beginning of COVID-19 lockdown period (weeks 4-7) were evaluated using an online survey.

Objective

To identify the characteristics of the diet and the perceived change in body weight at the beginning of the COVID-19 pandemic in Mexico.

Material and methods

Descriptive, cross-sectional study of 1281 people over 18 years of age, electronic survey in weeks 4-7 of confinement with sociodemographic data, food consumption and perception of body weight.

Results

The change in food consumption was 53.9%, finding differences according to gender in beverages (carbonated, juices, alcoholic), coffee/tea, fruits, legumes (p < 0.05). The perception of body weight increases by 3.4 (increased) and 2.1 (lowered) times more than the risk of change in diet.

Conclusions

The dietary differences refer to a tendency to the type of food consumed, mainly sugary drinks, with the perception of changes in positive body weight in women.

The impact of COVID-19 on the changes in health behaviours among Black, Asian and Minority Ethnic (BAME) communities in the United Kingdom (UK): a scoping review

BACKGROUND

The COVID-19 pandemic has led to changes in health behaviours, which include eating patterns and nutrition, smoking, alcohol consumption, sleeping patterns, physical activity and sedentary behaviour. There is a dearth of evidence reporting the impact of COVID-19 on the health behaviour of Black, Asian and minority ethnic (BAME) communities. This scoping review synthesises the available evidence on the impact of COVID-19 on the changes in health behaviours among BAME communities in the UK.

METHODS

Following a keyword strategy, 16 electronic databases were searched for articles that met the screening criteria. These articles were then reviewed in full text. Empirical studies that assessed COVID-19 related health behaviour changes among BAME communities in the UK, conducted during the COVID-19 pandemic between July 2020 and August 2021 and published in English language, were set as inclusion criteria. An initial 2160 studies were identified in the selected databases. After removing duplications and screening the title and abstracts of the 2154 studies, only 4 studies were selected to be reviewed as they met the inclusion criteria. The included studies employed different sample sizes which ranged from N = 47 to N = 30,375 and reported several health behaviour changes. Out of the 4 included studies, 3 studies included BAME groups within their sample as a subgroup while one study focused specifically on BAME groups.

RESULTS

The scoping review found that there were lower levels of physical activity among BAME groups compared to the White ethnic groups. About 41.7% of BAME groups reported drinking less alcohol than usual compared to their white counterparts who were 34%. Study participants from BAME backgrounds had the greatest effect of COVID-19 on decisions to purchase healthier food compared to those from white backgrounds whose decisions on purchasing healthier food were least affected. Some participants reported an increase in positive hygiene practices due to the COVID-19 pandemic.

CONCLUSION

COVID-19 had a significant impact on the health behaviours of BAME groups especially during the lockdowns as they reported changes to behaviour such as low levels of physical activities. Hence, it is important to promote health awareness among BAME groups to encourage healthy living. In addition, programmes such as physical fitness activities that favour BAME groups should be put in place, for example BAME women's walking groups to encourage people from BAME backgrounds to engage in physical activities. Furthermore, healthy food programmes such as food parcels can be given to people from BAME backgrounds who are not able to afford healthy food due to the impact of COVID-19. Nonetheless, the COVID-19 pandemic has increased positive hygiene among BAME groups which is important in preventing other diseases and infections.

How risk perception regarding the COVID-19 pandemic affected household food waste: Evidence from Brazil

Food waste is a worldwide problem. One third of the food produced in the world is lost or wasted every year. Most of this waste takes place downstream of the supply chain due to consumer behavior. This issue is expected to increase in both developed and emerging economies. With the beginning of the COVID-19 pandemic, a range of challenges led to changes in consumer behavior. This study explores household food waste behavior during the COVID-19 pandemic through the lens of the Theory of Planned Behavior. The risk perception regarding the pandemic was integrated into a broader framework, which was analyzed by Structural Equation Modeling. The sample comprises the participation of 452 Brazilian individuals. The results show that all the predictors incorporated in the model were statistically significant. The intention of reducing household food waste during the pandemic was found to be the strongest predictor of food waste behavior. Additionally, the pandemic apparently influenced consumers' perceptions about the control they think they have over food waste. This research has theoretical and managerial implications. From a theoretical perspective, this study identifies key predictors of household food waste by considering a period of health crisis in an emerging country. From a managerial standpoint, this research may provide a learning experience for future similar scenarios. Results may also motivate consumers to look for ways to reduce, reuse and recycle food waste.

Fat talk, old talk, or both? Association of negative body talk with mental health, body dissatisfaction, and quality of life in men and women

BACKGROUND

Little research has investigated the harmful effects of old talk-negative age-related body talk-on mental health and quality of life despite substantial research examining fat talk. Old talk also has only been evaluated in women and in relation to few outcomes. Of note, old talk and fat talk are strongly correlated, suggesting possible overlap in elements that drive negative outcomes. Thus, the primary aim of this study was to investigate the extent that old talk and fat talk contribute to negative mental health and quality of life outcomes when examined in the same model and when interacting with age.

METHODS

Adults (N = 773) ages 18-91 completed an online survey assessing eating disorder pathology, body dissatisfaction, depression, aging anxiety, general anxiety, quality of life, and demographics.

RESULTS

While fat talk and old talk were correlated with almost all outcome variables, fat talk was more commonly significantly associated with poorer outcomes than old talk. Additionally, the relationship between fat talk and old talk with poorer mental health was affected by age in men, but not women.

CONCLUSIONS

Future research is warranted to decipher the individual effects of old talk and fat talk on mental health and quality of life across the adult lifespan.

"I'll never sacrifice my well-being again:" The journey from negative to positive body image among women who perceive their body to deviate from societal norms

We conducted one-on-one interviews with 25 Canadian cisgender women who self-identified as having (a) a condition or characteristic causing their body to deviate from societal norms and (b) overcome a negative body image to develop a positive body image. Using coding reliability thematic analyses, we identified 12 themes (italicised) involving processes and experiences associated with shifts in body image. Women had moments that sparked and confirmed the importance of building positive body image (Enough is Enough). They experienced accepting Social Connections and Community and Accessed Critical Knowledge conducive to body positivity. They engaged in Joyful Movement, Adaptive Appearance Investment, and Joyful and Intuitive Eating. They identified how Changing Societal Norms, Becoming Older and Wiser, COVID-19 Pandemic, having Illnesses and Medical Conditions, Pregnancy and Motherhood, and Spirituality, Religion, and Nature affected their body image, values, and valued action. As women engaged in these processes and experiences, shifts occurred in their perceptions of their embodied selves in the world, represented by four "Bigger Lessons:" I Am More Than My Looks, I Am More Than My Body, I am More Than My Self, and I am Inherently Worthy of Love, Respect, and Joy. These findings can inform body image programmes and clinical interventions.

Exploring the impact of the COVID-19 pandemic on perceptual disturbances and dysfunctional eating attitudes and behaviors: A review of the literature

From the outbreak of the novel coronavirus 2019 (COVID-19) a new physical and social distancing environment has changed our lives and, more particularly, the way of perceiving oneself, as well as eating attitudes and behaviors. An increasing number of studies have highlighted a risky scenario in terms of negative perceptions of one’s body as well as disordered eating and eating disorder patterns in both clinical and general population. With regard to this postulate, this literature review posits two main concepts—perceptual disturbances and dysfunctional eating attitudes and behaviors—in the general and (sub-)clinical populations, to provide an understanding of these phenomena during the COVID-19 pandemic. The main objective of this article is to provide a comprehensive and critical review of published scientific literature about perceptual disturbances (i.e., negative body image, body image disturbances, low body esteem) and dysfunctional eating attitudes and behaviors, including disordered eating (e.g., restrictive eating, binge-eating episodes, overeating, emotional eating) and eating disorders features in community (i.e., general population) and clinical and sub-clinical samples worldwide during the COVID-19 pandemic. The PubMed, ScienceDirect, Ebsco, and Google Scholar databases were searched. The initial search produced 42 references. Scientific publications from March 2020 to April 2022 were included, and among the works compiled, only published research articles have been retained. Purely theoretical papers were also excluded. The final selection consisted of 21 studies, covering both community, clinical (i.e., eating disorder population), and sub-clinical samples. The details of the results are discussed taking into consideration the potential impact of changes in the way we perceive ourselves and interact with others (e.g., the popularity of videoconferencing and the over-use of social network sites due to social isolation) as well as changes in eating attitudes and behaviors, physical activity and exercise (e.g., as an emotional response to the insecurity generated by the pandemic context), in community and (sub-)clinical samples. The discussion sheds light on two outcomes: (1) a summary of findings with methodological considerations; (2) an intervention continuum to deal with the consequences of the COVID-19 pandemic; (3) and a final conclusion.

Zooming in: The relationship between appearance concerns and perceived performance whilst videoconferencing among Australian adults

Videoconferencing for work/study purposes has increased rapidly due to the COVID-19 global pandemic. Given this practice often involves viewing one's own video image, higher appearance concerns whilst videoconferencing may be linked to poorer performance whereby individuals may not feel they are able to engage or have control during a work/study meeting. The present study cross-sectionally examined whether both facial appearance concerns and fear of negative evaluation during videoconferencing for work/study purposes were directly and indirectly related to performance control and engagement, through self-focused attention and appearance distraction. Adult participants (N = 534, M_age = 26.32, SD = 11.08; 78% female) completed an online survey during the COVID-19 pandemic in Australia. Path analysis revealed direct and indirect effects, suggesting that heightened appearance self-consciousness was associated with greater self- and appearance-focused attention. In turn, this was related to impaired performance during videoconferencing. Multigroup analyses demonstrated that the magnitude of the proposed correlational effects were comparable across men and women. Given the ongoing reliance on videoconferencing, these findings have important theoretical and practical implications.

Effects of COVID-19 specific body positive and diet culture related social media content on body image and mood among young women

During the COVID-19 pandemic, social media content emerged that included explicit weight and shape pressure. In addition, however, body positive social media content that was pandemic-specific appeared. This study aimed to examine the effects of body positive and diet culture COVID-19 body-related social media content on the body image and mood of young women. A sample of 387 female identifying participants aged 18-25 were allocated to view one of three sets of social media images: body positive or diet related content specific to the COVID-19 pandemic, or a travel condition. Body image and mood before and after viewing the images were assessed. Trait level social media literacy and current social distancing and isolation restrictions were examined as moderators. Exposure to the body positive content was associated with improved body image and mood as compared to the diet culture content. No support was found for moderating effects although social media literacy was associated with improved body image after exposure. Findings suggest that even in the context of the COVID-19 pandemic, body positive content may be helpful to body image. Further work examining inter-individual differences in the effects of social media on body image and mood are warranted.

Nutritional changes during the COVID-19 pandemic: a rapid scoping review on the impact of psychological factors

COVID-19 and the resulting measures to curb the spread of the virus have significantly changed our lives, including our nutritional choices. In this rapid scoping review an overview is provided of what psychological factors may be associated with peoples' eating behaviour during COVID-19 restrictions. Relevant literature was identified using PubMed, PsycInfo, CINAHL and MEDLINE databases from 2019 onwards. For included studies, information on study characteristics, eating behaviours, and psychological factors were extracted. 118 articles were included, representing 30 countries. Findings indicated that most people consumed more and unhealthy food in times of COVID-19 restrictions, while some consumed less but often for the wrong reasons. Several psychological factors, related to (1) affective reactions, (2) anxiety, fear and worriers, (3) stress and (4) subjective and mental wellbeing were found to be associated with this increase in food consumption. These outcomes may help to be better inform future interventions, and with that, to be better prepared in case of future lockdown scenarios.

COVID-19-related changes in eating disorder pathology, emotional and binge eating and need for care: a systematic review with frequentist and Bayesian meta-analyses

PURPOSE

The COVID-19 pandemic has been a leading cause of stress and feelings of loss of control, both of which have been related to eating disorder (ED) pathology onset and deterioration. We aim to estimate the magnitude of changes in the prevalence rates of, and indicators for, ED psychopathology in the face of the COVID-19 pandemic.

METHOD

Pre-registered systematic review with frequentist and Bayesian meta-analyses. Searches for eligible studies were performed in PubMed, Web of Science and pre-print servers until January 15 2023.

RESULTS

Our searches yielded 46 eligible studies reporting on a total of 4,688,559 subjects. These data provide strong evidence indicating increased rates of diagnosed and self-reported ED's and a concordant increased need for care in the face of the pandemic. ED symptom severity scores in patients were not elevated during the pandemic, except for those related to anorexia nervosa. On average, people in the general population report relatively high levels of emotional and binge eating during the pandemic, although the evidential strength for these associations is only anecdotal to moderate. Moderators of between-study heterogeneity were not detected.

CONCLUSIONS

Altogether, our results suggest that the COVID-19 pandemic is associated with a wide spread negative effect on ED pathology in patient samples and the general population. The development of online prevention and intervention programs for EDs during stressful times like a pandemic is encouraged. A limitation is that the results reported here may be prone to biases, amongst others, self-report bias.

LEVEL OF EVIDENCE

Level I, systematic review and meta-analysis.

PREREGISTRATION

Prospero [ https://www.crd.york.ac.uk/prospero ] ID: CRD42022316105.

Sleep and emotionality in adolescents with anorexia nervosa during the Covid-19 pandemic

PURPOSE

The recent Covid-19 pandemic and its lockdown measures raised concerns about people's mental health, leading to an increased interest in identifying vulnerable groups especially at risk for mental distress. This cross-sectional study investigated the impact of this unprecedented situation on sleeping patterns and emotionality in adolescents with anorexia nervosa (AN).

METHODS

Variations in sleeping patterns and emotionality of two groups of adolescents with AN, assessed before (N = 50) and during (N = 51) the Covid-19 lockdown were analysed. We further investigated these variations over time, considering the two lockdown periods in France.

RESULTS

Adolescents self-reported significantly more sleep difficulties and lower rates of positive emotions during lockdown, compared to those evaluated before it. Furthermore, present findings overall suggest that as the lockdown progresses, adolescents with AN show an increased deterioration of sleep quality, as indicated by greater insomnia severity levels. They also show a significant decrease in the subjective experience of positive emotionality, in particular in feelings of tenderness.

CONCLUSIONS

These sleep and emotionality alterations may have amplified the severity and the incidence of AN in adolescents during the Covid-19 pandemic. These features may therefore represent therapeutic targets to optimise care of adolescents with AN. This is particularly urgent, considering kinetics of the deterioration. Tools such as those provided by cognitive behavioural therapy for insomnia and by the positive psychology framework seem appropriate to guide clinicians in this context.

LEVEL OF EVIDENCE

Level V, descriptive study (evaluation data retrospectively studied).

Experiences and impact of the UK lockdown amongst adults who have a facial visible difference

Globally, COVID-19 has been shown to have had a wide ranging and significant impact on individuals' daily living, and physical and mental health. However, there are some groups of individuals who may encounter unique challenges with regards to COVID-19 and whose experiences have not been investigated thus far. Therefore, this study aimed to understand the experiences of adults with a facial visible difference in relation to COVID-19 and lockdown. Semi-structured interviews were conducted with 21 adults with a variety of facial visible differences (e.g., cleft lip/palate, facial scars, skin conditions) and analyzed using inductive reflexive thematic analysis. This analysis generated three themes (Escaping the external gaze; Existing feelings manifesting in new challenges; COVID-19 taking priority). The results of this study suggest that the first U.K. lockdown from the COVID-19 pandemic created significant challenges for some individuals with a facial visible difference, and ongoing restrictions and social distancing measures might be particularly challenging for those who experience anxiety around social encounters. These findings highlight the importance of providing appropriate and accessible support for people with facial differences during lockdown and as restrictions ease.

The Association between Physical Activity, Self-Compassion, and Mental Well-Being after COVID-19: In the Exercise and Self-Esteem Model Revised with Self-Compassion (EXSEM-SC) Perspective

During the great life-altering challenges brought by Coronavirus 2019, school closures and lack of access to exercise and social interactions may have increased students' negative emotions. The current research acts as a follow-up study to the development of the EXSEM-SC, using the Repeated Measures Panel Analysis Framework (RMPAF) to examine the stability of the model in revealing the relationship between physical activity, self-compassion, and mental well-being among Hong Kong adolescents. It is also aimed at examining the changes in physical activity, self-compassion, and mental well-being among Hong Kong adolescents between, before, and after the peak of COVID-19 using the EXSEM-SC Model. The RMPAF has involved 572 (60% Female, Mage = 13.63, SD =1.31) Hong Kong secondary school students. Furthermore, using the abductive qualitative approach, a total of 25 (Mage = 14.84, SD = 1.40) students were involved in the in-depth interviews to further investigate the relationships within the EXSEM-SC. The quantitative results showed that the relationship between physical activity and self-compassion could be demonstrated by the EXSEM-SC, with a satisfactory goodness-of-fit index in the SEMs, as well as satisfying model construct consistency. Moreover, it showed no significant differences in the level of physical activity, self-compassion, and mental well-being during and after the peak of COVID-19. The qualitative results demonstrated two new categories within the EXSEM-SC variables, which are personality traits and injuries experiences. With the stability of the EXSEM-SC model among adolescents, it is expected that the physical activity intervention, which is based on the EXSEM-SC model, could also aim at easing Hong Kong adolescent's mental health issues. In addition, in terms of generating a long-term impact among students, the physical activity and self-compassionate intervention should be promoted among schools. However, the quantitative properties of the two new categories in the qualitative outcomes should be involved in future investigation.

Changes in Adults' Eating Behaviors During the Initial Months of the COVID-19 Pandemic: A Narrative Review

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.

Public Perception Before and After COVID-19 Vaccine Pass for the Unvaccinated to Eat Alone: Social Media Data Analytics

This study was conducted to compare the trends of public perception in South Korea about the vaccine pass requiring the unvaccinated to eat alone during the COVID-19 crisis. Data were collected via Text mining; frequency, association, and sentiment analysis using the social big data analysis service, (known as "Some-Trend"), 2 months before and after December 16, 2021, when the vaccine pass was announced. The total number of search results was 4899 occurrences of the keywords using "eating alone" and "Hon-bab" (Korean abbreviation for eating alone). During the week of December 16, the frequency was the highest (770 occurrences). Compared to the weeks before the announcement sentiment analysis shows that words including "Reject," "Discrimination," and "Uncomfortable," among others, either newly appeared or increased in frequency. And also, the percentage of positive words decreased from 54.5% to 34% and that of negative words increased from 30.2% to 43.3%. The introduction of the vaccine pass has raised negative public interest, particularly regarding the policy of unvaccinated people forcefully restricted to eat alone. Accordingly, this study showed that the vaccine policy had not gain positive perception of the public.

Risk and protective factors for new-onset binge eating, low weight, and self-harm symptoms in >35,000 individuals in the UK during the COVID-19 pandemic

OBJECTIVE

The disruption caused by the COVID-19 pandemic has been associated with poor mental health, including increases in eating disorders and self-harm symptoms. We investigated risk and protective factors for the new onset of these symptoms during the pandemic.

METHOD

Data were from the COVID-19 Psychiatry and Neurological Genetics study and the Repeated Assessment of Mental health in Pandemics Study (n = 36,715). Exposures were socio-demographic characteristics, lifetime psychiatric disorder, and COVID-related variables, including SARS-CoV-2 infection/illness with COVID-19. We identified four subsamples of participants without pre-pandemic experience of our outcomes: binge eating (n = 24,211), low weight (n = 24,364), suicidal and/or self-harm ideation (n = 18,040), and self-harm (n = 29,948). Participants reported on our outcomes at frequent intervals (fortnightly to monthly). We fitted multiple logistic regression models to identify factors associated with the new onset of our outcomes.

RESULTS

Within each subsample, new onset was reported by: 21% for binge eating, 10.8% for low weight, 23.5% for suicidal and/or self-harm ideation, and 3.5% for self-harm. Shared risk factors included having a lifetime psychiatric disorder, not being in paid employment, higher pandemic worry scores, and being racially minoritized. Conversely, infection with SARS-CoV-2/illness with COVID-19 was linked to lower odds of binge eating, low weight, and suicidal and/or self-harm ideation.

DISCUSSION

Overall, we detected shared risk factors that may drive the comorbidity between eating disorders and self-harm. Subgroups of individuals with these risk factors may require more frequent monitoring during future pandemics.

PUBLIC SIGNIFICANCE

In a sample of 35,000 UK residents, people who had a psychiatric disorder, identified as being part of a racially minoritized group, were not in paid employment, or were more worried about the pandemic were more likely to experience binge eating, low weight, suicidal and/or self-harm ideation, and self-harm for the first time during the pandemic. People with these risk factors may need particular attention during future pandemics to enable early identification of new psychiatric symptoms.

Disparities in eating disorder symptoms and mental healthcare engagement prior to and following the onset of the COVID-19 pandemic: Findings from a national study of US college students

OBJECTIVE

Early COVID-19 eating disorders (EDs) research used regionally restricted samples with little sociodemographic diversity. The present study aimed to address these research gaps by examining whether pandemic-related changes in ED symptoms and mental healthcare prevalence differed for historically marginalized groups within a national sample of US college students.

METHOD

Participants included 242,906 US college students (M_age  = 23.45, SD = 7.04; M_BMI  = 25.28, SD = 5.91) who completed the repeated cross-sectional multi-institute Healthy Minds Study between January 2019 and May 2021. Moderated logistic regressions examined whether pandemic-related changes in individuals' likelihoods of exhibiting current probable ED, reporting lifetime ED diagnoses, and-among individuals with current probable ED-mental healthcare engagement differed for diverse gender, sexual, and racial/ethnic identity groups, and by body mass index (BMI) and financial stress.

RESULTS

There were increases of 5% and 12% in individuals' likelihoods of exhibiting current probable ED and symptomatic individuals' mental healthcare engagement, respectively, pre- to post-COVID-19 onset, but no pandemic-related changes in lifetime ED diagnosis prevalence. There were also important variations in these time-trends for different marginalized groups. For example, individuals identifying as genderqueer/gender nonconforming and lesbian exhibited increasing ED symptoms pre- to post-COVID-19 onset, and individuals with current probable ED and higher BMIs were increasingly likely to receive mental healthcare. Associations between financial stress, and the ED and mental healthcare outcomes did not change over time.

DISCUSSION

These findings provide insight into groups of US college students that experienced disproportionate ED burden during the pandemic at the population level, and directions for research and interventions that warrant consideration.

Internalization of athletic body ideal as a mediating variable between family influence and body image of young women. A cross-cultural study of polish, Italian, and Ukrainian women

Introduction

Our aim was to analyze the strength of the family's influence on the internalization of the ideal of an athletic figure and, consequently, on the multifactorial image of the body, from the perspective of intercultural differences.

Methods

A total of 488 healthy women aged 19-26; of Polish (154), Ukrainian (228), and Italian (106) took part in the study. The Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-4) and the Multidimensional Body-Self Relations Questionnaire (MBSRQ 69) were used to measure athletic ideal internalization and family pressure. The body image of Ukrainian, Polish, and Italian women depends both on the degree of internalization the ideal of an athletic figure and influence of the family.

Results and Discussion

The research also suggests significant differences between the three populations, which may suggest cultural differences between young women living in Eastern, Central, and South European countries.

Women's body dissatisfaction, physical appearance comparisons, and Instagram use throughout the COVID-19 pandemic: A longitudinal study

OBJECTIVE

This study aimed to determine the evolution of Instagram use, body dissatisfaction and physical appearance comparisons throughout the coronavirus disease-2019 (COVID-19) pandemic, and to explore whether there was a relationship between the changes in Instagram use throughout the pandemic and body dissatisfaction and physical appearance comparisons.

METHOD

A total of 272 Spanish women (16-70 years old) were followed-up across four waves of assessment between November 2019 (before the pandemic started) and July 2021. Body dissatisfaction, social appearance comparisons, and Instagram use were assessed using the Eating Disorders Inventory-3, the Physical Appearance Comparison Scale-Revised, and an ad hoc questionnaire for Instagram use, respectively.

RESULTS

No statistically significant changes were found in the frequency of Instagram use, nor on the proportion of women following appearance-focused accounts on Instagram, among the data collection periods. Body dissatisfaction significantly increased from T1 to T4, and physical appearance comparisons significantly increased from T1 to T2, T3, and T4. These increases were not found to be significant for those with eating disorder risk. No significant differences were found in body dissatisfaction and physical appearance comparisons depending on whether participants' frequency of Instagram use had changed or remained the same, or whether they had started/stopped/continued following appearance-focused accounts on Instagram during the pandemic.

DISCUSSION

Women's body dissatisfaction and physical appearance comparisons seem to have increased throughout the pandemic. The experiences of individuals with eating disorder risk throughout the pandemic, and the relationship between the pandemic and Instagram use, might be complex and need further research.

PUBLIC SIGNIFICANCE

This study suggests that women's body dissatisfaction and physical appearance comparisons have increased throughout the COVID-19 pandemic. However, this increase might not be as clear for those who had eating disorder risk before the pandemic. Instagram frequency of use, and the percentage of women following appearance-focused accounts on Instagram, do not seem to have significantly increased. More research is needed to explore the impact of the pandemic.

Disordered eating in female Indian students during the Covid-19 pandemic: The potential role of family

BACKGROUND

Within a paternalistic culture where weight is socially important and parental pressures are strong, 10 female Indian university students across various countries faced particular problems when living with their parents during the Covid-19 lockdowns.

OBJECTIVE

The current interview study examines why cultural and familial factors during the Covid-19 lockdown had such an impact on female Indian university students' food and exercise behaviors and self-view.

METHOD

Semi-structured, online (Microsoft Teams) interviews were conducted with 10 female Indian university students aged 20-23, who had moved back in with their parents during lockdown. The recorded and transcribed interviews were analyzed using reflexive thematic analysis with a contextualist orientation.

RESULTS

Five themes were generated. Set within a context where eating and exercise habits are regulated by cultural and familial factors (Theme 1), lockdown living situations amplified these factors (Theme 2), severely impacting students' cognitions and affect (Theme 3), and relationships with their parents (Theme 4) even after lockdown was over. Participants' experiences led to greater awareness and motivation to confront their issues regarding body image and mental health (Theme 5).

CONCLUSIONS

These findings have practical implications for counseling and eating disorder (ED) therapy in universities: Improved understanding of cultural and familial factors that affect female Indian students likely leads to better support. Our findings also emphasizes the need for research into the role of family and the impacts of family dynamics in the development of disordered eating habits.

PUBLIC SIGNIFICANCE

In Indian culture, eating and exercise habits tend to be regulated by cultural and familial factors. When female university students moved back in with their parents during the Covid-19 lockdowns, their living situation amplified these factors, severely impacting students' thoughts and feelings about their body, and relationships with their parents even after lockdown was over. The study has strong practical implications for university counseling settings and adds to research on the role of culture in how ED develops.

Body perceptions, occupations, eating attitudes, and behaviors emerged during the pandemic: An exploratory cluster analysis of eaters profiles

Introduction

COVID-19 pandemic negatively impacted people's mental and physical health. Three areas have been significantly impacted, among others: eating-related behaviors, occupational balance, and exposure to self-image due to videoconferencing. This study aims to explore and document eaters profiles that were reported during the pandemic in the general Canadian population using a holistic perspective, including body perceptions, attitudes, and eating behaviors (i.e., body image, behaviors, attitudes, and motivations regarding food), and occupations (i.e., physical activity and cooking).

Methods

This cross-sectional study was conducted from May to September 2020. Two hundred and seventy-three Canada's residents, French speaking of 18 years of age and older, participated in an online survey on behaviors, attitudes, and motivations regarding food and eating as well as body image and occupations during the COVID-19 pandemic. A hierarchical cluster analysis was used to determine the eaters profiles. One-way ANOVA and Chi-square test were conducted to differentiate occupational characteristics between eaters profiles.

Results

Three distinctive profiles were found during the COVID-19 pandemic and could be placed on a continuum: the Congruent-driven eater is at the functional pole of the continuum, whereas the Incongruent-driven eater is at the dysfunctional pole of the eaters continuum. In the middle of the continuum, the Incongruent-perceptual eater is at a critical crossing point. Significant differences were reported between eaters profiles.

Discussion

The empirical results based on an eaters continuum conceptualization highlight the importance of understanding how people perceive their body to assess and promote food well-being.

How will the way we live look different in the wake of the COVID-19 pandemic? A nutrition survey in Greece

Background: As we move towards a post-pandemic society, a question arises: How will the way we live look different in the wake of the COVID-19 pandemic? Aim: The aim of this survey was to evaluate changes in eating habits and other lifestyle behaviours (i.e., exercise and smoking) of people of almost all ages, who live in Greece, during the COVID-19 pandemic. Methods: A web-based survey using conventional sampling was conducted from during December 2020, in Greece. A total of 2258 individuals, aged 17 years and older voluntarily participated (912 (40%) men). Results: 89 (3.94%) of the participants reported that they had, or currently have been diagnosed with COVID-19. Moreover, 36.4% of the participants reported that they have changed their dietary habits during the pandemic towards a healthier diet - those participants had median age of 35 years, were of both sexes, 17% had co-morbidities and 69% with higher education level; moreover, 19% of those participants have started or increased the frequency of receiving dietary supplements that enhance the immune system, 34% of the participants reported that they gained weight during the pandemic period, whereas 19.8% reported that they have lost weight, and 37% of the participants reported that they have started or increased, as compared to the pre-pandemic time, their frequency of physical activities. Conclusions: The COVID-19_pandemic seems to have forced people to discover again habits and traditions towards a more natural and healthier way of living. Long-term consequences and the evolution of these lifestyle changes after the COVID-19 pandemic have to be evaluated relevant to their implications in public health.

Association between the Health Belief Model, Exercise, and Nutrition Behaviors during the COVID-19 Pandemic

INTRODUCTION

The COVID-19 pandemic has affected our nation's health further than the infection it causes. Physical activity levels and dietary intake have suffered while individuals grapple with the changes in behavior to reduce viral transmission. With unique nuances regarding the access to physical activity and nutrition during the pandemic, the constructs of Health Belief Model (HBM) may present themselves differently in nutrition and exercise behaviors compared to precautions implemented to reduce viral transmission studied in previous research. The purpose of this study was to investigate the extent of exercise and nutritional behavior change during the COVID-19 pandemic and explain the reason for and extent of this change using HBM constructs (perceived susceptibility, severity, benefit of action, and barriers to action).

METHODS

This study used a cross-sectional design to collect 206 surveys. This survey collected information on self-reported exercise and nutrition changes during the pandemic and self-reported levels of the HBM constructs.

RESULTS

Findings showed individuals with medium or high exercise behavior change had greater odds of increased HBM score than individuals with little to no exercise behavior change (OR = 1.117, 95% CI: 1.020-1.223, SE: 0.0464, p = 0.0175). There was no association between nutritional behavior change and HBM score (OR = 1.011, 95% CI: 0.895-1.142, p = 08646).

CONCLUSION

Individuals who reported a more drastic change in either exercise had greater odds of increased feelings of perceived susceptibility and severity related to COVID-19 and decreased perceived benefits and increased barriers to exercise. This relationship was not found regarding nutrition behavior change. These results encourage public health practitioners to understand how an individual's perceived feelings about a threat may affect exercise and nutritional behaviors.

Association between body image perception with demographic characteristics of physically active individuals during COVID-19 lockdown in Saudi Arabia

Objective

This study aimed to determine the relationship between body image perception and demographic factors among physically active (men and women) during the COVID-19 lockdown in Saudi Arabia.

Methods

A descriptive cross-sectional survey was employed among physically active individuals in Saudi Arabia between June and July 2020. Eligible participants completed a 19-item self-administered questionnaire that covered three areas: demographic questions, reasons for physical activity, and role or perceptions of body image during the COVID-19 pandemic quarantine.

Results

A total of 323 physically active individuals participated in this study. The majority of the participants were female (N=217, 72.7%), were married (66.6%), and living in the Middle region of Saudi Arabia (N= 268, 83%). The analysis shows that majority of the participants were dissatisfied with their current body shape. The analysis also showed a significant association between participants' educational attainment and BMI and body dissatisfaction (p= 0.001). The strongest predictor was BMI level, recording an odds ratio (OR) of 5.99 (CI: 2.15 – 10.54, p=0.001) in obese and an OR of 4.55 (CI: 1.31 – 9.35, p=0.001) in overweight, indicating that compared with normal weight, obese and overweight participants were more likely to be dissatisfied by five and four times, respectively.

Conclusion

This study indicates that physically active individuals are greatly influenced by the confinement period. Programs that promote physical activity in their house or during lockdown may help to encourage, lessen their anxiety, and maintain their health. This may also decrease the anxiety of individuals, particularly those active ones.

Telehealth-based interventions on lifestyle, body mass index, and glucose concentration in university staff during the coronavirus disease 2019 pandemic: A pre-experimental study

Background: The coronavirus disease 2019 pandemic has impacted the health of the population. Technological advances become alternative tools for the promotion of lifestyle and prevention of non-communicable diseases in university personnel. Objective: This study analyzed the effect of an intervention based on a telehealth program and investigated its efficacy in improving lifestyle, body mass index, and glucose concentration in university staff during the coronavirus disease 2019 pandemic. Methods: A pre-experimental study was conducted between August and December 2021 on 100 workers of a private university located in Tarapoto, Peru. Information was collected on lifestyle practices and beliefs, body mass index, and glucose contraction before and after the intervention. After the intervention, 78 participants were analyzed; 22 workers did not respond to the invitation. Results: Comparison between pretest and follow-up showed an increase in lifestyle practices and beliefs (from 93.33 ± 9.44 to 96.23 ± 9.32, p < 0.01), although this value is considered an unhealthy lifestyle. Moreover, a decrease in body mass index (from 25.23 ± 3.08 to 24.98 ± 2.98, p < 0.05) and glucose concentration (from 98.35 ± 6.70 to 97.45 ± 5.61, p < 0.01) was observed. Conclusion: Telehealth-based educational interventions could be effective in university staff during the coronavirus disease 2019 pandemic, which, in turn, would support improved lifestyles and adequate body mass index and glucose levels.

Long-Term Impact of COVID-19 Pandemic in Sleep Quality and Lifestyle in Young Adults

Due to the evolution of COVID-19,restrictive measures were implemented. The quarantine resulted in significant changes in the social, economic, and psychological status of the population; however, its long-term effects have not yet been elucidated, especially in young adults. In the present study, people aged 18-25 years were studied, in relation to their sleeping, smoking, eating, and drinking habits and their physical activity before, during, and after the implementation of quarantine. We included 540 respondents (21.2 ± 2.3 years, 62.8% female). During quarantine, from 23 March to 4 May 2020, we observed an increase in sleep hours by 1.17 ± 1.98 h (p < 0.001), time of sleep arrival by 11.90 ± 30.41 min (p < 0.001), and number of daily meals by 0.66 ± 1.4 (p < 0.001). The subjects who consumed alcoholic beverages never or almost never had an upward change of 27.04%, and the time of daily exercise was reduced by 10.16 ± 48.68 min (p < 0.001). After quarantine, cigarettes per day increased by 1.14 ± 3.62 (p < 0.001) and the awakenings during night time increased by 0.37 ± 1.93 (p < 0.001). Our results suggest that the quarantine brought about significant changes in smoking, sleeping habits, physical activity, dietary habits, and the consumption of alcoholic beverages, some of which continue after its termination.

Working from Home during the COVID-19 Pandemic and Its Effects on Diet, Sedentary Lifestyle, and Stress

Many companies switched to working from home (WFH) after the COVID-19 pandemic. This paper aimed to examine the changes in dietary behavior, body weight, sedentary lifestyle, and stress in individuals who practice WFH. A cross-sectional, web-based questionnaire was administered between March and May 2021 and included socio-demographic characteristics, anthropometric measurements, WFH arrangement, changes in diet, sedentary lifestyle, and stress status. A total of 328 individuals (260 women, 68 men), aged 31.3 ± 8.3 years with a BMI of 24.9 ± 4.6 kg/m2, participated in the study. The questionnaire revealed that the daily working time increased with WFH. The majority of the individuals (59.1%) gained weight. The average daily sedentary time and the Perceived Stress Scale score increased significantly. The daily sedentary time and Non-Healthy Diet Index scores were higher in individuals who gained weight (p < 0.05). A multinominal regression model revealed that increased body weight was less likely in individuals with underweight and normal BMI classifications. Normal BMI, stable work shifts, and no physical activity were positive predictors for gaining weight. These results suggest that WFH may have significant negative effects on physical and mental status of individuals.

Usefulness of a Mobile Application (Mentali) for Anxiety and Depression Screening in Medical Students and Description of the Associated Triggering Factors

The impact of the COVID-19 health crisis on the mental health of the population requires the implementation of new primary screening strategies of mental health disorders to intervene in a timelier manner, and technology may provide solutions. We aimed to evaluate the usefulness of the mobile app Mentali (version 1.1.2; creators: Jorge Alfonso Solís Galván Sodel Vázquez Reyes, Margarita de la Luz Martínez Fierro, Perla Velasco Elizondo, Idalia Garza Veloz, Alejandro Mauricio González and Claudia Caldera Villalobos, Zacatecas, México) as a primary screening tool for anxiety and depression disorders in medical students and to assess the triggering risk factors. This was a descriptive and longitudinal study and included 155 Mexican medical students. Participants interacted with Mentali for 6 months. The mobile app integrated the Beck anxiety and depression inventories together with a mood module. At the end of the interaction, the students received psychological and psychiatric interventions to confirm their primary diagnoses. Symptoms of moderate/severe anxiety and depression were present in 62.6% and 54.6% of the studied population. When corroborating the diagnoses, Mentali obtained a sensitivity of 100%, 95%, and 43% to classify a mental health disorder, anxiety, and depression, respectively. The most important triggers found were as follows: belonging to a dysfunctional family, being introverted, and having suffered from bullying. The proportion of users with excellent/good mood decreased from 78.7% to 34.4% at the end of the semester, and the proportion of users who claimed to have bad/very bad mood increased from 7.4% to 34.4% at the end of the semester (p < 0.05). Mentali was useful for identifying users with anxiety and/or depression, and as an auxiliary tool to coordinate the provision of specialized interventions, allowing us to increase the proportion of patients who needed psychological care and received it by 30%. The efficacy of Mentali in identifying activities through time with an impact on the mood and mental health of the users was confirmed. Our results support the use of Mentali for the primary screening of mental health disorders in young adults, including medical students.

How did the COVID-19 pandemic influence health-related behaviour? An online survey on food choice, physical activity and changes in body weight among Swiss adults

The COVID-19 pandemic has affected all aspects of our everyday lives. To investigate these behaviour changes, an online survey was conducted with 1'028 individuals (51% female) in Switzerland between June and July 2020. The questions referred in particular to the lockdown in spring 2020. We put specific focus on the pandemic's impact on health-related behaviour, which includes food choice, physical activity and body weight management. For instance, participants reported whether and how their consumption of different foods changed during the lockdown. As a measure of healthy food choice, we chose consumption of vegetables and salad and in contrast, sweet snacks and alcohol consumption was used as a measure for unhealthy food choice. For physical activity and body weight, participants indicated whether it decreased, increased or did not change during the lockdown as compared before. In a next step, we investigated the influence of various predictors on health-related behaviour using multinomial logistic regression models. We find that the possibility to work remotely led to healthier food choices, that is, a reported increase in vegetable consumption and decrease in sweet snack consumption, but also to more unhealthy food choices and lifestyles, that is, a reported increase in alcohol consumption as well as an increase in sweet snack consumption. For weight change, the data indicated that individuals who worked remotely were more likely to gain or lose weight than individuals working from the office. Our findings demonstrate how individuals are affected differently by the pandemic and how complex the whole picture is. Further, these results are crucial in developing health recommendations for possible future lockdowns or health crises in general.

"I feel more protective over my body:" A brief report on pregnant women's embodied experiences during the COVID-19 pandemic

The COVID-19 pandemic has dramatically altered the experiences of pregnant people. For example, the pandemic has disrupted access to healthcare, social distancing has reduced social support, and vaccine rollout has led to safety concerns. Consistent with the Developmental Theory of Embodiment, which posits that our experiences of our bodies are influenced by social factors, studies have revealed an uptick in body dissatisfaction and disordered eating during this time. However, research on pregnant people's experiences of their body and body image during the pandemic has been largely overlooked. In this exploratory qualitative study, we aimed to broadly understand how the pandemic and quarantine have impacted the way pregnant women (N = 190) in the US and UK relate to their bodies. We used Consensual Qualitative Research-Modified (CQR-M) to analyze pregnant women's brief textual accounts of their embodied experiences during the pandemic and identified eight core domains across the dataset. Some participants reported no change in their embodied experiences, whereas others reported accounts of appearance and weight concerns, health behavior self-judgment, gratitude for isolation, body appreciation, maternal healthcare concerns, COVID health concerns, and health and safety strategies. We conclude with implications and recommendations for supporting pregnant people and their embodied well-being during health crises.

An 8-month longitudinal exploration of body image and disordered eating in the UK during the COVID-19 pandemic

Research suggests that the COVID-19 pandemic is negatively impacting mental health, with rates of eating disorder referrals in particular rising steeply during the pandemic. This study aimed to examine 8-month changes in body image and disordered eating during the COVID-19 pandemic, and explore whether any changes were moderated by gender, age, or eating disorder history. This study used a longitudinal survey design in which 587 adults living in the UK (85 % women; mean age = 32.87 years) completed assessments every two months over five timepoints from May/June 2020 to January/February 2021. Measures included body esteem, disordered eating, and psychological distress. Mixed effect models showed small but significant improvements in body esteem and disordered eating symptoms from May/June 2020 to January/February 2021. These improvements were independent of changes in psychological distress, and did not vary by gender, age or eating disorder history. Whilst poor body image and disordered eating may have been elevated in the early period of the pandemic, this study suggests improvements, rather than worsening, of these outcomes over time. This may reflect adaptation to this changing context.

New insights into perceptions of technology claims in greek-style yogurt: A view in the COVID-19 pandemic

The Covid-19 pandemic has strongly impacted people's lives and the food industry. In this sense, food products claiming nutritional and health-promoting benefits due to the presence of bioactive peptides and probiotics, such as Greek-style yogurt, have been in demand. The objective of this work was to investigate, through word association, the perception of the consumers regarding the seven concepts related to Greek-style yogurt (traditional, ultra-creamy, zero fat, high content proteins, zero lactose, light and with no added sugars), in the context of social isolation due to Covid-19. In this online survey, 346 participants completed a questionnaire. The participants were divided according to health concerns (increased, not changed, or decreased) and eating habits (improved, not changed, or worsened) during the Covid-19 pandemic. Chi-square and prototypical analysis were used as statistical tests. During the Covid-19 pandemic, based on self-report, around 66% of the participants had their eating habits and their concerns about health changed. The general associations were related to the categories pleasure, health, creamy, pleasant texture, food restriction, and loss of sensory quality. 'Health' and 'pleasure' were negatively associated with the conceptualization of Greek-style yogurt. For the zero-fat, light, and sugar-free Greek-style yogurts, the terms creamy and ultra-creamy are sensory appealing to the consumers. In general, the price and concerns about health are factors that strongly influence the purchase intention of Greek-style yogurts. The yogurts were associated with sensory and non-sensory characteristics, which can be useful for marketing strategies for of different product concepts.

The Covid-19 pandemic and food consumption at home and away: An exploratory study of English households

The Covid-19 pandemic has changed attitudes of English households towards food consumption at home and when eating out. Little academic research has however examined the scope and the scale of these changes, especially in the context of foodservice provision. This mixed methods study explores the effect of Covid-19 on food consumption in English households at home and away. It reveals increased frequency and variety of cooking during lockdown as a driver of household food wastage. The study demonstrates public hesitance towards eating out post-Covid-19. Foodservice providers are expected to re-design their business settings and adopt protective and preventative measures, such as frequent cleaning and routine health checks, to encourage visitation. After the pandemic, increased preference towards consuming (more) sustainable food at home, but not when eating out, is established. These insights can aid grocery and foodservice providers in offering more tailored products and services in a post-pandemic future.

Menstrual disorders in adolescents and young adults with eating disorders

Although amenorrhea is no longer a specific criterion required to make the diagnosis of anorexia nervosa (AN), the relationship between restrictive eating and menstrual status remains important in the diagnosis, treatment, and consequences for patients with eating disorders. Clinicians should understand the relationship between menstrual irregularities and malnutrition due to eating disorders, as it may be possible to intervene sooner if the diagnosis is made earlier. Treatment of AN (in those who are underweight) and atypical AN (in those who are not underweight) is aimed at cessation of restrictive thoughts and behaviors, restoration of appropriate nutrition and weight, and normal functioning of the body. While eating disorder thoughts and behaviors are helped by both therapy and nutrition, regular functioning of the body, including regular menstruation, is linked to both appropriate nutrition and weight. Patients who are not underweight based on their body mass index (BMI) may still have oligo/amenorrhea due to their caloric restriction; thus any patient who has irregular menses should have a detailed dietary evaluation as part of their workup. Timely diagnosis and treatment of patients with eating disorders and amenorrhea is important due to the impact on bone mass accrual for adolescents who have prolonged amenorrhea. Menstrual abnormalities may also be seen in patients with bulimia nervosa (BN).

Barriers and Facilitators of Physical Activity

Background Physical inactivity accounts for 16.6% of deaths in the United Kingdom. This study aims to review the recent (2016–2021) systematic reviews (SRs) on the facilitators and barriers to physical activity (PA) participation among (UK)-based adults.

Methods Using the Participants, Interventions, Comparators, and Outcomes framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses strategy, a SR of SRs of studies on the facilitators and barriers to PA among (UK)-based adults, published between 2016 and December 3, 2021, in the PubMed, SCOPUS, or Cochrane Database of Systematic Reviews, was done.

Results Three SRs (each published in 2016, 2019, and 2021) were included and reviewed in the study. None of the reviewed SR included a study conducted during the coronavirus disease 2019 (COVID-19) pandemic; also, a paucity of primary studies on PA among (UK)-based adult black, Asian, and ethnic minorities populations was recorded. Having a knowledge/appreciation of the benefits of PA, having the opportunity for social interaction/participation and PA-related support, and having a safe environment for PA were the persistently reported facilitators to PA among (UK)-based adults. On the other hand, having language difficulties/language barrier, lack of time, and having underlying health problems were the persistently reported barriers to PA among them. Not all the included SRs received project funding.

Conclusion The outcomes of this study had identified contemporary research gaps regarding the current challenges related to PA among (UK)-based adults. It is a fact that COVID-19 has come to stay in the (UK) and, as a result, it has affected ways of living, especially PA; hence, there is an imminent need for a SR to collate current primary evidence, with regards to the COVID-19 pandemic, on the facilitators and barriers of PA among (UK)-based adults.