Evaluation of nutritional behaviour related to COVID-19

Food insecurity, eating behaviour, and relative weight change among young adults in the aftermath of the COVID-19 lockdown

This study aims to investigate the association between food insecurity, eating behaviour and relative weight change among Malaysian young adults in the aftermath of the pandemic-led lockdown. Socio-demographics, body height, and body weight were self-reported by the young adults. Food security was assessed using the 8-item validated Food Insecurity Experience Scale (FIES), while the Three-Factor Eating Questionnaire-Revised 18-item (TFEQ-R18) was adopted to evaluate the eating behaviour of young adults. Of the 447, 45.9% maintained the same body weight as before the pandemic-led lockdown. While almost half of the young adults (47.2%) were food secure, about one-fourth (24.8%) suffered moderate-to-severe food insecurity. Meanwhile, the standardised raw scores for all the eating behaviour subscales were in the ascending order of cognitive restraint (49.37 ± 18.60) < uncontrolled eating (50.61 ± 20.37) < emotional eating (50.68 ± 24.50). The findings of the Sobel test indicated that the mediation effects of eating behaviour were not statistically significant (p > 0.05), suggesting that eating behaviour (cognitive restraint, uncontrolled eating and emotional eating) did not mediate the relationship between moderate-to-severe food insecurity and relative weight change. Health promotion interventions such as introducing food assistance programs, offering incentives for nutritious food purchases, and re-emphasising healthy eating are essential to rectify food insecurity and disordered eating among Malaysians.

Intuitive eating has reduced the chances of being overweight in university students during the COVID-19 pandemic

Introduction

University students have been particularly affected during the COVID-19 pandemic, and several sociodemographic and behavioral factors may be associated with the risk of overweight in this population. The aim of this study was to assess the impact of the pandemic on the eating behavior and nutritional status of university students, and the factors associated with these changes, especially the role of intuitive eating in this process.

Methods

This is a repeated measures observational study with data collected in the first and third year of the COVID-19 pandemic in Brazil, from students over the age of 18 in the undergraduate programs of a federal university in southeastern Brazil. The survey was conducted using an online form. Eating behavior was assessed using the "Intuitive Eating Scale-2".

Results

251 university students took part, most of them female with a median age of 22. There was an increase in body mass index (BMI) and intuitive eating score between the two periods. In the first year of the pandemic, being female and using tobacco reduced the chances of students being overweight. Living in a marital relationship, worrying about weight gain and body dissatisfaction increased the chances of this outcome. In the third year of the pandemic, it was observed that practicing restrictive diets, having inadequate body perception, worrying about weight gain and living in a marital relationship increased the chances of students being overweight. Being female and eating more intuitively, in line with bodily needs, reduced these odds, demonstrating a protective role in this scenario.

Conclusion

There was an increase in BMI and intuitive eating score during the pandemic. Sociodemographic, lifestyle and behavioral variables had both a positive and negative influence on nutritional status. Intuitive eating was shown to be a protective factor during this period, reducing the chances of being overweight in this population. Thus, more intuitive eating may favor greater weight stability, and may, therefore, have helped to reduce the impact of the pandemic on weight gain. In this way, people who ate more intuitively partially resisted the context that favored weight gain (stress, changes in diet and physical inactivity).

How has the strict lockdown during the SARS-COV-2 outbreak changed the diet of Spaniards?

Purpose

We investigate the impact of a specific macroeconomic shock that occurred as a response to the SARS-COV-2 outbreak, namely the strict lockdown imposed in Spain on the March 14, 2020.

Methods

We use fortnightly purchase data relating to over 50,000 households from a supermarket chain in Catalonia from March to June in 2019 and 2020. Using a panel data approach, we analyse the impact of the lockdown on the caloric content, sugar composition, and alcohol content in beverages and food purchases bought before and after lockdown. We corrected our results to take into account the likelihood of stockpiling.

Results

The lockdown is related to an increase in unhealthy beverage and food purchases. We find heterogeneous effects across groups of the sample based on cardholder characteristics. Families with children or babies and those in the upper two income quintiles had the unhealthiest changes. As the lockdown went through phases of relaxation, households made better food decisions but maintained unhealthy beverage choices.

Conclusions

The very restrictive lockdown negatively impacted the characteristics of food and beverage purchases made by Spaniards. However, we are unsure whether there was substitution to restaurant and bar visits. Additional work to find out whether there were permanent changes in purchasing behaviour after lockdown ended is needed in the future.

The mediating role of sleep quality in the relationship between orthorexia nervosa and fear of COVID-19

The COVID-19 (SARS-CoV-2) pandemic has jeopardized humanity worldwide and has considerably altered the healthy lifestyle behaviors of societies. This study examined the possible mediating role of sleep quality in the relationship between orthorexia nervosa and fear of COVID-19 among Turkish adults. This study used an observational and descriptive design. It was carried out online with 1,130 participants across Turkey between April and August 2021. The data were collected using a questionnaire, the Fear of COVID-19 Scale (FC-19S), the Pittsburgh Sleep Quality Index (PSQI), and Orthorexia Nervosa-R (ON-R). The participants had an ON-R mean score of 3.08 ± 0.90 and a mean PSQI score of 8.03 ± 2.80. Likewise, their mean FC-19S score was 18.24 ± 6.55. There was a significant positive correlation between the FC-19S and the PSQI (r = 0.208; p = 0.000) as well as a significant negative correlation between the ON-R and the PSQI (r = - 0.145; p = 0.000). In addition, the results of the process model analysis supported our hypotheses that the PSQI was a predictor of ON-R and that its direct and indirect effects were moderated by FC19S and the PSQI. A one-unit increase in FC-19S scores causes an average 1% increase on the ON-R scale, while it generates an 8% increase on the PSQI. It was determined that the PSQI total score caused an average of 6% increase in the ON-R scale score. The findings of this study showed that sleep quality has a mediating role in the relationship between orthorexia nervosa and fear of COVID-19 experienced by Turkish adults during the pandemic. For this reason, governments need to take the necessary precautions concerning this subject when creating action plans for possible global crisis situations that may adversely affect public health in the future.

The Impact of COVID-19 Pandemic on Weight Loss, Eating Behaviour and Quality of Life after Roux-en-Y Gastric Bypass

Background and Objectives: The global pandemic of coronavirus disease (COVID-19), declared on 11 March 2020, had an extensive impact on bariatric patients. The aim of this study was to evaluate short-term weight loss outcomes, changes in eating behaviour, and health-related quality of life (HRQoL) among patients who had Roux-en-Y gastric bypass (RYGB) before and during the COVID-19 pandemic. Materials and Methods: This cohort study included 72 patients (Group S) who underwent RYGB surgery in the Surgery Department of the Lithuanian University of Health Sciences during the COVID-19 pandemic in the years 2020-2022. Data for the control group (Group C) of 87 patients (operated on in 2010-2012) were collected from a prospective study. The data referred to the period before and a year after the RYGB. The information about patients' weight changes, hunger, satiety, fullness sensations, appetite, diet, and eating patterns was queried. Eating behaviour and HRQoL evaluation were conducted by the Three-Factor Eating Questionnaire (TFEQ-R18) and the medical outcomes study Short-Form-36 (SF-36), respectively. Results: One year after the surgery, % excess body mass index loss (%EBMIL) was 77.88 (26.33) in Group S, 76.21 (19.98) in Group C, p = 0.663. Patients in Group S tended more to choose snacks between main meals: 79.2% versus 28.7%, p < 0.0001. Cognitive restraint significantly increased in Group S from 45.93 (13.37) up to 54.48 (13.76), p = 0.001; additionally, significantly worse overall health status was found in Group S compared to Group C, 53.27 (24.61) versus 70.11 (31.63), p < 0.0001. Mental HRQoL (50.76 versus 60.52 score, p < 0.0001) and social functioning (44.79 versus 57.90, p < 0.0001) were worse in Group S. Conclusions: In this study, the COVID-19 pandemic had no impact on short-term weight loss after RYGB. However, one year after, RYGB patients tended to snack more, and mental HRQoL and social functioning were worse in the study group.

Delayed Mid-Sleep Time Associated With Weight Gain While Controlling for Eating Behaviors and Attention Deficit Hyperactivity Disorder Symptoms During the COVID-19 Pandemic

OBJECTIVE

Society's sleep-wake cycle and eating behaviors have altered and are considered the psychological outcomes of the coronavirus disease-2019 (COVID-19) pandemic. Our aim was to examine the relationship between sleep-wake rhythms, eating behaviors (dieting, oral control, and bulimic behaviors), and attention deficit hyperactivity disorder (ADHD) symptoms with weight gain during the COVID-19 pandemic.

METHODS

The participants were 578 female university students divided into three groups based on weight change during COVID-19 who lost weight, whose weight did not change (nWC), and who gained weight (WG). The participants' information about weight change in the last year and responses to the Pittsburg Sleep Quality Index, Eating Attitudes Test, Adult ADHD Severity Rating Scale, and Wender Utah Rating Scale were collected via an online survey from January 8, 2021 to January 11, 2021.

RESULTS

The sleep-wake phase was more delayed in WGs than in the other two groups. The bulimic behavior score was higher and the oral control behavior score was lower in the WG group than in the nWC group. A hierarchical regression analysis model, in which weight change scores were dependent variables, showed that mid-sleep time in second step (β=4.71, t=2.18, p=0.03), and oral control (β=-0.11, t=-3.24, p=0.001)/bulimic behaviors (β=0.20, t=3.20, p=0.001) in third step were associated with weight change after controlling for both current and childhood ADHD symptoms.

CONCLUSION

Chronotherapeutic approaches that regulate sleep-wake rhythm may facilitate weight control of individuals during stressful periods, such as the COVID-19 outbreak.

Does mindful eating affect the diet quality of adults?

OBJECTIVES

This study aimed to examine the relationship between mindful eating and diet quality among adults in Turkey.

METHODS

A total of 207 adults, 138 women (66.7% of 207) and 69 men (33.3%), participated. This cross-sectional survey was carried out among adults aged 20-50 y. The following data were collected from face-to-face interviews: sociodemographic variables, health information, nutritional habits, anthropometric measurements, 24-h dietary records, and scores from the Mindful Eating Questionnaire (MEQ), Mediterranean Diet Adherence Screener (MEDAS), and Healthy Eating Index-2015 (HEI-2015).

RESULTS

The mean MEDAS scores of females were higher than those of males (P = 0.012). The mean HEI-2015 scores did not significantly differ between females and males (P > 0.05). The mean scores of the MEQ (P = 0.024) and its disinhibition (P = 0.005) and emotional eating (P = 0.000) subfactors were higher in males than in females. The MEQ mean score was negatively associated with daily energy (P = 0.038), carbohydrate (P = 0.046), and fat intake (P = 0.036). As the MEQ mean score increased, the greens and beans score (P = 0.009) and dairy intake score (P = 0.031) increased. A positive correlation was present between the eating discipline subfactor of the MEQ score and both the HEI-2015 (P = 0.002) and MEDAS mean scores (P = 0.001). However, no significant correlation was found between the mean MEQ and HEI-2015 scores and the MEDAS mean scores (P > 0.05).

CONCLUSIONS

Developing mindful eating might be helpful for individual health promotion and quality of life by providing improvements in diet quality of adults.

Depression and the risk factors for isolated infectious disease fever patients in the hospital during the COVID-19

Objectives

To compare and analyze the incidence of anxiety and depression of infectious disease fever patients in hospitalized isolation and home isolation during the COVID-19 pandemic, as well as the risk factors for the negative emotions of hospitalized isolation patients.

Methods

Forty isolated infectious disease fever patients in Baoding No.1 Hospital were randomly selected as the study group, and the other 40 isolated infectious disease fever patients at home were randomly selected as the control group from March 2020 to August 2020. The scores and prevalence of depression and anxiety between the two groups were compared and analyzed. The logistic regression analysis was used to judge and analyze the negative psychological factors of hospitalized isolation patients such as depression and anxiety.

Result

The HAMA and HAMD-17 scores of study group are significantly higher than those of control group (HAMA, p=0.00; HAMD-17, p=0.01). The prevalence of anxiety and depression in the study group was significantly higher than that in the control group (p=0.03, p=0.04). The gender (p=0.002), economic status (p=0.004) and isolation attitude (p=0.023) are the related factors of anxiety, among which economic status is the protective factor, while women and resistant attitude are the risk factors. Economic status (p=0.003) and isolation attitude (p=0.001) are the related factors of depression, among which economic status is the protective factor, and resistant attitude is the risk factor.

Conclusion

The prevalence and severity of anxiety and depression in hospitalized isolation patients due to infectious disease fever are significantly higher than those of home isolation patients. The focus groups are women, with bad economic status and poor isolation attitude. Necessary psychological counseling and social support should be provided to these groups to reduce negative emotions and increase the experience of isolated patients.

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

PURPOSE

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

LEVEL OF EVIDENCE

Level I, systematic review and meta-analysis.

PREREGISTRATION

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

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

Factors such as regulations and health concerns shifted daily habits, including eating behaviors, during the early months of the coronavirus disease 2019 (COVID-19) pandemic. This comprehensive narrative review synthesizes research on eating behavior changes during the early months of the pandemic (February to June 2020), including changes in amount, rate, and timing of food consumption, types and healthfulness of foods consumed, the occurrence of other specified eating behaviors (eg, restrained eating or binging), and reasons for eating (eg, stress or cravings), among adults. A literature search using three EBSCOhost databases and Google Scholar was conducted to identify relevant articles made available in 2020. A total of 71 articles representing 250,715 individuals from more than 30 countries were reviewed. Findings show eating behaviors changed little during the early COVID-19 pandemic for most participants. Among those whose eating behaviors changed, increases in both intake and frequency of eating meals and snacks were more common than decreases. Findings on timing of eating and healthfulness of food consumed showed mixed results. However, when changes occurred in the type of food consumed, increases were more common for snacks, homemade pastries, white bread/pasta, legumes, and fruits/vegetables; decreases were more common for meats, seafood/fish, frozen foods, fast food, dark breads/grains, and dark leafy green vegetables. During the pandemic, binging, uncontrolled eating, and overeating increased, meal skipping decreased, and restrictive eating had mixed findings. Changes in factors such as emotions and mood (eg, depression), cravings, and environmental factors (eg, food insecurity) were related to changes in eating behaviors. Findings can inform clinical practitioners in efforts to mitigate disruptions to normal, healthy eating patterns among adults both in and outside of global health catastrophes.

Determining the relationship between anxiety levels, stress coping styles, and emotional eating of women in the COVID-19 pandemic

PURPOSE

This study aimed to determine the relationship between women's anxiety levels and their style of coping with stress and emotional eating in the COVID-19 pandemic.

METHODS

This is a cross-sectional study and data were collected using online surveys. The sample of the study consisted of 450 women between the ages of 18-65, who have no understanding and perception problems, and who are willing to participate in the study. The data were obtained using the "Introductory Information Form", "Coronavirus Anxiety Scale", "Stress Coping Styles Scale" and "Emotional Eating Scale". Descriptive statistics, Pearson correlation analysis and multiple regression analysis were used to analyze the data.

RESULTS

Increased emotional eating was increased helpless approach, submissive approach and Coronavirus anxiety increase while decreasing the self-confident approach. Increased Coronavirus anxiety was increased the total scores of helpless approach, submissive approach, disinhibition, guilt, and emotional eating increased while decreasing the scores of the self-confident approach and optimistic approach. BMI, weight change in pandemic, age, self-confident approach to coping with stress and helpless approach score explained emotional eating 30.8 %.

CONCLUSION

Considering the emotional eating score average (11-20), women were emotional eating, and their Coronavirus anxiety score was below the average. In minimizing emotional eating in women, first of all, emotional eating awareness should be created, and it is recommended to increase their awareness of stress coping styles for the stress that causes this situation.

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.

Nutrition and behavior change: a review of recent literature

PURPOSE OF REVIEW

The current article will highlight recent trends and novel approaches to behavior change strategies in nutrition. Physicians, nurses, and other healthcare professionals play key roles in counseling patients on lifestyle change, which is critical for patients with chronic conditions. Nutrition science continues to advance, and new approaches to behavior change are needed for successful implementation at the individual and population level.

RECENT FINDINGS

The solutions to obstacles around healthful eating patterns are varied, population-dependent, and require a multipronged approach. One area of focus is the language around behavior change, ensuring it is clear and emphasizes its multifactorial nature. For young adults, the careful use of video games and social media may be essential. For older adults, altering food consistency and ensuring proper nutrient intake are crucial factors. Vulnerable populations remain susceptible to malnutrition and need special attention. Despite significant advances in managing and treating diseases, there are still gaps in nutrition counseling and behavior change efforts.

SUMMARY

Every age and stage of life needs a focus on healthful foods, and nutrition counseling at each stage has its unique nuances. Careful attention to the language of change and the phrasing used in counseling is vital for educating, connecting with, and empowering patients to change. Changing healthcare operations and provider behavior around nutrition counseling is a part of the solution to the worldwide problem of unhealthy eating patterns and practices.

Nutritional behavior during the COVID-19 pandemic: the association of fear and sleep quality with emotional eating

PURPOSE

Even though it is known that fear and poor sleep quality trigger emotional eating, whether fear and poor sleep quality are associated with emotional eating during the COVID-19 pandemic is not clear. This study aimed to evaluate the association of fear of COVID-19, sleep quality, and some sociodemographic characteristics with emotional eating during the COVID-19 pandemic.

METHOD

This cross-sectional descriptive study was completed with 495 participants in Turkey. The participants filled out a questionnaire that asked about sociodemographic characteristics, fear of COVID-19, nutritional behaviors, sleep quality, and self-reported weight and height through email or social media.

RESULTS

The fear of COVID-19 score (β: 0.090, p < 0.05) and sleep quality score (β: 0.289, p < 0.001) were associated with the emotional eating score at the rate of 0.8% and 8.3%, respectively. The association of fear of COVID-19 with emotional eating disappeared when combined with various factors. The collective association of all factors, fear of COVID-19 (β: 0.042, p > 0.05), sleep quality (β: 0.246, p < 0.001), BMI (β: 0.275, p < 0.001), age (β:  - 0.259, p < 0.001) and gender (β:  - 0.169, p < 0.001) were associated with the emotional eating score at the rate of 18.3%.

CONCLUSIONS

These findings suggest that fear of COVID-19, sleep quality, BMI, age, and gender were associated with emotional eating during the pandemic. We hope that this study will help in the development of guidelines and strategies through understanding the factors associated with nutritional behavior during the pandemic period.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

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

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

Relationship between Mental Health and Emotional Eating during the COVID-19 Pandemic: A Systematic Review

Obesity is one of the most dangerous epidemics of the 21st century. In 2019, the COVID-19 pandemic began and caused many deaths among patients with obesity with and without complications. Simultaneously, the lockdown related to the COVID-19 pandemic caused a host of emotional problems including anxiety, depression, and sleep disturbances. Many people began to cope with their emotions by increasing food (emotional eating) and alcohol consumption and in combination with decreased physical activity, promoted the development of overweight and obesity. Emotional eating, also known as stress eating, is defined as the propensity to eat in response to positive and negative emotions and not physical need. It should be noted that emotional eating may be the first step in the development of binge eating disorder and its extreme subtypes such as food addiction. Interestingly in some post-bariatric surgery patients, an increased frequency of addictive disorders has been observed, for example food addiction replaced by alcohol addiction called: “cross addiction” or “addiction transfer”. This data indicates that obesity should be treated as a psychosomatic disease, in the development of which external factors causing the formation of negative emotions may play a significant role. Currently, one of these factors is the COVID-19 pandemic. This manuscript discusses the relationships between the COVID-19 pandemic and development of emotional eating as well as potential implications of the viral pandemic on the obesity pandemic, and the need to change the approach to the treatment of obesity in the future.

The impacts of COVID-19 on eating disorders and disordered eating: A mixed studies systematic review and implications

Purpose

The unique constraints to everyday life brought about by the COVID-19 pandemic have been suggested to negatively impact those with pre-existing mental health issues such as eating disorders. While individuals with eating disorders or disordered eating behaviors likely represent a vulnerable group to the COVID-19 pandemic, the impact of the pandemic is yet to be fully established.

Methods

We systematically examined the impact of the COVID-19 pandemic on eating disorders and disordered eating behaviors. We searched electronic databases MEDLINE, PsycINFO, CINAHL, and EMBASE for literature published until October 2021. Eligible studies were required to report on individuals with or without a diagnosed eating disorder or disordered eating behaviors who were exposed to the COVID-19 pandemic.

Findings

Seventy-two studies met eligibility criteria with the majority reporting an increase in eating disorder or disordered eating behaviors associated with the COVID-19 pandemic. Specifically, it appears children and adolescents and individuals with a diagnosed eating disorder may present vulnerable groups to the impacts of the COVID-19 pandemic.

Discussion

This mixed systematic review provides a timely insight into COVID-19 eating disorder literature and will assist in understanding possible future long-term impacts of the pandemic on eating disorder behaviors. It appears that the role of stress in the development and maintenance of eating disorders may have been intensified to cope with the uncertainty of the COVID-19 pandemic. Future research is needed among understudied and minority groups and to examine the long-term implications of the COVID-19 pandemic on eating disorders and disordered eating behaviors.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=284749, PROSPERO [CRD42021284749].

Dietary Behaviours of University Students during the COVID-19 Pandemic. A Comparative Analysis of Nursing and Engineering Students

The university stage is a crucial stage that influences the decision-making process of students. At this stage, they acquire dietary habits that are guided by their likes, beauty ideals, biological influences, and economic factors. During the COVID-19 pandemic, universities closed and turned to online teaching, changing their life habits under the duress of confinement. The aim of the present work was to identify the dietary behaviours of nursing and engineering degree students at the University of Huelva during the period of confinement, in addition to identifying the factors influencing these habits. The methodological strategy employed was mixed in nature. In this sense, a cross-sectional descriptive study was first performed, followed by a phenomenological qualitative study that was descriptive in nature. Examination of outcomes revealed the presence of four lines of argument founded on the influence of context, life habits, emotional changes experienced during the COVID-19 pandemic, and the factors facilitating or limiting adaption to this period. Taking into account that confinement, restrictive measures, the absence of family, closeness and affection, and training influenced changes to feeding habits and approaches to consumption, universities could carry out interventions oriented in this line to favour healthy eating habits.

Associação entre comportamento alimentar e hábitos de vida e aumento de crises de migrânea em universitários na pandemia da COVID-19

Introdução: A pandemia da COVID-19 provocou alterações nos hábitos de vida e padrão alimentar da população, importantes gatilhos para as crises migranosas. Objetivo: Avaliar a associação entre comportamento alimentar e hábitos de vida e aumento das crises de migrânea em universitários na pandemia da COVID-19. Material e Métodos: Estudo descritivo, de corte transversal, retrospectivo, realizado com acadêmicos de universidade de Salvador, Bahia, entre dezembro/2020 a junho/2021. Os universitários foram convocados pelo Whatsapp® e pelo e-mail institucional e direcionados ao termo de consentimento livre e esclarecido e questionário, preenchidos via aplicativo de gerenciamento de pesquisa. Esta pesquisa foi aprovada pelo Comitê de Ética em Pesquisa, sob parecer 4.351.573. Dados analisados por meio de estatística descritiva. Resultados: Amostra de 83 indivíduos, 89,2% mulheres, 45,8% sedentários, 51,8% ganharam peso recentemente, 73,4% apresenta baixa ingestão hídrica, 59% têm dificuldade para conciliar e 50,6% têm dificuldade de manutenção do sono. Antes da pandemia, 7,3% relataram 7-14 dias de enxaqueca por mês e, após, aumento para 24,1%. 36,1% dos acadêmicos associaram alimentos às crises de enxaqueca, sendo os principais gatilhos: café (20,5%), chocolate (14,5%), embutidos (12%), álcool (9,6%) e açúcar (6%). O aumento dos dias com enxaqueca associou-se à dificuldade de manutenção do sono (p < 0,002). Conclusão: Apesar do resultado estatisticamente significante apenas entre a dificuldade em conciliar o sono e maior frequência de enxaqueca, as mudanças no estilo de vida e comportamento alimentar ocasionadas pela pandemia da COVID-19 também parecem implicar no aumento de dias com enxaqueca em universitários.

Nutritional and health behaviour predictors of the weight gain during the COVID-19 pandemic

Purpose

This study aims to examine the effects of the COVID-19 pandemic on the body weight, nutritional habits, physical activity, and food consumption of adults living in Turkey and evaluate the effects of changes in these health behaviours on body weight.

Methods

A cross-sectional study was conducted with an online questionnaire. Data were collected through social media platforms using the snowball sampling method. A self-reported questionnaire included socio-demographic information, anthropometric data, dietary habits, food consumption, and lifestyle changes. In this study, 4181 people were included. Logistic regression analysis was used to evaluate the variables associated with the increase in body weight.

Results

The findings obtained in this study showed that the bodyweight of 58.5% of the participants increased during the COVID-19 pandemic, and this increase was the highest (66.3%) among the obese. The rate of those who stated that their physical activity decreased was 69.5%. The foods consumed the most by individuals were homemade desserts (54%), nuts (53.8%) and fresh fruits (52.3%). Those whose serving size increased [OR = 4.98 (3.76–6.60)], those whose physical activity decreased or increased [OR = 2.94 (2.38–3.63) or 2.52 (1.84–3.45), respectively], and those whose number of main meals consumed increased [OR = 2.17 (1.72) − 2.75)], those with increased consumption of white bread (OR = 1.63 (1.20–2.22) and those with increased consumption of packaged sweet products [OR = 1.53 (1.23–1.89)] were more likely to gain weight.

Conclusion

The results of this study show that there are significant changes in the body weight, physical activities, and eating habits of the participants during the COVID-19 pandemic. It is necessary to provide and follow-up specific guidance and support services for different groups to protect public health, improve and prevent nutrition-related diseases.

Cognitive restraint, emotional eating and uncontrolled eating: Exploring factors associated with the cycle of behaviors during the COVID-19 pandemic

The objective of this study was to analyze the factors associated with Cognitive Restraint, Emotional Eating, and Uncontrolled Eating behaviors with perceptions of life habits, body image, eating habits, and food consumption during the COVID-19 pandemic. Sociodemographic data, eating behavior, perceptions about life and eating habits, body image, and food consumption were collected. Factors associated with each of the three eating behaviors were accessed through three multiple linear regressions controlled for age, sex, BMI, education level, and monthly income. Cognitive restraint was associated with being active during the pandemic (β=5.85), attempted weight loss (β=11.89), perception of overweight (β=9.10), better eating habits in the pandemic (β=6.55), and decreased consumption of refined cereals (β=5.60) and fast foods (β=8.23). Emotional eating was associated with increased stress during the pandemic (β=7.10), worse sleep (β=4.74), body dissatisfaction (β=4.85), perception of overweight (β=7.45), attempted weight loss (β=4.19), increase in the amount of food consumed (β=9.34), increased food delivery purchase (β=5.13), increase in consumption of sweets and desserts (β=7.17) and reduction in consumption of vegetables (β=- 5.26). Uncontrolled eating was associated with working more than 8 hours/day (β=4.04), increased stress during the pandemic (β=3.65), body dissatisfaction (β=6.59), worse eating habits in the pandemic (β=5.21), and an increase in the amount of food consumed (β=8.73). Cognitive restraint behavior was associated with healthy life habits and negative body image variables. In contrast, emotional eating and uncontrolled eating were associated with negative body image and unhealthy eating habits.

Eating Habits during the COVID-19 Pandemic and the Level of Antibodies IgG and FRAP—Experiences of Polish School Staff: A Pilot Study

The coronavirus 19 (COVID-19) pandemic has brought many changes in terms of lifestyle, education, stress levels, and social contacts. The aim of our research was to evaluate changes in eating habits, physical activity, and selected lifestyle elements in a group of school staff, as well as their immune response to vaccination against COVID-19, and FRAP (ferric reducing antioxidant power) level. In total, 108 primary school teachers and other school staff with integration departments were included in the study. An original survey was conducted with the school staff. Of the study group, 45.4% chose to be vaccinated against COVID-19. In this group, the level of IgG antibodies was assessed, as well as the level of FRAP before vaccination, and after the first and second dose. An original questionnaire was also carried out. A decrease in physical activity and an increase in the time spent in front of the computer have been demonstrated, but a positive observation was a favorable change in most eating habits. After the second dose of vaccination, all subjects achieved the appropriate level of IgG antibodies (above 22 U/mL), with the maximum level recorded in 51%. There was also a significant increase in FRAP levels in the group after the first and second dose of the vaccine compared to the baseline level; an issue that requires further observation.

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.

Quality of life and eating habits of patients with obesity during the COVID-19 pandemic

Objective:

to verify the quality of life and eating habits of patients with obesity during the COVID-19 pandemic.

Method:

cross-sectional study with 68 outpatients, candidates for bariatric surgery, at university hospital in the Southern Brazil. Data collection was carried out by telephone, with questions about the profile of the participants and social distancing; questionnaires on quality of life and eating habits were also used. The data analysis, the logistic regression model, Spearman correlation, Mann-Whitney U and Student t-tests were used for independent samples.

Results:

the general quality of life was 57.03 points and the eating habit with the highest score was cognitive restraint (61.11 points). Most patients (72.1%) were socially distancing themselves and 27.9% had not changed their routine. The chance of isolation was 3.16 times greater for patients who were married. There is a positive correlation between the domains of the Quality of Life questionnaire and cognitive restraint from the questionnaire about eating habits.

Conclusion:

we found that the participants tended to have a better quality of life as cognitive restraint increased.

Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review

Background: Several data suggest that coronavirus disease 2019 (COVID-19) pandemic may exacerbate or trigger eating disorders (EDs). The aim of this paper was to summarize current literature studies on COVID pandemic and EDs. Methods: Literature search, study selection, methods, and quality evaluation were performed according to the preferred reporting items for systematic review and meta-analyses (PRISMA) guidelines. Results: A systematic search allowed the initial selection of 172 papers; 21 (12.2%) papers were eligible and included in the review. In selected studies, a total number of 29,108 subjects were enrolled (range: 10-11,391; mean/SD: 1,386 ± 2,800), 6,216 were men (21.4%), 22,703 were women (77.9%), and 189 (0.7%) were gender fluid or not declared. The mean age/SD of subjects was 30.2 ± 7.7. About 12 studies (57.1%) were online surveys, 4 (19.0%) were retrospective studies, 2 (9.5%) were qualitative studies, 2 (9.5%) were longitudinal cohort studies, and 1 was a social media survey (4.8%). Their analysis revealed five main findings: (1) changes in the routines of physical activities were related to the worsening of preoccupation on weight/body shape; (2) food access limitation during pandemic represented the risk factors for both triggering and exacerbating EDs; (3) restriction in healthcare facilities contributed to increase anxiety levels and to modify treatment compliance; (4) social isolation was related to the exacerbation of symptoms in patients with EDs who are home-confined with family members; and (5) conflicts and difficulties in relationships with "no way out" were the maintenance factors for ED symptoms, especially in adolescents and young adults. Conclusion: The COVID-19 pandemic had a negative impact on EDs that might be triggered by the exceptional conditions derived from COVID-19-related stress in predisposed subjects. Patients who were already affected by EDs experienced the worsening of their clinical conditions and related quality of life (QoL).

Changes in nutrition and lifestyle habits during the COVID-19 pandemic in Turkey and the effects of healthy eating attitudes

BACKGROUND: Social isolation required by the pandemic has led to some changes in individuals’ eating and lifestyle habits. OBJECTIVE: This study aimed to examine the change in nutrition and lifestyle habits of Turkish people during the COVID-19 outbreak and investigate the effects of individuals’ attitudes to healthy eating on this change. METHOD: At the beginning of the pandemic, individuals over the age of 18 participated in this cross-sectional study using an online questionnaire. Demographic information (age, gender, education level, place of residence and occupation), anthropometric data (reported weight and height); nutritional behavior information (number of meals per day, changes in consumption of various foods, use of nutritional supplements, etc.) and changes in lifestyle habits were requested from the participations. In addition, the Healthy Nutrition Attitude Scale (ASHN) was used to determine the healthy eating attitudes of the participants. RESULTS: A total of 432 volunteers participated in the study. It was revealed that body weight increased in 38.0% of the participants and activity level decreased in 73.1% of them during the initial stage of the pandemic. Nevertheless, 44.7% of participants reported increased sleep time, 77.8% reported increased social media use, and 66.7% reported increased stress and anxiety. It was found that the most commonly used nutritional supplements during this period were vitamin C, vitamin D and multivitamin complex. Women have significantly higher ASHN scores compared to men (p < 0.001). The total ASHN scores of those whose body weight did not change and those who increased their activity level were found to be significantly higher. It was determined that as the age and education level increased, the healthy eating attitude increased. CONCLUSION: In this study, findings regarding the negative effects of the COVID-19 quarantine on the nutrition and lifestyle of the Turkish people are presented. However, those with a positive attitude toward healthy eating were observed to have better weight control and eating habits and stress management during the pandemic. Therefore, it is thought that the dissemination of healthy eating attitudes in society may contribute to the maintenance of physical and mental health in the event of a pandemic.

Social Isolation and Loneliness During the COVID-19 Pandemic: Impact on Weight

PURPOSE OF REVIEW

Social isolation and loneliness have long been identified as risk factors for poorer physical and mental health and increased mortality. These factors have also been shown to impact dietary behavior and physical activity which play a role in precipitating and maintaining obesity. Less is known about the impact of social isolation resulting from the COVID-19 pandemic in which social distancing is a major component of public health initiatives. This narrative review will examine the existing literature on the relationships between social isolation, loneliness, mental health, and weight as they relate to the COVID-19 pandemic.

RECENT FINDINGS

Individuals with obesity are at very high risk for worsening course of COVID-19, hospitalization, and death. This population may also be more significantly impacted by the dietary and physical activity consequences resulting from lockdown, social distancing, and isolation. The pandemic has led to significant lifestyle disruptions. However, early studies have largely relied upon cross-sectional studies or convenience samples. Future research will need to study the impact more rigorously, particularly among populations at greatest risk.

Quarantine During COVID-19 Outbreak: Eating Behavior, Perceived Stress, and Their Independently Associated Factors in a Brazilian Sample

The study aimed to assess the eating behavior [uncontrolled eating (UE), emotional eating (EE), and cognitive restraint (CR)], the perceived stress, and independently associated factors among Brazilians during the COVID-19 pandemic. An online survey was conducted and data about 1,368 participants were evaluated. Multivariate logistic regression models were performed to identify factors independently associated (socioeconomic, lifestyle, and eating habits data) with eating behaviors and perceived stress. Working in the COVID-19 frontline (OR = 2.19), increased food delivery (OR = 1.49), increased food intake (OR = 1.48), increased number of meals (OR = 1.13), and EE (OR = 1.05) were factors independently associated with UE. Variables that were independently associated with EE were: increased food intake (OR = 2.57), graduation in a non-health-related course (OR = 1.78), perceived stress (OR = 1.08), UE (OR = 1.07), and CR (OR = 1.02). Reduced snacking (OR = 2.08), female gender (OR = 1.47), having a higher degree (OR = 1.44), increased homemade meals (OR = 1.31), the higher difference in the frequency of instant meals and snacks intake (OR = 0.91), EE (OR = 1.01), not increased alcohol dose intake (OR = 0.57), and increased physical activity (OR = 0.54) were independently associated with CR. Perceived stress was independently associated with changes in the way of working or studying (OR = 2.48), worse sleep quality (OR = 2.22), younger age (OR = 1.06), and EE (OR = 1.02). This study indicates that socioeconomic variables, lifestyle, and eating habits were independently associated with the eating behaviors of Brazilians and perceived stress during the quarantine.

Personality Traits and Changes in Health Behaviors and Depressive Symptoms during the COVID-19 Pandemic: A Longitudinal Analysis from Pre-pandemic to Onset and End of the Initial Emergency Conditions in Finland

The COVID-19 pandemic and social distancing measures targeting the transmission of the virus impacted everyday life in 2020. This study investigated pre- to in-pandemic changes in health behaviors and depressive symptoms during the COVID-19 pandemic and the role of personality traits in these changes in Finland. Data from a larger population-based cohort study of 51-59-year-old Finnish women were used (n = 358). Self-reported questionnaires gathered information about depressive symptoms, eating behavior, physical activity, and alcohol consumption before the pandemic time, at the onset, and at the end of the COVID-19 emergency conditions. Information about personality traits (extraversion and neuroticism) and sociodemographic factors was available from the pre-pandemic baseline. Women reported more depressive symptoms and unhealthier eating habits at the end of the emergency conditions compared to the pre-pandemic time. An increase in depressive symptoms was associated with changing to unhealthier eating habits. Higher extraversion was associated with a perceived decrease in alcohol consumption and with changing to healthier eating habits. Women with higher neuroticism reported changing to either healthier or unhealthier eating habits. In general, some women reported healthier lifestyle changes while other women reported the opposite. Personality traits help to understand these individual differences in adaptation to the pandemic situation.

The Association Between Body Mass Index, Emotional Eating and Perceived Stress during COVID-19 Partial Quarantine in Healthy Adults

Objective:

We investigated emotional eating behaviours and perceived stress during COVID-19 partial quarantine according to BMI levels in healthy adults.

Design:

Cross-sectional study.

Setting:

An online survey including demographic variables, eating attitude-related questions, Emotional Eater Questionnaire (EEQ) and Perceived Stress Scale-14 (PSS-14) was sent via online data collection platform. Self-reported weight, height and weight changes during the quarantine were also collected.

Participants:

A total of 506 people aged between 20–65 years who were partially quarantined due to COVID-19 participated in this study.

Results:

BMI was positively correlated with EEQ (r 0 ·205, P = 0·001). However, BMI was negatively linked with PSS-14 during COVID-19 (r -0·125, P = 0·001), indicating that participants with lower BMI had higher perceived stress during COVID-19. Participants gained weight during the lockdown situation (+1·20 ± 1·70 kg in men; +0·91 ± 1·40 kg in women). EEQ and PSS-14 scores of women found to be significantly higher than men (9·39 ± 5·37 in men v. 11·17 ± 5·85 in women for EEQ; 24·67 ± 8·32 in men v. 27·99 ± 7·34 in women for PSS-14). Obese participants consumed sweetened and carbonated drinks two-fold more in those compared with other participants.

Conclusion:

These findings suggest that partial quarantine may be closely related to emotional eating and weight gain, and participants with higher BMI showed more emotional eating behaviours. Therefore, certain precautions should be considered beforehand in order not to cause long-term eating disorder problems.