Eating to Cope With the COVID-19 Pandemic and Body Weight Change in Young Adults

COVID-19 and changes in young adults' weight concerns

The COVID-19 pandemic introduced fundamental challenges to nearly all aspects of college students' lives, yet changes in key domains of their health, including weight concerns, remain untested. The current study utilized a longitudinal project comprised of 355 young-adult college students (Mage=19.5, 66.8% female, 33.2% male) oversampled for recent substance use behavior. Participants completed multiple assessments (mode = 5) from September 2017 to September 2021. Piecewise growth-curve models tested whether COVID-19 onset was associated with changes in the trajectories of young adults' weight concerns. Analyses also examined participants' sex as a moderator of these trajectories. On average, participants reported a significant increase in weight concern levels around the start of COVID-19, although weight concern slopes were not significantly different before and after COVID-19. Additionally, moderation analyses showed that females (but not males) had a significant increase in weight concern levels after COVID-19 onset.

Predicting the Transition to Metabolically Unhealthy Obesity Among Young Adults With Metabolically Healthy Obesity in South Korea: Nationwide Population-Based Study

BACKGROUND

Globally, over 39% of individuals are obese. Metabolic syndrome, usually accompanied by obesity, is regarded as a major contributor to noncommunicable diseases. Given this relationship, the concepts of metabolically healthy and unhealthy obesity, considering metabolic status, have been evolving. Attention is being directed to metabolically healthy people with obesity who have relatively low transition rates to noncommunicable diseases. As obesity rates continue to rise and unhealthy behaviors prevail among young adults, there is a growing need for obesity management that considers these metabolic statuses. A nomogram can be used as an effective tool to predict the risk of transitioning to metabolically unhealthy obesity from a metabolically healthy status.

OBJECTIVE

The study aimed to identify demographic factors, health behaviors, and 5 metabolic statuses related to the transition from metabolically healthy obesity to unhealthy obesity among people aged between 20 and 44 years and to develop a screening tool to predict this transition.

METHODS

This secondary analysis study used national health data from the National Health Insurance System in South Korea. We analyzed the customized data using SAS (SAS Institute Inc) and conducted logistic regression to identify factors related to the transition from metabolically healthy to unhealthy obesity. A nomogram was developed to predict the transition using the identified factors.

RESULTS

Among 3,351,989 people, there was a significant association between the transition from metabolically healthy to unhealthy obesity and general characteristics, health behaviors, and metabolic components. Male participants showed a 1.30 higher odds ratio for transitioning to metabolically unhealthy obesity than female participants, and people in the lowest economic status were also at risk for the transition (odds ratio 1.08, 95% CI 1.05-1.1). Smoking status, consuming >30 g of alcohol, and insufficient regular exercise were negatively associated with the transition. Each relevant variable was assigned a point value. When the nomogram total points reached 295, the shift from metabolically healthy to unhealthy obesity had a prediction rate of >50%.

CONCLUSIONS

This study identified key factors for young adults transitioning from healthy to unhealthy obesity, creating a predictive nomogram. This nomogram, including triglycerides, waist circumference, high-density lipoprotein-cholesterol, blood pressure, and fasting glucose, allows easy assessment of obesity risk even for the general population. This tool simplifies predictions amid rising obesity rates and interventions.

Bidirectional relationships between nicotine vaping and maladaptive eating behaviors among young adults

Background

Past research indicates that young adult cigarette smokers are at risk of engaging in maladaptive eating behaviors (MEBs); however, whether this relationship extends to nicotine vaping is unclear. The current study assessed bidirectional associations between four types of MEBs and nicotine vaping among young adults.

Methods

1,303 young adults (20.5 ± 2.3 years; 63 % female) from a public, urban university were recruited and completed online surveys at six-month intervals from spring 2021 (W1) to spring 2023 (W5). Past 30-day nicotine vaping and four types of MEBs (susceptibility to external cues, emotional eating, routine restraint, and compensatory restraint) were evaluated.

Results

Longitudinal cross-lagged models examined the bidirectional relationships between past 30-day nicotine vaping and each type of MEB across five waves. Nicotine vaping predicted both susceptibility to external cues (β = 0.10, p <.05; Wave 2 to 3) and emotional eating (β = 0.08, p <.05; Wave 1 to 2). A significant cross-lag regression (Wave 4 to 5) showed nicotine vaping predicted to routine restraint (β = 0.08, p <.05), and routine restraint predicted to nicotine vaping (β = 0.12, p <.05).

Conclusions

Results indicated that nicotine vaping predicted MEBs; however, the type of MEB differed across waves, which may have been due to the COVID-19 pandemic context. Nicotine vaping predicted to MEBs reflecting vulnerability to the external environment and emotion regulation during a period of heightened restrictions, whereas later when pandemic restrictions had ceased nicotine vaping predicted only to routine restraint. Integrating research and practice on nicotine vaping and MEBs may inform public health efforts to decrease co-occurring health-risks in young adulthood.

Cardiovascular autonomic evaluation and body fat analysis in COVID-19-recovered patients in Dakshina Kannada, India

BACKGROUND

The pandemic, coronavirus disease 2019 (COVID-19) has led to a heavy toll on the human health. The aim of this study was to determine the influence of body fat distribution, evolving long-term effect on autonomic function, and its correlation with Chalder Fatigue Severity Score in post-COVID-19-recovered individuals of Indian ethnicity.

MATERIALS AND METHOD

A case-control study was conducted in the Department of Physiology on 31 cases and 29 age- and gender-matched controls. Cardiovascular evaluation including heart rate variability (HRV), galvanic skin response (GSR), body fat analysis, and Chalder Fatigue Severity Score was performed on the study participants. The continuous variables of basal anthropometric parameters, GSR values, HRV indices, and body fat parameters are expressed as mean and standard deviation (SD).

RESULTS

Diastolic blood pressure (DBP) was significantly increased among cases (P = 0.04). GSR (average) for cases is higher when compared to controls and was borderline significant (P = 0.05). There were no statistically significant differences in the HRV parameters. Cases showed significantly higher body fat distribution as compared to the control group indicating increased susceptibility of the obese population to COVID-19. Chalder's post-COVID-19 Fatigue Severity Score of cases showed a negative correlation with LF:HF and RMSSD but it was not statistically significant.

CONCLUSION

In our study, we conclude that there was a significant increase in DBP and GSR (average) with significantly higher visceral fat percentage, body fat percentage, subcutaneous fat percentage, skeletal muscle percentage, and trunk fat percentage in cases as compared to the control group suggestive of higher propensity of obese individuals suffering from COVID-19 and resulting in dysautonomia as compared to the controls.

Effects of Covid-19-related anxiety on overeating and weight gain in a diverse college sample

The outbreak of the Covid-19 pandemic has been linked with caloric overeating and weight gain. We employed a mediation analysis to determine whether pandemic-associated overeating was a direct effect of Covid-19-related anxiety (affect regulation theory) or mediated by a coping mechanism of escape eating (escape theory). A diverse pool of college students participated in a repeated cross-sectional study during three separate waves: May 2021 (wave 1, n = 349), December 2021 (wave 2, n = 253), and March 2022 (wave 3, n = 132). The results revealed a significant indirect effect of Covid-19-related anxiety on high-caloric overeating mediated by escape eating, but no direct path between Covid-19-related anxiety and caloric overeating. Analysis of racial/ethnic status uncovered significantly greater Covid-weight gain in Hispanic participants compared with White, Black, and Asian participants. Our results suggest that Covid-19 weight gain is a byproduct of a mediated escape mechanism differentially affecting racial/ethnic groups.

COVID-19 risk communication gaps, needs, and strategies related to pandemic preparedness plans among vulnerable, Black American subgroups: A qualitative study

OBJECTIVE

Improving current and future risk communication plans is critical to mitigate the COVID-19 pandemic and begin to prepare for future pandemics. Minority groups, particularly African Americans, have been limited in engagement to prepare these plans which has been demonstrated to be disadvantageous. We report findings from a qualitative study that describes gaps, needs, and strategies to improve communication among vulnerable, Black American subgroups during the COVID-19 pandemic.

METHODS

Sixty-two Black Americans in uniquely, vulnerable subgroups participated in qualitative, semi-structured interviews from May to September 2020. Thematic analyses were used to identify themes.

RESULTS

Participants were 16 essential workers, 16 parents, 15 young adults, and 15 individuals with underlying medical conditions. Emerging themes were: (1) Poor communication and miscommunication fueled fear and confusion; (2) Information sources and channels: How do I choose one?; (3) Communication needs were simple yet complex; (4) All information sources are not trusted information sources; (5) Preferred yet trusted channels and types of information; and (6) Dissemination of COVID Research: Why and How. Subgroups varied in information sources and processes for choosing the source, communication needs, and channels and types of information needed. They shared why they did and did not trust certain sources along with the importance of COVID research dissemination to promote informed decision-making throughout the pandemic.

DISCUSSION

This study found that Black American subgroups had diverse, yet trusted and non-trusted messages, messengers, and strategies for communication and wanted research results disseminated. We describe multi-level stakeholders and strategies to help improve risk communication for pandemics, and potentially preparedness and health outcomes.

Mindfulness, mental health, and motives for eating tasty foods when not in metabolic need

Habitual consumption of highly palatable foods when not in metabolic need (HPF eating) is linked to obesity. High HPF consumption is also linked to mental health disorder (MHD) symptoms. Mindfulness-based interventions are popular treatments for obesity and MHDs, but little is known about the relationship between trait mindfulness and motive-based HPF eating. Therefore, a total of 927 young adults completed a survey that included the Palatable Eating Motives Scale-7 (which identifies Coping-, Reward enhancement-, Social-, and Conformity-eating), the Mindful Attention Awareness Scale, the Perceived Stress Scale, and demographic and body mass index (BMI) questions. An MHD questionnaire allowed a comparison of HPF eating between participants with and without various MHDs. Regressions revealed that Coping-eating was independently associated with lower mindfulness and also greater perceived stress, higher BMI, and female sex. Of these variables, only lower mindfulness was independently associated with Reward-, Social-, and Conformity-eating. Coping- and Reward-eating were more frequent in participants with versus without an anxiety disorder, depression, ADD/ADHD, and PTSD. Coping-eating was also more frequent in participants with body dysmorphic disorder. These findings warrant investigations in participants with clinically validated diagnoses for DSM-specific MHDs. Results from such investigations and the uncovered nature of associations between motive-specific HPF eating and trait mindfulness could provide novel targets to improve mindfulness-based interventions for obesity and MHDs.

The impact of COVID-19 lockdowns on the body mass index of people living with obesity: A UK retrospective cohort study using the UK Clinical Practice Research Datalink

BACKGROUND

Restrictions implemented by governments during the coronavirus disease 2019 (COVID-19) pandemic affected people's eating habits and physical activity. We investigated the effect of COVID-19 lockdowns and restrictions on body mass index (BMI) and weight in a UK population, according to BMI class, sex, age and ethnicity.

METHODS

This retrospective observational cohort study used the Clinical Practice Research Datalink AURUM database. Baseline spanned from 22 March 2017-22 March 2020, and the follow-up lockdown period was from 23 March 2020 (start of the lockdown in the UK) to 13 March 2021. The descriptive analysis included individuals with ≥ 1 valid BMI/weight measurements during both the baseline and follow-up periods, while the model-based analysis comprised individuals with ≥ 1 valid measurement(s) during baseline. Results were stratified by baseline BMI category, sex, age and ethnicity.

RESULTS

In the descriptive analysis (n = 273,529), most individuals did not change BMI category post-lockdown (66.4-83.3%). A greater proportion of women (12.6%) than men (9.5%) moved up BMI categories post-lockdown. Compared with older groups, a higher proportion of individuals < 45 years old increased post-lockdown BMI category. The model-based analysis (n = 938,150) revealed consistent trends, where changes in body weight and BMI trajectories pre- and post-lockdown were observed for women and for individuals < 45 years.

CONCLUSION

During COVID-19 restrictions, women and young individuals were more likely than other groups to increase BMI category and weight post-lockdown.

Stress during Home Confinement Is Associated with Eating Misalignment among Adults during COVID-19 Lockdown

BACKGROUND

The COVID-19 pandemic forced Saudi Arabia to implement several measures including mandatory home confinement, banning entry to many cities, and suspending religious activities. Studies have reported inconsistent findings of the effect of home confinement on lifestyle factors. This study aims to assess the psychological impact of COVID-19 during home confinement and explore its association with dietary habits and weight change.

METHODS

A cross-sectional study was conducted among Saudi adults using an online survey between May and June 2020. Data on dietary habits, sleep quality, and stress were collected.

RESULTS

A total of n = 503 participants responded. Of 254 analyzed, 87% were females, 49% were overweight/obese (body mass index (BMI) ≥ 25 kg/m2), and 79% were under lockdown for >40 days. In multiple linear regression, higher stress scores during confinement were associated with higher stress scores before confinement and poorer sleep quality. In multiple logistic regression, those who did not eat at the same time had higher stress scores compared to those who always ate at the same time, whereas consuming ≥three meals was associated with lower stress scores than consuming one-two meals. The odds of gaining weight during confinement were higher among married adults, those with lower sleep quality, and consuming ≥three meals.

CONCLUSIONS

Stress during home confinement was associated with eating misalignment and the number of meals consumed. Although this study was limited by its cross-sectional design and reliance on self-reported data, it provides valuable insights into the dietary habits and weight-gain associated factors that need to be further explored and addressed in any future restrictions for improved well-being.

The Effects of COVID-19 Virtual Learning on Body Fat and Insulin Resistance in Adolescents with Overweight or Obesity

(1) Background: COVID-19 virtual learning reduced structural supports for adolescent physical activity and diet, threatening metabolic health, especially in teens with overweight or obesity (OWOB). (2) Methods: Adolescents (N = 14) with OWOB completed fasting blood draws (measuring insulin resistance, IR) and Dual Energy X-Ray Absorptiometry (DXA, measuring total body fat percent, TBF%) pre-COVID-19 and during COVID-19. Changes in TBF% and IR were calculated (1) pre-COVID-19 and (2) from pre-COVID-19 to during COVID-19. Age and body mass index (BMI) percentile-matched data assessed normative changes across similar, non-COVID-19 time periods. Paired t-tests compared TBF% change pre- to during COVID-19 with (1) TBF% change pre-COVID19 and (2) TBF% normative change. Two ANCOVAs compared IR change pre- to during COVID-19 with (1) IR change pre-COVID-19 controlling for BMI z-score and difference in time between assessments and (2) normative change in IR controlling for sex/race. (3) Results: The TBF% change pre-COVID-19 and the normative change were similar. The TBF% increased more (~six percentage points) during COVID-19 compared to normative change (p < 0.01). During COVID-19, IR increased more (~2.5 units) than change pre-COVID-19 (p = 0.03) and increased more (~3.5 units) than normative change (p = 0.01). (4) Conclusions: TBF% and IR increased exponentially during COVID-19 in teens with OWOB compared to pre-COVID-19 and normative changes.

'It feels smaller now': The impact of the COVID-19 lockdown on apartment residents and their living environment - A longitudinal study

Introduction

The COVID-19 pandemic and associated lockdown restrictions prolonged residents' exposure to their home environment. The impact of lockdowns could be heightened for apartment residents as they typically have smaller, less versatile homes, and share communal and circulation spaces. This study examined changes in apartment residents' perceptions and experiences of their dwelling before and after the Australian COVID-19 national lockdown.

Methods

Participants consisted of 214 Australian adults who completed a survey on apartment living between 2017 and 2019 and a follow-up survey in 2020. Questions focused on residents' perceptions of their dwelling design, apartment living experiences, and personal life events/changes due to the pandemic. Differences between pre- and post-lockdown periods were assessed via paired sample t-tests. The lived experience of a subset of residents (n = 91) following lockdown was also assessed using qualitative content analysis of free-text responses to an open-ended survey item.

Results

Compared to the pre-pandemic period, after the lockdown residents reported less satisfaction with the amount/layout of their apartment space and private open space (e.g., balconies or courtyards). Increased noise annoyance from indoor and outdoor noise sources was also reported, however disputes with neighbours decreased. The qualitative content analysis highlighted a complex interplay of personal, social and environmental impacts of the pandemic on residents.

Conclusions

Findings suggest an increased 'dose' of the apartment facilitated by stay-at-home orders negatively influenced residents' apartment perceptions. Design strategies that maximise spacious, flexible dwelling layouts with health-promoting elements (e.g., enhanced natural light/ventilation and private open space) are recommended to promote healthy and restorative living environments for apartment residents.

Cardiovascular prevention in women: an update by the Italian Society of Cardiology working group on 'Prevention, hypertension and peripheral disease'

The recent pandemic has substantially changed the approach to the prevention of cardiovascular diseases in women. Women have been significantly impacted by the changes that occurred during the pandemic and the quarantine adopted to prevent the spread of the disease. Changes involved prevention both through the reduction of visits and preventive screening and through social and economic changes. It is necessary to adopt new cardiovascular prevention approaches focused on returning to healthy lifestyles, reducing stress and depression also using modern tools such as telemedicine, mobile phone applications and the web. These tools convey messages in a persuasive way especially in young and adult women. There is less impact of these new tools on older women towards whom it is important to adopt a more traditional approach. This review focuses on the new approach to cardiovascular prevention in women in light of the lifestyle changes recorded during the pandemic and which led to an increase in obesity examines the effects on the cardiovascular system induced by stress and depression and analyses the new high blood pressure guidelines and indications that are specific to women.

Overview of the cardio-metabolic impact of the COVID-19 pandemic

Evidence has shown that cardiometabolic disorders (CMDs) are amongst the top contributors to COVID-19 infection morbidity and mortality. The reciprocal impact of COVID-19 infection and the most common CMDs, the risk factors for poor composite outcome among patients with one or several underlying diseases, the effect of common medical management on CMDs and their safety in the context of acute COVID-19 infection are reviewed. Later on, the changes brought by the COVID-19 pandemic quarantine on the general population's lifestyle (diet, exercise patterns) and metabolic health, acute cardiac complications of different COVID-19 vaccines and the effect of CMDs on the vaccine efficacy are discussed. Our review identified that the incidence of COVID-19 infection is higher among patients with underlying CMDs such as hypertension, diabetes, obesity and cardiovascular disease. Also, CMDs increase the risk of COVID-19 infection progression to severe disease phenotypes (e.g. hospital and/or ICU admission, use of mechanical ventilation). Lifestyle modification during COVID-19 era had a great impact on inducing and worsening of CMDs. Finally, the lower efficacy of COVID-19 vaccines was found in patients with metabolic disease.

Weight changes during the COVID-19 shutdown in older individuals with type 2 diabetes: the Look AHEAD Study

OBJECTIVE

The aims of this study were as follows: 1) examine weight changes in older adults (mean age = 76 years) with type 2 diabetes and overweight or obesity during the COVID-19 shutdown; and 2) compare the behavioral and psychosocial effects of the shutdown in those who had large weight losses (>5%), those who had small weight losses (2%-5%), those who remained weight stable (±2%), or those who gained weight (>2%).

METHODS

Look AHEAD (Action for Health in Diabetes) participants (N = 2544) were surveyed during the COVID-19 shutdown (2020), and they self-reported their current weight, reasons for weight change, weight-related behaviors, psychosocial measures, and negative and positive effects of the pandemic on their lives.

RESULTS

Comparing self-reported weight during the COVID-19 shutdown with earlier measured weight, Look AHEAD participants lost, on average, 2.2 kg during the COVID-19 shutdown: 47% lost >2%, and only 18% gained >2% (p < 0.0001). Decreases in physical activity and increases in screen time were reported frequently in all weight-change categories. Similarly, there were few differences among the categories on standardized psychosocial measures or self-reported effects of the shutdown on participants' lives. However, when differences were seen, the most negative impact was in those who gained weight.

CONCLUSIONS

Although weight loss appeared more common than weight gain during the shutdown, the weight-change groups did not differ on most psychosocial and behavioral variables.

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.

Evaluation of Health-Related Quality of Life and Mental Health in 729 Medical Students in Indonesia During the COVID-19 Pandemic

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has impacted the health-related quality of life (HRQoL) and mental health worldwide. However, its impact on medical students in Indonesia has not been well documented. This study aimed to evaluate HRQoL and mental health in 729 Indonesian medical students during the COVID-19 pandemic. MATERIAL AND METHODS We conducted a cross-sectional study from 31 August to 30 September 2021. The study instrument was an online questionnaire that was distributed via social media platforms. The 12-item short form version 2 (SF12v2) was used to measure HRQoL, and the 21-item Depression, Anxiety, and Stress Scale (DASS-21) was used to measure mental health. RESULTS From 729 Indonesian medical students included in the analyses, 37.3% had impaired physical component and 66.9% had impaired mental component of HRQoL. The determinants were medical students' island of residence, history of hospitalization, and family member's hospitalization and death due to COVID-19. Concerning mental health, the prevalence of reported symptoms of depression, anxiety, and stress were 45.4%, 65.2%, and 60.9%, respectively. Sex, study method, grade, previous COVID-19 disease severity, comorbidities, previous learning experience, and history of family isolation were identified as the determinants of mental health. CONCLUSIONS This study highlights the adverse effects of COVID-19 on HRQoL and mental health in Indonesian medical students. The results identified key associations, including SARS-CoV-2 infection and comorbidities experienced by the students, the health of their families, including grief following bereavement, and the effects of social isolation during the pandemic.

Impact of the COVID-19 Pandemic on the Perceived Physical and Mental Health and Healthy Lifestyle Behaviors of People With Disabilities: A Quantitative Analysis of the International Community Survey

OBJECTIVE

This study aims to determine the perceived impact of the coronavirus pandemic on physical and mental health and healthy lifestyle behaviors in community-dwelling persons with disabilities, as compared with those without disabilities.

DESIGN

A prospective cross-sectional study was conducted with a web-based global survey.

RESULTS

Over 3 mos, 3550 responses were collected from 65 countries. The study included 2689 responses without skipped questions as full data for analysis. Most respondents were women (82.82%), and approximately half (52.81%) were between the ages of 25 and 39 yrs, followed by those between the ages of 40 and 60 yrs (38.6%). Among the participants, 52% indicated physical activity levels decreased and 20% reported eating less fruit and vegetables than before. Furthermore, 45% noted that they slept less than before. Perceived physical and mental health and changes to eating habits during the pandemic showed a significant difference in people with and without disabilities. Furthermore, perceived effects on physical health had a significant effect on the reported degree of disability.

CONCLUSIONS

This study indicates that the pandemic had a larger impact on perceived physical and mental health and changes in eating habits and tobacco use among people with disabilities than people without disabilities.

Obesity and weight change during the COVID-19 pandemic in children and adults: A systematic review and meta-analysis

Many obesity risk factors have increased during the COVID-19 pandemic, including physical inactivity, poor diet, stress, and poverty. The aim of this systematic review was to evaluate the impact of the COVID-19 pandemic, as well as associated lockdowns or restrictions, on weight change in children and adults. We searched five databases from January 2020 to November 2021. We included only longitudinal studies with measures from before and during the pandemic that evaluated the change in weight, body mass index (BMI) (or BMI z-scores for children), waist circumference, or the prevalence of obesity. Random effects meta-analyses were conducted to obtain pooled estimates of the mean difference in outcomes. Subgroups were evaluated for age groups and diabetes or obesity at baseline. The risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale, and the certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. A total of 74 studies were included (3,213,776 total participants): 31 studies of children, 41 studies of adults, and 2 studies of children and adults. In children, the pooled mean difference was 1.65 kg (95% confidence interval [CI]: 0.40, 2.90; 9 studies) for weight and 0.13 (95% CI 0.10, 0.17; 20 studies) for BMI z-scores, and the prevalence of obesity increased by 2% (95% CI 1%, 3%; 12 studies). In adults, the pooled mean difference was 0.93 kg (95% CI 0.54, 1.33; 27 studies) for weight and 0.38 kg/m² (95% CI 0.21, 0.55; 25 studies) for BMI, and the prevalence of obesity increased by 1% (95% CI 0%, 3%; 11 studies). In children and adults, the pooled mean difference for waist circumference was 1.03 cm (95% CI -0.08, 2.15; 4 studies). There was considerable heterogeneity observed for all outcomes in both children and adults, and the certainty of evidence assessed using GRADE was very low for all outcomes. During the first year of the COVID-19 pandemic, small but potentially clinically significant increases in weight gain, BMI, and increased prevalence of obesity in both children and adults were observed. Increases were greater in children, and targeted prevention interventions may be warranted.

Emotional Appetite Questionnaire: psychometric properties in Brazilian adult samples before and after the COVID-19 pandemic onset

Background

Appetite represents a desire of a person to eat specific food in order to reach satisfaction and pleasure states. This desire may be associated with the experience of negative or positive emotions (emotional appetite). Emotional appetite can influence eating behavior, and its investigation is relevant to avoid possible damage to health resulting from a disordered eating.

Objectives

To adapt the Emotional Appetite Questionnaire (EMAQ) to the Portuguese language; to assess the validity and reliability of the data; and to assess emotional appetite in three samples of adults collected before and after the outbreak of the COVID-19 pandemic.

Methods

This is a cross-sectional study with non-probabilistic convenience sampling. The Portuguese version of the EMAQ was presented after translation, back-translation, and content analysis. Two studies were conducted, the first before and the second after the pandemic onset. Three samples were formed (2019: Sample 1 (age = 19.7 ± 1.5 years) n = 323; 2020: Sample 2 (age = 21.3 ± 1.8 years) n = 1,011; and Sample 3 (age = 28.9 ± 3.1 years) n = 909). An exploratory strategy with parallel analysis was performed. The analyses were conducted in FACTOR and R (lavaan and semTools packages) software. After determining the best-fit model for the data, emotional appetite was examined considering decrease, non-alteration, and increase in appetite in the face of positive and negative emotions/situations. The profile of emotional appetite was determined using a circumplex model.

Results

The two-factor model described by the valence of emotions/situations fitted the samples (Comparative Fit Index_{minimum-maximum} = 0.95-0.98; Tucker-Lewis Index = 0.94-0.98; Root Mean Square Error of Approximation = 0.03-0.08; α_ord = 0.78-0.88). Increases in appetite were more frequent for positive emotions/situations (52.0-57.5%), and both decreases (35.4-44.5%) and increases (50.0-56.2%) in appetite were observed for negative emotions/situations. Emotions with negative valence and activation were more relevant to appetite reduction, while a significant increase in appetite was observed with anxiety (negative valence and positive activation).

Conclusion

Different emotions and situations may influence appetite in people, and such an investigation may be useful in preparing eating protocols.

Factors Associated with Dietary Restriction and Emotional and Uncontrolled Eating in Adults from Spanish-Speaking Countries during the COVID-19 Confinement: Results of the CoV-Eat Project

The first COVID-19 confinement has led to changes in the population’s behaviour. However, little has been analysed about the changes in eating behaviour beyond the decrease in adherence to healthy dietary patterns. The aim of the CoV-Eat project was to identify factors related to each of the following eating behaviours (EB): cognitive restraints (CR), uncontrolled eating (UE), and emotional eating (EE) in adults from Spanish-speaking countries. Participants completed an anonymous online survey. EB was assessed using the Three-Factor Eating Questionnaire and the scores were classified into tertiles. Socio-demographic characteristics and lifestyle habits including physical activity, sleep quality, screen use, smoking consumption, and relationship with food were also collected. A total of 9849 participants from 21 countries were included in this study. The median of CR, UE, and EE behaviours was 15, 24, and 9, respectively. We observed that higher age, days of confinement, number of times leaving home in the last week, changes in sleep quality, and their relationship with food were negatively associated with CR, EE, and UE, while being a man was positively associated with an increased in all these EBs. A higher household income was negatively associated with a higher score of CR, and a higher education level (>primary) was positively associated with a medium score of EE. Lower physical activity was a factor negatively associated with a medium score of EE and UE. Higher screen use showed the same negative association for a medium score of EE and UE and a high score of CR. In addition, higher tobacco consumption was found to be a protective factor against having a medium or high score of CR and EE. In conclusion, some sociodemographic characteristics and lifestyle changes may be important factors for EB and should be considered in emergency situations such as confinement to prevent risky eating behaviour.

The effects of the COVID-19 pandemic on disordered eating symptoms in women: A 49-day, daily study before and during the outbreak in the United States

Longitudinal data are needed to examine effects of the COVID-19 pandemic on disordered eating. We capitalized on an ongoing, longitudinal study collecting daily data to examine changes in disordered eating symptoms in women across 49 days that spanned the time before and during the COVID-19 outbreak in the United States. Women from the Michigan State University Twin Registry (N = 402) completed daily questionnaires assessing a range of symptoms (e.g., binge eating, weight/shape concerns, liking/wanting of palatable food (PF) and whole foods, hunger). Dates of the first US COVID-19 case, first case in each participant's state, and onset of the initial stay-at-home orders (SHOs) were used to categorize women into those who completed all daily assessments prior to, during, or after these dates. We used mixed linear models and specification-curve analysis to examine between-person (i.e., differences between women assessed before vs during/after COVID-19) and within-person (i.e., changes in symptoms from days before to days after the dates) effects of the pandemic. Results showed significantly higher levels of binge-related pathology (e.g., odds of binge eating, liking/wanting of PF) in women who completed assessments during/after COVID-19 events, and significantly increased liking/wanting of PF in the days following the pandemic onset. By contrast, minimal between- or within-person differences were observed for other variables, including weight/shape concerns, compensatory behaviors, hunger, or liking/wanting whole foods. Overall, results suggest a specific effect of the pandemic on binge-related phenotypes in women. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Binge-eating behaviors in adolescents and young adults during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic and subsequent public health measures have resulted in a worsening of eating disorder symptoms and an increase in psychological distress. The present study examined symptoms and behaviors in adolescents and young adults with emotional eating, bingeing behaviors and binge eating disorder during the pandemic. Additionally, the study explored if individuals who experienced pandemic-related food availability and food affordability issues experienced increased binge-eating symptoms and negative feelings.

METHOD

Participants (n = 39) were a convenience sample who participated between November 2020 and January 2021 in a weight and lifestyle management program at an urban New England pediatric hospital. Participants completed online surveys that assessed (1) participant's exposure to COVID-19 related stress and binge-eating behaviors using the COVID-19 Exposure and Family Impact Survey-Adolescent and Young Adult Version (CEFIS-AYA) and the Binge Eating Scale (BES) respectively, (2) participants' and their families' ability to attain and afford food and its association with bingeing behaviors, and (3) the relationship between food availability and affordability and negative emotions.

RESULTS

Nearly half of all participants (48.7%) reported moderate to severe bingeing during the COVID-19 pandemic; those who experienced greater COVID-related stress reported more binge-eating behaviors (p = 0.03). There were no associations between indicators of food availability and affordability and binge eating or between food availability and affordability and negative feelings.

CONCLUSIONS

Higher pandemic-related stress was associated with more binge-eating behaviors among adolescents and young adults. These results underscore the need to monitor symptoms and provide treatment for these patients despite barriers to care imposed by the COVID-19 pandemic. Research and clinical care for adolescents and young adults with EDs must recognize and respond to pandemic effects across the weight and disordered eating spectrum.

African Americans and the COVID-19 pandemic: A qualitative inquiry of preparedness, challenges, and strategies on how we can move forward

RATIONALE

The COVID-19 pandemic has disproportionately impacted Black Americans. Inequities in systems and social determinants of health along with racial health disparities impact degree of pandemic preparedness.

OBJECTIVE

In early pandemic stages, we aimed to explore: 1) state of pandemic preparedness; 2) effects of socio-ecological factors on preparedness; and 3) multi-level strategies to increase preparedness among uniquely, vulnerable Black American subgroups.

METHODS

We conducted 62 in-depth interviews with Black American community members representing parents, individuals with underlying medical conditions, essential workers, and young adults. Based on the McLeroy's Model Ecological for Health Promotion, an inductive-deductive content analysis approach was used to analyze the interview data around the factors influencing preparedness on individual, interpersonal processes and primary groups, community/institutional, and public policy.

RESULTS

Majority (56.5%) of the participants stated they were somewhat or very prepared. We identified four themes: 1) Lived Experiences during the COVID-19 Pandemic; 2) Challenges experienced during the COVID-19 Pandemic; 3) I would do this differently they say; 4) Changes Needed to Survive the Pandemic relate to Public Policy, Community/institutional factors, and Interpersonal processes and primary group(s). All participants described their adjustments to live in the new norm. Participants identified perceived challenges and solutions on multi-levels, driven by subgroup.

CONCLUSIONS

Pandemic response plans should use targeted strategies across multi-levels to enhance the preparedness of Black Americans, especially those in vulnerable groups. This could reduce the disproportionate COVID-19 disease burden exhibited by Black Americans and better prepare for future pandemics.

Stress and cardiovascular risk burden after the pandemic: current status and future prospects

INTRODUCTION

The recent COVID-19 pandemic has induced an increase in anxiety, stress, and depression in the world population, prompting a reevaluation of these well-known risk factors on cardiovascular burden.

AREAS COVERED

This short report analyzes the impact of the pandemic on stress and depression, highlighting how the phenomenon has particularly affected women and highlights the strategies that can be undertaken after the pandemic to reduce stress and depression. We have analyzed the pandemic because it has completely changed the scenario of cardiovascular risk factors with an important increase in socio-economic stressors.

EXPERT OPINION

It is still difficult to assess the damage produced on cardiovascular risk just as it is almost impossible to predict how the overwhelming and important increase in Long-Covid Syndromes will impact the population. Strong action is needed to support critical situations and to implement social campaigns aimed at restoring healthy lifestyles. Physical activity can be an easy and inexpensive tool to help cope with stress and depression.

Fear of COVID-19 mediates the relationship between negative emotional reactivity and emotional eating

Recent studies have highlighted high levels of emotional eating during the coronavirus (COVID‐19) pandemic, but have not satisfactorily explained these changing eating patterns. Here, we tested one potential explanatory model broadly based on a biosocial model of emotional eating. Specifically, we examined the extent to which negative emotional reactivity was associated with emotional eating, as well as the mediating role of fear of COVID‐19. A total of 474 women from Romania were asked to complete measures of emotional eating, negative emotional reactivity, and fear of COVID‐19. Mediation analysis showed that higher negative emotional reactivity was significantly and directly associated with greater emotional eating. This direct relationship was also mediated by fear of COVID‐19. These results highlight one possible route through which the ongoing COVID‐19 pandemic may have resulted in elevated rates of emotional eating, though further research is needed.

Lifestyle changes during the coronavirus disease 2019 pandemic impact metabolic dysfunction-associated fatty liver disease

BACKGROUND AND AIMS

The coronavirus disease 2019 (COVID-19) pandemic precipitated lifestyle changes. We aimed to clarify whether COVID-19-induced lifestyle changes affected the development of metabolic dysfunction-associated fatty liver disease (MAFLD).

METHODS

This retrospective longitudinal study included 973 participants who underwent health check-ups between 2018 and 2020. We used data from the MedCity21 health examination registry. Participants' clinical characteristics and lifestyle habits were investigated. Independent lifestyle predictors of MAFLD development before the pandemic (2018-2019) and during the pandemic (2019-2020) were identified using logistic regression analysis.

RESULTS

In 2018, 261 (27%) patients were diagnosed with MAFLD. Before the pandemic, 22 patients developed new MAFLD. During this time, routine late-night meals were identified as an independent lifestyle predictor of MAFLD development (hazard ratio [HR] 2.54, 95% confidence interval [CI] 1.02-6.36, P = .046). In contrast, 44 patients developed new MAFLD during the pandemic. During this time, higher daily alcohol intake was identified as an independent lifestyle predictor of MAFLD development (HR 1.03, 95% CI 1.01-1.05, P = .008). In participants aged <60 years, daily alcohol intake and the proportion of participants who ate 2 times/day were significantly higher in patients who developed MAFLD during the pandemic than in those who did not. In participants aged ≥60 years, no lifestyle habits were associated with MAFLD development before or during the pandemic.

CONCLUSIONS

New MAFLD diagnoses increased during the COVID-19 pandemic. Changes in lifestyle factors, particularly in those aged <60 years, must be monitored and addressed as the pandemic continues.

Orthorexia nervosa vs. healthy orthorexia: relationships with disordered eating, eating behavior, and healthy lifestyle choices

BACKGROUND

Orthorexia nervosa (OrNe) is a pattern of disordered eating behavior characterized by excessive preoccupation with overvalued ideas about healthy eating. Healthy orthorexia (HeOr) refers to a non-pathological interest in healthy eating and nutrition. Despite converging evidence that OrNe is correlated with measures of psychopathology and personality traits, there is relatively little empirical data relating OrNe and HeOr to eating and health-promoting behavior.

METHODS

Aim 1: exploratory structural equation modeling was used to evaluate the factor structure of an English-language version of the Teruel Orthorexia Scale, the only measure of OrNe that also assesses HeOr in two samples (Yoga practitioners, N = 469, and Mechanical Turk workers, N = 453). Aim 2: conducted in the Mechanical Turk sample, partial correlation and linear regression analyses were used to evaluate the relationships of OrNe and HeOr with other symptoms of, and clinical impairment from, disordered eating, food choices, diet quality, body mass index (BMI), nutrition knowledge, alcohol/tobacco/vaping use, and sedentary behavior.

RESULTS

The two-factor structure of the TOS was replicated. HeOr and OrNe had opposing relationships with measures of disordered eating behavior and distress, food choices, diet quality, and nutrition knowledge. HeOr was negatively related to BMI, whereas OrNe was positively related to substance use and sedentary behavior.

CONCLUSIONS

OrNe and HeOr are distinct latent constructs, with the latter reflecting non-pathological behavior. Only OrNe is related to elevated disordered eating and clinical impairment. Despite involving obsessions and compulsions related to healthy eating, OrNe was associated with relatively unhealthy eating and other lifestyle behaviors.

LEVEL OF EVIDENCE

Level V, descriptive cross-sectional study.

A Qualitative Study Exploring Management of Food Intake in the United Kingdom During the Coronavirus Pandemic

The coronavirus pandemic has impacted dietary quality through increased emotional eating and extended time spent at home, as well as instances of panic buying due to uncertainty over food availability. We recruited an opportunistic sample of 40 adults living in the United Kingdom (Female = 25; Mean age = 41.9 years) (SD = 14.4) without any prior history of eating disorders. Semi-structured interviews were conducted in June 2020 and focused on the impacts of the COVID-19 lockdown on eating habits and experiences of panic buying. The data were transcribed and organized using the softwares Otter and Quirkos, respectively. Reflexive thematic analysis identified positive and negative changes to eating habits. Overall, themes highlighted that effective organization was vital to manage food purchases and consumption due to a reduced shopping frequency. However, overconsumption frequently occurred due to boredom and ease of accessing energy dense foods, which had negative implications for weight and body image. After indulging, participants attempted to revert to prior eating habits and adhere to a nutritious diet. Many also expressed the importance of having enough food to feed families, which was often reported as a reason for buying extra supplies. Understanding the long-term impacts of changes to eating habits that account for the novel coronavirus context is required to preserve health and prevent unintended changes to weight.

A Systematic Review of the Impact of the First Year of COVID-19 on Obesity Risk Factors: A Pandemic Fueling a Pandemic?

Obesity is increasingly prevalent worldwide. Associated risk factors, including depression, socioeconomic stress, poor diet, and lack of physical activity, have all been impacted by the coronavirus disease 2019 (COVID-19) pandemic. This systematic review aims to explore the indirect effects of the first year of COVID-19 on obesity and its risk factors. A literature search of PubMed and EMBASE was performed from 1 January 2020 to 31 December 2020 to identify relevant studies pertaining to the first year of the COVID-19 pandemic (PROSPERO; CRD42020219433). All English-language studies on weight change and key obesity risk factors (psychosocial and socioeconomic health) during the COVID-19 pandemic were considered for inclusion. Of 805 full-text articles that were reviewed, 87 were included for analysis. The included studies observed increased food and alcohol consumption, increased sedentary time, worsening depressive symptoms, and increased financial stress. Overall, these results suggest that COVID-19 has exacerbated the current risk factors for obesity and is likely to worsen obesity rates in the near future. Future studies, and policy makers, will need to carefully consider their interdependency to develop effective interventions able to mitigate the obesity pandemic.

The Impact of the COVID-19 Pandemic on Young Australian Adults' Food Practices

Background

Young Australian adults exhibit poor food behaviors. These include increased consumption of Energy-Dense, Nutrient-Poor (EDNP) foods, sugar-sweetened beverages, and low consumption of fruit and vegetables. However, little is known about how the coronavirus disease 2019 (COVID-19) pandemic affected young Australian adults' pre-existing adverse food behaviors.

Objectives

The present study aimed to understand the impact of the COVID-19 pandemic on food practices by exploring views of young adults living in Australia.

Methods

Through qualitative descriptive methods, data gathered through individual interviews were thematically analyzed. Participants included 38 young adults aged 18-30 y with a mean age of 24.1 y (76% female).

Results

Five themes emerged: 1) disruption of routines, 2) increased flexibility, 3) changes in food practices, 4) heightened psychological distress, and 5) impact on future behaviors. Disruption of routines and increased flexibility associated with working/learning from home resulted in both positive and negative changes in food practices. Negative changes included increased consumption of EDNP foods, increased consumption of foods prepared outside of home, decreased purchases and consumption of fresh foods, meal skipping, and a lack of meal planning. Positive changes included an increase in home cooking; consistent weekly eating patterns; decreased consumption of EDNP foods; smaller, more frequent meals; and decreased consumption of foods prepared outside of home.

Conclusions

Young Australian adults reported more negative and fewer positive changes in food practices. The observed negative changes in food practices are likely to have accentuated young Australian adults' previously known poor food behaviors. This study adds to the international literature by reporting ways that young adults implemented positive changes during the pandemic and future directions of their food practices.

Impact of the Coronavirus Disease Pandemic on Patients with Head Injuries in South Korea

Objective

The coronavirus disease 2019 (COVID-19) pandemic is affecting the characteristics of patients with head injuries. This study aimed to evaluate the effect of the COVID-19 pandemic on patients with head injuries at a regional emergency medical center in South Korea.

Methods

From April 2019 to November 2020, 350 patients with head injuries were admitted to our hospital. The study period was divided into the pre-COVID-19 (n=169) and COVID-19 (n=181) eras (10 months each). Patients with severe head injuries requiring surgery (n=74) were categorized into those who underwent surgery (n=41) and those who refused surgery (n=33).

Results

Head injuries in pediatric patients (<3 years) were more frequent in the COVID-19 era than in the pre-COVID-19 era (8.8% vs. 3.6%, p=0.048). More patients refused surgery in the COVID-19 era than in the pre-COVID-19 era (57.9% vs. 30.6%, p=0.021). Refusal of surgery was associated with old age (67.7±14.5 vs. 52.4±19.1, p<0.001), marital status (married, 84.8% vs. 61.0%, p=0.037), unemployment (42.4% vs. 68.3%, p=0.034), COVID-19 era (66.7% vs. 39.0%, p=0.021), and lower Glasgow coma scale scores (6.12±3.08 vs. 10.6±3.80, p<0.001). Multivariable logistic regression analysis revealed that refusal of surgery was independently associated with old age (adjusted odds ratio [OR], 1.084; 95% confidence interval [CI], 1.030–1.140; p=0.002), COVID-19 era (adjusted OR, 6.869; 95% CI, 1.624–29.054; p=0.009), and lower Glasgow coma scale scores (adjusted OR, 0.694; 95% CI, 0.568–0.848; p<0.001).

Conclusion

We observed an increased prevalence of head injuries in pediatric patients (<3 years) during the COVID-19 pandemic. Additionally, among patients with severe head injuries requiring surgery, more patients refused to undergo surgery during the COVID-19 pandemic.

Systematic review of the effects of pandemic confinements on body weight and their determinants

Pandemics and subsequent lifestyle restrictions such as ‘lockdowns’ may have unintended consequences, including alterations in body weight. This systematic review assesses the impact of pandemic confinement on body weight and identifies contributory factors. A comprehensive literature search was performed in seven electronic databases and in grey sources from their inception until 1 July 2020 with an update in PubMed and Scopus on 1 February 2021. In total, 2361 unique records were retrieved, of which forty-one studies were identified eligible: one case–control study, fourteen cohort and twenty-six cross-sectional studies (469, 362 total participants). The participants ranged in age from 6 to 86 years. The proportion of female participants ranged from 37 % to 100 %. Pandemic confinements were associated with weight gain in 7·2–72·4 % of participants and weight loss in 11·1–32·0 % of participants. Weight gain ranged from 0·6 (sd 1·3) to 3·0 (sd 2·4) kg, and weight loss ranged from 2·0 (sd 1·4) to 2·9 (sd 1·5) kg. Weight gain occurred predominantly in participants who were already overweight or obese. Associated factors included increased consumption of unhealthy food with changes in physical activity and altered sleep patterns. Weight loss during the pandemic was observed in individuals with previous low weight, and those who ate less and were more physically active before lockdown. Maintaining a stable weight was more difficult in populations with reduced income, particularly in individuals with lower educational attainment. The findings of this systematic review highlight the short-term effects of pandemic confinements.

Late chronotypes, late mealtimes. Chrononutrition and sleep habits during the COVID-19 lockdown in Italy

The emerging field of chrononutrition provides useful information on how we manage food intake across the day. The COVID-19 emergency, and the corresponding restrictive measures, produced an unprecedented change in individual daily rhythms, possibly including the distribution of mealtimes. Designed as a cross-sectional study based on an online survey, this study aims to assess the chrononutrition profiles (Chrononutrition Profile Questionnaire, CP-Q) in a sample of 1298 Italian participants, during the first COVID-19 lockdown, and to explore the relationship with chronotype (reduced Morningness-Eveningness Questionnaire, rMEQ), sleep quality (Pittsburgh Sleep Quality Index, PSQI) and socio-demographics. Our findings confirm a change in eating habits for 58% of participants, in terms of mealtimes or content of meals. Being an evening chronotype and experiencing poor sleep imply a higher likelihood of changing eating habits, including a delay in the timing of meals. Also, under these unprecedented circumstances, we report that the timing of breakfast is a valuable proxy capable of estimating the chronotype. From a public health perspective, the adoption of this straightforward and low-cost proxy of chronotype might help in the early detection of vulnerable subgroups in the general population, eventually useful during prolonged stressful conditions, as the one caused by COVID-19 pandemic.

The Impact of COVID-19 Pandemic on Weight and Body Mass Index in Saudi Arabia: A Longitudinal Study

The COVID-19 pandemic has had a major impact on various health conditions. The objective of this study was to assess the impact of the COVID-19 pandemic on body weight and body mass index (BMI) in Saudi Arabia. We used electronic health records obtained from a healthcare system representing five hospitals in three different regions in the Kingdom to examine the change in weight utilizing a longitudinal design. The study included all adults who had visited outpatient clinics in two different time points, pre-2020 (years 2018 and 2019 prior to COVID-19) and post-2020 (the year 2021). Weight and BMI changes in percentages were described. Also, bivariate chi-square test, paired t-test, and multivariable multinomial logistic regression model were used for the analyses. A total of 165,279 individuals were included in the study. On average, a significant weight gain of 0.33 kg (95% CI: 0.29-0.36) was observed in our study. Approximately 10% of the population had shifted to either overweight or obese BMI classes during the study period, as 4.8% of those with normal BMI pre-2020 had shifted to overweight or obese classes at post-2020, and 5.1% of those who were overweight had shifted to obese class. Also, 23.1% of the population had gained 5% or more of their pre-2020 weight, while 17% had lost 5% or more. Young individuals were over three times more likely to gain 5% or more than older individuals (OR: 3.34; 95% CI: 3.12-3.56). Females had 24% higher odds to gain 5% or more of their pre-2020 weight than males (OR: 1.24; 95% CI: 1.21-1.27). Diabetics were 27% more likely to lose 5% or more than non-diabetics (OR: 1.27; 95% CI: 1.23-1.31). Our findings provide insights into the impact of COVID-19 on weight and population health. Further investment in interventions for weight management is warranted during similar circumstances such as lockdowns due to infection waves or new variants. Future studies are also needed to explore the modifications that have occurred during the pandemic in the weight-related lifestyle factors such as dietary choices and physical activity levels.

Coping Using Sex, Health-Related Behaviors, and Mental Health During COVID-19 Lockdown in the UK

BACKGROUND

Peoples' sexual behaviors have changed during the period of enforced COVID-19 social distancing, in some cases, to cope with negative feelings during lockdown. Research on coping using sex is relatively restricted to samples of men with a history of sexual offending, and it is unknown whether coping using sex is associated with health-related behaviors and mental health in the general population.

AIM

We examined if coping using sex before and during lockdown was associated with adverse outcomes (i.e., self-perceived reduction in health-related behaviors and mental health) in a community sample.

HYPOTHESES

We hypothesized that participants who reported greater use of sex to cope in the weeks preceding lockdown would show a greater decline in health-related behaviors and mental health during lockdown. Furthermore, that changes in coping using sex resulting from lockdown would account for further variance in the worsening of health-related behaviors and mental health.

METHODS

Participants were UK residents, aged 18-60 years, and fluent in English. 789 participants completed an online survey, providing demographic information, self-reported social distancing, loneliness, and coping using sex over a 14-day period during lockdown, and retrospectively preceding lockdown.

OUTCOMES

Participants reported perceived changes in health-related behaviors and mental health symptomatology during lockdown compared to before the pandemic. They also self-reported levels of stress, anxiety and depression during lockdown.

RESULTS

Greater coping using sex prior to lockdown predicted positive change in health-related behaviors, for example, higher scores were associated with participants reporting having exercised and slept more. It was also associated with higher trait levels of anxiety, stress and depression during lockdown. Changes in coping using sex from before to during lockdown did not predict perceived changes in health related behaviors or mental health symptomatology.

CONCLUSIONS

Overall, greater coping using sex prior to lockdown was associated with worse mental health symptomatology during lockdown (anxiety, depression and stress), however, it was also associated with perceived positive change in health-related behaviors compared with before lockdown. This suggests that coping using sex may be associated with negative emotional reactions during lockdown, but may also be linked with positive change in health-promoting behaviors.

Comparison of Food-Based and Music-Based Regulatory Strategies for (Un)Healthy Eating, Depression, Anxiety and Stress

There are many ways to regulate emotions. People use both adaptive (e.g., regulation by music) and maladaptive (e.g., regulation by food) strategies to do this. We hypothesized that participants with a high level of food-based regulatory strategies and a low level of music-based regulatory strategies (a group with the least adaptive form of emotion regulation) would have significantly greater levels of unhealthy eating behaviours, depression, anxiety and stress, as well as a significantly lower level of healthy eating behaviours than those with a low level of food-based regulatory strategies and a high level of music-based regulatory strategies (a group with the greatest adaptive form of emotion regulation). Participants (N = 410; M_age = 31.77, SD = 13.53) completed: the Brief Music in Mood Regulation Scale, the Emotional Overeating Questionnaire, the Healthy and Unhealthy Eating Behavior Scale, the Depression, Anxiety and Stress Scale and a socio-demographic survey. The four clusters were identified: (a) Cluster 1 (N = 148): low food-based regulatory strategies and high music-based regulatory strategies; (b) Cluster 2 (N = 42): high food-based regulatory strategies and high music-based regulatory strategies; (c) Cluster 3 (N = 70): high food-based regulatory strategies and low music-based regulatory strategies; (d) Cluster 4 (N = 150): low food-based regulatory strategies and low music-based regulatory strategies. Overall, our outcomes partially support our hypothesis, as higher levels of unhealthy eating behaviours, depression, anxiety and stress were observed in participants with high food-based and low music-based regulatory strategies as compared with adults with low food-based and high music-based regulatory strategies. To sum up, the results obtained indicate that during the COVID-19 pandemic the group of people regulating their emotional state and unhealthy eating predominantly with food is potentially characterized by worse functioning than the group of people regulating with music. Therefore, it can be concluded that people who regulate their functioning using food should be included in preventive measures by specialists. During the visit, psychologists and primary care physicians can ask patients about their daily strategies and based on this information specialists can estimate the potential risk of developing high levels of stress and anxiety, depressive disorders and unhealthy eating habits and provide specific (match) intervention.

Do COVID-19-Related Stress, Being Overweight, and Body Dissatisfaction Contribute to More Disordered Eating in Polish Women?-A Cluster Analysis Approach

We hypothesized that women who are overweight, experiencing COVID-19-related stress, and with high body dissatisfaction would have significantly greater disordered eating than those of healthy weight, without stress, and with low body dissatisfaction. Participants (N = 1354 women; Mage= 31.89 years, SD = 11.14) filled in the Contour Drawing Rating Scale, the Emotional Overeating Questionnaire, the Eating Motivation Survey, the Mindful Eating Questionnaire, and a COVID-19-related stress measure and sociodemographic survey. The cluster analysis technique revealed four distinct clusters: (a) Cluster 1 (N = 314): healthy body weight, no COVID-related stress, and low body dissatisfaction (M = 1.19); (b) Cluster 2 (N = 131): overweight, no COVID-related stress, and high body dissatisfaction (M = 2.41); (c) Cluster 3 (N = 597): healthy body weight, COVID-related stress, and low body dissatisfaction (M = 1.27); (d) Cluster 4 (N = 312): overweight, COVID-related stress, and high body dissatisfaction (M = 2.84). Generally, our outcomes partially support our hypothesis, as higher levels of some types of disordered eating were observed in women who were overweight with COVID-related stress and high body dissatisfaction (Cluster 4) as compared with women with healthy body weight, no COVID-related stress, and with low levels of body dissatisfaction (Cluster 1). Our results indicate that both body weight status, as well as COVID-19-related stress and body dissatisfaction, may contribute to the intensity of disordered eating. During future epidemic-related quarantines, this may be an argument in favor of organizing support regarding emotional functioning, body image, and eating behaviors, particularly for the most vulnerable groups-including overweight and obese women.

"I'm losing everything all over again": Responses from youth experiencing homelessness during the COVID-19 pandemic

PURPOSE

Already at high-risk for adverse consequences associated with daily living, youth experiencing homelessness face additional barriers to health and well-being during the COVID-19 pandemic. The purpose of this study was to identify the self-reported experiences and healthcare needs of youth experiencing homelessness as services in the community began to shut down at the beginning of the pandemic.

METHOD

From May through November 2020, qualitative data were obtained by telephone or Facebook messenger from 20 youth (M = 22.4, SD = 2.64 years) who had been enrolled in a longitudinal intervention study.

RESULTS

Content analysis of qualitative data yielded 5 categories and 1 overall theme. Categories were resource availability, financial instability, mental health, relationship conflict, and maladaptive coping. The overall theme was multiple losses. Youths lost jobs, means of financial support for self and family, access to social and healthcare services, meaningful and important relationships, and skills and controls over high-risk behaviors such as substance abuse.

CONCLUSIONS

Having similar experiences such as social isolation as those of high school students during the pandemic, the youths in this sample experienced multiple and simultaneous losses, needing time to grieve, and leaving them once more at high-risk for adverse outcomes.

Consumer risk perception and trusted sources of food safety information during the COVID-19 pandemic

Risk perceptions and trusted sources of information may have influenced consumer food handling practices during the COVID-19 pandemic. This study used a mixed-method qualitative-quantitative approach to assess consumer risk perception and trusted sources of food safety information during the pandemic. From April to August of 2020, five waves of online surveys (N = 3,584, with a minimum of 700 per month) were distributed to a U.S. consumer panel, which included only primary food preparers and grocery shoppers. The online focus groups recruited participants (N = 43) from the first wave of survey respondents and were conducted via Webex from May to July 2020. Topics covered in both studies focused on food safety risk perceptions and trusted sources of information during the pandemic. Trusted sources of information included government agencies, healthcare professionals, scientists, and social media. Throughout the longitudinal study, survey respondents and focus group participants perceived a higher risk of getting COVID-19 from people than from food. Survey respondents believed that handwashing could protect them more from COVID-19 than from foodborne illnesses. Many focus group participants practiced handwashing to prevent them from contracting COVID-19 from food items. Both survey respondents and focus group participants trusted the U.S. Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and healthcare professionals for COVID-19 and food safety information. Focus group participants trusted these entities because they provide information that is "scientifically proven." Survey data for all five months reported social media to be the least-trusted source of both COVID-19 and food safety information. Focus group participants agreed that social media has "misinformation." The findings suggest that increased risk perception may have caused consumers to adopt good hand hygiene. However, consumers may not be connecting such practices to food safety. Food safety educators can use this time of heightened risk perception to connect COVID-19 and food safety practices. Trusted entities of information also need to be aware of their impact on consumer behavior and provide consumers with proper food safety information.

Factors associated with the weight change trend in the first year of the COVID-19 pandemic: the case of Turkey

BACKGROUND/OBJECTIVES

To determine the weight change trend among the adult Turkish population after 1 yr of the coronavirus disease 2019 (COVID-19) pandemic and factors associated with weight change.

MATERIALS/METHODS

This cross-sectional study was conducted between 26 February and 6 March 2021 using an online questionnaire that included questions for sociodemographic variables, eating habits, stress level, and the Three-Factor Eating Questionnaire-R18. Those who weighed themselves 1-2 weeks before the pandemic was declared in Turkey and remembered their weight were invited to participate in the study. Trends in weight and body mass index (BMI) change were calculated. The variables associated with a 1% change in BMI were assessed using hierarchical regression analysis.

RESULTS

The study was conducted with 1,630 adults (70.25% female) with a mean age of 32.09 (11.62) yrs. The trend of weight change was found to increase by an average of 1.15 ± 6.10 kg (female +0.72 ± 5.51, male +2.16 ± 7.22 kg) for the first year of the COVID-19 pandemic. The rate of participants with a normal BMI (18.50-24.99 kg/m2) decreased to 51.91% from 55.75%. Consuming an "Increased amount of food compared to before the pandemic" was found to be the independent variable that had the strongest association with a 1% increase in BMI (β = 0.23 P < 0.001). The average change in the BMI was higher in older individuals than in those who were younger. A high stress level was associated with a decrease in BMI (β = -0.04 P = 0.048).

CONCLUSIONS

In this study, the factors associated with weight change after 1 yr of the pandemic in the Turkish population was reported for the first time. A high stress level and increased weight gain trend still occur in Turkey after 1 yr of the pandemic.

The role of COVID-19 fears and related behaviors in understanding daily adolescent health behaviors during the pandemic

We examined the prospective associations of COVID-19 fears and behavior, and daily physical activity and dysregulated eating. Adolescents (N = 31) aged 11-17 completed selected subscales of the Fear of Illness and Virus Evaluation and completed a 7-day health behavior diary. Greater fear of contamination was associated with lower daily physical activity. In contrast, greater COVID-19 precautionary behavior was associated with greater daily physical activity. COVID-19 fears and precautionary behaviors have differential associations with health promoting behavior engagement. Future studies should explore the mechanisms underlying these links to guide adaptation of health behavior interventions for this unique cohort.

A cross-sectional examination of reported changes to weight, eating, and activity behaviors during the COVID-19 pandemic among United States adults with food addiction

Prior studies have demonstrated the effects of the COVID-19 pandemic on weight management and lifestyle behaviors, though identification of who may be at greatest risk for negative consequences has not been fully explored. Addictive-like eating behavior, or food addiction, has been associated with an array of problematic eating behaviors, which may suggest heightened susceptibility to poorer outcomes. In this online, cross-sectional study, adults (ages 18–78; M = 42.36, SD = 13.08) living in the United States (n = 288) completed questionnaires assessing food addiction and reported changes to their weight, eating, and physical activity before and during the COVID-19 pandemic. Individuals with food addiction gained an average of 12.42 lb (5.63 kg) since March 2020, compared to an average weight gain of 2.14 lb (0.97 kg) for those without food addiction (p < .001). Linear regression analyses controlling for age and body mass index (BMI) showed that food addiction was independently associated with higher weight gain (B = 9.28, t = 4.97, p < .001), greater intake of ultra-processed foods before and during COVID-19 (B = 1.08, t = 5.71, p < .001; B = 1.18, t = 6.42, p < .001, respectively), greater attribution of their overall current eating behaviors to COVID-19 circumstances (B = 23.19, t = 4.62, p < .001), and higher distress about their overall current eating behaviors (B = −22.12, t = −2.50, p = .01). Interaction effects demonstrated that individuals with food addiction who are older may be at particularly high risk for weight gain and distress. The present research suggests that food addiction is a uniquely meaningful phenotype, beyond the effects of BMI, to identify risk for the negative consequences of COVID-19. Individuals with food addiction, particularly those who are older, may benefit from support with weight management and addictive-like eating as the COVID-19 pandemic persists and resolves.

Adolescents' Exposure to and Experiences of Weight Stigma During the COVID-19 Pandemic

OBJECTIVE

The COVID-19 pandemic has increased attention to the proliferation of pediatric obesity amidst significant changes in weight-related health functioning (e.g., compromised physical activity, limited food access, increased stress). The present cross-sectional study investigated adolescents' feelings about their bodies and perceived changes in weight stigma from peers, parents, and social media during the pandemic.

METHODS

Four hundred fifty-two adolescents (11-17 years old) completed an online survey during the Fall of 2020. Measures assessed perceived changes in exposure to weight stigmatizing social media content (stress eating jokes, weight gain memes) and experiences of weight stigma (weight-based bullying, teasing, hurtful comments) by parents and peers, as well as body dissatisfaction, during the COVID-19 pandemic. Weight status and gender were examined as individual difference variables.

RESULTS

The majority (53%) of adolescents reported increased exposure to at least one form of weight stigmatizing social media content during the pandemic. Additionally, pandemic-related increases in body dissatisfaction were prevalent (41%), especially among girls with higher body mass index (≥85th percentile; 67%). On average, the extent to which adolescents experienced weight-based mistreatment from parents and peers remained consistent with their pre-pandemic experiences.

CONCLUSIONS

Overall, these findings highlight changes in the social messages that adolescents receive about their bodies, as well as their subjective body satisfaction, during the pandemic. Results underscore the need for healthcare providers and mental health professionals to be aware of the potential rise in weight stigma during the pandemic, and encourage families and schools to engage in supportive, rather than stigmatizing, weight-related communication with youth.

A Rapid Review on the Influence of COVID-19 Lockdown and Quarantine Measures on Modifiable Cardiovascular Risk Factors in the General Population

Preceding coronavirus outbreaks resulted in social isolation, which in turn is associated with cardiovascular consequences. Whether the current COVID-19 pandemic negatively impacts cardiovascular health is unclear. The aim of the rapid review was to investigate, whether COVID-19 lockdown influences modifiable cardiovascular risk factors (i.e., physical inactivity, sedentary behaviour, smoking, alcohol use, unhealthy diet, obesity, bad blood lipids, and hypertension) in the general population. Medline and EMBASE were searched until March 2021. Title, abstracts, and full texts were screened by one reviewer and 20% by a second reviewer. Only studies using probability sampling were included in order to ensure the representativeness of the target population. Data extraction and critical appraisal were done by one reviewer and double-checked by another reviewer. We identified 32 studies that fulfilled our inclusion criteria. Findings show that physical activity decreased, and sedentary behaviour increased among all age groups during the COVID-19 lockdown. Among adults, alcohol consumption increased, dietary quality worsened, and the amount of food intake increased. Some adults reported weight gain. Studies on children and adolescents were sparse. This rapid review found a high number of epidemiological studies on the impact of COVID-19 lockdown measures on modifiable cardiovascular risk factors, but only a few used probability sampling methods.

Assessment of Dietary Habits and Physical Activity Changes during the Full COVID-19 Curfew Period and Its Effect on Weight among Adults in Jeddah, Saudi Arabia

The World Health Organization declared coronavirus disease 2019 (COVID-19) a pandemic in March 2020. Global efforts have been made to prevent the disease from spreading through political decisions and personal behaviors, all of which rely on public awareness. The aim of our study was to examine the effect of dietary habits on weight and physical activity (PA) during the COVID-19 stay-at-home order in Jeddah, Saudi Arabia. An online questionnaire was distributed using social media (Facebook, Twitter, Instagram, and WhatsApp) and email communication. A total of 472 adults (age range, 18-59 years), over half of the study population (68.0%) being females, 55.5% being between 19 and 29 years old, 15.0%-between 30 and 39 years old, and 11.2%-older than 50 years old, participated in the study. Our results indicated that the overall body weight was slightly increased among the 50+ age group (47.2%, p > 0.05), but it highly increased among the 30-39-years-old age group (32.4%, p > 0.05) as compared to before the pandemic lockdown period. Therefore, our results show that a significant difference (p < 0.05) was found for all the assessments: weight status, physical activity patterns, hours spent on screen time, homemade meals, and changes in dietary habits before and during the full COVID-19 curfew period. This study demonstrated that changes in eating habits were commonly reported among the participants who represented the full COVID-19 curfew period and that changes in eating habits and decreased physical activity led to weight gain.

Differing Experiences of Boredom During the Pandemic and Associations With Dietary Behaviors

OBJECTIVE

To examine how changes in feeling bored and eating because of boredom during the coronavirus disease 2019 (COVID-19) pandemic relate to intuitive eating, diet quality, and snacking.

METHODS

A representative sample of 360 US adults completed an online survey including changes in feeling bored and eating because of boredom since the COVID-19 pandemic. An ANCOVA and multivariate analysis of covariance were used to examine relationships between intuitive eating, diet quality, and snacking in individuals who experienced: (1) increases in feeling bored and eating because of boredom, (2) eating because of boredom only, (3) increases in feeling bored only, and (4) no change/decreases in feeling bored and eating because of boredom.

RESULTS

Individuals who increased feeling bored and eating because of boredom and increased eating because of boredom only snacked more and scored lower in intuitive eating. Diet quality did not differ across groups.

CONCLUSIONS AND IMPLICATIONS

Although diet quality did not differ, eating because of boredom is potentially a negative impact on diet quality. Programs enhancing intuitive eating may be helpful.

Knowledge, Attitudes and Practices (KAP) regarding the Novel Coronavirus Disease (COVID-19) Post-lockdown in Trinidad and Tobago

The Novel Coronavirus Disease (COVID-19) was declared a pandemic by the World Health Organization (WHO) in March 2020. Trinidad and Tobago reported its first infection on March 12^th 2020. This study assessed knowledge, attitudes and practices toward COVID-19 among Trinidadians during the post-lockdown period. A validated questionnaire was used to conduct a cross-sectional survey from May 25^th to June 6^th 2020.Most respondents (512, 96.6%) knew that COVID-19 is highly infectious. Many (523, 98.7%) identified vulnerable groups as persons 65 years and older and those with preexisting co-morbidities (480, 90.6%). Respondents identified COVID-19 symptoms as fever (498, 94.0%), dry cough (495, 93.4%), myalgia (403, 76.0%) and sore throat (441, 83.2%). Most 504 (95.1%) acknowledged that COVID-19 threatened the country's economy. Dominant practices included regular hand washing (97.2%) and social distancing (512, 96.6%).Health authorities should continue public education efforts to increase knowledge and the adoption of recommended practices.