Effect of the COVID-19-induced lockdown on nutrition, health and lifestyle patterns among adults in Zimbabwe

High uptake of menstrual health information, products and analgesics within an integrated sexual reproductive health service for young people in Zimbabwe

BACKGROUND

Despite being integral to women's well-being, achieving good menstrual health (MH) remains a challenge. This study examined MH services uptake (including information, analgesics, and a choice of MH products - the menstrual cup and reusable pads) and sustained use of MH products within an integrated sexual and reproductive health intervention for young people in Zimbabwe.

METHODS

This mixed-methods study was nested within a cluster randomised trial of integrated sexual and reproductive health services (CHIEDZA) for youth in three provinces (Harare, Mashonaland East, and Bulawayo). The study collected qualitative and quantitative data from 27,725 female clients aged 16-24 years, who accessed CHIEDZA from April 2019 - March 2022. Using a biometric (fingerprint recognition) identification system, known as SIMPRINTS, uptake of MH information, products, and analgesics and other services was tracked for each client. Descriptive statistics and logistic regression were used to investigate MH service uptake and product choice and use over time, and the factors associated with these outcomes. Thematic analysis of focus group discussions and interviews were used to further explore providers' and participants' experiences of the MH service and CHIEDZA intervention.

RESULTS

Overall, 36,991 clients accessed CHIEDZA of whom 27,725 (75%) were female. Almost all (n = 26,448; 95.4%) took up the MH service at least once: 25433 took up an MH product with the majority (23,346; 92.8%) choosing reusable pads. The uptake of cups varied across province with Bulawayo province having the highest uptake (13.4%). Clients aged 20-24 years old were more likely to choose cups than reusable pads compared with those aged 16-19 years (9.4% vs 6.0%; p < 0.001). Over the implementation period, 300/1819 (16.5%) of clients swapped from the menstrual cup to reusable pads and 83/23346 (0.4%) swapped from reusable pads to the menstrual cup. Provision of the MH service encouraged uptake of other important SRH services. Qualitative findings highlighted the provision of free integrated SRH and MH services that included a choice of MH products and analgesics in a youth-friendly environment were key to high uptake and overall female engagement with SRH services.

CONCLUSIONS

High uptake demonstrates how the MH service provided much needed access to MH products and information. Integration of MH within an SRH intervention proved central to young women accessing other SRH services.

COVID-19 and related social distancing measures induce significant metabolic complications without prominent weight gain in Korean adults

Background

This study using multi-center health examination data from Korean adults was conducted to confirm changes in weight, and their related cardiometabolic parameters, before and after strengthening of social distancing regulations.

Methods

A retrospective cohort study was conducted using health check-up data from 13 university hospitals. The study period was from January 2018 to July 2020. To examine the effect of systematic social distancing measures, participants who underwent a health check-up (Visit 3) between July 2020 and July 2021 (during full scale social distancing), and had undergone two previous health check-ups (Visits 1 and 2) between January 2018 and June 2020 (before social distancing), were selected. In total, data from 7,875 participants were analyzed. Linear mixed-effect models were used to calculate estimates of anthropometric indices and metabolic markers measured on Visits 2 and 3, compared with measurements from Visit 1.

Results

There were no significant differences in body weight, body mass index, waist circumference, and body composition on Visit 3 than on Visits 1 and 2. However, the odds of metabolic syndrome and its components, including hypertension, high glucose, diabetes, hypercholesterolemia, hypertriglyceridemia, hyper-non-high-density lipoprotein cholesterolemia, and dyslipidemia were significantly higher on Visit 3 than on Visits 1 and 2. The increase in metabolic complications was marked, particularly in relatively young adults who visited health check-up centers located in the capital area.

Conclusion

Metabolic syndrome and its components were significantly worse after high level social distancing, although there were no significant increases in anthropometric indices and body fat levels. Healthcare providers need to prevent and manage worsening of metabolic parameters in subpopulations prone to be more sedentary and eat unhealthy food during the COVID-19 pandemic and associated social distancing measures.

Weight change-related factors during the COVID-19 pandemic: a population-based cross-sectional study using social cognitive theory

Background

Published studies during the Coronavirus-19 (COVID-19) pandemic have focused on eating and exercise behaviors and failed to portray a comprehensive understanding of the factors associated with weight change in a setting of a behavioral change framework. This study explores factors associated with weight change during the COVID-19 pandemic among Lebanese residents using the Social Cognitive Theory (SCT) framework, integrating behavioral, environmental, and cognitive factors.

Materials & Methods

This study uses a cross-sectional design using an anonymous online survey. Participants were recruited from a tertiary hospital patient portal and social media posts. The survey included four domains: demographics, cognitive, behavioral, psychological, and environmental factors. Multiple validated self-reported instruments were included Generalized Anxiety Disorder-2 items (GAD-2), Patient Health Questionnaire-2 (PHQ-2), General Self Efficacy Scale (GSES), Alcohol Use Disorders Identification Test-Concise (AUDIT-C), and the dietary pattern evaluation tool.

Results

A sample of 335 complete responses was obtained. Mean age was 39.0 ± 13.4 years old. Participants were mostly females (n = 224, 66.9%), employed (n = 191, 57.4%), nonsmokers (n = 227, 70.5%), reporting depression (n = 224, 80.3%) and anxiety (n = 242, 84.3%). Mean weight change was -7.0 ± 6.0 kg in the decrease weight group and 6.4 ± 5.0 kg in the increase group. When compared to stable weight, the multinomial logistic model factors that were found to correlate significantly to weight gain were: overeating/binge eating (p-value = 0.001) and unbalanced food pattern (p-value = 0.012). Baseline BMI (p-value = 0.003), anxiety (p-value = 0.020) and smoking (p-value = 0.004) were significant factors of weight loss as compared to stable weight.

Conclusions

COVID-19-related weight change is multifactorial and is associated with specific behavior and individual characteristics. Hence, addressing people's behaviors and relationship to food is vital to control weight change during this continuing and future pandemic or natural occurrence.

Impact of Nutrition in the Management of Nutritional Status of Covid-19 Patients

Abstract:

The second outbreak of severe acute respiratory syndrome coronavirus (SARS-CoV-2) is of great concern due to its awful mortality and morbidity rate with decreasing nutritional status and poor lifestyle as well as noteworthy food crisis and affected economy of the world. Increasing food prices, food crisis, global hunger and decreasing availability and feasibility of food are the foremost causes of decreasing nutritional status, which increases the risk of susceptibility to infection and, in turn, leads to unfavorable outcomes of the diseases. Although, in times of the Covid- 19 pandemic, nutrition is of potential attention, and there is a requirement for more exploration in the field of nutrition for the prevention of diseases arising from coronavirus infection. Elderly and individuals with co-morbidity, such as respiratory diseases, cardiovascular diseases, diabetes mellitus and metabolic diseases, are more prone towards getting infected with the coronavirus. Good nutrition is mandatory for healthy immune responses, which can be improved by the inclusion of vitamin A, B6, B12, C, D, E, zinc, selenium, iron, copper and an antioxidant-rich diet.

Impact of COVID-19 and Nationwide Lockdowns on Vegetable Prices: Evidence from Wholesale Markets in China

In this paper, we employ a combination of time regression discontinuity design method (T-RD) and the difference-in-difference method (DID) to identify and quantify the causal effects of the strict lockdown policy on vegetable prices using multiple-year daily price data from 151 wholesale markets of Chinese cabbage. We find that the lockdown policy caused a large and immediate surge in price and price dispersion of Chinese cabbage, though they fluctuated smoothly for the same period in normal years. The DID results further show that the price surge peaked in the fourth week of lockdown but gradually came down to the level of a normal year by week 11. However, the price rose again (though to a much smaller extent) in response to the resurgence of COVID-19 in a few provinces in early-mid April but quickly returned to the normal level in week 15 when the lockdown measures were largely removed. We also find that the supply chain disruption is the driving factor for the price hike. Policy implications are drawn.

The Impact of Lockdown During the COVID-19 Outbreak on Dietary Habits in Various Population Groups: A Scoping Review

Background: Since the beginning of the COVID-19 pandemic, access to fresh food has been restricted, and people are spending more time inside and have limited their physical activity. However, more time at home may have resulted in some positive habits including an increase in cooking. The aim of this review was to assess dietary changes during the first lockdown. Themes and patterns were considered and associations with other lifestyle factors were assessed. Methods: Between June and July 2020, the PubMed, Google Scholar, and Science Direct databases were searched, and results were screened for eligibility based on title, abstract, and full text. The inclusion criteria of this search included: papers published (or in pre-print) in the year 2020; studies that investigated the impact of COVID-19 lockdown on diet; papers published in English. Exclusion criteria were as follows: papers examining dietary changes in those following a structured diet based on diagnosed conditions or dietetic advice; literature, systematic, or narrative studies reviewing previous research. Researchers agreed on the study characteristics for extraction from final papers. Results: Four thousand three hundred and twenty-two studies were originally considered with 23 final full-text papers included. Four themes were identified: dietary patterns, dietary habits (favorable), dietary habits (unfavorable), and other (includes physical activity levels, weight gain). A total of 10 studies reported an increase in the number of snacks consumed, while six studies found that participants increased their meal number and frequency during quarantine. Eleven studies reported favorable changes in dietary habits with an increase in fresh produce and home cooking and reductions in comfort food and alcohol consumption. However, nine studies found a reduction in fresh produce, with a further six reporting an increase in comfort foods including sweets, fried food, snack foods, and processed foods. Two studies reported an increase in alcohol consumption. In eight studies participants reported weight gain with seven studies reporting a reduction in physical exercise. Conclusion: The effect of COVID-19 lockdown both negatively and positively impacted dietary practices throughout Europe and globally, and negative diet habits were associated with other poor lifestyle outcomes including weight gain, mental health issues, and limited physical activity. Both in the short term and if sustained in the long term, these changes may have significant impacts on the health of the population.

COVID-19 pandemic's impact on eating habits in Saudi Arabia

Background: COVID-19 virus has been reported as a pandemic in March 2020 by the WHO. Having a balanced and healthy diet routine can help boost the immune system, which is essential in fighting viruses. Public Health officials enforced lockdown for residents resulting in dietary habits change to combat sudden changes. Design and Methods: A cross-sectional study was conducted through an online survey to describe the impact of the COVID-19 pandemic on the eating habits, quality and quantity of food intake among adults in Saudi Arabia. SPSS version 24 was used to analyze the data. Comparison between general dietary habits before and during COVID-19 for ordinal variables was performed by Wilcoxon Signed Rank test, while McNemar test was performed for nominal variables. The paired samples t-test was used to compare the total scores for food quality and quantity before and during COVID-19 periods. Results: 2706 adults residing in Riyadh completed the survey. The majority (85.6%) of the respondents reported eating homecooked meals on a daily basis during COVID-19 as compared to 35.6% before (p<0.001). The mean score for the quality of food intake was slightly higher (p=0.002) before the COVID-19 period (16.46±2.84) as compared to the during period (16.39±2.79). The quantity of food mean score was higher (p<0.001) during the COVID-19 period (15.70±2.66) as compared to the before period (14.62±2.71). Conclusion: Dietary habits have changed significantly during the COVID-19 pandemic among Riyadh residents. Although some good habits increased, the quality and the quantity of the food was compromised. Public Health officials must focus on increased awareness on healthy eating during pandemics to avoid negative consequences. Future research is recommended to better understand the change in dietary habits during pandemics using a detailed food frequency questionnaire.