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Farrugia F, Refalo D, Bonello D, Cuschieri S. The impact of the COVID-19 pandemic on Mediterranean diet adherence: A narrative systematic review. Nutr Health 2024; 30:215-233. [PMID: 37439029 PMCID: PMC10345400 DOI: 10.1177/02601060231187511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
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.
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Affiliation(s)
- Francesca Farrugia
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Daniel Refalo
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - David Bonello
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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2
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Keyes B, McCombe G, Broughan J, Frawley T, Guerandel A, Gulati G, Kelly BD, Osborne B, O'Connor K, Cullen W. Enhancing GP care of mental health disorders post-COVID-19: a scoping review of interventions and outcomes. Ir J Psychol Med 2023; 40:470-486. [PMID: 35545971 DOI: 10.1017/ipm.2022.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Considerable literature has examined the COVID-19 pandemic's negative mental health sequelae. It is recognised that most people experiencing mental health problems present to primary care and the development of interventions to support GPs in the care of patients with mental health problems is a priority. This review examines interventions to enhance GP care of mental health disorders, with a view to reviewing how mental health needs might be addressed in the post-COVID-19 era. METHODS Five electronic databases (PubMed, PsycINFO, Cochrane Library, Google Scholar and WHO 'Global Research on COVID-19') were searched from May - July 2021 for papers published in English following Arksey and O'Malley's six-stage scoping review process. RESULTS The initial search identified 148 articles and a total of 29 were included in the review. These studies adopted a range of methodologies, most commonly randomised control trials, qualitative interviews and surveys. Results from included studies were divided into themes: Interventions to improve identification of mental health disorders, Interventions to support GPs, Therapeutic interventions, Telemedicine Interventions and Barriers and Facilitators to Intervention Implementation. Outcome measures reported included the Seven-item Generalised Anxiety Disorder Scale (GAD-7), the Nine-item Patient Health Questionnaire (PHQ-9) and the 'The Patient Global Impression of Change Scale'. CONCLUSION With increasing recognition of the mental health sequelae of COVID-19, there is a lack of large scale trials researching the acceptability or effectiveness of general practice interventions. Furthermore there is a lack of research regarding possible biological interventions (psychiatric medications) for mental health problems arising from the pandemic.
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Affiliation(s)
| | | | | | - Timothy Frawley
- UCD School of Nursing, Midwifery and Health Systems, Dublin, Ireland
| | - Allys Guerandel
- UCD School of Medicine, Dublin, Ireland
- Department of Psychiatry and Mental Health Research, St. Vincent's University Hospital, Dublin, Ireland
| | - Gautam Gulati
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Brendan D Kelly
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Brian Osborne
- Irish College of General Practitioners, Dublin, Ireland
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Fleischer E, Landaeta-Díaz L, González-Medina G, Horovitz O. Anxiety, anhedonia, and related food consumption in Israelis populations:An online cross-sectional study two years since the outbreak of COVID-19. Heliyon 2023; 9:e17211. [PMID: 37332908 PMCID: PMC10266889 DOI: 10.1016/j.heliyon.2023.e17211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 06/03/2023] [Accepted: 06/09/2023] [Indexed: 06/20/2023] Open
Abstract
Background The COVID-19 pandemic has significantly impacted daily life. Beyond severe health and economic consequences, psychological consequences have surfaced that require in-depth research to understand the pandemic's effects on mental health. Aims: This study aimed to evaluate the association between anxiety levels and anhedonia with food consumption patterns and changes in body weight over the two years since the COVID-19 outbreak in Israel. Methods This cross-sectional study utilized non-randomized sampling through an online survey that included 741 study participants aged 18 to 94. participants were asked to complete the Beck's Anxiety Questionnaire, the Snaith-Hamilton Pleasure Scale for Anhedonia Measurement, the Mediterranean Nutrition Questionnaire, and self-reports of body weight and serving size changes. Results Those who reported severe anxiety and anhedonia reported the highest intake of fats, sugars, and carbohydrates and the highest weight gain (e.g., Butter and cream food: severe anxiety (M = 1.342, SEM = 0.217); low anxiety (M = 0.682, SEM = 0.042), Sweet pastries: severe anxiety (M = 4.078, SEM = 0.451); low anxiety (M = 3.175, SEM = 0.436)). Anhedonic participants consumed more sweetened beverages (M = 0.987, SEM = 0.013) than hedonic participants (M = 0.472, SEM = 0.231). Among participants that gained weight, severe anxiety participants consumed significantly more salty pastries (M = 2.263, SEM = 0.550) than those with low anxiety (M = 1.096, SEM = 0.107; p = .003). A significant interaction was found between weight, anxiety, and consuming salty pastries. High anxiety subjects and weight gain declared the highest intake of this food (p = .018); Significant interactions were found between those with severe anxiety and anhedonia, who reported the highest consumption of butter and cream (p = .005) and salty pastries (p = .021). Significant associations were found between weight and anhedonia and weight and anxiety levels (p = .000, p = .006 - respectively). Conclusions The outbreak of COVID-19 and its long-term presence strengthen the negative psychological aspects and increase the consumption of foods high in fat and sugar. Further attention to nutritional health is needed since crises may occur, and we must be prepared to prevent adverse consequences.
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Affiliation(s)
- E Fleischer
- The Physiology and Behavior Laboratory, Tel-Hai Academic College, 9977 North Districts, Israel
- Psychology Department, Tel-Hai Academic College, 9977 North Districts, Israel
| | - L Landaeta-Díaz
- Faculty of Health and Social Sciences, University of the Americas, Av. Walker Martínez 1360, piso 3, Edificio A, La Florida, Santiago, Chile
| | - G González-Medina
- Faculty of Medicine, Department of Public Health, Pontifical Catholic University of Chile, Av. Libertador Bernardo O'Higgins 340, Santiago, 8331150, Santiago, Chile
| | - O Horovitz
- The Physiology and Behavior Laboratory, Tel-Hai Academic College, 9977 North Districts, Israel
- Psychology Department, Tel-Hai Academic College, 9977 North Districts, Israel
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Van Laren A, Drießen M, Rasa S, Massar K, Ten Hoor GA. Nutritional changes during the COVID-19 pandemic: a rapid scoping review on the impact of psychological factors. Int J Food Sci Nutr 2023; 74:124-187. [PMID: 36823035 DOI: 10.1080/09637486.2023.2180613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
COVID-19 and the resulting measures to curb the spread of the virus have significantly changed our lives, including our nutritional choices. In this rapid scoping review an overview is provided of what psychological factors may be associated with peoples' eating behaviour during COVID-19 restrictions. Relevant literature was identified using PubMed, PsycInfo, CINAHL and MEDLINE databases from 2019 onwards. For included studies, information on study characteristics, eating behaviours, and psychological factors were extracted. 118 articles were included, representing 30 countries. Findings indicated that most people consumed more and unhealthy food in times of COVID-19 restrictions, while some consumed less but often for the wrong reasons. Several psychological factors, related to (1) affective reactions, (2) anxiety, fear and worriers, (3) stress and (4) subjective and mental wellbeing were found to be associated with this increase in food consumption. These outcomes may help to be better inform future interventions, and with that, to be better prepared in case of future lockdown scenarios.
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Affiliation(s)
- Anthea Van Laren
- Department Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Mona Drießen
- Department Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Sophia Rasa
- Department Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Karlijn Massar
- Department Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Gill A Ten Hoor
- Department Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
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Delgado-Floody P, Chirosa-Ríos L, Guzmán-Guzmán IP, Vargas CA, Sandoval-Aguilera K, Caamaño-Navarrete F, Guede-Rojas F, Alvarez C. The Social Distance Impacts from COVID-19 Pandemic on the Development of Two Orders of a Concurrent Training Programme for Morbidly Obese Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13408. [PMID: 36293985 PMCID: PMC9603355 DOI: 10.3390/ijerph192013408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Although there is relevant information regarding the consequences of the coronavirus SARS-CoV-2 (COVID-19), little is known about the impact of the imposed social confinement (at home) on the development of exercise training programmes in populations with morbid obesity. AIM To describe the effects of the imposed COVID-19 confinement on the cardiometabolic health benefits acquired through a concurrent training programme that started before the pandemic in populations with morbid obesity. METHODS This was an experimental randomized clinical study, in which sedentary morbidly obese women were assigned 1:1 to a high-intensity interval training (HIIT) plus resistance training (RT) group (HIIT + RT; n = 11; BMI 42.1 ± 6.6) or to the same exercise dose, but in different order group of RT plus HIIT group (RT + HIIT; n = 7; BMI 47.5 ± 8.4). Both groups undertook two sessions/week. When COVID-19 confinement at home started, a post-test was applied in January 2020 (Post1) and after 20 months (Post2). The main outcomes were waist circumference (WC), systolic (SBP) and diastolic blood pressure (DBP), high-density lipids (HDL-c), triglycerides (Tg), and fasting plasma glucose (FPG). RESULTS In the HIIT + RT group, the WC showed significant increases from Post1 to Post2 (Δ + 3.1 cm, p = 0.035); in the RT + HIIT group, it decreased from Post1 to Post2 (Δ - 4.8 cm, p = 0.028). In the HIIT + RT group, SBP showed significant increases from Post1 to Post2 (Δ + 6.2 mmHg, p = 0.041); the RT + HIIT group decreased SBP from Pre0 to Post1 (Δ - 7.2 mmHg, p = 0.026) and increased DBP from Pre0 to Post1 (Δ + 8.1 mmHg, p = 0.015). Tg in the HIIT + RT group decreased from Pre0 to Post1 (Δ - 40.1 mg/dL, p = 0.023) but increased from Post1 to Post2 (Δ + 86.3 mg/dL, p < 0.0001). CONCLUSIONS The COVID-19 social confinement worsened metabolic syndrome (MetS) outcomes that had improved from 20 weeks' RT + HIIT during the training period, such as WC, SBP, and Tg from HIIT + RT, when, worryingly, SBP increased to another more serious clinical classification in both groups.
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Affiliation(s)
- Pedro Delgado-Floody
- Department of Physical Education, Sport and Recreation, Universidad de La Frontera, Temuco 4811230, Chile
- Department Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain
- Strength & Conditioning Laboratory, CTS-642 Research Group, Department Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain
| | - Luis Chirosa-Ríos
- Department Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain
- Strength & Conditioning Laboratory, CTS-642 Research Group, Department Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain
| | - Iris Paola Guzmán-Guzmán
- Faculty of Chemical-Biological Sciences, Universidad Autónoma de Guerrero, Chilpancingo 39087, Mexico
| | - Claudia Andrea Vargas
- Department of Physical Education, Sport and Recreation, Universidad de La Frontera, Temuco 4811230, Chile
| | - Karina Sandoval-Aguilera
- Department of Physical Education, Sport and Recreation, Universidad de La Frontera, Temuco 4811230, Chile
| | | | - Francisco Guede-Rojas
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago de Chile 7591538, Chile
| | - Cristian Alvarez
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago de Chile 7591538, Chile
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Serur Y, Dikstein H, Shilton T, Gothelf D, Latzer Y, Lewis Y, Enoch-Levy A, Pessach I, Gur E, Stein D. The emotional-behavioral state of Israeli adolescent and young adult females with anorexia nervosa during the COVID19 pandemic. J Eat Disord 2022; 10:145. [PMID: 36209127 PMCID: PMC9547577 DOI: 10.1186/s40337-022-00668-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 09/30/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND During the COVID-19 pandemic in Israel, the number of patients with eating disorders (EDs) seeking treatment increased significantly. The present study sought to evaluate whether, during the pandemic (2020-21), patients with anorexia nervosa (AN) would show more ED-related, comorbid, and COVID-19-related symptoms in comparison to a naturalistic control group, and whether differences would be found between adult and adolescent patients with AN. We also examined attitudes to telemedicine use during the pandemic in patients receiving long-distance interventions. METHODS Using online self-report questionnaires, we assessed general and COVID-19-specific symptoms with a secure digital platform (REDCap®) in 36 female adolescents with AN, 35 female adults with AN, and 25 female controls. RESULTS Compared with controls, patients with AN showed more symptoms of EDs, anxiety, depression, and post-traumatic stress disorder (PTSD), elevated suicidal ideation, more COVID-related emotional-behavioral disturbances, and lower resilience. Adult patients with AN fared worse than adolescent patients on most of these measures. Adult patients using telemedicine during the COVID-19 pandemic showed fewer positive attitudes toward this treatment than adolescents (telemedicine was offered to all, but used by 18/35 adolescents and 21/36 adults with AN). Last, elevated COVID-19-related symptomatology was correlated with more symptoms of ED, anxiety, depression and PTSD, and with lower resilience. CONCLUSIONS Our findings suggest that the emotional-behavioral state of Israeli females with AN, particularly adults, was worse during the COVID-19 pandemic in comparison to controls. Many patients did not use telemedicine for their treatment. Adult patients using telemedicine were less satisfied with it than adolescent patients.
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Affiliation(s)
- Yaffa Serur
- Pediatric Psychosomatic Department, Sheba Medical Center, Safra Children's Hospital, Tel Hashomer, Israel.,Psychatric Division, Sheba Medical Center, Safra Children's Hospital, Tel Hashomer, Israel.,Sheba Medical Center, Safra Children's Hospital, Tel Hashomer, Israel
| | - Hadar Dikstein
- Pediatric Psychosomatic Department, Sheba Medical Center, Safra Children's Hospital, Tel Hashomer, Israel.,Psychatric Division, Sheba Medical Center, Safra Children's Hospital, Tel Hashomer, Israel.,Sheba Medical Center, Safra Children's Hospital, Tel Hashomer, Israel
| | - Tal Shilton
- Psychiatric Division, Psychiatric Department, Sheba Medical Center, Safra Children's Hospital, 5265601, Tel Hashomer, Israel.,Psychatric Division, Sheba Medical Center, Safra Children's Hospital, Tel Hashomer, Israel.,Sheba Medical Center, Safra Children's Hospital, Tel Hashomer, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Doron Gothelf
- Psychiatric Division, Psychiatric Department, Sheba Medical Center, Safra Children's Hospital, 5265601, Tel Hashomer, Israel.,Psychatric Division, Sheba Medical Center, Safra Children's Hospital, Tel Hashomer, Israel.,Sheba Medical Center, Safra Children's Hospital, Tel Hashomer, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Latzer
- Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.,Psychiatric Division, Eating Disorders Institution, Rambam Health Care Campus, Haifa, Israel
| | - Yael Lewis
- Shalvatah Mental Health Center, Hod Hasharon, Israel
| | - Adi Enoch-Levy
- Pediatric Psychosomatic Department, Sheba Medical Center, Safra Children's Hospital, Tel Hashomer, Israel.,Psychatric Division, Sheba Medical Center, Safra Children's Hospital, Tel Hashomer, Israel.,Sheba Medical Center, Safra Children's Hospital, Tel Hashomer, Israel
| | - Itai Pessach
- Sheba Medical Center, Safra Children's Hospital, Tel Hashomer, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eitan Gur
- Center for the Treatment of Eating Disorders and Obesity, Sheba Medical Center, Tel Hashomer, Israel
| | - Daniel Stein
- Pediatric Psychosomatic Department, Sheba Medical Center, Safra Children's Hospital, Tel Hashomer, Israel. .,Psychatric Division, Sheba Medical Center, Safra Children's Hospital, Tel Hashomer, Israel. .,Sheba Medical Center, Safra Children's Hospital, Tel Hashomer, Israel. .,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Impact of COVID-19 Lockdown on Non-Alcoholic Fatty Liver Disease and Insulin Resistance in Adults: A before and after Pandemic Lockdown Longitudinal Study. Nutrients 2022; 14:nu14142795. [PMID: 35889752 PMCID: PMC9319232 DOI: 10.3390/nu14142795] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 11/19/2022] Open
Abstract
Background: Non-alcoholic fatty liver disease is a chronic disease caused by the accumulation of fat in the liver related to overweight and obesity, insulin resistance, hyperglycemia, and high levels of triglycerides and leads to an increased cardiovascular risk. It is considered a global pandemic, coinciding with the pandemic in 2020 caused by the “coronavirus disease 2019” (COVID-19). Due to COVID-19, the population was placed under lockdown. The aim of our study was to evaluate how these unhealthy lifestyle modifications influenced the appearance of metabolic alterations and the increase in non-alcoholic fatty liver disease. Methods: A prospective study was carried out on 6236 workers in a Spanish population between March 2019 and March 2021. Results: Differences in the mean values of anthropometric and clinical parameters before and after lockdown were revealed. There was a statistically significant worsening in non-alcoholic fatty liver disease (NAFLD) and in the insulin resistance scales, with increased body weight, BMI, cholesterol levels with higher LDL levels, and glucose and a reduction in HDL levels. Conclusions: Lockdown caused a worsening of cardiovascular risk factors due to an increase in liver fat estimation scales and an increased risk of presenting with NAFLD and changes in insulin resistance.
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Madani S, Ahmadi A, Shoaei‐Jouneghani F, Moazen M, Sasani N. The relationship between the Mediterranean diet and Axis I disorders: A systematic review of observational studies. Food Sci Nutr 2022; 10:3241-3258. [PMID: 36249971 PMCID: PMC9548357 DOI: 10.1002/fsn3.2950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 05/11/2022] [Accepted: 05/24/2022] [Indexed: 11/30/2022] Open
Abstract
Axis I disorders are one of the major health burdens worldwide. Evidence suggests that Mediterranean diet has key biological factors associated with reducing the progression of these disorders. This systematic review aimed to clarify the relationship between Mediterranean diet and Axis I disorders. PubMed and Scopus databases were searched from January 2016 up to June 2021. Those observational studies in English language that assessed the relationship between Mediterranean diet and Axis I disorders (such as depression, anxiety, eating disorders, schizophrenia, etc.) were included in this review. The Newcastle–Ottawa Scale was used to evaluate the quality of studies. Thirty‐six studies (15 cohorts, 19 cross‐sectional, and 2 case–control) met the inclusion criteria. The results revealed that more than two‐thirds of the studies (25 studies, 69.44%) had significant protective relationship between receiving Mediterranean diet and reducing the symptoms or incidence of Axis I disorders. Most studies were performed on depression (29 studies measured depression at least as one of the Axis I disorders), of which 72.41% reported an inverse relationship. There were also 9 studies on anxiety (studies that measured anxiety at least as one of the Axis I disorders), that 77.77% of them observed protective association. Moreover, majority of the studies (25 studies, 69.44%) had high quality, of which 76% found an inverse relationship. In conclusion, it seems that the Mediterranean diet can reduce the symptoms or the occurrence of Axis I disorders (especially depression and anxiety). However, more extensive review studies, particularly with interventional designs, are necessary to prove the result.
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Affiliation(s)
- Samaneh Madani
- Nutrition Research Center School of Nutrition and Food Sciences, Shiraz University of Medical Sciences Shiraz Iran
| | - Afsane Ahmadi
- Nutrition Research Center School of Nutrition and Food Sciences, Shiraz University of Medical Sciences Shiraz Iran
| | - Firoozeh Shoaei‐Jouneghani
- Nutrition Research Center School of Nutrition and Food Sciences, Shiraz University of Medical Sciences Shiraz Iran
| | - Mahsa Moazen
- Nutrition Research Center School of Nutrition and Food Sciences, Shiraz University of Medical Sciences Shiraz Iran
| | - Najmeh Sasani
- Nutrition Research Center School of Nutrition and Food Sciences, Shiraz University of Medical Sciences Shiraz Iran
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Lockdown Due to COVID-19 and Its Consequences on Diet, Physical Activity, Lifestyle, and Other Aspects of Daily Life Worldwide: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116832. [PMID: 35682411 PMCID: PMC9180681 DOI: 10.3390/ijerph19116832] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/21/2022] [Accepted: 05/24/2022] [Indexed: 12/23/2022]
Abstract
The novel coronavirus, termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is responsible for the disease called coronavirus disease 2019 (COVID-19). Besides the important rates of mortality and morbidity directly attributed to the infection itself, many studies detected an important shift towards mostly unhealthy lifestyle patterns in previously healthy non-infected populations all around the world. Although most of the changes in lifestyle had or will have a negative impact on general population health status, some findings are encouraging. Notwithstanding that there was an obvious necessity for governments to apply national lockdowns, it is also necessary to identify and comprehend the consequences they have caused. A narrative literature review was performed, based on scientific articles and previous reviews. An accurate description of changes in eating habits and alcohol consumption, physical activity, mental health, daily routines, economic impacts, and broader effects on society is provided for each continent and different age groups through this review. The volume of selected scientific surveys encompasses approximately 400,000 persons.
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10
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Hibino S, Hayashida K. Modifiable Host Factors for the Prevention and Treatment of COVID-19: Diet and Lifestyle/Diet and Lifestyle Factors in the Prevention of COVID-19. Nutrients 2022; 14:1876. [PMID: 35565841 PMCID: PMC9102954 DOI: 10.3390/nu14091876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/20/2022] [Accepted: 04/24/2022] [Indexed: 11/17/2022] Open
Abstract
Many studies have shown that the immune system requires adequate nutrition to work at an optimal level. Not only do optimized nutritional strategies support the immune system, but they also reduce chronic inflammation. Nutritional supplements that are recommended for patients with critical illnesses are thought to also be effective for the coronavirus disease 2019 (COVID-19) patients in the intensive care unit. Some studies have recommended fresh fruits and vegetables, soy, nuts, and antioxidants, such as omega-3 fatty acids, to improve immune system activity. Although nutritional status is considered to be an important prognostic factor for patients with COVID-19, there is to date no sufficient evidence that optimal nutritional therapies can be beneficial for these patients. Some have argued that the COVID-19 pandemic is a good opportunity to test the effectiveness of nutritional intervention for infectious diseases. Many researchers have suggested that testing the proposed nutritional approaches for infectious diseases in the context of a pandemic would be highly informative. The authors of other review papers concluded that it is important to have a diet based on fresh foods, such as fruits, vegetables, whole grains, low-fat dairy products, and healthy fats (i.e., olive oil and fish oil), and to limit the intake of sugary drinks as well as high-calorie and high-salt foods. In this review, we discuss the clinical significance of functional food ingredients as complementary therapies potentially beneficial for the prevention or treatment of COVID-19. We believe that our review will be helpful to plan and deploy future studies to conclude these potentials against COVID-19, but also to new infectious diseases that may arise in the future.
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Affiliation(s)
- Sawako Hibino
- Y’s Science Clinic Hiroo, Medical Corporation Koshikai, Tokyo 106-0047, Japan
- Department of Clinical Gene Therapy, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Kazutaka Hayashida
- Division of Pulmonary Medicine, Boston Children’s Hospital, Boston, MA 02459, USA;
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Rentería I, García-Suárez PC, Moncada-Jiménez J, Machado-Parra JP, Antunes BM, Lira FS, Jiménez-Maldonado A. Unhealthy Dieting During the COVID-19 Pandemic: An Opinion Regarding the Harmful Effects on Brain Health. Front Nutr 2022; 9:876112. [PMID: 35571935 PMCID: PMC9097874 DOI: 10.3389/fnut.2022.876112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
Since 2020, the world has been suffering from a pandemic that has affected thousands of people regardless of socio-economic conditions, forcing the population to adopt different strategies to prevent and control the advance of the disease, one of which is social distancing. Even though social distancing is a safe strategy to reduce the spread of COVID-19, it is also the cause of a rising sedentary behavior. This behavior develops an excess of fat tissue that leads to metabolic and inflammatory disruption related to chronic diseases and mental health disorders, such as anxiety, depression, and sleep issues. Furthermore, the adoption of dietary patterns involving the consumption of ultra-processed foods, higher in fats and sugars, and the reduction of fresh and healthy foods may play a role in the progress of the disease. In this perspective, we will discuss how an unhealthy diet can affect brain function and, consequently, be a risk factor for mental health diseases.
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Affiliation(s)
- Iván Rentería
- Facultad de Deportes, Universidad Autónoma de Baja California, Ensenada, Mexico
| | - Patricia Concepción García-Suárez
- Facultad de Deportes, Universidad Autónoma de Baja California, Ensenada, Mexico
- Department of Health, Sports and Exercise Sciences, University of Kansas, Lawrence, KS, United States
| | - José Moncada-Jiménez
- Human Movement Sciences Research Center (CIMOHU), University of Costa Rica, San José, Costa Rica
| | | | | | - Fabio Santos Lira
- Exercise and Immunometabolism Research Group, Department of Physical Education, Paulista State University, UNESP, Presidente Prudente, São Paulo, Brazil
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Ramírez Manent JI, Altisench Jané B, Sanchís Cortés P, Busquets-Cortés C, Arroyo Bote S, Masmiquel Comas L, López González ÁA. Impact of COVID-19 Lockdown on Anthropometric Variables, Blood Pressure, and Glucose and Lipid Profile in Healthy Adults: A before and after Pandemic Lockdown Longitudinal Study. Nutrients 2022; 14:nu14061237. [PMID: 35334894 PMCID: PMC8953154 DOI: 10.3390/nu14061237] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/03/2022] [Accepted: 03/11/2022] [Indexed: 01/08/2023] Open
Abstract
In December 2019, 27 cases of pneumonia were reported in Wuhan. In 2020, the causative agent was identified as a virus called SARS-CoV-2. The disease was called “coronavirus disease 2019” (COVID-19) and was determined as a Public Health Emergency. The main measures taken to cope with this included a state of lockdown. The aim of this study was to assess how the unhealthy lifestyles that ensued influenced different parameters. A prospective study was carried out on 6236 workers in a Spanish population between March 2019 and March 2021. Anthropometric, clinical, and analytical measurements were performed, revealing differences in the mean values of anthropometric and clinical parameters before and after lockdown due to the pandemic, namely increased body weight (41.1 ± 9.9–43.1 ± 9.9), BMI (25.1 ± 4.7–25.9 ± 4.7), and percentage of body fat (24.5 ± 9.1–26.9 ± 8.8); higher total cholesterol levels, with a statistically significant increase in LDL levels and a reduction in HDL; and worse glucose levels (90.5 ± 16.4–95.4 ± 15.8). Lockdown can be concluded to have had a negative effect on health parameters in both sexes in all age ranges, causing a worsening of cardiovascular risk factors.
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Affiliation(s)
- José Ignacio Ramírez Manent
- General Practitioner Department, Balearic Islands Health Service, 07003 Palma, Illes Balears, Spain; (J.I.R.M.); (L.M.C.)
- Health Institute of the Balearic Islands (IDISBA), Balearic Islands Health Research Institute Foundation, 07003 Palma, Illes Balears, Spain; (P.S.C.); (Á.A.L.G.)
| | - Bárbara Altisench Jané
- General Practitioner Department, Balearic Islands Health Service, 07003 Palma, Illes Balears, Spain; (J.I.R.M.); (L.M.C.)
- Correspondence:
| | - Pilar Sanchís Cortés
- Health Institute of the Balearic Islands (IDISBA), Balearic Islands Health Research Institute Foundation, 07003 Palma, Illes Balears, Spain; (P.S.C.); (Á.A.L.G.)
- Chemistry Department, University Balearic Islands, 07003 Palma, Illes Balears, Spain
| | - Carla Busquets-Cortés
- Faculty of Odontology, University School ADEMA Palma, 07003 Palma, Illes Balears, Spain; (C.B.-C.); (S.A.B.)
- Investigation Group IUNICS, Health Research Institute of the Balearic Islands (IDISBA), 07003 Palma, Illes Balears, Spain
| | - Sebastiana Arroyo Bote
- Faculty of Odontology, University School ADEMA Palma, 07003 Palma, Illes Balears, Spain; (C.B.-C.); (S.A.B.)
- Investigation Group IUNICS, Health Research Institute of the Balearic Islands (IDISBA), 07003 Palma, Illes Balears, Spain
| | - Luis Masmiquel Comas
- General Practitioner Department, Balearic Islands Health Service, 07003 Palma, Illes Balears, Spain; (J.I.R.M.); (L.M.C.)
- Health Institute of the Balearic Islands (IDISBA), Balearic Islands Health Research Institute Foundation, 07003 Palma, Illes Balears, Spain; (P.S.C.); (Á.A.L.G.)
| | - Ángel Arturo López González
- Health Institute of the Balearic Islands (IDISBA), Balearic Islands Health Research Institute Foundation, 07003 Palma, Illes Balears, Spain; (P.S.C.); (Á.A.L.G.)
- Faculty of Odontology, University School ADEMA Palma, 07003 Palma, Illes Balears, Spain; (C.B.-C.); (S.A.B.)
- Investigation Group IUNICS, Health Research Institute of the Balearic Islands (IDISBA), 07003 Palma, Illes Balears, Spain
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Dicken SJ, Mitchell JJ, Newberry Le Vay J, Beard E, Kale D, Herbec A, Shahab L. Impact of the COVID-19 Pandemic on Diet Behaviour Among UK Adults: A Longitudinal Analysis of the HEBECO Study. Front Nutr 2022; 8:788043. [PMID: 35096934 PMCID: PMC8793888 DOI: 10.3389/fnut.2021.788043] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/22/2021] [Indexed: 12/16/2022] Open
Abstract
COVID-19 pandemic restrictions impacted dietary habits during the initial months of the pandemic, but long-term effects are unclear. In this longitudinal study, self-selected UK adults (n = 1,733, 71.1% female, 95.7% white ethnicity) completed three online surveys (May-June, August-September, and November-December 2020, with a retrospective pre-pandemic component in the baseline survey), self-reporting sociodemographics, lifestyle, and behaviours, including high fat, salt, and sugar (HFSS) snacks, HFSS meals, and fruit and vegetable (FV) intake. Data were analysed using generalised estimating equations. Monthly HFSS snacks portion intake increased from pre-pandemic levels (48.3) in May-June (57.6, p < 0.001), decreased in August-September (43.7, p < 0.001), before increasing back to pre-pandemic levels in November-December (49.2, p < 0.001). A total of 48.5% self-reported increased [25.9 (95% confidence interval: 24.1, 27.8)] and 47.7% self-reported decreased [24.1 (22.4, 26.0)] monthly HFSS snacks portion intakes in November-December compared with pre-pandemic levels. Monthly HFSS meals portion intake decreased from pre-pandemic levels (7.1) in May-June (5.9, p < 0.001), was maintained in August-September (5.9, p = 0.897), and then increased again in November-December (6.6, p < 0.001) to intakes that remained lower than pre-pandemic levels (p = 0.007). A total of 35.2% self-reported increased [4.8 (4.3, 5.3)] and 44.5% self-reported decreased [5.1 (4.6, 5.6)] monthly HFSS meals portion intakes in November-December compared with pre-pandemic levels. The proportion meeting FV intake recommendations was stable from pre-pandemic through to August-September (70%), but decreased in November-December 2020 (67%, p = 0.034). Increased monthly HFSS snacks intake was associated with female gender, lower quality of life, and - in a time - varying manner - older age and higher HFSS meals intake. Increased monthly HFSS meals intake was associated with female gender, living with adults only, and higher HFSS snacks intake. Reduced FV intake was associated with higher body mass index (BMI) and lower physical activity. These results suggest large interindividual variability in dietary change during the first year of the pandemic, with important public health implications in individuals experiencing persistent increases in unhealthy diet choices, associated with BMI, gender, quality of life, living conditions, physical activity, and other dietary behaviours.
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Affiliation(s)
- Samuel J. Dicken
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - John Joseph Mitchell
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | | | - Emma Beard
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Dimitra Kale
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Aleksandra Herbec
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- Department of Clinical, Educational, and Health Psychology, University College London, London, United Kingdom
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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14
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Boaz M, Navarro DA, Raz O, Kaufman-Shriqui V. Dietary Changes and Anxiety during the Coronavirus Pandemic: Differences between the Sexes. Nutrients 2021; 13:nu13124193. [PMID: 34959744 PMCID: PMC8703590 DOI: 10.3390/nu13124193] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/14/2021] [Accepted: 11/20/2021] [Indexed: 11/24/2022] Open
Abstract
The SARS-CoV-2 (COVID-19) pandemic has been associated with both increased anxiety, deterioration in diet and weight gain. These associations may differ by sex. The present report examines differences by sex in diet quality in order to determine whether associations between diet and psychological stress during the initial phase of the COVID-19 pandemic differed by sex. This online study is available internationally in seven languages. The Mediterranean Diet Score was used to measure diet quality, while the General Anxiety Disorder 7-point scale (GAD-7) was used to measure anxiety. Findings were compared by self-reported sex (male vs. female). A total of 3797 respondents provided informed consent and met eligibility criteria, of whom 526 women were omitted due to being pregnant or six months or less post-partum, or due to reproductive status not being reported. Thus, 3271 individuals are included in the present report, of whom 71.2% were women. The median age of women was 30 (interquartile range (IQR) = 16) years vs. 31 (IQR = 19) years, p = 0.079. The median diet quality score was 9 (IQ = 3) in both women and men (p = 0.75). Despite the overall similarity in diet score, several components of the score differed significantly by sex. Women reported consuming significantly more olive oil, daily servings of vegetables, and weekly servings of sweet baked goods. Men reported consuming significantly more sweetened/carbonated drinks, red meat, alcohol, legumes, and hummus/tahini. Women reported a GAD-7 score of 6 (IQR = 8), while men reported 3 (6), p < 0.001. An inverse association was detected between the Mediterranean diet score and the GAD-7 score in both women (rho = −0.166, p < 0.001) and men (rho = −0.154, p < 0.001), and the correlation coefficients did not differ by sex (p = 0.76). Mediterranean diet score and age both reduced the odds of elevated anxiety (GAD-7 ≥ 10), while female sex, deterioration of diet quality during the outbreak, unemployment, and completing the survey in English increased the odds of this outcome. During the COVID-19 lockdowns, overall diet quality did not differ by sex; however, some differences by sex in components of the total score were detected. Moderate to severe anxiety was positively associated with female sex and poorer diet quality even after controlling for age, employment status, and the language in which the survey was performed.
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Affiliation(s)
- Mona Boaz
- Department of Nutrition Sciences, Ariel University, Ariel 40700, Israel; (D.A.N.); (O.R.); (V.K.-S.)
- Correspondence: ; Tel.: +972-50-212-9666
| | - Daniela Abigail Navarro
- Department of Nutrition Sciences, Ariel University, Ariel 40700, Israel; (D.A.N.); (O.R.); (V.K.-S.)
| | - Olga Raz
- Department of Nutrition Sciences, Ariel University, Ariel 40700, Israel; (D.A.N.); (O.R.); (V.K.-S.)
| | - Vered Kaufman-Shriqui
- Department of Nutrition Sciences, Ariel University, Ariel 40700, Israel; (D.A.N.); (O.R.); (V.K.-S.)
- Centre for Urban Health Solutions (C-UHS), St. Michael’s Hospital, 209 Victoria St., Toronto, ON M5B 1W8, Canada
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15
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Silva FB, Osborn DE, Owens MR, Kirkland T, Moore CE, Patterson MA, Tucker WJ, Miketinas DC, Davis KE. Influence of COVID-19 Pandemic Restrictions on College Students' Dietary Quality and Experience of the Food Environment. Nutrients 2021; 13:nu13082790. [PMID: 34444951 PMCID: PMC8400929 DOI: 10.3390/nu13082790] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 12/22/2022] Open
Abstract
The COVID-19 pandemic restrictions sent college students online and off campus, potentially reducing access to healthy food. The objective of this cross-sectional, internet-based study was to use qualitative and quantitative survey methods to evaluate whether COVID-19 pandemic restrictions in Texas, USA affected college students’ ability to buy food, how/what they shopped for, how they prepared food, what they ate, how they felt about eating, and overall dietary quality (assessed using Healthy Eating Index [HEI] scores). Survey responses from 502 students (87.5% female; 59.6% nonwhite, mean age 27.5 ± 0.4 years, >50% graduate students) were analyzed. The qualitative analysis of open-ended questions revealed 110 codes, 17 subthemes, and six themes. Almost all students experienced changes in at least one area, the most common being changes in shopping habits. Participants with low or very low food security had lower HEI scores compared to food secure students (p = 0.047). Black students were more likely to report changes in their ability to buy food (p = 0.035). The COVID-19 restrictions varied in their impact on students’ ability to access sufficient healthy food, with some students severely affected. Thus, universities should establish procedures for responding to emergencies, including identifying at-risk students and mobilizing emergency funds and/or food assistance.
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Affiliation(s)
- Francilia Brito Silva
- Department of Nutrition and Food Sciences, Texas Woman’s University, Denton, TX 76024, USA; (F.B.S.); (D.E.O.)
| | - Dawn E. Osborn
- Department of Nutrition and Food Sciences, Texas Woman’s University, Denton, TX 76024, USA; (F.B.S.); (D.E.O.)
| | - Meghan R. Owens
- Department of Nutrition and Food Sciences, Texas Woman’s University, Houston, TX 77030, USA; (M.R.O.); (C.E.M.); (M.A.P.); (W.J.T.); (D.C.M.)
| | - Tracie Kirkland
- Department of Nursing, University of Southern California, Los Angeles, CA 90089, USA;
| | - Carolyn E. Moore
- Department of Nutrition and Food Sciences, Texas Woman’s University, Houston, TX 77030, USA; (M.R.O.); (C.E.M.); (M.A.P.); (W.J.T.); (D.C.M.)
| | - Mindy A. Patterson
- Department of Nutrition and Food Sciences, Texas Woman’s University, Houston, TX 77030, USA; (M.R.O.); (C.E.M.); (M.A.P.); (W.J.T.); (D.C.M.)
- Institute for Women’s Health, College of Health Sciences, Houston, TX 77030, USA
| | - Wesley J. Tucker
- Department of Nutrition and Food Sciences, Texas Woman’s University, Houston, TX 77030, USA; (M.R.O.); (C.E.M.); (M.A.P.); (W.J.T.); (D.C.M.)
- Institute for Women’s Health, College of Health Sciences, Houston, TX 77030, USA
| | - Derek C. Miketinas
- Department of Nutrition and Food Sciences, Texas Woman’s University, Houston, TX 77030, USA; (M.R.O.); (C.E.M.); (M.A.P.); (W.J.T.); (D.C.M.)
| | - Kathleen E. Davis
- Department of Nutrition and Food Sciences, Texas Woman’s University, Denton, TX 76024, USA; (F.B.S.); (D.E.O.)
- Correspondence: ; Tel.: +01-940-898-2651
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16
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Enriquez-Martinez OG, Martins MCT, Pereira TSS, Pacheco SOS, Pacheco FJ, Lopez KV, Huancahuire-Vega S, Silva DA, Mora-Urda AI, Rodriguez-Vásquez M, Montero López MP, Molina MCB. Diet and Lifestyle Changes During the COVID-19 Pandemic in Ibero-American Countries: Argentina, Brazil, Mexico, Peru, and Spain. Front Nutr 2021; 8:671004. [PMID: 34150828 PMCID: PMC8206276 DOI: 10.3389/fnut.2021.671004] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/28/2021] [Indexed: 12/14/2022] Open
Abstract
This study aimed to evaluate changes in dietary and lifestyle habits during the period of confinement due to the first wave of the COVID-19 pandemic in Ibero-American countries. A cross-sectional investigation was conducted with 6,325 participants of both genders (68% women), over 18 years of age and from five countries: Brazil (N = 2,171), Argentina (N = 1,111), Peru (N = 1,174), Mexico (N = 686), and Spain (N = 1,183). Data were collected during the year 2020, between April 01 and June 30 in Spain and between July 13 and September 26, in the other countries studied using a self-administered online survey designed for the assessment of sociodemographic, employment, physical activity, health status, and dietary habits changes. Most participants (61.6%), mainly those from Spain, remained constant, without improving or worsening their pattern of food consumption. Among those who changed, a pattern of better eating choices prevailed (22.7%) in comparison with those who changed toward less healthy choices (15.7%). Argentina and Brazil showed the highest proportion of changes toward a healthier pattern of food consumption. Peruvians and Mexicans were less likely to make healthy changes in food consumption (OR: 0.51; 95% CI: 0.4-0.6 and OR: 0.69; 95% CI: 0.4-0.8, respectively), when compared to Argentinians. Most respondents did not change their pattern of meal consumption, but those who did reduced their consumption of main meals and increased intake of small meals and snacks. Although most participants affirmed to be doing physical activity at home, about one-half reported perception of weight gain. Individuals with alterations in sleep pattern (either by increasing or decreasing sleep time) were more likely to change their diets to a healthier pattern. In contrast, individuals with confirmed diagnosis of COVID-19 and those who reported feeling anxious were more likely to perform changes to a less healthy eating pattern (OR: 1.72; 95% CI: 1.2-2.3 and OR: 1.21; 95% CI: 1.1-1.4, respectively). In conclusion, although most participants remained constant in their eating habits, lifestyle changes and anxiety feelings were reported. Among those who changed patterns of food consumption, healthier choices prevailed, with differences between countries. However, there were alterations in the distribution of meals, with higher consumption of snacks and small meals. These results can be used to guide policies to prevent deleterious consequences that may affect the incidence of chronic diseases.
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Affiliation(s)
- Oscar G Enriquez-Martinez
- Public Health Program, Health Sciences Center, Federal University of Espírito Santo, Vitória, Brazil
| | - Marcia C T Martins
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Entre Ríos, Argentina.,Institute for Food Science and Nutrition, Universidad Adventista del Plata, Entre Ríos, Argentina.,Master in Science of Human Motricity, Adventist University of Chile, Chillán, Chile
| | - Taisa S S Pereira
- Department of Health Sciences, Universidad de las Américas Puebla, San Andrés Cholula, Puebla, Mexico
| | - Sandaly O S Pacheco
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Entre Ríos, Argentina.,Institute for Food Science and Nutrition, Universidad Adventista del Plata, Entre Ríos, Argentina
| | - Fabio J Pacheco
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Entre Ríos, Argentina.,Institute for Food Science and Nutrition, Universidad Adventista del Plata, Entre Ríos, Argentina
| | - Karen V Lopez
- Department of Health Sciences, Universidad de las Américas Puebla, San Andrés Cholula, Puebla, Mexico
| | - Salomon Huancahuire-Vega
- Department of Basic Sciences, Faculty of Health Sciences, School of Human Medicine, Universidad Peruana Unión, Lima, Peru
| | - Daniela A Silva
- Department of Integrated Health Education, Federal University of Espírito Santo, Vitória, Brazil
| | - Ana I Mora-Urda
- Biology Department, Universidad Autónoma de Madrid, Madrid, Spain
| | - Mery Rodriguez-Vásquez
- Department of Basic Sciences, Faculty of Health Sciences, School of Human Medicine, Universidad Peruana Unión, Lima, Peru
| | | | - Maria C B Molina
- Public Health Program, Health Sciences Center, Federal University of Espírito Santo, Vitória, Brazil.,Health and Nutrition Program, Federal University of Ouro Preto, Ouro Preto, Brazil
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