Eating in the lockdown during the Covid 19 pandemic; self-reported changes in eating behaviour, and associations with BMI, eating style, coping and health anxiety

Investigating the role of top-down regulation and bottom-up cues in eating styles transitions: a one-year cohort study with young adults

Young adults often experience deterioration in eating habits during transition periods. However, longitudinal evidence on the changes of eating styles and associated determinants remains limited. This study aimed to explore the eating style transitions among young adults in their graduate transitions and investigate the influences of top-down regulatory factors and bottom-up environmental cues on their eating style transitions. This is a two-wave cohort study involving 594 Hong Kong young adults completing the baseline assessment during their post-secondary graduation year, of whom, 424 completed the one-year follow-up survey. Eating behaviours were measured at both points. Executive function (EF), coping style, exposure to digital food environments, responsiveness to food cues, perceived stress and demographics were also measured. Latent profile analysis was used to explore main eating styles among participants while multinomial logistic regression models were used to assess determinants of eating style transitions. In follow-up assessment, 5.9 % of participants were consistently approaching eaters (APE) across two time points, while 28.8 % have transitioned from moderate eaters (MOE) or APE to mixed eaters (MIE). The multinominal logistic regression model revealed that although EF and coping style were no longer significantly associated with participants' eating style transitions outcomes, greater exposure to digital food environments (OR = 2.60, p = 0.028) and higher responsiveness to food cues (OR = 5.86, p = 0.005) were associated with Persistent APE, while higher responsiveness to food cues (OR = 2.36, p = 0.009) and higher perceived stress (OR = 1.05, p = 0.046) were associated with Converted MIE. Bottom-up cues may dominate eating style transitions compared to top-down regulations. Future interventions should leverage environmental cues, thereby targeting the automatic decision-making process and supporting healthy eating habits during stressful life stages.

Global Burden of Disease Due to High Body Mass Index and Projections to 2040: A Study Based on the Global Burden of Disease Study 2019

BACKGROUND

The prevalence of high body mass index (BMI) contributes to an increased risk of various diseases. This study aimed to identify global disease burden trends associated with high BMI from 1990 to 2019 and forecasts up to 2040.

METHODS

Using data from the global burden of disease (GBD) 2019 study, we analysed the number and ratio of disability-adjusted life years (DALYs) related to high BMI. The data were analysed by sex, ages, socio-demographic index (SDI), world health organization (WHO) region, and disease level. The autoregressive integrated moving average (ARIMA) model was employed to predict high BMI-related disease burden up to 2040.

RESULTS

In 2019, the global burden of disease due to high BMI was 1932.54 (95% uncertainty interval [UI]: 1276.61, 2639.74), representing an increase of 0.18 (95% UI: 0.02, 0.42). Disease burden was consistently higher in males, middle-aged and older populations, particularly noting a narrowing gap between those aged 50-69 years and≥ 70 years in the forecast results until 2040. Additionally, regions with a middle SDI and the North Africa and Middle East WHO super-regions exhibited the highest disease burdens. Also, Cardiovascular disease ranked highest among diseases.

CONCLUSION

The rising disease burden associated with high BMI highlights the need for targeted health policies focussing on older populations, low and middle-income countries, and major conditions like cardiovascular disease and diabetes. Addressing these trends requires an integrated, equity-focused approach to health planning and management to mitigate global impacts.

Lessons learned from the lived experiences of people living with obesity during the first COVID-19 lockdown in the United Kingdom

BACKGROUND

Quantitative studies have shown that people living with obesity experienced deteriorations in mental health and health-related behaviours during the first UK's Coronavirus Disease-2019 (COVID-19) lockdown. However, there is a lack of qualitative research exploring their lived experiences during this period.

METHODS

Thematic analysis of large-scale free-text survey data was conducted to understand the challenges faced by adults with obesity during the first UK's COVID-19 lockdown.

RESULTS

Among 543 participants, 467 (86%) responded to the free text questions. The majority were female (87.8%), with a mean age of 51.6 (SD 9.9) years. Of these, 65.3% has a body mass index ≥40 kg/m2, and 57.7% were not enroled in weight management services. Five overarching themes and 10 sub-themes were identified with the five key themes being (1) increased fear and anxiety, (2) the impact of obesity being classified as 'high risk', (3) disruption in weight management services, (4) the impact on health-related behaviours, and (5) the adverse impact on mental health. Participants expressed fear of contracting COVID-19 and concerns about weight gain. UK Government messages linking obesity with severe COVID-19 complications exacerbated feelings of shame and stigma. The reduced provision of weight management services caused further health concerns, highlighting the need for digital health technologies for continued support. Participants reported changes in shopping, diet, physical activity, and sleep patterns, leading to deteriorated mental health.

CONCLUSION

People living with obesity experienced distinct challenges during the first COVID-19 lockdown, affecting their ability to practice and maintain health-related behaviours.

Associations between dietary diversity and self-rated health in a transverse study of four local food systems (French Guiana, Guadeloupe, Portugal and Senegal)

BACKGROUND

The nutrition transition is linked to the double-burden of malnutrition worldwide, and its impact on the quality of life is considerable. The dietary diversity score and self-rated health are two proxies that have been used to assess, for the former, nutrient adequacy and overall diet quality, and for the latter, health from a sociological, epidemiological and economical lens. The general aim of this study was to evaluate the relation between food and subjective health, and to test the hypothesis that greater dietary diversity is positively associated with a better perception of health.

METHODS

A transverse comparison of foods consumed in four highly contrasted local socio-ecosystems (i.e., two French oversea territories: French Guiana, Guadeloupe, Portugal and Senegal) was conducted using 24-hour dietary recalls. Dietary diversity was calculated using 18 food groups based on classifications provided by WHO and FAO. Binary logistic regressions were used to assess the relationship between dietary diversity scores and answers to the question assessing self-rated health.

RESULTS

Overall, 465 individuals, 18 years and older, from Senegal, Guiana, Guadeloupe and Portugal were interviewed using a 24-hour dietary recall. Participants were selected via a combination of non-probability sampling methods. The mean dietary diversity score for all regions combined was 9.22. Over one-third of participants reported their health as 'good' (39.8%), whereas 'bad' and 'excellent' health were the least reported, at 6.45% and 9.03%, respectively. Multiple binary logistic regression notably found that dietary diversity score (OR = 0.88, 95% CI [0.79, 0.99], p = 0.010) and at-home meal preparation, specifically with the reference category 'all the time' compared to 'never' (OR = 3.31, 95% CI [1.55, 7.07], p = 0.002) were statistically significant predictors of self-rated health (i.e., declaring overall bad health).

CONCLUSIONS

This study demonstrates a positive association between dietary diversity and self-rated health across distinct cultural contexts. The findings reinforce the importance of diverse diets for subjective well-being, regardless of differences in food systems. Public health messaging should continue to promote dietary diversity and home-cooked meals as effective strategies for improving health. Self-rated health could serve as a useful tool for quickly assessing the outcomes of nutrition therapy.

Portion Estimation, Satiety Perception and Energy Intake Following Different Breakfast Portion Sizes in Healthy Adults

Expected satiety is a key element in predicting meal portion size and food consumption; however, how this can be affected by different breakfast portion sizes is unknown. The study examined the impact of different breakfast portions on satiety, portion size, and energy intake and comprised an online survey and an experimental intervention. Sixteen adults (9 women, BMI: 24.9 ± 4.3 kg/m2) rated images of three portion sizes (small, standard, large) of the same breakfast using an ordinal scale. Subsequently, they were asked to self-prepare and consume ad libitum the three breakfast portions in a randomised order on different days and to complete a food diary. Satiety and portion size perception were re-measured upon consumption of each breakfast. For both the visual image and breakfast consumption, the small breakfast portion was rated as the smallest and least filling, while the large portion was rated as the largest and most filling (p < 0.05). When consuming the small breakfast, participants reported being hungrier and less full between breakfast and lunch (p < 0.05) and had a higher energy intake from lunch onward, due to more snacking (p < 0.05). However, the total daily energy intake was not different among the three breakfast portion sizes. Individuals seemed accustomed to predicting satiety and portion size from images. The consumption of the small breakfast was judged as not filling enough and was accompanied by a higher energy intake via energy-dense snacks. Based on these preliminary findings, breakfast size reduction may lead to unhealthy compensatory energy intake by snacking on energy-dense foods.

Home office is associated with weight gain during the COVID-19 pandemic: Brazilian population-based studies

The COVID-19 pandemic caused changes in life, affecting habits and behaviors, and one of its consequences is an increase in weight. We aimed to evaluate the association between remote work and weight gain during the COVID-19 pandemic in two cities in southern Brazil. A population-based cross-sectional study carried out in the southern region of Brazil. Data were collected face-to-face, in households selected by census sampling. The outcome was weight gain, and the exposure was remote working. To verify this association, Poisson Regression was used to calculate the crude and adjusted prevalence ratio and its 95% confidence intervals, using 5% significance level. In total, 2,152 individuals were interviewed. The prevalence of weight gain during the pandemic was 38.4% (95%CI 36.1-40.7), being significantly higher in those who worked remotely (47.0% vs 37.7, p=0.02). Those individuals who worked remotely were 23% more likely to gain weight during the pandemic compared to those who did not work remotely (PR: 1.23; 95%CI 1.02-1.49). Health and education services may be encouraged to implement educational actions at the collective level, aimed at enlightening the population and preventing weight gain in periods of confinement.

Understanding the impact of the pandemic on university students: Changes in sleep, eating patterns, and psychological well-being

BACKGROUND

Covid-19 is one of the world's major pandemics. It has affected millions of people in various ways.

OBJECTIVE

This study investigates the influence of pandemic-induced shifts in eating and sleeping behaviors on the psychological well-being of university students.

METHODS

The study adopted a cross-sectional research design. A total of 604 students participated in the study. The Personal Form, the Psychological Well-Being Index, and the Pittsburgh Sleep Quality Index were used to collect data. The research was conducted between October 2021 and December 2022.

RESULTS

The participants reported a mean psychological well-being score of 40.76 ± 9.38, alongside a Pittsburgh Sleep Quality Index score of 7.46 ± 3.30. Analysis revealed a significant negative correlation between the mean psychological well-being scores and the Pittsburgh Sleep Quality Index scores (p < 0.01). Throughout the pandemic, the participants experienced a decline in physical activity, an increase in their body weight, and a change in their eating habits. While psychological well-being remained relatively high, sleep quality was notably poor. Notably, improvements in psychological well-being corresponded with enhancements in sleep quality, suggesting a reciprocal relationship between the two variables.

CONCLUSIONS

The pandemic negatively impacted the physical activity and body weight of young adults. This study highlights the importance of promoting physical activity among university students during pandemics and similar crises to reduce adverse effects on body weight. It also highlights the importance of educating students about the importance of healthy sleep and how to maintain good sleep hygiene.

COVID-19 and shifting food preferences: A panel study among Chilean students

The COVID-19 pandemic had a profound impact on various aspects of life. This study aims to investigate whether the COVID-19 pandemic changed food preferences, focusing on cost perceptions, environmental factors, and health attributes. We conducted a panel study with self-administered online surveys among undergraduate students in Chile, both before and during the first wave of the pandemic. Each survey included a discrete choice experiment (DCE) to elicit food preferences. Using mixed logit models, our analysis shows that during the COVID-19 pandemic, sensitivity to cost, preference for foods with low environmental impact, and preference for vitamin-rich foods increased. These changes in preferences can be attributed to individuals' perceived health risks. These findings suggest that the pandemic increased awareness of sustainable and healthy food choices, with important implications for promoting these choices during global crises.

Evaluation of the Awareness and Anxiety Levels and Oral Hygiene Habits of University Students During the Coronavirus Disease 2019 (COVID-19) Pandemic

AIM

The aim of this study was to evaluate the awareness and anxiety levels and oral hygiene habits of university students during the coronavirus disease 2019 (COVID-19) pandemic.

MATERIALS AND METHODS

A total number of 560 university students were included at different education levels. Sociodemographic data regarding age, gender, current school level, family income, and smoking frequency status were obtained. Anxiety levels were evaluated through the Coronavirus Anxiety Scale and awareness levels through the Coronavirus Awareness Scale. Oral hygiene habits before and during the COVID-19 pandemic were also recorded. In addition, the participants were asked to evaluate their oral hygiene and general health status before and after the pandemic. Data were collected online using a data collection form consisting of five sections via the Google Forms (Google Inc., Mountain View, California, United States) platform. The data were statistically analyzed. p<0.05 was considered statistically significant.  Results: The statistical analysis revealed that there is a statistically significant difference in COVID-19 anxiety levels according to the current school level and family income (all with p<0.05). COVID-19 awareness levels differed significantly according to the current school level and family income (all with p<0.05). A statistically significant discrepancy was identified in the oral hygiene habits of the examined population according to gender, smoking frequency status, and family income prior to the onset of the pandemic (all with p<0.05). The examination of oral hygiene habits during the pandemic revealed statistically significant differences in accordance with the subjects' gender, smoking frequency status, current school level, and family income (all with p<0.05). During the pandemic, there was an increase in the frequency of tooth brushing, tongue brushing, toothbrush change, dental floss use, and acidic beverage consumption compared to the pre-pandemic period (all with p<0.05).

CONCLUSION

The present study examined the impact of the ongoing pandemic on oral hygiene habits among university students. The findings revealed a notable increase in the frequency of many oral hygiene habits during the pandemic compared to pre-pandemic levels. However, the study also observed that while anxiety levels were low, awareness levels were high. This study is the first to evaluate awareness and anxiety levels and oral hygiene habits in this context.

Sex-related differences in eating behaviors during COVID-19 pandemic: A systematic review with metanalysis

Eating behavior can be influenced by external factors; however, there is no consensus on the existence of differences in eating behavior between the sexes in stressful situations, such as the COVID-19 pandemic. This systematic review assessed whether there was a difference in eating behavior between sexes during the COVID-19 pandemic. A search of nine databases (Medline/Pubmed, Embase, Scielo, VHL, Scopus, PsycINFO, Web of Science, ProQuest, Google Scholar) was conducted in October 2023. Studies reporting eating behaviors in males and females during the COVID-19 pandemic were included. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Instrument. Stratified meta-analyses were conducted using the STATA software. Of the 2388 studies identified, 45 were included in the qualitative synthesis, and 36 in the meta-analysis, encompassing a total of 35,792 participants. Validated questionnaires were used to assess eating behavior, including the TFEQ (33.3%), DEBQ (24.4%), EEQ (22.2%), EES (11.1%), EOQ-5 (2.2%), AEBQ (2.2%), EAS (2.2%), and EMAQ (2.2%). Overall, males exhibited lower scores in emotional eating (Cohen's d = -0.32, 95%CI: 0.46 to -0.17) and restrained eating (Hedges'g = -0.11, 95%CI: 0.16 to -0.06) compared to females. However, the subgroup analysis indicated no differences in emotional eating (subgroup difference p = 0.39) or restrained eating (subgroup difference p = 0.30) according to the year of pandemic. These findings underscore the importance of sex-specific interventions, the address eating behaviors during periods of heightened insecurity in worldwide health emergencies, such as the COVID-19 pandemic. Additionally, our results emphasize the necessity for public health strategies to monitor and promote healthy eating behaviors to mitigate their impact on overall health outcomes, even in males, as their eating behavior may be affected over the course of a global health crisis, as well as females.

Did COVID-19 influence fruit and vegetable consumption? Explaining and comparing pandemic peak and post-peak periods

The COVID-19 pandemic, one of the worst global health crises in the last century, impacted nearly every aspect of people's lives, including their dietary choices and food consumption patterns. It arrived during a long shift in American diets featuring increasingly large portions of processed foods as well as fruit and vegetable consumption that is well below recommended levels. Improving the latter has been a key part of policymakers' efforts to improve consumers' diets. This study surveyed individuals in the US South to determine the factors influencing their consumption of fruit and vegetables during the pandemic peak and how these have changed post-peak. During the peak, food venue, demographics, and concerns about diet and the seriousness of the virus heavily affected consumption. Greater amounts of fresh fruit and vegetables were consumed post-peak pandemic. Changes post-peak were predicted by food venue. Cooking meals at home was the main positive predictor for consumption. US policymakers should try and leverage the changes since the peak to promote greater consumption of fruit and vegetables.

Path analysis of the role of coping strategies between emotional intelligence and lifestyle habits during COVID-19 lockdown

The relationship between Emotional Intelligence (EI) and lifestyle choices during the COVID-19 pandemic is obscure and not very well understood. To clarify the mechanisms underlying this relationship, we proposed to test the hypothesis that different coping styles (avoidant and approach) have an indirect effect on the association between EI and many types of lifestyle habits. A cross-sectional study was conducted between December 2020 and January 2021. Our target sample consisted of Lebanese adults from the general population. In path analysis, approach coping mediated the association between EI and different lifestyle habits (rest, nutrition, general physical conditions), but not exercise. Furthermore, avoidant coping did mediate the association between EI and general physical conditions, but not between EI and other lifestyle choices (namely rest, exercise, and nutrition). To conclude, individuals with high EI, and that are users of approach coping strategies to deal with stressors, have increased rest time, healthy nutrition and general physical conditions. This cautiously implies that fostering approach coping may help improve the positive effects of EI on healthy lifestyles during crises such as this pandemic.

Impact of COVID-19 on Chinese urban consumers' food safety knowledge and behavior - A comparative study between pre and post pandemic eras

The COVID-19 pandemic caused notable changes to the food-related habits of consumers worldwide due to their concerns about the risk of infection and the requirement to follow government mandates. To investigate the impact of the pandemic on Chinese consumers' food safety knowledge, food safety behaviors, and their most recent food poisoning experiences, we compared the results from an online survey (n = 583, Dec 2019) conducted before the pandemic was officially announced with an identical survey (n = 599, Aug 2023) conducted seven months after the Chinese government downgraded restrictions related to COVID-19. Post-pandemic there was a significant decrease in consumers' food safety knowledge and self-reported food safety behaviors and a significant increase in their self-reported experiences of food poisoning. Despite respondents stating that their food safety knowledge and behaviors had improved since the start of the pandemic, the data obtained from the two surveys and the respondents self-reporting of foodborne illness suggest that in fact their safety knowledge and behaviors had decreased. These findings highlight the need to reinforce food safety education and behaviors during times when the food system is disrupted, and consumers are focusing on what they perceive to be more immediate issues.

Workers' healthy eating practices during the COVID-19 pandemic and their relationship with physical activity and quality of life

The lifestyle of the population has undergone significant changes due to the COVID-19 pandemic, which could have influenced alterations in dietary habits and overall well-being among workers. This study aimed to evaluate healthy eating practices and their relationship with the workers' quality of life and physical activity during the COVID-19 pandemic. This was a cross-sectional investigation involving workers in the city of Curitiba, southern Brazil. The study was conducted through the application of an online questionnaire. The data were evaluated using non-parametric tests and fitting a logistic regression model. A total of 123 workers participated in the study, most of them male (53.2%), aged between 31 and 40 years (42.2%), with a predominance of workers with postgraduate degrees (62.6%, n = 77), and the majority of workers (68.2%, n = 84) were performing their professional activities remotely for at least one day during the week, and 73.2% (n = 90). It was observed that 52.8% had excellent healthy eating practices, and the older their age and the greater the practice of physical activity (time and frequency), the better the workers' healthy eating practices. When assessing quality of life, the lowest average score for healthy eating practices was in the domain of social relationships. A direct relationship of older age, social relationships, and the practice of physical activity with the best individuals' healthy eating practices was detected. Considering that remote work continues to be adopted post-pandemic, evaluating the dietary practices, physical activity, and quality of life of workers is necessary to understand this new labour phenomenon.

Mental distress and nutrition of family physicians, a European based cross-sectional study

Family physicians are a pillar of the primary healthcare system, and their own mental well-being is integral to their performance. However, many studies have suggested a high prevalence of mental distress. The contributing factors include the emotional demands of the profession, work overload, budgetary constraints, loss of autonomy, and erosion of professional values. Outbreaks such as the COVID-19 pandemic exacerbate distress due to a greater risk of exposure to the virus, increased working hours, and fear of infecting families. Thus, it is crucial to assess risks and provide preventive measures. This study aimed to evaluate the association between the dietary patterns of family physicians and their mood. This study used a cross-sectional descriptive method and a validated Food-Mood Questionnaire (FMQ), shared via social networks across 10 European countries, to collect data from family physicians. Permission to use the FMQ was obtained. The breakfast-pattern subscale had the highest mean score (14.670 ± 4.305). The other subscale mean scores were as follows: health pattern (13.317 ± 5.388), mental distress pattern (11.184 ± 3.824), and western diet pattern (9.827 ± 3.604). According to Pearson correlation test there was a positive correlation between breakfast and Western diet patterns and between breakfast and health patterns. There was a negative correlation between health and mental distress pattern. Evidence suggests that mental distress may arise from different dietary deficiencies. Physicians' nutritional patterns have an impact on health indicators and are distributed in relation to sociodemographic factors, especially the regions they live in. Diet assessment is becoming a vital modifiable risk factor for mental health, but further research in this field is needed.

Effect of COVID-19 pandemic on bioimpedance health indicators in young adults

OBJECTIVES

Herein, we investigate the relationships between the COVID-19 pandemic and overcoming the virus, and its effects on body composition parameters in young adults from Slovakia.

METHODS

We assessed 773 adults aged 18 to 30 years in pandemic-status sub-groups. Individual lifestyles and overcoming the COVID-19 effects were evaluated by a detailed questionnaire, and body composition parameters were analyzed using the InBody 770 bioimpedance analyzer.

RESULTS

Statistically significant lower values were observed in the male group during the pandemic for the following parameters; proteins and minerals, fat free mass (FFM), skeletal muscle mass (SMM), lean body mass (LBM) and its values in the right and left arm and trunk, total body water (TBW) and its values in the right and left arm and trunk, body cell mass (BCM), basal metabolic rate (BMR) and phase angle (PA). The regression analysis confirmed the negative pandemic effect and the negative impact of COVID-19 on men in the following parameters: proteins (p = .027 for pandemic and p = .005 for COVID-19), FFM (p = .023 for pandemic and p = .005 for COVID-19), LBM (p = .022 for pandemic and p = .004 for COVID-19), SMM (p = .028 for pandemic and p = .005 for COVID-19), TBW (p = .020 for pandemic and p = .004 for COVID-19), BMR (p = .024 for pandemic and p = .005 for COVID-19) and PA (p = .009 for pandemic). Physical activity was a further significant predictor in men for all the above parameters.

CONCLUSIONS

We observed significantly lower body composition parameters associated with fat free mass in young adult men during the pandemic than before it. However, future research is warranted to determine if these effects have long-term significance.

Weight gain, new-onset overweight or obesity, and their influencing factors during the social distancing era of the COVID-19 pandemic

The prevalence of obesity is gradually increasing in South Korea, and the coronavirus disease 2019 (COVID-19) pandemic has accelerated the weight gain. In response to COVID-19, South Korea implemented targeted distancing measures based on the number of COVID-19 cases, rather than a full lockdown. This study focused on two subgroups that influence the rise in obesity prevalence during the early stages of the COVID-19 pandemic and explored the factors contributing to rapid weight gain in this group during this period. This cross-sectional study involved 3,462 participants recruited through the MicroEmbrain Inc. Online survey panel. Participation emails were sent by the research company to the online survey panel, and individuals who voluntarily agreed to participate responded to the survey. The participants consisted of residents aged 19 and above from Seoul, with sample distribution taking considering sex, age, and region. Height, and weight before and during the COVID-19 pandemic were self-reported. The analysis revealed that compared with that of pre-COVID-19 statistics, 11 % of all participants entered the overweight or obese categories post COVID-19, and among those who were overweight or obese before COVID-19, 42.5 % reported weight gain. Both groups had relatively younger individuals, higher stress levels, spent more time alone, and had increased usage of online platforms including online food purchasing. Post-COVID-19 wt gain among individuals with pre-existing overweight or obesity status was associated with a higher frequency of solitary drinking (odds ratio [OR] = 1.407, 95 % confidence interval [CI] = 1.024-1.932), increased online leisure time (OR = 1.336, 95 % CI = 1.063-1.678), and increased use of meal delivery services (OR = 1.307, 95 % CI = 1.026-1.664). The prevalence of obesity has continued to rise after COVID-19 pandemic, highlighting the need for interventions that mitigate the negative impact of the pandemic on health behavior.

Rotating shift and BMI increase among healthcare workers in a military hospital: pre- and post-pandemic analysis in Taiwan

Background

The increasing prevalence of high body mass index (BMI) emphasizes the need for action. Understanding of BMI factors among military hospital healthcare workers remains limited. This study aims to address this gap by analyzing BMI risk factors and changes pre- and post-coronavirus 2019 pandemic among military hospital healthcare workers in central Taiwan from 2019 to 2021.

Methods

Conducted at a military hospital in central Taiwan, this study analyzed anonymized health examination data from 2019 to 2021 for 483 healthcare workers. We performed generalized estimating equations to investigate trends in BMI and its association with various factors, including age, sex, job titles, military status, job tenure, work shifts, and lifestyle habits.

Results

The risk of increased BMI was higher in 2021 compared to 2019 (risk ratio [RR]: 1.008, 95% confidence interval [CI]: 1.001-1.014). Individuals on rotating shifts had a higher risk of increased BMI compared to day shift workers (RR: 1.021; 95% CI: 1.008-1.035) and higher odds of obesity (odds ratio: 1.546; 95% CI: 1.099-2.175). Among obese individuals, BMI in soldiers was approximately 4.9% lower than in non-soldiers (RR: 0.951; 95% CI: 0.915-0.988).

Conclusions

This study identified a significant post-pandemic increase in BMI among healthcare workers in a Taiwanese military hospital, with rotating shifts being a key risk factor for both increased BMI and obesity. Work-related factors influenced BMI changes among obese individuals, while non-work-related factors were significant for non-obese individuals. These findings highlight the broader effects of the pandemic and the specific impact of work-related factors on obese healthcare workers.

Impact of the COVID-19 pandemic lockdown on Body Mass Index: a three-year follow up study in 6,156 Chinese college students

Background

The novel coronavirus disease 2019 as the most pervasive and consequential pandemic in recent years, has exerted significant impacts on human health, including aspects related to body weight. Objectives: This study aims to assess the influence of the lockdown measures implemented during the COVID-19 pandemic on Chinese college students' Body Mass Index (BMI) through a three-year cohort study.

Methods

We recruited 6156 college students (n = 4,248, 69% male, and n = 1,908, 31% female, with an average age of 18.68 ± 0.86 yr.) from a University in China to participate in this three-year cohort study. All of the subjects took the same physical fitness tests from 2019 to 2021 (pre-lockdown, during lockdown and post-lockdown). Participants' height and weight data were objectively measured by Tongfang Health Fitness Testing Products 5000 series. A paired t-test was performed in the analysis.

Results

During the lockdown, there is 4.2% increase of BMI among the college student (p<0.001). Moreover, males had a greater overall mean BMI rate increase of 4.74% (p<0.001) than females (2.86%, p<0.001). After the lockdown, there is 0.94% increase of BMI among the college student (p<0.001). However, females had a greater overall mean BMI rate increase of 1.49% (p<0.001) than males (0.72%, p<0.001). During this period, the obese and overweight group's growth rate from 2019 to 2020 was smaller than the normal and underweight group, which were 2.94% (p<0.001), 3.90% (p<0.001), 4.44% (p<0.001) and 5.25% (p<0.001), respectively.

Conclusion

BMI increased both during and post-lockdown periods among Chinese college students. However, during the lockdown, participants with higher BMI groups appeared to have a diminished BMI growth rate compared to those with lower BMI. After the lockdown, participants with higher BMI levels appeared to have an augmented BMI growth rate. Public policy action is needed to increase the level of physical activity of Chinese college students and take action to improve students' physical fitness performance after the lockdown.

Could commercial meal kits be part of the solution to food insecurity during pregnancy? An Australian exploratory study

AIM

To explore the nutritional content of meal kits from two main Australian companies over a 6-week period against healthy eating guidelines for pregnancy.

METHOD

Across the 6-week period, weekly meal kits from both Provider 1 and Provider 2 were purchased, 36 individual meals were assessed. All data were analysed for the development of a macronutrient and micronutrient profile of meals. Extracted data were macronutrient, vitamin, and mineral composition, which were compared against the healthy eating guidelines for pregnant women in Australia and New Zealand.

RESULTS

Meal kits include higher levels of sodium, and lower levels of dietary fibre, calcium, magnesium, zinc, iron, thiamin, riboflavin, grains, and dairy when compared against the guidelines for healthy eating for pregnant women in Australia and New Zealand.

CONCLUSIONS AND IMPLICATIONS

Meal kits may increase meals prepared and consumed in the home, and thanks to the clear instructions and pre-portioned ingredients, may reduce stress related to food preparation. They have the potential to provide nutritionally adequate meals to pregnant women as a way to mitigate food insecurity or hunger during pregnancy and may provide some nutritional benefits and have the potential to remove some of the challenges with maintaining an adequate diet when pregnant.

Effects of working from home on lifestyle behaviors and mental health during the COVID-19 pandemic: A survey study

The COVID-19 outbreak has led to relevant changes in everyday life worldwide. One of these changes has been a rapid transition to and an increasing implementation of working from home (WH) modality. This study aimed to evaluate the impact of mandatory WH during the COVID-19 pandemic on lifestyle behaviors, Mediterranean diet adherence, body weight, and depression. An online cross-sectional survey was conducted in the early 2022 at the National Research Council of Italy using ad hoc questions and validated scales collecting information on physical activity, sedentary behavior, hobbies/pastimes, dietary habits including adherence to the Mediterranean diet, body weight, and depression during WH compared with before WH. 748 respondents were included in the study. An increased sedentary lifetime was reported by 48% of respondents; however, the subsample of workers who previously performed moderate physical activity intensified this activity. Body weight gain during WH was self-reported in 39.9% of respondents. Mediterranean diet adherence increased (p≪0.001) during WH compared with before WH. The average level of mental health did not record an overall variation; however, the proportion of subjects with mild and moderate depression increased (p = 0.006), while workers who reported values indicative of depression before the transition declared an improvement. These findings highlight health-related impact of WH during the COVID-19 pandemic that may inform future strategies and policies to improve employees' health and well-being.

Impacts of the SARS-CoV-2 pandemic on the dietary practices of university students in Germany

Purpose

The dietary practices (DPs) of university students are influenced by many external factors. Therefore, we investigate how the DPs of students in Germany changed during the SARS-CoV-2 pandemic, what the main motivations were for those changes, and what effect the closure of university catering had on the DPs of students.

Methods

A total of 560 students from two universities in Lübeck (Germany) were surveyed online during a pilot phase. The final online questionnaire was subsequently administered at 10 other German universities (399 respondents). The questionnaire surveyed sociodemographic factors, dietary habits, food consumption frequencies, and the relevance of university catering before and during the SARS-CoV-2 pandemic.

Results

Regarding changes in DPs, similarities to previous studies were found, especially positive eating behaviors and an increasing interest in health- and nutrition-related sustainability. Students prepared meals freshly more often during the pandemic; consumed legumes, plant-based meats and dairy alternatives more often; and reduced their consumption of meat and milk compared to before the pandemic. The consumption frequency of sweets also decreased. It was observed that students consider eating communal in the university canteen to be highly relevant for their social interactions, which was only possible to a limited extent during the pandemic.

Conclusion

In Germany, the DPs of university students as well as criteria regarding health and sustainability changed during the first 2 years of the SARS-CoV-2 pandemic. The social aspect of DPs became evident due to closed university catering. Still, changes in dietary patterns and eating habits were positively related to health and revealed some differences in the cross section of the population.

Associations between body mass index and episodic memory for recent eating, mindful eating, and cognitive distraction: A cross-sectional study

Objectives

Eating while distracted has been associated with a higher body mass index (BMI), whereas mindful eating and episodic memory for recent eating have shown the opposite pattern. This pre-registered, global study (https://osf.io/rdjzk) compared the relative association between these variables (and four "positive controls": restraint, disinhibition, emotional eating, plate clearing) and self-reported BMI. The timing of data collection (April-May 2020) during the SARS-CoV-2 pandemic enabled an investigation of the impact of stay-at-home restrictions imposed on the UK population on the measures of eating behavior.

Methods

An online survey was completed, including: (i) demographic data (e.g., self-reported BMI), (ii) Likert ratings assessing episodic memory for recent eating, mindful eating, cognitive distraction, restrained eating, emotional eating, disinhibition and plate clearing over the last 12 months and the last 7 days (during the first UK COVID-19 lockdown), and (iii) the Mindful Eating Questionnaire (MEQ).

Results

A large adult sample participated (N = 846; mean (SD) age = 33.0 (14.3) years; mean (SD) BMI = 24.6 (5.6) kg/m2). Mindful eating (MEQ-total score) was associated with a lower self-reported BMI (β = -0.12; 95% CI = -0.20, -0.04; p = 0.004), whereas disinhibited eating was associated with a higher self-reported BMI (β = 0.30; 95% CI = 0.21, 0.38; p < 0.001). In UK participants (n = 520), consistent changes in eating behavior during lockdown were not found. For those that did experience change, decreases were reported in; emotional eating, disinhibited eating, focusing on taste during a meal (a measure of mindful eating), and using a smart phone while eating.

Conclusions

These findings provide evidence in a large global sample for associations between BMI and (i) mindful eating, and (ii) disinhibited eating. Future research should evaluate whether mindful eating demonstrates a prospective association with body weight and should consider mechanisms of action.

Do nutritional habits and supplement use affect health-related quality of life during social isolation period in the community of North Cyprus?

The aim of study was to comprehensively investigate the effect of nutritional habits and supplement use on health-related quality of life during social isolation period. This study was a cross-sectional study. A total of 418 participants (73.4% were women and 26.6% were men) participated in this study. Participants' demographic information, nutritional habits, and quality of life were questioned, and anthropometric measurements were obtained. A significant difference was found in the main meal skipping status of individuals by age group. The consumption of milk, yoghurt, ayran, legumes, cereal products other than bread, vegetables, fruits, oilseeds, and snack foods was similar in both periods. Furthermore, frequencies of multivitamins, multiminerals, vitamin B12, vitamin C, vitamin D, iron, calcium, omega-3, and probiotics were similar during and before the pandemic. A significant difference was found in scores obtained on the Quality of Life Scale (QOLS) by age group. There was a significant difference in the quality of life scores by body mass index (BMI) groups. It was concluded that quality of life decreased due to the increase in body weight during pandemic period. The social isolation period did not make a clear difference in the nutritional habits of individuals and the use of nutritional supplements. When the main meal skipping situations were evaluated within the scope of nutritional habits, those who did not skip their main meal received the highest score on the QOLS.

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.

Influence of the COVID-19 pandemic on prenatal and postpartum patient experiences and well-being

BACKGROUND

It has yet to be fully elucidated how differing populations of obstetric patients adapted to the disruptions in perinatal care and postpartum support from the COVID-19 pandemic. We surveyed an enriched sample of socioeconomically advantaged patients to understand the influence of COVID-19 on their perinatal care experience, well-being, and coping.

METHODS

We surveyed pregnant and postpartum patients (n = 6140) at a large academic medical center in the Midwest of the United States using the Coronavirus and Perinatal Experiences instrument in Spring 2021.

RESULTS

The survey was sent to 6141 pregnant and postpartum patients; 1180 (17.8%) respondents completed the survey, including 256 who were pregnant and 834 postpartum. Most pregnant patients experienced no changes in their prenatal care with 16.5% indicating somewhat worsened care. In the postpartum cohort, 37.5% stated their care had somewhat worsened. In describing influences on stress and mental health, 58.1% of postpartum respondents stated it was moderately, and 17.4% significantly, worse. The pandemic had a somewhat or moderately negative influence for 72.7% of respondents, with 11.0% stating these effects were extremely negative. Both cohorts characterized a range of coping strategies, most commonly, talking with friends and family (76.3%).

CONCLUSION(S)

Even among this sample of socioeconomically advantaged patients, respondents indicated that the pandemic disrupted many facets of their medical care and daily life, especially social activities and postpartum support. Our findings suggest that counseling on coping and adaptation strategies for stressors and increased health systems support be part of perinatal care during public health emergencies for all demographic groups.

COVID-19 Pandemic Associations on Mental and Physical Health in African Americans Participating in a Behavioral Intervention

The COVID-19 pandemic has had disproportionate effects on communities of color, with higher death rates among African Americans (AA). The purpose of this study was to assess associations in African Americans' mental and physical health with the COVID-19 pandemic. Data for this study came from a larger nutrition intervention of AAs in the Southeastern United States, the Nutritious Eating with Soul study. Data collected before and after March 15, 2020 (the day when local South Carolina schools and businesses closed), were analyzed to assess the association of the pandemic on participants' stress, control of healthy eating, physical activity, and body mass index. Repeated measures analysis of covariance using full maximum likelihood estimation to handle missing data was used. At the onset of the COVID-19 pandemic, 150 participants were enrolled in the study (48.2 ± 10.6 years old, 79% female, 75% with college degree or higher). Participants' reporting of stress did not show statistically significant change over time. Cognitive control increased 1.43 points (F = 20.60, p < 0.0001) and body mass index increased 0.72 kg/m2 (F = 10.68, p = 0.001). Future longitudinal studies should investigate how the COVID-19 pandemic continues to present challenges to understanding and improving health among African Americans. The study is registered at www.clinicaltrials.gov NCT03354377.

The Impact of the First Wave of the COVID-19 Pandemic on University Staff Dietary Behaviours, Sleeping Patterns, and Well-Being: An International Comparison Study

This study assessed the impact of the first wave of the COVID-19 pandemic on well-being by measuring the changes to food security, dietary behaviour, and sleeping patterns of university staff in England, Poland, Saudi Arabia, and China. Using a cross-sectional study design, participants in four universities in the respective countries were surveyed between June and July 2020. The mean age of the 902 participants was 42 years old and 67% were female. The findings indicate a reduction in emotionally driven food behaviour [t (901.00) = -20.87, p <  0.001], food acquisition location [t (901.00) = -51.55, p < 0.001], skipping meals [t (901.00) = -24, p < 0.001], and consumption of canned fruit and vegetables [t (901.00) = -10.18, p < 0.001]. However, home cooking [t (901.00) = 36.61, p < 0.001] and the food shopping experience [t (901.00) = 4.53, p <  0.001] markedly increased during lockdown. The participants had higher levels of well-being during the pandemic and experienced a significant increase in sleeping hours (p < 0.001). Increased age and sleeping hours were positively associated with overall well-being. Conversely, emotionally driven food behaviour (i.e., buying and eating more food out of boredom/fear or anxiety) and skipping meals decreased the overall well-being. Lockdown had beneficial effects on dietary behaviours, sleeping patterns, and well-being, but there were variations between countries.

Did the COVID-19 pandemic impact the dietary intake of individuals living with and beyond breast, prostate, and colorectal cancer and who were most likely to experience change?

PURPOSE

The present work investigated dietary changes amongst individuals living with and beyond cancer (LWBC) from before to during the pandemic. To identify those at greatest risk of unhealthy changes, it was further examined whether patterns varied by sociodemographic, health-related, and COVID-19-related characteristics.

METHODS

This longitudinal cohort study analysed data from 716 individuals LWBC participating in the Advancing Survivorship Cancer Outcomes Trial (ASCOT). Using data provided before and during the pandemic, changes in fruit and vegetable, snack, and alcohol intake were tested using mixed-effect regression models.

RESULTS

Fruit and vegetable (95%CI: - 0.30; - 0.04) and alcohol consumption (95%CI: - 1.25; - 0.31) decreased, whilst snacking increased (95%CI: 0.19; 0.53). Women and individuals with limited social contact were more likely to reduce fruit and vegetable intake during the pandemic. Women and individuals with poorer sleep quality, limited social contact, and shielding requirements and without higher education were more likely to increase snacking during the pandemic. Individuals with poorer sleep quality, poorer mental health, and regular social contact were more likely to decrease alcohol consumption during the pandemic.

CONCLUSIONS

Findings suggest decreased intake for fruit, vegetable, and alcohol consumption and increased snack intake in response to the pandemic amongst individuals LWBC. These changes appear to differ across various characteristics, suggesting the pandemic has not equally impacted everyone in this population. Findings highlight the need for targeted post-COVID strategies to support individuals LWBC most adversely affected by the pandemic, including women and socially isolated individuals. This encourages resources to be prioritised amongst these groups to prevent further negative impact of the pandemic. Whilst the findings are statistically significant, practically they appear less important. This is necessary to acknowledge when considering interventions and next steps.

Changes in Body Mass Index and Their Associations with Psychological Distress, Worries, and Emotional Eating during the COVID-19 Pandemic: A Norwegian Cohort Study

In 2020, the COVID-19 pandemic highlighted obesity's long-term rise. Some of the impacts of the pandemic were increased psychological distress, emotional eating, higher consumption of high-sugar foods and drinks, and a more sedentary lifestyle. This study examined BMI changes over time and their associations with psychological distress and lifestyle changes. This population-based cohort study had 24,968 baseline participants and 15,904 and 9442 one- and two-year follow-ups, respectively. Weight, height, psychological distress, high-sugar foods and drinks, physical activity, and emotional eating were assessed. These factors and BMI were examined at baseline and over time. We used mediation analyses and structural equation modeling to determine how psychological distress affects BMI. The mean BMI was 25.7 kg/m2 at baseline and 26.2 kg/m2 at two years. High psychological distress, daily emotional eating, and low physical activity were associated with higher BMI at baseline and higher yearly increases in BMI compared to reference levels. Emotional eating mediated 33% of the psychological distress BMI effect. Overall, BMI increased during the pandemic. Psychological distress during the pandemic was linked to weight gain partly through emotional eating. This association remained strong over time during different stages of the pandemic.

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.

The Impact of the COVID-19 Pandemic on Outcomes in Acute Pancreatitis: A Propensity Score Matched Study Comparing before and during the Pandemic

We aimed to evaluate the outcomes and survival of patients with acute pancreatitis who shared the same clinical form, age, and sex before the pandemic, during the pandemic, and among those with confirmed COVID-19 infection upon hospital admission. This consideration used the sparse data in the existing literature on the influence of the pandemic and COVID-19 infection on patients with acute pancreatitis. To accomplish this, we conducted a multicentric, retrospective case-control study using propensity score matching with a 2:1 match of 28 patients with SARS-CoV-2 infection and acute pancreatitis, with 56 patients with acute pancreatitis pre-pandemic, and 56 patients with acute pancreatitis during the pandemic. The study outcome demonstrated a six-fold relative risk of death in patients with acute pancreatitis and SARS-CoV-2 infection compared to those with acute pancreatitis before the pandemic. Furthermore, restrictive measures implemented during the pandemic period led to a partial delay in the care of patients with acute pancreatitis, which likely resulted in an impairment of their immune state. This, in certain circumstances, resulted in a restriction of surgical treatment indications, leading to a three-fold relative risk of death in patients with acute pancreatitis during the pandemic compared to those with acute pancreatitis before the pandemic.

Food access, domestic environments, and dietary quality of low-middle income Chilean children during the COVID-19 pandemic

Introduction

Food access is associated with dietary quality; however, people living in similar physical environments can have different food access profiles. Domestic environments may also influence how food access relates to dietary quality. We studied food access profiles of 999 low-middle income Chilean families with children during the COVID-19 lockdown and how these profiles relate to dietary quality; secondarily, we also explore the role of the domestic environment in this relationship.

Materials and methods

Participants of two longitudinal studies conducted in the southeast of Santiago, Chile, answered online surveys at the beginning and end of the COVID-19 pandemic lockdown. Food access profiles were developed by a latent class analysis considering food outlets and government food transfers. Children's dietary quality was estimated by self-reported compliance with the Chilean Dietary Guidelines of Americans (DGA) and daily ultra-processed food (UPF) consumption. Logistic and linear regressions were used to assess the association between food access profiles and dietary quality. Domestic environment data (i.e., the sex of the person who buys food and cooks, meal frequency, cooking skills, etc.) were incorporated in the models to assess their influence on the relationship between food access and dietary quality.

Results

We have categorized three food access profiles: Classic (70.2%), Multiple (17.9%), and Supermarket-Restaurant (11.9%). Households led by women are concentrated in the Multiple profile, while families from higher income or education levels are focused on the Supermarket-Restaurant profile. On average, children presented poor dietary quality, with a high daily UPF consumption (median = 4.4; IQR: 3) and low compliance with national DGA recommendations (median = 1.2; IQR: 2). Except for the fish recommendation (OR = 1.77, 95% CI:1.00-3.12; p: 0.048 for the Supermarket-Restaurant profile), the food access profiles were poorly associated with children's dietary quality. However, further analyses showed that domestic environment variables related to routine and time use influenced the association between food access profiles and dietary quality.

Conclusion

In a sample of low-middle income Chilean families, we identified three different food access profiles that presented a socioeconomic gradient; however, these profiles did not significantly explain children's dietary quality. Studies diving deeper into household dynamics might give us some clues on intra-household behaviors and roles that could be influencing how food access relates to dietary quality.

What's in a commercial meal kit? Structured review of Australian meal kits

OBJECTIVE

The aim of this project is to review the products and recipes contained within popular subscription meal kits to determine if they are suitable for wider use among people who are food insecure.

DESIGN

Across the 6-week period, weekly meal kits from both HelloFresh and Markey Spoon were purchased, resulting in thirty-six individual meals that were prepared and assessed. Meals were assessed based on the content included in the meal kit compared with the recipe card and the nutrition panel, the costs of the individual foods if purchased at one of two major supermarkets and the ease of preparation.

SETTING

Australia.

PARTICIPANTS

Households were comprised of two, 2-person households who were provided with 2 meals each week, and two, single-person households who were provided with one meal each week.

RESULTS

The findings of this research suggest that while the meal kits are convenient and, in general, the recipes are easy to follow, and the meals would be made again, the high levels of salt and fat may preclude these kits from regular inclusion in a healthy diet. The meal kits were also found to be more costly than the same ingredients if purchased from a major supermarket. However, the convenience of having most of the foods needed to prepare a full meal with little to no wastage may counterbalance this cost.

CONCLUSIONS

Meal kits may be a useful component of a healthy diet, that can increase meals prepared and consumed in the home, and thanks to the clear instructions and pre-portioned ingredients, may reduce stress related to food preparation.

Chinese university students showed less disordered eating during the COVID-19 campus lockdown

OBJECTIVE

The rapid spread of the Omicron variant of COVID-19 in China had resulted in campus lockdown in many universities since February 2022, profoundly affecting students' daily lives. Campus lockdown conditions differ considerably from home quarantine, so that the eating patterns of university students may be different. Thus, the current study aimed to: (1) investigate university students' eating patterns during campus lockdown; (2) identify factors associated with their disordered eating.

METHOD

An online survey about recent life changes, disordered eating, stress, depression, and anxiety was carried out from April 8th to May 16th, 2022. A total of 2541 responses from 29 provinces/cities of China were received.

RESULTS

2213 participants were included in the main analysis, and other 86 participants were analyzed separately as a subgroup due to their diagnosis of eating disorder. Participants who were undergoing campus lockdown (the lockdown group) showed less disordered eating than those who had never been in campus lockdown (the never-lockdown group), as well as those who had experienced campus lockdown before (the once-lockdown group). However, they perceived more stress and felt more depressed. Being female, higher BMI, gaining weight, increasing exercise, spending more time on social media, higher level of depression and anxiety were all related to disordered eating in the lockdown group.

CONCLUSIONS

Disordered eating among Chinese university students was less prevalent during campus lockdown due to the strict and regular diet. However, there is a potential risk of "revenge eating" after campus lockdown ends. Thus, there should be further tracking and related prevention.

LEVEL OF EVIDENCE

IV, uncontrolled trials without any interventions.

Lifestyle Changes during the SARS-CoV-2 Pandemic as Predictors of BMI Changes among Men and Women in Poland

BACKGROUND

Social isolation during the SARS-CoV-2 pandemic affected people's body weight, therefore, this study was designed to evaluate the association between lifestyle elements and the change in BMI during lockdown.

METHODS

This retrospective observational study involved 290 questionnaires completed by adult participants divided into three groups according to BMI change during isolation. The structured questionnaire included a general description of the study objective and collected data regarding sociodemographics, anthropometrics, physical activity, sedentary behaviour, sleep duration, and food intake pre- and during COVID-19 lockdown.

RESULTS

A decrease or increase in BMI was found in 23.6% and 47.8% of women and 18.5% and 42.6% of men, respectively. Among those who lost weight, 46.5% of women and 40% of men followed a diet of their own choice, 30.2% of women and 25% of men changed their product mix and reduced their intake, 40% of men stopped eating outside the home. An increase in BMI was associated with increased food intake (32.2% of women and 28.3% of men), increased sleep duration on weekdays (49.2% of women and 43.5% of men) and, in more than 50% of subjects, decreased physical activity. In women, increased BMI was associated with the highest frequency of snacking (p = 0.0003), the highest intake of sweets (p = 0.0021), and in men with the highest intake of alcohol (p = 0.0017).

CONCLUSIONS

The observed changes in BMI during social isolation were the result of lifestyle modifications including dietary behaviour and differed by gender.

Impact of Final Phase Social Isolation and the COVID-19 Pandemic on Eating Behavior, Sleep Quality, and Anxiety Level

The coronavirus disease 2019 (COVID-19) pandemic has resulted in economic, social, and behavioral changes in people, which may favor several long-term consequences. This study evaluated the effects of the COVID-19 pandemic on eating behavior and mental health in the final phase of social isolation. This cross-sectional study included 756 adults that completed an online questionnaire. Individuals were stratified into those who had been infected with COVID-19 (GCOV) and those who did not (GNCOV). The GCOV group had higher weight (p = 0.013), body mass index (BMI) (p = 0.005), anxiety levels (p = 0.040), sleep disorders (p = 0.009), and poorer sleep quality (p = 0.0028). In the GCOV, the consumption of ultra-processed foods was associated with higher anxiety levels and poorer sleep quality. A higher proportion of individuals who consumed more than five servings of in natura food was observed in the group with taste and olfactory dysfunction than in the group without. Obesity contributes to uncontrolled and emotional eating disorders, increased anxiety, and worsened sleep. Therefore, COVID-19 impaired mental health and eating behavior even in the long term. These changes were potentiated by the presence of obesity and consumption of ultra-processed foods, evidencing the importance of monitoring these individuals even after the resolution of COVID-19.

University students' living conditions during the COVID-19 pandemic and predictors of their subjective health views: A cross-sectional survey

This study aimed to explore the factors influencing subjective health views based on the living conditions and concerns of university students during the coronavirus infection 2019 (COVID-19) pandemic. From March to April 2021, a questionnaire survey was administered to 8,547 Japanese university students, and logistic regression analysis was used to explore factors related to subjective health views. The results showed that satisfaction with quality of sleep (OR = 2.651, 95% Cl 2.370-2.966,p < 0.001), satisfaction with university life (OR = 2.486, 95%Cl 2.215-2.789, p < 0.001), satisfaction with diet (OR = 1.849, 95% CI: 1.496-2.285, p < 0.001), regular exercise (OR = 1.759, 95% CI: 1.594-1.941, p < 0.001), consciousness of nutritional balance (OR = 1.276, 95% CI: 1.147-1.420,p < 0.001), eating breakfast every day (OR = 1.247, 95% CI: 1.121-1.387, p < 0.001), and consuming soft drinks at least once a week (OR = 0.865, 95% CI: 0.755-0.966, p = 0.010) were positive factors for subjective views of health. On the other hand, anxiety about whether the necessary credits can be obtained (OR = 0.885, 95% CI: 0.799-0.980, p = 0.019), infection from minimal outings (OR = 0.881, 95% CI: 0.794-0.976, p = 0.016) building and maintaining friendships on campus (OR = 0.867, 95% CI: 0.767-0.980, p = 0.023), and being able to continue working (OR = 0.713, 95% CI: 0.640-0.795, p < 0.001) were identified as negative factors. To ensure a healthy university life during the COVID-19 pandemic or future pandemic, supports tailored to students' living conditions and measures to address their anxieties are required.

Snacking and anxiety during the coronavirus disease (COVID-19) pandemic: A prospective cohort study

Anxiety and snacking increased during the initial coronavirus disease 2019 (COVID-19) lockdowns, but it remains unknown whether this change in snacking persisted and if it related to anxiety levels. We used prospective data to examine changes in snacking frequency from t1 (eased restrictions in England in May-June 2020) to t2 (national lockdown in December 2020-March 2021), the association of anxiety (assessed by the Generalised Anxiety Disorder-7 questionnaire at t1) with the snacking change, and the mediating and moderating effects of disinhibition and flexible restraint (assessed by the Three Factor Eating Questionnaire in 2016-17). Analyses including 2128 adults (mean age 28.4 y) residing in England from the Avon Longitudinal Study of Parents and Children showed that snacking frequency increased over time (mean change 1.23 (95% CI 0.81, 1.65) snacks/wk). Linear regressions of snacking adjusted for sociodemographic covariates showed that having clinical levels of generalised anxiety at t1, versus not, was associated with 1.22 (95% CI 0.07, 2.37) more snacks/wk at t2. Disinhibition partially mediated the association between Generalised Anxiety Disorder and snacking (βindirect = 0.15, 95% CI 0.01, 0.32), while there was no evidence that flexible restraint moderated the association (β = 0.05, 95% CI -0.57, 0.66). Our longitudinal findings highlight a detrimental anxiety-snacking association partly operating via disinhibition, suggesting future research could target mitigating anxiety and disinhibited eating behaviours to benefit diet-related outcomes following the pandemic.

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.

Weight status of working adults: The effects of eating misalignment, chronotype, and eating jetlag during mandatory confinement

This study aimed to examine the association between chronotype, eating jetlag, and eating misalignment with weight status among Malaysian adults during the COVID-19 restriction. This online cross-sectional study included 175 working adults recruited from March to July 2020. The chronotype was assessed using Morningness Eveningness Questionnaire (MEQ) while eating jetlag and mealtime variability were measured using Chrononutrition Profile Questionnaire (CPQ). Multiple linear regression demonstrated that lower breakfast frequency (β=-0.258, p = .002) and longer eating duration (β = 0.393, p < .001) were associated with later first eating events on workfree days. Both intermediate (β = 0.543, p < .001) and evening chronotypes (β = 0.523, p = .001) tend to eat their first meals later compared to morning person. Similar patterns were observed for overall eating jetlaggers in which lower breakfast frequency (β=-0.022, p = .011), longer eating duration (β = 0.293, p < .001), intermediate chronotype (β = 0.512, p < .001), and evening chronotype (β = 0.495, p = .003) were associated with eating later meals on workfree days. Additionally, higher BMI was also associated with eating later meals on workfree days (β = 0.181, p = .025). During movement restriction, discrepancies of mealtimes during work and workfree days offer new insight into modern eating habits that can influence weight status and general eating habits such as breakfast skipping and total daily eating duration. Population meal timing variability was affected during movement restrictions, and it was closely related to weight status.

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.

The role of technology use in food practices during the COVID-19 pandemic

Over the last three years, COVID-19, with its lockdowns, social restrictions, and work from home structures, had a significant influence on our daily lives. The resulting changes in technology practices are likely to be explored in the years ahead. We will contribute to this exploration by looking specifically at the impact of COVID-19 on everyday food practices and the role of involved technology. To explore food practices and technology use, we conducted a qualitative interview study with 16 interviewees and delved into the underlying influencing factors behind them. Thereby we can better understand potential behavioral changes and technology usage by people to design not only for future pandemics and exceptional situations but to also for non-pandemic times.

Post-traumatic growth in PhD students during the COVID-19 pandemic

Throughout the COVID-19 pandemic, graduate students have faced increased risk of mental health challenges. Research suggests that experiencing adversity may induce positive psychological changes, called post-traumatic growth (PTG). These changes can include improved relationships with others, perceptions of oneself, and enjoyment of life. Few existing studies have explored this phenomenon among graduate students. This secondary data analysis of a survey conducted in November 2020 among graduate students at a private R1 University in the northeast United States examined graduate students' levels and correlates of PTG during the COVID-19 pandemic. Students had a low level of PTG, with a mean score of 10.31 out of 50. Linear regression models showed significant positive relationships between anxiety and PTG and between a measure of self-reported impact of the pandemic and PTG. Non-White minorities also had significantly greater PTG than White participants. Experiencing more negative impact due to the pandemic and ruminating about the pandemic were correlated with greater PTG. These findings advance research on the patterns of PTG during the COVID-19 pandemic and can inform future studies of graduate students' coping mechanisms and support efforts to promote pandemic recovery and resilience.

The Association between Vegan, Vegetarian, and Omnivore Diet Quality and Depressive Symptoms in Adults: A Cross-Sectional Study

Dietary patterns and depressive symptoms are associated in cross-sectional and prospective-designed research. However, limited research has considered depression risk related to meat-based and plant-based dietary patterns. This study explores the association between diet quality and depressive symptoms across omnivore, vegan, and vegetarian dietary patterns. A cross-sectional online survey utilised the Dietary Screening Tool (DST) and the Centre for Epidemiological Studies of Depression Scale (CESD-20) to measure diet quality and depressive symptoms, respectively. A total of 496 participants identified as either omnivores (n = 129), vegetarians (n = 151), or vegans (n = 216). ANOVA with Bonferroni post hoc corrections indicates that dietary quality was significantly different between groups F(2, 493) = 23.61, p < 0.001 for omnivores and vegetarians and omnivores and vegans. Diet quality was highest in the vegan sample, followed by vegetarian and omnivore patterns. The results show a significant, moderately negative relationship between higher diet quality and lower depressive symptoms (r = -0.385, p < 0.001) across groups. Hierarchical regression showed that diet quality accounted for 13% of the variability in depressive symptoms for the omnivore sample, 6% for vegetarians, and 8% for vegans. This study suggests that diet quality in a meat-based or plant-based diet could be a modifiable lifestyle factor with the potential to reduce the risk of depressive symptoms. The study indicates a greater protective role of a high-quality plant-based diet and lower depressive symptoms. Further intervention research is needed to understand the bi-directional relationship between diet quality and depressive symptoms across dietary patterns.

Emotional eating in relation to psychological stress during COVID-19 pandemic: a cross-sectional study in faculty of medicine, Tanta University, Egypt

BACKGROUND

Stress, anxiety, and depression resulting from the COVID-19 pandemic as well as subsequent restrictive measures had a negative impact on eating behaviors. This study aimed to determine the emotional eating behaviors and the perceived stress level and to assess the relation between them among adults in the faculty of medicine during the late period of lockdown during the COVID-19 pandemic.

METHODS

This was a cross-sectional study among 580 persons from the faculty of medicine, at Tanta University, Egypt conducted over a period of one month during the last period of partial lockdown (October 2020). A self-administered structured questionnaire consisted of five parts used in the study (sociodemographic factors, COVID-19-related parameters, nutrition-related information during the pandemic, emotional eating scale, and perceived stress scale).

RESULTS

More than two-fifths of students, employees, and staff (45.2%, 45.5%, and 44.2%, respectively) stated that their weight increased as a result of the lockdown. 50.8% of students, 42.5% of employees, and 54.6% of staff were in the moderate emotional eating groups. Similarly, the majority of students, employees, and staff reported moderate levels of stress(84%, 80.8%, and 76.1% respectively). The total emotional eating score was positively correlated with the total perceived stress scores (r = 0.13, p = 0.001*).

CONCLUSION

COVID-19 pandemic, particularly during the period of lockdown, had a negative impact on individuals' psychological stress levels and levels of emotional eating behaviors.

Emotional Eating and Changes in High-Sugar Food and Drink Consumption Linked to Psychological Distress and Worries: A Cohort Study from Norway

Psychological distress is linked to unhealthy eating behaviors such as emotional eating and consumption of high-sugar food and drinks. Cross-sectional studies from early in the COVID-19 pandemic showed a high occurrence of worries and psychological distress, and this was associated with emotional eating. Few larger studies have examined how this coping pattern develops over time. This cohort study with 24,968 participants assessed changes over time in emotional eating, consumption of sugary foods as an example of unhealthy food choices, and consumption of fruits and vegetables as an example of healthy food choices. Further, associations between these and psychological distress, worries, and socio-demographic factors were assessed. Data were collected at three time points (April 2020, initially in the COVID-19 pandemic, then one and two years later). Emotional eating and intake of sugary foods and drinks were high at the start of the pandemic, followed by a reduction over time. High psychological distress was strongly associated with higher levels of emotional eating and high-sugar food intake, and lower levels of healthy eating habits. The strength of this association reduced over time. Our findings indicate the high frequency in unhealthy food choices seen early in the COVID-19 pandemic improved over time.

Who has experienced better or worse health conditions since the outbreak of COVID-19?: results from a representative cross-sectional survey in Seoul

BACKGROUND/OBJECTIVES

The coronavirus disease 2019 (COVID-19) pandemic has affected the entire world population in many ways. This study aimed to analyze the patterns of changes in eating, food purchasing and preparation, physical activity, and subjective health after COVID-19 outbreak by various sociodemographic factors and to understand the factors associated with changes in subjective health.

SUBJECTS/METHODS

A cross-sectional survey using a representative sample from Seoul was used for the analysis. The data collection was conducted from September to October 2020. A total of 3,833 citizens aged more than 18 years old participated in the Seoul Food Survey. Descriptive statistics and generalized ordinal logistic regression models were used to understand the changes in health behaviors, health indicators, and subjective general health by various socioeconomic status.

RESULTS

It was shown that the changes in household income, food expenditure, food consumption and physical activities differed significantly by age, education, occupation, income, weight, and food security status. Low-income and food-insecure households were affected more severely by the pandemic. Older age, household food insecurity, income reduction, increased home cooking and frequency of having instant foods, decreased physical activity and weight gain were significant factors explaining worse perceived health during the COVID-19 pandemic.

CONCLUSIONS

The results suggest that focusing on older populations and low-income families with food insecurity should be prioritized during infectious disease outbreaks. In addition, the role of physical activities and instant food consumption in explaining perceived health should be investigated further in this prolonged battle with the pandemic situation.

Coping as a Mediator and Moderator between Psychological Distress and Disordered Eating Behaviors and Weight Changes during the COVID-19 Pandemic

Previous research has already shown the negative impact of the COVID-19 pandemic on college students' well-being and mental health. Eating problems and weight gain due to changes in eating habits and physical activity experienced during this period have also been noticed. However, few studies have explored the role of students' resources as used during the COVID-19 pandemic, such as coping strategies. This study aimed to (1) explore the associations among psychological distress, disordered eating, coping strategies, and weight changes; (2) examine the moderating role of coping strategies in the process of weight gain and weight loss; and (3) study the mediating role of coping strategies in the process of weight gain and weight loss. The participants in this study were 772 students at a Portuguese university. The data collected included sociodemographic data and three self-reported questionnaires (Depression, Anxiety, and Stress Scale; Eating Disorder Examination Questionnaire; Brief COPE) during the first few months of the pandemic, which included a 72-day full national lockdown. The results showed that depression, anxiety, stress, and disordered eating were related to increased weight. Guilt, denial, self-distraction, use of substances, and behavior disinvestment were also related to increased weight. Behavioral disinvestment had a strong mediating effect on weight gain. Additionally, planning, positive reframing, and acceptance all showed a moderating effect between psychological distress and weight changes. In conclusion, coping strategies allow for a better understanding of the mechanisms by which psychological distress and disordered eating were related to weight changes during the pandemic.