Lifestyle habits of adults during the COVID-19 pandemic lockdown in Cyprus: evidence from a cross-sectional study

Longitudinal changes in Mediterranean diet adherence and perceived benefits and barriers to its consumption in US university students

Objective

The Dietary Guidelines for Americans has recommended consumption of a Mediterranean diet (MD) for overall health and wellbeing, and the US News & World Report has ranked the MD as the top diet overall for the past six consecutive years. However, it is uncertain if university students in the United States (US) have increased their adoption of this dietary approach over these past six years.

Design

Longitudinal cross-sectional survey conducted in three cohorts (2018, 2020, 2022) utilizing regression models to assess MD Adherence and other relevant outcomes variables.

Setting

University in the southern US.

Participants

Students (n = 761) enrolled in undergraduate introductory nutrition course.

Results

Survey respondents were 83% female, 91% white, and 97% ages 18-24. Predictors of MD adherence were older age, female gender, and health-related qualifications. MD adherence was lowest in 2022. The 2022 group perceived less MD health benefits, weight loss, ethical concerns, natural content, and sensory appeal compared to the 2018 group. During the COVID-19 pandemic, changes in eating behavior were examined in the 2020 and 2022 groups. We observed that participants in the 2022 group had a greater frequency of snacking and a lower frequency of eating out compared to 2020 group.

Conclusion

MD adherence did not increase over time in US university students. These findings underscore the need for targeted interventions and education to promote healthier eating habits in university students.

The impact of the COVID-19 pandemic on Mediterranean diet adherence: A narrative systematic review

BACKGROUND

The COVID-19 pandemic upended many aspects of daily life. For some individuals, this was an opportunity to re-evaluate their life and make better choices, while others were overwhelmed with stressors, leading to a deterioration in mental and physical health.

AIM

The aim of this narrative systematic review is to explore the effects of the COVID-19 pandemic on Mediterranean diet adherence.

METHODS

A systematic literature search was carried out on PubMed, Scopus and Web of Science electronic databases utilising the search terms 'Mediterranean diet' AND 'COVID-19'. This yielded 73 articles that fulfilled the inclusion criteria.

RESULTS

The data suggests that a substantial proportion of individuals adhered less to the Mediterranean diet during the COVID-19 lockdown period. However, individuals receiving some form of lifestyle intervention had better adherence to the Mediterranean diet than their unassisted counterparts.

CONCLUSION

This emphasises the importance of professional support during times of crisis to avoid deterioration of a population's health.

A cross-sectional study on adult lifestyle habits during the COVID-19 pandemic

COVID-19 has spread and developed into a pandemic disease, forcing countries to impose challenging protocols and lockdowns. This study assessed shopping, food consumption behavior, and feelings in Jordan and several Arab countries during the COVID-19 pandemic. A cross-sectional web-based survey among the Middle East population was conducted using an online questionnaire between July and September 2022. Participants were requested to answer a standardized and validated structured questionnaire. Demographic information, shopping behavior information, and mental health data were requested. A total of 542 respondents were included in the study. During COVID-19 quarantine, participants (68.6%) reported decreased shopping frequency and buying more food than usual (37.5%). Cereals and legumes were the primary food types stored by participants (76.9%). Multiple logistic regression revealed the age of the participant as a significant factor affecting storing of food (being ≤ 25 years old (OR = 0.456, p value = 0.038)). 75.7% of female participants eat less frequently in restaurants than usual. In contrast, among males, 48.5% reported that they eat at restaurants less frequently than usual. The country of residency and gender were the significant factors affecting negative feelings and emotions. Participants in countries other than Jordan had a higher negative feeling score (Beta = 0.086, p value = 0.042). Furthermore, females had a higher negative feeling score (Beta = -0.128, p value = 0.003) as the negative feelings score for females was 3.58 (SD = 5.443). On the other hand, it was 2.10 (SD = 5.091) for males. The COVID-19 pandemic has altered Jordanians' attitudes, shopping, and food consumption habits. Although positive behaviors have improved, such as shopping less frequently, eating home-cooked meals, and dining with family, frequent snacking and food storage have increased. Finally, public awareness of shopping and food consumption habits should be promoted.

Changes in Sleep Duration and Sleep Timing in the General Population from before to during the First COVID-19 Lockdown: A Systematic Review and Meta-Analysis

BACKGROUND

The COVID-19 lockdown had a profound effect on everyday life, including sleep health. This systematic review and meta-analysis evaluated changes in quantitative sleep parameters during the first lockdown compared with pre-lockdown in the general population.

METHODS

A search in scientific databases was performed to identify eligible observational studies from inception to 8 February 2023. We performed a random effects meta-analysis of those studies reporting (a) means of sleep duration, time in bed (TIB), and sleep timing (bedtime and wake-up time); (b) the percentages of atypical sleep duration before and during the lockdown; (c) the percentages of change in sleep duration and sleep timing.

RESULTS

A total of 154 studies were included. A small increase in sleep duration (0.25 standardized mean difference, 95% CI 0.180-0.315) was found, with 55.0% of the individuals reporting changes, predominantly an increase (35.2%). The pooled relative risk for sleeping more than 8/9 h per night was 3.31 (95% IC 2.60-4.21). There was a moderately significant delay in sleep timing and a surge in napping.

CONCLUSION

An increase in sleep duration and napping, and delayed sleep timing were observed. High-quality studies should evaluate whether these parameters have now become chronic or have returned to pre-lockdown values.

Exploring the Relationship between Mediterranean Diet Adherence and Subjective Well-Being among Greek and Cypriot Adults

Associations between subjective well-being (SWB) and dietary habits, employment status, and habitual activities are increasingly capturing the focus of researchers as well as policymakers worldwide. This study aimed to explore these associations in a sample of the population in Greece and Cyprus via an online survey. In total, 936 questionnaires (470: Cyprus, 466: Greece) were analyzed to study the associations between the Mediterranean Diet (MD) (using the 14-item MEDAS score, (14-MEDAS)), subjective well-being (SWB), and several socioeconomic factors. Key remarks of this survey highlight the positive impact of MD adherence on some well-being items. Namely, statistically significant differences were found on the following items: Satisfied with life (p < 0.001), Life worthwhile (p < 0.001), Feeling happy (p < 0.001), worried (p = 0.005), and depressed (p = 0.001), when comparing Low MD adherence (14-MEDAS < 5) to High MD adherence (14-MEDAS > 10). Other lifestyle habits such as spending time with friends and family, spending time in nature, and habitual physical activity were associated with aspects of SWB such as Life satisfaction, Life worthwhile, Feeling happy, and energetic. The findings support adherence to the MD, since it is associated with higher life satisfaction and self-reported happiness in this sample and should be considered when developing health policies on well-being.

Greek adaptation of the Teruel Orthorexia Scale (TOS) in adults from the Republic of Cyprus: A bidimensional model may not be universal

The Teruel Orthorexia Scale (TOS) is a 17-item instrument designed to assess distinct facets of Orthorexia Nervosa (ON) and Healthy Orthorexia (HO). While a bidimensional model of TOS scores has been supported in diverse national and linguistic groups, the psychometric properties of the TOS have not been previously assessed in Greek-speaking populations. To rectify this, we assessed the psychometric properties of a novel Greek translation of the TOS in a sample of adults from Cyprus. A total of 1248 respondents (710 women, 538 men) completed the Greek TOS, as well as previously validated measures of perfectionism, obsessive-compulsive symptomatology, eating restriction, negative affect, and appearance evaluation. Our results showed that a bidimensional model of the TOS had less-than-adequate fit when modelled using both confirmatory factor analysis and exploratory structural equation modeling (ESEM). Conversely, both exploratory factor analysis and ESEM supported extraction of a 3-factor model consisting of a HO facet and separate components of emotional orthorexia and cognitive-social orthorexia. This 3-factor model showed a lack of measurement bias (measurement invariance across gender identity and lack of differential item functioning as function of age and body mass index), but there were differences in latent factor means as function of respondent age and body mass index. The 3-factor model showed adequate evidence of construct validity, with the latent emotional orthorexia and cognitive-social orthorexia facets showing significant and moderate associations with the additional constructs measured in the survey. Broadly speaking, these findings support the psychometric properties of a 3-factor model of the Greek TOS, but also suggest that the bidimensional model of the TOS may not have universal applicability. We encourage further assessments of factorial validity in other national and linguistic contexts.

Factors influencing coping skills of middle-aged adults in COVID-19, South Korea

Background

In light of the persistent COVID-19 pandemic, there is a compelling imperative to enhance the COVID-19 coping capacity among middle-aged adults within the South Korean population. Consequently, there is a need for further research endeavors in this area.

Objective

This study aims to explore and identify the factors influencing the coping skills of middle-aged adults in COVID-19, South Korea.

Methods

This study used a cross-sectional descriptive design. Participants were 147 middle-aged adults living in Seoul, Geounggi-do, and Chungchung-do in South Korea. Data included demographics, coping skills, the impact of the event, perceived health status, psychological wellbeing, and family support. The data were analyzed using the SPSS Statistics 25.0 program. Data were collected from March to July 2020.

Results

The regression model was significant (F = 13.56, p < 0.001), and the adjusted R-squared representing the explanatory power of the model was 0.63. The strongest predictor was perceived health status (β = 0.34), followed by family support (β = 0.31), impact of event (β = -0.24), underlying disease (β = -0.13), and economic status (β = 0.11).

Conclusion

This study suggests that to improve the coping skills of middle-aged adults with COVID-19, their perceived health status and family support should be strengthened, and the impact of the event should be decreased. Also, it needs that underlying diseases are managed and economic status is improved. Nurses need to pay more attention to the influencing factors to improve the coping skills of middle-aged adults in COVID-19, South Korea.

Mediterranean Diet and Sleep Features: A Systematic Review of Current Evidence

The prevalence of sleep disorders, characterized by issues with quality, timing, and sleep duration is increasing globally. Among modifiable risk factors, diet quality has been suggested to influence sleep features. The Mediterranean diet is considered a landmark dietary pattern in terms of quality and effects on human health. However, dietary habits characterized by this cultural heritage should also be considered in the context of overall lifestyle behaviors, including sleep habits. This study aimed to systematically revise the literature relating to adherence to the Mediterranean diet and sleep features in observational studies. The systematic review comprised 23 reports describing the relation between adherence to the Mediterranean diet and different sleep features, including sleep quality, sleep duration, daytime sleepiness, and insomnia symptoms. The majority of the included studies were conducted in the Mediterranean basin and reported a significant association between a higher adherence to the Mediterranean diet and a lower likelihood of having poor sleep quality, inadequate sleep duration, excessive daytime sleepiness or symptoms of insomnia. Interestingly, additional studies conducted outside the Mediterranean basin showed a relationship between the adoption of a Mediterranean-type diet and sleep quality, suggesting that biological mechanisms sustaining such an association may exist. In conclusion, current evidence suggests a relationship between adhering to the Mediterranean diet and overall sleep quality and different sleep parameters. The plausible bidirectional association should be further investigated to understand whether the promotion of a healthy diet could be used as a tool to improve sleep quality.

Beyond the Books: COVID-19's Influence on Future Life Behaviors of Aspiring Medical and Health Professionals

BACKGROUND

The lifestyle of most people was forced to change due to the COVID-19 pandemic. Perhaps after the pandemic, we will find that these subtle changes in life and from the depths of our hearts are thorough and profound. They may form our conceptual consensus and behavioral habits, becoming part of our long-term personal consciousness. This study explored the impacts of the COVID-19 pandemic on the future life behavior intentions of medical and health-related students studying at universities in China.

METHODS

Electronic questionnaires were distributed to students studying at 3 universities in China. A total of 251 valid questionnaires were obtained, and the chi-squared test was used to compare the corresponding groups.

RESULTS

In the future, students plan to pay more attention to wearing masks and maintaining social distance in public places, do more online shopping, have more meals at home or in the canteen, engage in less international travel, and have fewer gatherings with friends. However, compared with Chinese students, more non-Chinese students plan to increase domestic and international travel and reduce online learning. Furthermore, only among non-Chinese students did gender, urban or rural origin, and family economic conditions influence how the COVID-19 pandemic affected their future life behaviors.

CONCLUSION

The COVID-19 pandemic changed the future life behavior intentions of medical and health-related students. The future behaviors of these students will impact the entire society. This study will help the government and policymakers predict and prepare for general lifestyle changes in our society.

Impact of COVID-19 lockdown on smoking and vaping: systematic review and meta-analysis

OBJECTIVES

COVID-19 and the implementation of lockdowns have impacted daily lives worldwide. This systematic review and meta-analysis aimed to investigate the impact of lockdowns on the smoking and vaping behaviours of adults during the pandemic.

STUDY DESIGN

This was a systematic review and meta-analysis.

METHODS

A systematic literature search was conducted up to 28 April 2022 in the following databases: PubMed, Embase and Web of Science.

RESULTS

In total, 77 studies met the inclusion criteria for this review. In 34 studies, an increase in smoking behaviour was reported for the majority of participants; however, in 21 and 18 studies, 'no change' and 'decrease' in smoking were the predominant responses, respectively. The results from the meta-analysis, which examined the change in the number of cigarettes smoked per day, showed no difference between the pre- and post-lockdown periods: 0.81 weighted mean difference (95% confidence interval, -0.59 to 2.21). Regarding vaping, three of seven studies reported an increase in smoking for the majority of participants, whereas 'no change' and 'decrease' were the predominant answers in the other four studies.

CONCLUSIONS

The results show that lockdowns led most participants to increase smoking/vaping, whereas a decrease or cessation of smoking/vaping was only reported in the minority of participants. Attention should be given to the non-communicable diseases that could arise as a result of the increase in smoking/vaping during lockdowns, and further research in this area is needed.

Effects of COVID-19 Pandemic on Metabolic Status and Psychological Correlates of a Cohort of Italian NAFLD Outpatients

Non-alcoholic fatty liver disease (NAFLD) is a potentially progressive condition characterized by the presence of fat in more than 5% of hepatocytes, representing the hepatic expression of metabolic syndrome (MetS). A reduction of at least 5–7% in initial body weight improves the metabolic profile underlying NAFLD. The aim of our study was to evaluate the effects of the COVID-19 lockdown on a cohort of non-advanced NAFLD Italian outpatients. We identified 43 patients with 3 available time point visits in our center: first visit (T0) when behavioral indications aimed at controlling MetS were provided, a pre-COVID visit (T1) and a post-COVID visit (T2). During the lockdown, an online compilation of validated psychological tests (SRQ-20, EQ5D, SF-12 and STAI) and a specifically formulated questionnaire for NAFLD was presented to our cohort and completed by 14 consenting patients. Patients who had lost more than 5% of the initial weight at T1 (9 subjects, 21%) maintained the results even at T2, with an overall reduction in BMI and liver stiffness; patients who had not lost the desired weight at T1 (34 subjects, 79%) displayed a further increase in BMI and visceral adiposity at T2. Of interest is that patients in the latter group reported signs of psychological suffering. Our data demonstrated that the setting of good counseling was effective in controlling the metabolic disorder underlying NAFLD in our cohort of outpatients. Given the need for patients to play an active role in the behavioral therapy for NAFLD, we advocate that a multidisciplinary approach be adopted, including a psychological support to obtain the best results over time.

Psychometric properties of a Greek translation of the Functionality Appreciation Scale (FAS) in adults from the Republic of Cyprus

The Functionality Appreciation Scale is a widely used instrument for the measurement of an individual's appreciation of their body for what it can do and is capable of doing (i.e., functionality appreciation). In the present study, we examined the psychometric properties of a novel Greek translation of the FAS in Cypriot adults. A total of 448 women and 345 men from the Republic of Cyprus completed the FAS, as well as validated measures of body appreciation, appearance evaluation, and symptoms of disordered eating, and self-esteem. Exploratory and confirmatory factor analyses supported a unidimensional model of FAS scores, with all 7 items retained. Scores achieved scalar invariance across gender, with the gender difference in FAS scores not reaching significance. FAS scores were also found to have adequate composite reliability and convergent (significant associations with body appreciation, appearance evaluation, and symptoms of disordered eating) and concurrent validity (significant associations with self-esteem). Finally, functionality appreciation predicted self-esteem once the effects of all other variables had been accounted for, supporting incremental validity. Overall, these results suggest that the Greek FAS is a psychometrically valid tool for the assessment of functionality appreciation in adults from Cyprus.

Relationship between Health Status and Daily Activities Based on Housing Type among Suburban Residents during COVID-19 Self-Isolation

COVID-19 significantly impacted residents' health status and daily activities in suburban residential areas. This study elucidated the relationship between health scores, daily activities, and housing types. The method was a questionnaire survey of 378 residents of suburban residential estates in Teraikedai, Kongo District, Japan, during the COVID-19 self-isolation period. Since the survey cohort was New Town, the suburban residential area identified by the Ministry of Land, Infrastructure, Transport and Tourism was targeted. The questions included participant demographics, the Basic Survey on Japanese Social Life, and the SF-12v2. The Tukey-Kramer HSD test and stepwise decreasing logistic regression were used for the statistical analysis of the responses. The COVID-19 self-isolation led to lower physical and mental health scores than usual, and the health scores of residents living in detached houses were better than those of residents in apartments, both those over the age of 65 and those under the age of 65. There was also a correlation between residents' daily activities and their health scores. For those aged under 65 years, the health scores of residents living in detached houses were significantly better than those living in apartments, indicating that daily activities such as sports and recreational hobbies may contribute to health scores.

Changes in sleep quality and sleep disturbances in the general population from before to during the COVID-19 lockdown: A systematic review and meta-analysis

Introduction

This systematic review and meta-analysis aims to explore changes in sleep quality and sleep disturbances in the general population from before to during the COVID-19 lockdown.

Methods

The protocol was registered in PROSPERO (CRD42021256378) and the PRISMA guidelines were followed. The major databases and gray literature were systematically searched from inception to 28/05/2021 to identify observational studies evaluating sleep changes in the general population during the lockdown with respect to the pre-lockdown period. A random effects meta-analysis was undertaken for studies reporting (a) the means of the Pittsburgh Sleep Quality Index (PSQI) global scores or the means of the sleep onset latency (SOL) times (minutes - min) before and during the lockdown, (b) the percentages of poor sleep quality before and during the lockdown, or (c) the percentages of changes in sleep quality. Subgroup analysis by risk of bias and measurement tool utilized was carried out. A narrative synthesis on sleep efficiency, sleep disturbances, insomnia and sleep medication consumption was also performed.

Results

Sixty-three studies were included. A decline in sleep quality, reflected in a pooled increase in the PSQI global scores (standardized mean difference (SMD) = 0.26; 95% CI 0.17-0.34) and in SOL (SMD = 0.38 min; 95% CI 0.30-0.45) were found. The percentage of individuals with poor sleep quality increased during the lockdown (pooled relative risk 1.4; 95% CI 1.24-1.61). Moreover, 57.3% (95% CI 50.01-61.55) of the individuals reported a change in sleep quality; in 37.3% (95% CI 34.27-40.39) of these, it was a worsening. The studies included in the systematic review reported a decrease in sleep efficiency and an increase in sleep disturbances, insomnia, and in sleep medication consumption.

Discussion

Timely interventions are warranted in view of the decline in sleep quality and the increase in sleep disturbances uncovered and their potentially negative impact on health. Further research and in particular longitudinal studies using validated instruments examining the long-term impact of the lockdown on sleep variables is needed.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021256378, identifier CRD42021256378.

Psychometric properties of a Greek translation of the Intuitive Eating Scale-2 (IES-2) in adults from Cyprus

The construct of intuitive eating is commonly assessed using the 23-item, 4-factor Intuitive Eating Scale-2 (IES-2; Tylka & Kroon Van Diest, 2013). In this study, we assessed the psychometric properties of a novel Greek translation of the IES-2 in adults from Cyprus. In Study 1 (N = 626), an exploratory factor analysis indicated that the IES-2 should be conceptualized as consisting of six factors that showed complete invariance across women and men. Study 2 (N = 793), using exploratory structural equation modelling (ESEM) and beifactor analysis (B-ESEM), indicated that the 6-factor B-ESEM model had adequate fit and evidenced complete invariance across sex once the correlated uniqueness of negatively worded IES-2 items was accounted for. This final model evidenced adequate composite reliability, and a global G-factor evidenced adequate convergent, concurrent, and discriminant validity. In contrast, the IES-2 S-factors showed more equivocal patterns of validity, with some S-factors showing less-than-adequate associations with body image variables, self-esteem, symptoms of disordered eating, and fruit and vegetable intake. In general, these results provide satisfactory evidence of the psychometric properties of the Greek IES-2 in adults from Cyprus, but also suggest that models of IES-2 scores may vary across national or cultural contexts.

Impact of the COVID-19 lockdown on lifestyle behaviors and their association with personality among adults in Qatar: A cross-sectional study

The coronavirus pandemic (COVID-19) resulted in lockdowns and social distancing measures enforced by governments around the world. This study aimed to identify changes in adherence to the Mediterranean diet (MD) and physical activity (PA) and associations with personality during lockdown. Using a cross-sectional design, a convenient sample of 543 adults in Qatar completed an online questionnaire consisting of validated tools to measure adherence to MD (MEDAS questionnaire, score ranges 0–13), PA (IPAQ, assessing light, moderate high intensity PA) and personality (BFI-10, categorizing individuals’ personalities). The majority of the participants were female (89%), aged between 21 and 29 years (45%). The overall MD adherence decreased during lockdown (5.9 vs. 6.1, p < 0.001). There was an increase in olive oil (9% vs. 12%; p < 0.001), vegetables (54.3% vs. 58.7%; p = 0.005), legumes (11.8% vs. 15.3%; p = 0.007), sofrito (70.9% vs. 77.3%; p < 0.001) and fat (45.9% vs. 53.8%; p < 0.001) consumption and a decrease in fresh fruit (39.4% vs. 15.8%; p < 0.001) and fish/seafood (5.9% vs. 3.9%; p = 0.0035) consumption during lockdown. Met-min/week values of total PA (1330.5 vs. 1836.7), vigorous activity (711.5 vs. 867.4), moderate activity (208.3 vs. 301.3), and walking (410.7 vs. 668.0) all decreased during lockdown (p < 0.001, p = 0.010, p = 0.010 p < 0.001, respectively), while sitting increased (3837.3 vs. 2896.4 p < 0.001). The extraversion personality dimension had a higher MD adherence (p = 0.039) compared to agreeableness before lockdown. No changes in MEDAS scores were observed during lockdown in those with high levels of openness. Openness was positively associated with all PA (p = 0.027), including walking (p = 0.026), and negatively associated with sitting (p = 0.038) before lockdown, while participants with high scores for neuroticism were less likely to be sitting during lockdown (p = 0.042). The findings can be used to guide the development of appropriate personality-tailored lifestyle interventions.

COVID-19-related anxiety and lifestyle changes

This study aimed to identify factors that affect lifestyle changes and focused on coronavirus disease (COVID-19)-related anxiety since the COVID-19 outbreak in South Korea. Data from 213,848 individuals from the 2020 Korean Community Health Survey were analyzed using a complex sampling design. Descriptive statistics, t-tests, one-way ANOVA, and multiple regression analyses were performed. Participants reported a high level of COVID-19-related anxiety, with a score of 19.28 out of 25. The score of healthy behavioral change index was -0.51, indicating negative changes in physical activity, dietary habits, and sleep patterns. A slight positive change was reported for addictive behavioral change index, such as smoking and alcohol consumption, at 0.27 scores, indicating a decrease in these behaviors. COVID-19-related anxiety was an important factor that negatively affected health behavior. The high-risk groups that were vulnerable to anxiety included older adults and those who have little social support or few social encounters. Thus, identifying high-risk groups with the potential for worsened health behavior and providing interventions to reduce the anxiety caused by COVID-19 are necessary.

Multiple health-related behaviours among Fly-In Fly-Out workers in the mining industry in Australia: A cross-sectional survey during the COVID-19 pandemic

BACKGROUND

Fly-In-Fly-Out (FIFO) workers travel to work at isolated locations, and rotate continuous workdays with leave periods at home, and such work practice is common in the offshore oil and gas and onshore mining industry worldwide. The COVID-19 pandemic and accompanying public health actions appear to have had a negative impact on several health-related behaviours among the general population. However, little is known about the impact of the COVID-19 pandemic on the health behaviours of FIFO workers, who have shown higher pre-pandemic rates of risky behaviours than the general population in Australia. This study examined the health-related behaviours of FIFO workers in the mining industry during the COVID-19 pandemic.

METHODS

A descriptive cross-sectional study was conducted. FIFO workers from an Australian mining company who underwent COVID-19 screening between May and November 2020 completed an online survey about their regular health-related behaviours. The independent sample t-test and Pearson's chi-square test where appropriate were conducted to examine the differences between males and females for the behavioural outcomes.

RESULTS

A total of 768 FIFO workers (633 males and 135 females) participated in the study. Prevalence of smoking was high (32%). Males smoked more cigarettes per day than females (15.2±7.0 vs 13.1±7.1, p = .174). Most participants (74.7%) drank alcohol on more than two days per week. Compared to females, more males (20.2% vs 8.0%) consumed alcohol at short-term harmful levels (p = .010). About a third (34.4%) of the workers (33.5% of males and 38.5% of females, p = .264) engaged in inadequate moderate-vigorous exercises/physical activity. About a third (33.1%) of workers (33.7% of males and 30.4% of females; p = .699) had multiple risk behaviours.

CONCLUSIONS

Prevalence of multiple risk behaviours was high. Interventions aimed at the prevention of risky health-related behaviours should target the different behavioural patterns and may require emphasis on gender-informed techniques particularly when addressing alcohol consumption.

Evaluation of Health Promoting Lifestyle Habits During Pandemic Period: A cross-sectional study

Objective: The COVID-19 pandemic imposed lifestyle changes. The aim of this study was to evaluate the health-promoting lifestyle habits of individuals who applied to a primary care center during the pandemic period. Methods: This descriptive and cross-sectional study was conducted with the voluntary participation of 524 individuals. The data was collected through a research questionnaire form and the Health Promoting Lifestyle Scale (HPLS). Results: Women accounted for 58.2% (n=305) of all participants, 45.2% of them (n=237) had chronic disease and 32.1% (n=168) were smoking. Mean age was 41.26±14.28 (min:18, max:75) years old. Among these participants, %53.2 had equal income to their expenses (n=279), 52.3% experienced sleep pattern changes (n=274), 35.7% had COVID-19 disease and 66.6% vaccinated for COVID-19. The mean HPLS score was 162.75±8.10 points. Interpersonal relationships, stress management and total HPLS scores were higher in women (p

COVID-Inconfidentes: how did COVID-19 and work from home influence the prevalence of leisure-time physical inactivity? An analysis of before and during the pandemic

BACKGROUND

The COVID-19 pandemic has brought drastic changes to the lives of the global population. The restrictions imposed by government agencies impacted the daily lives of citizens, influencing several health behaviors, such as physical activity (PA). Thus, the present study aimed to assess the prevalence of physical inactivity (PI) and its associated factors before and during the COVID-19 pandemic.

METHODS

A population-based household seroepidemiological survey was conducted in two Brazilian municipalities located in the state of Minas Gerais, in which 1750 volunteers were interviewed between October and December 2020. Face-to-face interviews were conducted using a structured questionnaire in an electronic format. The moments considered for the PI analysis were M0 (before the pandemic), M1 (from March to July 2020), and M2 (from October to December 2020). Descriptive statistics and univariate and multivariate logistic regression were used to examine the factors associated with PI before (M0) and during the pandemic (M1 and M2).

RESULTS

The prevalence of PI was higher in the first months of the pandemic (M1) (67.3%; 95% confidence interval (CI): 62.4-71.9) than in the months from October to December 2020 (M2) (58.7%; 95% CI: 52.8-64.3); however, at both times (M1 and M2), PI was more prevalent than in the period before the pandemic started (M0) (39.7%; 95% CI: 35.6-43.8). Individuals who were overweight, obese, and had low educational levels were more likely to be physically inactive. At both M1 and M2, individuals who worked at a work from home were less likely to have PI.

CONCLUSIONS

The results suggest that the COVID-19 pandemic negatively influenced PA, substantially increasing the prevalence of PI. The determinants associated with PI were education, body mass index, and work from home.

COVID-19 Lockdown Effects on Mood, Alcohol Consumption, Academic Functioning, and Perceived Immune Fitness: Data from Young Adults in Germany

Recently, a study was conducted in the Netherlands to evaluate the impact of the coronavirus disease (COVID-19) pandemic and its associated lockdown periods on academic functioning, mood, and health correlates, such as alcohol consumption. The Dutch study revealed that lockdowns were associated with significantly poorer mood and reductions in perceived immune fitness. Overall, a reduction in alcohol consumption during lockdown periods was shown. Academic functioning in terms of self-reported performance was unaffected. However, a significant reduction in interactions with other students and teachers was reported. However, there was considerable variability among students; both increases and reductions in alcohol consumption were reported, as well as both improvements and poorer academic functioning during periods of lockdown. The aim of the current online study was to replicate these findings in Germany. To achieve this, a slightly modified version of the survey was administered among young adults (aged 18 to 35 years old) in Germany. The survey assessed possible changes in self-reported academic functioning, mood, and health correlates, such as smoking and alcohol consumption, perceived immune functioning, and sleep quality during periods of lockdown as compared to periods with no lockdowns. Retrospective assessments were made for five periods, including (1) ‘BP’ (the period before the COVID-19 pandemic), (2) ‘L1’ (the first lockdown period, March–May 2020), (3) ‘NL1’ (the first no-lockdown period, summer 2020), (4) ‘L2’ (the second lockdown, November 2020 to May 2021), and (5) ‘NL2’ (the second no-lockdown period, summer 2021). This article describes the content of the survey and the corresponding dataset. The survey was completed by 371 participants.

Tobacco product use and the risks of SARS-CoV-2 infection and COVID-19: current understanding and recommendations for future research

Heterogeneity in the clinical presentation of SARS-CoV-2 infection and COVID-19 progression underscores the urgent need to identify individual-level susceptibility factors that affect infection vulnerability and disease severity. Tobacco product use is a potential susceptibility factor. In this Personal View, we provide an overview of the findings of peer-reviewed, published studies relating tobacco product use to SARS-CoV-2 infection and COVID-19 outcomes, with most studies focusing on cigarette smoking in adults. Findings pertaining to the effects of tobacco product use on the incidence of SARS-CoV-2 infection are inconsistent. However, evidence supports a role for cigarette smoking in increasing the risk of poor COVID-19 outcomes, including hospital admission, progression in disease severity, and COVID-19-related mortality. We discuss the potential effects of tobacco use behaviour on SARS-CoV-2 transmission and infection, and highlight the pathophysiological changes associated with cigarette smoking that could promote SARS-CoV-2 infection and increased disease severity. We consider the biological mechanisms by which nicotine and other tobacco product constituents might affect immune and inflammatory responses to SARS-CoV-2 infection. Finally, we identify current knowledge gaps and suggest priorities for research to address acute and post-acute health outcomes of COVID-19 during and after the pandemic.

The Impact of COVID-19 on Physical (In)Activity Behavior in 10 Arab Countries

Insufficient physical activity is considered a strong risk factor associated with non-communicable diseases. This study aimed to assess the impact of COVID-19 on physical (in)activity behavior in 10 Arab countries before and during the lockdown. A cross-sectional study using a validated online survey was launched originally in 38 different countries. The Eastern Mediterranean regional data related to the 10 Arabic countries that participated in the survey were selected for analysis in this study. A total of 12,433 participants were included in this analysis. The mean age of the participants was 30.3 (SD, 11.7) years. Descriptive and regression analyses were conducted to examine the associations between physical activity levels and the participants' sociodemographic characteristics, watching TV, screen time, and computer usage. Physical activity levels decreased significantly during the lockdown. Participants' country of origin, gender, and education were associated with physical activity before and during the lockdown (p < 0.050). Older age, watching TV, and using computers had a negative effect on physical activity before and during the lockdown (p < 0.050). Strategies to improve physical activity and minimize sedentary behavior should be implemented, as well as to reduce unhealthy levels of inactive time, especially during times of crisis. Further research on the influence of a lack of physical activity on overall health status, as well as on the COVID-19 disease effect is recommended.

Change of Dietary and Lifestyle Habits during and after the COVID-19 Lockdown in Cyprus: An Analysis of Two Observational Studies

Background: People’s dietary and lifestyle habits appeared to be influenced by restrictive measures imposed in response to the COVID-19 pandemic. This study examines the differences in dietary and lifestyle habits during and after the lockdown measures in Cyprus. Methods: Two online cross-sectional surveys were conducted, using a self-administered, anonymous questionnaire to collect information on sociodemographic and anthropometric characteristics, smoking habits, physical activity, and dietary habits. The first survey was conducted between 6 April 2020 and 20 June 2020 (during national lockdown) while the second survey was conducted between 27 October 2021 and 20 January 2022 (post-lockdown). Results: A total of 2503 individuals participated in the study. A higher consumption of fruits, vegetables, legumes/pulses, fish, and poultry was identified during lockdown compared to the period after the lockdown. Moreover, a greater daily intake of olive oil and a lower consumption of alcohol was found during the confinement period compared to the post-confinement period. During lockdown, most participants (43.0%) never or rarely used delivery services, while the largest proportion of the participants after lockdown used delivery services 1−3 times per month (37.0%) (p < 0.001). During lockdown, around 66% of the participants were physically active, compared to 55.5% after lockdown (p < 0.001). Furthermore, when compared to those with a normal BMI, more overweight and obese respondents ordered food 1−2 times per week in both periods (p < 0.001). Conclusions: Dietary and lifestyle habits of the participants were healthier throughout the lockdown period than after the end of the restrictive measures due to the COVID-19 pandemic. It is critical to encourage the Cypriot population to maintain the healthy dietary and lifestyle habits established during the lockdown in their daily lives after the confinement.

Health and health inequalities impact assessment for non-clinical measures to control COVID-19 in the Basque Country and Navarre (Spain)

This article describes the results of a health and health inequalities impact assessment of the COVID-19 pandemic control measures in the regions of the Basque Country and Navarre in Spain. A literature review was conducted on Pubmed and Web of Science (WoS) databases, in addition to individual semi-structured interviews and focus groups with experts, key informants and different profiles of citizens. A wide variety of social determinants of health have been affected by the measures, which included individual health-related behaviors, service disruption in formal care, educational settings, and health care provision. These changes have particularly affected certain population groups including children and adolescents, older people, those with health conditions and disabilities together with caregivers, women, as well as people with low levels of education, income, and resources. In future scenarios it will be necessary to pay attention to the potential impacts of policy responses on health inequalities to avoid an increase in existing health gaps.

The impact of COVID-19 pandemic on lifestyle among the Saudi population

Background

During COVID-19, major change occurred in the governmental regulations to combat the pandemic. Lifestyle factors are changeable habits and routine behaviors with an impact on physical and mental health. With the pandemic, sudden and radical changes occurred in the lifestyle of people worldwide. The main purpose of the study is to assess the impact of COVID-19 on lifestyle factors including (dietary habits, physical activity, sleeping patterns, smoking, and alcohol use) among the Saudi population.

Design and methods

This is a cross-sectional study on a convenient sample of adults residing in Saudi Arabia. An online survey was distributed via social media channels. Descriptive statistics were used to analyze the distribution of demographic variables using Chi-square χ2 tests for categorical variables and t-test for continuous variables. Bowker test, and McNemar's Test were performed to evaluate the effects of lockdown on lifestyle factors.

Results

A total of 1051 participants were included in the study. There was a slight decrease in the overall diet score during the pandemic (14.98%) compared to before the pandemic (15.05%) (p-value = 0.02), indicating poorer dietary intake during the lockdown. Approximately one-fourth of the participants (26.1%) reported following specific eating habits or a restricted diet during the pandemic (p-value = 0.0001). There was increased consumption of most components of dietary intake categories, during the lockdown. An increase in physical activities for three or more times was reported. A higher proportion of respondents reported sleeping nine or more hours a day during the lockdown (10.8%). Similarly, a higher percentage of individuals reported smoking daily during the lockdown (12.2%). As of overall health status, higher percentage of respondents reported poor health status during lockdown (6.1%).

Conclusion

This study revealed major changes in lifestyle factors, negative shifts were revealed in dietary habits and smoking patterns. Positive changes were shown in physical activity, drinking water, and sleeping patterns. Our findings suggest that COVID-19 played a major role in changing lifestyle factors among adults in Saudi Arabia. Healthcare providers and public health officials are encouraged to increase awareness of healthy lifestyle factors that strengthen the immune system to combat COVID-19. The Saudi population needs increased awareness programs about healthy lifestyles to be prepared during pandemics.

Correlation between stress and lifestyle in teachers at some schools in Lima, Peru, during telework in 2020

BACKGROUND: Stress and unhealthy lifestyle are serious problems in public health and education, particularly due to their significant relevance in the context of the COVID-19 pandemic. OBJECTIVES: To determine the correlation between stress and lifestyle in teachers at some schools in Lima, Peru, during telework in 2020. METHODS: This observational, quantitative, analytical, cross-sectional study was conducted in 217 school teachers from Lima. Lifestyle was measured using the FANTASTIC questionnaire; stress was measured using the Teaching Stress Scale (ED-6), comprised of the anxiety, depression, maladaptive beliefs, work pressure and poor coping dimensions. The Spearman correlation between numerical variables, and the difference of the FANTASTIC score according to the categorical variables, were analyzed with the Mann–Whitney U test or Kruskal–Wallis test, as necessary. Multivariable analysis was done with a multiple linear regression model to find raw and adjusted β (βa). RESULTS: The median of the ED-6 scale was 81 (RI: 64–105). Sixty-four percent of the teachers had a good-excellent lifestyle; 27.2%, regular; and 8.49%, bad-dangerous. The FANTASTIC score had an inverse correlation with ED-6 (βa: –0.16, 95%; CI: –0.20 to –0.12) adjusted for age and cohabitation with children. Likewise, teachers between 40 and 49 years old (βa: 2.89, 95%; CI: 0.17 to 5.62) had a better lifestyle; and teachers who lived with children (βa: –5.48, 95%; CI: –7.89 to –3.06), a worse lifestyle. CONCLUSIONS: As stress increased, the lifestyle quality worsened in teachers at some schools in Lima, Peru, during telework in 2020.

Impact of COVID-19 Pandemic on the Jordanian Eating and Nutritional Habits

Since the emergence of the COVID-19 pandemic, variable measures have been implemented to control the invasion of SARS-CoV-19 worldwide. Some of these measures included lockdowns for several months in some countries. In Jordan, various protocols have been implemented to deal with the epidemic, such as border closures, closures and local protocols for open days until we reach the partial opening in mid-2021. These measures and protocols have affected all sectors in the country, including the education system and the economy. In addition, lifestyle is one of the measurement issues that have been affected by government regulations during the COVID-19 pandemic. In this study, we aimed to investigate the impact of the COVID-19 pandemic on the eating and nutrition habits of the Jordanian population. An online sectional survey was built using Google Forms from Google. Responses were collected from November 12, 2020, through November 24, 2020. Researchers submitted a total of 2,511 responses. The results showed that there was a significant decrease in sugar intake (P = <0.005) with no critical fat and oil intake (P = 0.12). There was a significant change in daily consumption of fruits, vegetables, garlic, onions, and ginger, and downloads of health-related applications and supplements (P < 0.005). In addition, there was an increase in appetite, weight and number of daily meals. These changes are attributed to the extra free time due to lockdown and studying or working from home has significant impacts. However, 31.4% of respondents reported that the limited economic availability of food products and the closure of restaurants and cafes lead to a healthier lifestyle. Only 26.2% have been influenced by family members, friends, doctors, or social media to change their eating habits during the pandemic.

Lifestyle and Psychological Factors Affecting Eating Habits and Physical Activity Among Government Servants in the States With the Highest Cumulative Cases in Malaysia During the COVID-19 Pandemic

Introduction

Like many other countries, the federal government of Malaysia took the initiative to implement nationwide home confinement as a preventive measure in response to the pandemic COVID-19 outbreak, better known as Movement Control Order (MCO). Many have suffered economically, which led to poor states of well-being. This study investigates the relationship between lifestyle, psychological factors affecting eating habits, and physical activity among government servants in states with the highest cumulative cases during the COVID-19 pandemic.

Methods

A cross-sectional online survey was conducted among 210 government servants from four states (Selangor, Sabah, Kuala Lumpur, and Johor) from May 2021 to June 2021. Three validated questionnaires were used, namely, Emotional-Eater Questionnaire (EEQ), and Malay International Physical Activity Questionnaire (IPAQ-M) from López-Moreno et al. (1).

Results

There were significant gender differences (P &lt; 0.001) for supplement intake, with 30.4% among men and 62.3% in women. Almost half (49.1%) were classified as emotional or very emotional eaters. Also, a significant difference (P &lt; 0.005) was found in the perception of boredom and apathy between men (35.7%) and women (31.8%). A majority (56.2%) stated that their mood positively affected their eating habits. The total metabolic equivalent of task (MET) for 132 subjects was 3495.8 ± 3862.7 min/week for physical activity. Significant differences were observed between MET and gender (Mann–Whitney U-test: P = 0.019), with men showing higher MET value (5001.4 ± 5354.0 min/week men, 2864.3 ± 2754.3 min/week women). A significant difference was observed among women for body weight and body mass index (BMI) before and during MCO (P &lt; 0.001). For the emotional eater, there were correlations with eating habits before the MCO for quantity of food intake (P = 0.003), frequency of mealtime (P &lt; 0.001), changes of food habits (P = 0.005), cooking methods (P = 0.016), and frequency of food intake (P = 0.020). There is no correlation (P = 0.577) between psychological factors affecting eating habits and physical activity during COVID-19.

Conclusion

Changes were reported before and during MCO on lifestyle, eating habits, and physical activity. Such information will help design strategies to improve the economic and health status among government servants in Malaysia during the implementation of MCO or something similar.

Sleep disturbances during the COVID-19 pandemic: A systematic review, meta-analysis, and meta-regression

This systematic review and meta-analysis evaluated the extent of sleep disturbances during the COVID-19 pandemic. Eleven databases and six preprint repositories were searched for the period from November 1, 2019, to July 15, 2021. The DerSimonian and Laird method was used to develop random-effect meta-analyses. Two hundred and fifty studies comprising 493,475 participants from 49 countries were included. During COVID-19, the estimated global prevalence of sleep disturbances was 40.49% [37.56; 43.48%]. Bayesian meta-analysis revealed an odds of 0.68 [0.59; 0.77] which translates to a rate of approximately 41%. This provides reassurance that the estimated rate using classical meta-analysis is robust. Six major populations were identified; the estimated prevalence of sleep problem was 52.39% [41.69; 62.88%] among patients infected with COVID-19, 45.96% [36.90; 55.30%] among children and adolescents, 42.47% [37.95; 47.12%] among healthcare workers, 41.50% [32.98; 50.56%] among special populations with healthcare needs, 41.16% [28.76; 54.79%] among university students, and 36.73% [32.32; 41.38%] among the general population. Sleep disturbances were higher during lockdown compared to no lockdown, 42.49% versus 37.97%. Four in every ten individuals reported a sleep problem during the COVID-19 pandemic. Patients infected with the disease, children, and adolescents appeared to be the most affected groups.

The effect of COVID-19 pandemic on lifestyle-related behaviours in Turkey: A web-based cross-sectional study

Background

The COVID‐19 pandemic and restrictions imposed to eradicate it have affected healthy lifestyle‐related behaviours.

Aim

The aim of this study was to determine the effect of COVID‐19 on lifestyle‐related behaviours.

Methods

This cross‐sectional web‐based survey research was performed with a convenience sample of 1020 adults residing in Turkey. Data were collected with self‐report data collection tools on 8–28 April 2021: a sociodemographic characteristics form and the impact of COVID‐19 on lifestyle‐related behaviours questionnaire.

Results

Eating behaviours, physical activity and sleep patterns of the participants were negatively affected during COVID‐19 pandemic (p < 0.001). More than half of the participants experienced weight gain during the pandemic. Also, stress levels and smoking increased (p < 0.01). The participants reported having changes in their lifestyles most frequently due to the fear of COVID‐19 infection, stress, decreased motivation, closure of the facilities for social and sports activities and increased food prices. Predictors of lifestyle‐related behaviours were found to be education (β = .189), income (β = −.101), residing in a village (β = .113) and the presence of a chronic disease (β = .075) (p < 0.001).

Conclusions

During the pandemic, COVID‐19‐related restrictions should be applied whilst taking account of both social distancing measures and maintenance of healthy lifestyle‐related behaviours. Nurses should offer counselling for maintenance of healthy lifestyle‐related behaviours.

What is already known about this topic?

Studies performed at the beginning and during the course of COVID‐19 pandemic in different countries have shown that lifestyle‐related behaviours are negatively affected.

Few studies have used a valid and reliable tool to determine the effect of COVID‐19 on lifestyle‐related behaviours.

The effect of COVID‐19 on lifestyle‐related behaviours has not been examined from a nursing perspective.

What this paper adds?

In the present study, which was performed at a time when night curfews and weekend shutdowns were imposed in Turkey, lifestyles of the participants were found to be negatively affected.

More than half of the participants gained weight and had increased stress and smoking and a decreased sleep quality.

The negative effect on lifestyle‐related behaviours was more severe in participants with low education and income levels, living in a village and suffering from a chronic disease.

The implications of this paper:

Restrictions introduced during the pandemic should both take account of social distancing measures and allow healthy lifestyle‐related behaviours.

Nurses playing a role in first line health care services should offer education and counselling for maintenance of healthy lifestyle‐related behaviours by utilizing information and communication technology (e.g., video calls).

Adherence to the Mediterranean Diet and COVID-19: A Segmentation Analysis of Italian and US Consumers

The COVID-19 pandemic has led many countries to implement restrictions on individual freedom to stop the contagion. The imposition of lockdowns has affected many socio-economic aspects and, in particular, eating habits, highlighting the need to analyse the healthiness of new consumption patterns. The aim of our study was to investigate the changes in adherence to the Mediterranean diet, a dietary model universally recognized as healthy, that have occurred both during and since the lockdown. The subsequent profiling of consumers allowed us to understand which sociodemographic and psychographic factors favoured the development of more or less adherence to Mediterranean diet consumption patterns. The study was conducted by administering a questionnaire to a representative sample of Italians and New Yorkers. Both groups, defined by deep socio-economic differences and by their own eating habits compared to the Mediterranean diet model, were affected by similar lockdown measures. The data collected were processed by cluster analysis that allowed to identify four homogeneous groups with respect to the adherence to the Mediterranean diet model. The results highlight a worrying situation with respect to the impacts of the pandemic on maintaining a proper dietary style according to the principles of the Mediterranean diet. In fact, there has been a general worsening trend due to an increase in consumption, in part linked to emotional eating, which is a cause for concern about the potential future impacts on the health of consumers. The study highlights the need, therefore, to implement actions by public decision-makers aimed at raising the awareness of citizens on the issue of correct eating habits and at developing adequate food policies to stem the trend towards unhealthy diets.

Impact of Nationwide Lockdowns Resulting from the First Wave of the COVID-19 Pandemic on Food Intake, Eating Behaviors, and Diet Quality: A Systematic Review

The lockdowns resulting from the first wave of the coronavirus disease 2019 (COVID-19) pandemic impacted deeply on all life activities, including diet. We performed a systematic review to investigate changes in food intake, eating behaviors, and diet quality during lockdown as compared with before the lockdown. A literature search was performed using 3 electronic databases from inception until 13 June 2021. Observational studies evaluating changes in general populations during the COVID-19 pandemic lockdown were eligible. Of 1963 studies retrieved from the search strategy, 95 met inclusion criteria (85 in adults, 10 in children/adolescents), and the majority were of high quality (72.6%). Most of the studies were web-based surveys using convenience sampling, mainly focused on variations in the consumption of foods and eating behaviors during lockdown, whereas only 15 studies analyzed diet quality through dietary indices. On the basis of the definition of a healthful diet as reflected by a traditional Mediterranean diet, an increase in recommended foods such as fruit and vegetables, legumes, cereals, and olive oil was observed, although a sharp decrease in fish intake and an increase in dairy products were documented. Accordingly, a reduction in foods that should be eaten less frequently was reported-namely, red and processed meat. However, a higher consumption of unhealthy foods (e.g., snacks and sweets) was also observed. Results indicated improved diet quality in Europe, especially among Mediterranean countries, with the exception of France, while a switch to poor nutrient patterns was observed in Colombia and Saudi Arabia. Analyses of eating behaviors suggest an increase in food intake, number of daily meals, and snacking. In conclusion, changes in intake of major food groups, apart from fish intake, were in line with the definition of a traditional Mediterranean diet, indicating a consistent moderate improvement in dietary habits worldwide. This review protocol was registered at https://www.crd.york.ac.uk/prospero/ as CRD42020225292.

Changes in alcohol use during COVID-19 and associations with contextual and individual difference variables: A systematic review and meta-analysis

OBJECTIVE

The present study meta-analyzed studies examining changes in alcohol consumption during the coronavirus disease (COVID-19) pandemic and systematically reviewed contextual and individual difference factors related to these changes.

METHOD

Following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) protocol, studies were gathered via PsycINFO, PubMed/MEDLINE, and preprint databases (published April 29, 2021) that examined individual-level changes in consumption during the initial COVID-19 mitigation measures (before October 2020). Next, sample proportion increases and decreases in consumption, in addition to mean change in consumption variables from pre- to during-COVID, were meta-analyzed, and contextual and individual difference variables related to consumption changes during the pandemic were summarized.

RESULTS

One hundred and twenty-eight studies provided data from 58 countries (M n = 3,876; Mdn n = 1,092; aggregate sample n = 492,235). The average mean change in alcohol consumption was nonsignificant (Cohen's d = -0.01, p = .68); however, meta-analysis revealed that 23% of participants reported increases in consumption and 23% reported decreases. These changes were moderated by per capita gross domestic product and country. Narrative synthesis revealed multiple predictors of increased drinking, including contextual changes (e.g., children at home, income loss, working remotely), individual difference variables (being female, a young-to-middle aged adult, or Black), and mental health/alcohol-related risk factors (e.g., depression).

CONCLUSIONS

The identified factors associated with increased alcohol consumption should be considered in planning behavioral health services during future crisis events that abruptly alter everyday environments in ways that increase stress and decrease access to naturally occurring rewards. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Lifestyle Variations during and after the COVID-19 Pandemic: A Cross-Sectional Study of Diet, Physical Activities, and Weight Gain among the Jordanian Adult Population

The way that COVID-19 has been handled since its inception in 2019 has had a significant impact on lifestyle-related behaviors, such as physical activities, diet, and sleep patterns. This study measures lifestyle-related behavior during the COVID-19 pandemic lockdown using a 22-item questionnaire. The responses were collected from March 2021 to September 2021. A total of four hundred and sixty-seven Jordanian participants were engaged in assessing the changes caused by the pandemic and their effect on BMI. The validity and reliability of the questionnaire were tested for 71 participants. Cronbach's alpha values for the questionnaire exceeded 0.7, demonstrating good reliability and internal consistency. The effect of each question regarding physical activity and dietary habits over the BMI difference was studied using ANOVA. The study shows that more than half of the participants reported snacking more between meals and increased their sitting and screen time, while 74% felt more stressed and anxious. BMI difference among the individuals throughout the lockdown was significantly associated with these variables. In contrast, 62% of the participants showed more awareness about their health by increasing the intake of immunity-boosting foods, and 56% of the participants showed an increase in the consumption of nutrition supplements. Females and married individuals tended to be healthier. Therefore, their BMI showed stability compared to others based on their gender and marital status. Exercise, sleep, and avoiding 'junk' food, which contributes to weight gain and COVID-19 vulnerability, are strongly recommended.

Exploring the effects of COVID-19 restrictions on wellbeing across different styles of lockdown

Countries have instigated different restrictions in response to the COVID-19 pandemic. For instance, nationwide, strict "lockdown" in Scotland was enacted with breaches punishable by law, whereas restrictions in Japan allowed for travel and interaction, with citizens requested rather than required to conform. We explored the impact of these differential strategies on health behaviours and wellbeing. In February 2021, 138 Scottish and 139 Japanese participants reported their demographic information, pandemic-induced health behaviour-change (alcohol consumption, diet, perceived sleep quality, physical activity), negative mood, and perceived social isolation. Scottish participants' health behaviours were characterised by greater change (typically negative), most likely due to greater lifestyle disruption, whereas Japanese participants' behaviours were more-stable. Negative changes to health behaviours were typically associated with poorer mental wellbeing and isolation. Interestingly though, Japanese participants reported greater negative mood but not isolation despite the less-restrictive lockdown. Taken together, different lockdown styles led to different changes in health behaviours.

"Coronavirus Changed the Rules on Everything": Parent Perspectives on How the COVID-19 Pandemic Influenced Family Routines, Relationships and Technology Use in Families with Infants

This study explores how the first wave of the COVID-19 pandemic influenced family routines, relationships and technology use (smartphones and tablet computers) among families with infants. Infancy is known to be an important period for attachment security and future child development, and a time of being susceptible to changes within and outside of the family unit. A qualitative design using convenience sampling was employed. A total of 30 mothers in Perth, Western Australia participated in semi-structured interviews by audio or video call. All mothers were parents of infants aged 9 to 15 months old. Interviews were audio-recorded and transcribed, and data were analysed using thematic analysis to code and identify themes in an inductive manner. Families described staying home and stopping all external activities. Three themes relating to family interactions and wellbeing were found: enhanced family relationships; prompted reflection on family schedules; and increased parental stress. Two themes related to family device use were found: enabled connections to be maintained; and source of disrupted interactions within the family unit. Overall, participants described more advantages than downsides of device use during COVID-19. Findings will be of value in providing useful information for families, health professionals and government advisors for use during future pandemic-related restrictions.

Adherence to the Mediterranean Diet during the COVID-19 national lockdowns: a systematic review of observational studies

BACKGROUND AND AIM OF THE WORK

During the COVID-19 pandemic, many countries adopted restrictive measures to mitigate infection spread, which might have influenced people's lifestyle and dietary habits. We conducted a systematic review to evaluate the impact of national lockdowns on adherence to the Mediterranean Diet (MD).

METHODS

Studies were identified searching Medline, Embase, Web of Science, and the Cochrane Library. Studies published until 4th May 2021 were included. We only considered studies reporting original data from quantitative analysis and assessing changes in adherence to the MD, using validated dietary scores, or in consumption of MD food items. Data extraction, pooling, and quality appraisal of included studies were conducted following the PRISMA guidelines.

RESULTS

Forty-two studies were retrieved. After screening, 12 studies met inclusion criteria and were included in the review, of which 4 (33%) were longitudinal studies. Six (85.7%) of the seven studies that measured changes in MD adherence before-during lockdown reported an increase (rate of change of high-adherence to MD ranged between +3.3% and +21.9%). Evidence indicates that consumption of MD food items increased during lockdown but is heterogeneous in study design, quality, and findings.

CONCLUSIONS

Our results suggest adherence to the MD during lockdown might have increased in some settings, while the determinants of such a trend are to be further explored. We raise awareness of the need to research further the impacts and long-term consequences of COVID-19 containment measures on dietary and lifestyle habits.

Impact of Plant-Based Meat Alternatives on the Gut Microbiota of Consumers: A Real-World Study

Eating less meat is increasingly seen as a healthier, more ethical option. This is leading to growing numbers of flexitarian consumers looking for plant-based meat alternatives (PBMAs) to replace at least some of the animal meat they consume. Popular PBMA products amongst flexitarians, including plant-based mince, burgers, sausages and meatballs, are often perceived as low-quality, ultra-processed foods. However, we argue that the mere industrial processing of ingredients of plant origin does not make a PBMA product ultra-processed by default. To test our hypothesis, we conducted a randomised controlled trial to assess the changes to the gut microbiota of a group of 20 participants who replaced several meat-containing meals per week with meals cooked with PBMA products and compared these changes to those experienced by a size-matched control. Stool samples were subjected to 16S rRNA sequencing. The resulting raw data was analysed in a compositionality-aware manner, using a range of innovative bioinformatic methods. Noteworthy changes included an increase in butyrate metabolising potential-chiefly in the 4-aminobutyrate/succinate and glutarate pathways-and in the joint abundance of butyrate-producing taxa in the intervention group compared to control. We also observed a decrease in the Tenericutes phylum in the intervention group and an increase in the control group. Based on our findings, we concluded that the occasional replacement of animal meat with PBMA products seen in flexitarian dietary patterns can promote positive changes in the gut microbiome of consumers.

The Impact of a Culinary Coaching Telemedicine Program on Home Cooking and Emotional Well-Being during the COVID-19 Pandemic

The coronavirus pandemic enforced social restrictions with abrupt impacts on mental health and changes to health behaviors. From a randomized clinical trial, we assessed the impact of culinary education on home cooking practices, coping strategies and resiliency during the first wave of the COVID-19 pandemic (March/April 2020). Participants (n = 28) were aged 25–70 years with a BMI of 27.5–35 kg/m². The intervention consisted of 12 weekly 30-min one-on-one telemedicine culinary coaching sessions. Coping strategies were assessed through the Brief Coping with Problems Experienced Inventory, and resiliency using the Brief Resilient Coping Scale. Home cooking practices were assessed through qualitative analysis. The average use of self-care as a coping strategy by the intervention group was 6.14 (1.66), compared to the control with 4.64 (1.69); p = 0.03. While more intervention participants had high (n = 5) and medium (n = 8) resiliency compared to controls (n = 4, n = 6, respectively), this difference was not significant (p = 0.33). Intervention participants reported using home cooking skills such as meal planning and time saving techniques during the pandemic. The key findings were that culinary coaching via telemedicine may be an effective intervention for teaching home cooking skills and promoting the use of self-care as a coping strategy during times of stress, including the COVID-19 pandemic.

Multiplying effects of COVID-19 lockdown on metabolic risk and fatty liver

BACKGROUND

Social containment measures imposed in Europe during the lockdown to face COVID-19 pandemic can generate long-term potential threats for metabolic health.

METHODS

A cohort of 494 non-COVID-19 subjects living in 21 EU countries were interviewed by an anonymous questionnaire exploring anthropometric and lifestyle changes during 1-month lockdown. A subgroup of 41 overweight/obese Italian subjects with previously diagnosed nonalcoholic fatty liver (NAFLD) joined the study following a 12-month follow-up period promoting weight loss by healthy lifestyle.

RESULTS

During the lockdown, body weight increased in 55% of subjects (average 2.4 ± 0.9 kg). Weight change increased with age, but not baseline body mass index. Subjects living in Italy had greater weight gain than those living in other European Countries. Weight gain during the lockdown was highest in subjects reporting no physical activity, and low adherence to Mediterranean diet. In the NAFLD group, weight gain occurred in 70% of cases. Subjects reporting weight loss during lockdown had decreased fatty liver score at 3 months before the lockdown, as compared with 1 year before.

CONCLUSIONS

Strict measures of social containment-even short-term-pave the way to the increased risk of metabolic abnormalities in the medium-long term. In this context, adherence to Mediterranean diet and regular physical activity play a protective role both in terms of weight gain and fatty liver development/progression, with implication for primary and secondary prevention. When adopting measures imposing social containment, intensive educational campaigns must increase public awareness about beneficial effects of healthy lifestyles.

Increased physical inactivity and weight gain during the COVID-19 pandemic in Sri Lanka: An online cross-sectional survey

AIMS

This study aimed to investigate the immediate impact of COVID-19 quarantine measures on physical inactivity and weight gain among Sri Lankans.

METHODS

An online cross-sectional survey was conducted from the 27th of May to 2nd of June 2021 using Google forms. The questionnaire including socio-demographics and physical activity related questions was distributed through social media platforms.

RESULTS

A total of 3707 respondents were included in the analysis (59.6% females). The majority were employed, resided in Colombo district and, as a minimum, had a degree. More than half of the respondents (52.4%) reported decreased exercise levels, 63.5% increased sitting time and 82.7% increased screen time. Adults of 31-35 (OR 1.96; 95% CI,1.321-2.894, p < 0.001) and 36-40 (OR 1.67; 95% CI, 1.099-2.524, p < 0.016) had increased sitting times compared to other age groups. A weight gain was reported by 38.5% with a mean (SD) increase of 3.61 (±2.35) kg. There was a significant difference in weight gain between genders (p < 0.001) and ethnic groups (p < 0.001).

CONCLUSIONS

An overall increase in physical inactivity such as reduced exercises, increased sitting time and screen time were observed. Furthermore, a considerable proportion of the population has increased body weight.

Persistent Moderate-to-Weak Mediterranean Diet Adherence and Low Scoring for Plant-Based Foods across Several Southern European Countries: Are We Overlooking the Mediterranean Diet Recommendations?

The Mediterranean diet (MD) has been sponsored worldwide as a healthy and sustainable diet. Our aim was to update and compare MD adherence and food choices across several Southern European countries: Spain (SP), Portugal (PT), Italy (IT), Greece (GR), and Cyprus (CY) (MED, Mediterranean), and Bulgaria (BG) and the Republic of North Macedonia (NMK) (non-MED, non-Mediterranean). Participants (N = 3145, ≥18 y) completed a survey (MeDiWeB) with sociodemographic, anthropometric, and food questions (14-item Mediterranean Diet Adherence Screener, 14-MEDAS). The MED and non-MED populations showed moderate (7.08 ± 1.96) and weak (5.58 ± 1.82) MD adherence, respectively, with significant yet small differences across countries (SP > PT > GR > IT > CY > BG > NMK, p-value < 0.001). The MED participants scored higher than the non-MED ones for most of the Mediterranean-typical foods, with the greatest differences found for olive oil (OO) and white meat preference. In most countries, ≥70% of the participants reported quantities of red meat, butter, sweet drinks, and desserts below the recommended cutoff points, whereas <50% achieved the targets for plant-based foods, OO, fish, and wine. Being a woman and increasing age were associated with superior adherence (p-value < 0.001), but differences were rather small. Our results suggest that the campaigns carried out to support and reinforce the MD and to promote plant-based foods have limited success across Southern Europe, and that more hard-hitting strategies are needed.