A Humanities-Based Explanation for the Effects of Emotional Eating and Perceived Stress on Food Choice Motives during the COVID-19 Pandemic

Stress factors and food purchase prioritization during the pandemic of coronavirus disease 2019

BACKGROUND

The pandemic of coronavirus disease 2019 (COVID-19) pandemic confinement has an impact on stress levels, which causes changes in food purchase and consumption behaviors. The objective of this study is to associate food purchase prioritization with stress level during the COVID-19 pandemic confinement.

METHODS

Multicenter, observational and cross-sectional study, an online questionnaire that included data on sociodemographic variables, stress factors and food purchase prioritization was disseminated through digital platforms and social networks.

RESULTS

A number of 6357 participants were included, of whom 83.6% were female, 56.3% were from the middle socioeconomic level, 71.2% had completed higher education and 78.3% had a job. At greater stress levels it was observed a higher prioritization of canned foods (Odds ratio (OR): 1.91, 95% CI: 1.56; 2.34), sweets (OR: 1.58, 95% CI: 1.06; 2.34) and flours (OR: 1.45, 95% CI: 1.25; 1.68). While lower stress levels are associated with nuts (OR: 0.75, 95% CI: 0.66; 0.85), vegetables (OR: 0.82, 95% CI: 0.72; 0.94), and fruits (OR: 0.90, 95% CI: 0.80; 1.01), after adjusting for confounders.

CONCLUSIONS

There is an association between food purchase prioritization and stress level during the COVID-19 confinement. At greater stress levels, individuals purchase more food, both healthy and unhealthy. The later may have a negative impact on people's health, leading to or further aggravating malnutrition by excess and nutrition-related noncommunicable diseases.

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

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

Emotional eating behaviors in later life: Identifying key factors for healthy aging

BACKGROUND

Pathological, physiological, and psychosocial factors could influence the eating behaviors of older adults in Egypt. Nurses and other healthcare professionals should understand this complex interaction to effectively address their nutritional issues. This study aimed to identify the predictors of emotional eating behaviors among older adults.

METHODS

The study followed a cross-sectional survey. A probability sampling technique was used to select the participants. Data was collected using the Emotional Eating Questionnaire and Perceived Stress Scales.

RESULTS

98 % of the respondents were identified as moderate or severe emotional eaters. The study found a significant positive correlation between perceived stress and emotional eating behaviors (r = .436; p = .000). Multivariate analysis revealed that perceived stress, age, gender, marital status, and body mass index (BMI) have a significant positive relationship with emotional eating behaviors (p < .001), accounting for 39.3 % of the variation.

CONCLUSION

Emotional eating is common among older adults and is influenced by factors such as age, gender, marital status, BMI, and perceived stress. Nurses can use these findings to develop nutritional plans to promote healthy eating habits of this population.

Relationships Between Three Eating Behaviors and Nine Motives for Food Choices Among Brazilian Adults: A Structural Equation Model

We examined the relationships between three eating behaviors and nine motives underlying food choices made by Brazilian adults. Using participant responses to the short version of the Three-Factor Eating Questionnaire and the Food Choice Questionnaire, we investigated eating behaviors (cognitive restriction, uncontrolled eating, and emotional eating) and motives for food choices (health, mood, convenience, sensory appeal, natural content, price, weight control, familiarity, and ethical concern). We used a structural equation model to test relationship pathways (β), with eating behaviors as independent variables and motives for food choices as dependent variables. Participants were 1297 individuals (69.5% female) with a mean age of 25.0 years (SD = 5.8). We confirmed the validity and reliability of the questionnaires in this sample. Restrictive eating behavior was significantly related to motives of health (β = .415), mood (β = .127), natural content (β = .364), weight control (β = .681), and ethical concern (β = .161). Emotional eating behavior was related to motives of mood (β = .277), health (β = -.137), and natural content (β = -.136). Uncontrolled eating behavior was related to motives of convenience (β = .226), sensory appeal (β = .121), price (β = .153), and familiarity (β = .090). We believe these findings can now help design future research and clinical interventions for managing people's risky eating behaviors and promoting beneficial food choices.

Affordability of Canada's Food Guide: Current challenges amid COVID-19, War in Ukraine, and other world events

Since the 2019 Canada Food Guide was released, there have been concerns raised over the cost of food, with an emphasis on the affordability of nutritious food. In this study, we evaluate the affordability of the 2019 Canada Food Guide in relation to the previous edition from 2007. As a result of the pandemic and other significant world events, many are feeling financial stress as prices in many areas of life rise, including housing, gas, and food. Our results show that it is more cost-effective, on average, for children and teens to follow the 2019 Canada Food Guide, but more expensive for adults, when compared to the 2007 edition.

Nutritional changes during the COVID-19 pandemic: a rapid scoping review on the impact of psychological factors

COVID-19 and the resulting measures to curb the spread of the virus have significantly changed our lives, including our nutritional choices. In this rapid scoping review an overview is provided of what psychological factors may be associated with peoples' eating behaviour during COVID-19 restrictions. Relevant literature was identified using PubMed, PsycInfo, CINAHL and MEDLINE databases from 2019 onwards. For included studies, information on study characteristics, eating behaviours, and psychological factors were extracted. 118 articles were included, representing 30 countries. Findings indicated that most people consumed more and unhealthy food in times of COVID-19 restrictions, while some consumed less but often for the wrong reasons. Several psychological factors, related to (1) affective reactions, (2) anxiety, fear and worriers, (3) stress and (4) subjective and mental wellbeing were found to be associated with this increase in food consumption. These outcomes may help to be better inform future interventions, and with that, to be better prepared in case of future lockdown scenarios.

Financial and Other Life Stressors, Psychological Distress, and Food and Beverage Consumption among Students Attending a Large California State University during the COVID-19 Pandemic

The novel coronavirus disease 2019 (COVID-19) pandemic abruptly disrupted the daily lives and health of college students across the United States. This study investigated several stressors (e.g., financial strain/uncertainty), psychological distress, and dietary behaviors among college students attending a large state university during the pandemic. A cross-sectional online survey was administered to students from the California State University, Los Angeles between April and May 2021 (final analytic sample n = 736). Differences in gender and race/ethnicity were examined using chi-square, t-test, and one-way ANOVA tests. Paired t-tests were performed to compare variables before and during the pandemic. Negative binomial regression models examined the associations between various stressors, psychological distress, and three key dietary outcomes. Descriptive results showed that the consumption of fruits and vegetables, fast food, and sugary beverages, along with psychological distress, all increased during the pandemic. Significant differences in fruit and vegetable and fast food consumption by gender and race/ethnicity were also observed. In the regression models, several stressors, including financial strain and psychological distress, were associated with unfavorable food and beverage consumption, thereby suggesting that college students may need more support in mitigating these stressors so they do not manifest as poor dietary behaviors. Poor diet quality is associated with poor physical health outcomes such as premature development of type 2 diabetes or hypertension.

The Mediating Role of Eating Attitudes in Sociocultural Attitudes toward the Body in Predicting Obligatory Exercise among Young People: A Polish and Chinese Comparison

The main aims of this study were to determine which sociocultural predictors of obligatory exercise are universal for young men or women and which are specific to particular cultural conditions (Polish or Chinese culture) and to examine the mediating role of eating attitudes. A cross-sectional study was conducted among Poles (n = 259) and Chinese (n = 208) aged 18 to 30. Descriptive and comparative statistics, Spearman's rho, and multiple regression analysis were used. The main analyses showed that Internalization-Athlete was a common positive direct predictor of obligatory exercise among young Polish and Chinese women; Information and Internalization-Athlete were only specific direct positive predictors of obligatory exercise in young Chinese men; some variables in eating attitudes mediated the development of obligatory exercise in young Polish and Chinese men and women and indicated that there were cross-cultural differences. In understanding obligatory exercise among young people, attention should be paid to their sociocultural attitudes toward the body and eating, and cultural and gender differences need to be considered.

COVID-19 and Eating Problems in Daily Life: The Mediating Roles of Stress, Negative Affect and Posttraumatic Stress Symptoms

Background The COVID-19 pandemic poses a challenge to individuals' mental health. People worldwide are experiencing increased stress, negative affect, and posttraumatic stress symptoms, which may lead to eating problems. The purpose of this study was to explore the impact of the perceived severity of COVID-19 on eating problems and the mediating effects of stress/negative affect/posttraumatic stress symptoms both at the personal level and interpersonal level. Methods: During the COVID-19 outbreak, a total of 108 college students were recruited to report their perceived severity of COVID-19, stress, negative affect, posttraumatic stress symptoms, and eating problems three times a day for seven consecutive days using Ecological Momentary Assessment. Results: State perceived severity of COVID-19 predicted fewer subsequent eating problems in daily life at the personal level. Both state negative affect and posttraumatic stress symptoms were positively associated with eating problems in daily life. At the interpersonal level, trait-like perceived severity of COVID-19, stress, negative affect, and posttraumatic stress symptoms were positively associated with overall eating problems. There were no mediating effects of stress/negative affect/posttraumatic stress symptoms on the relations between perceived severity of COVID-19 and eating problems at the personal/interpersonal level. Conclusions: The perceived severity of COVID-19, stress, negative affect, and posttraumatic stress symptoms might increase the risk of eating problems.

Adherence to Mediterranean diet and dietary changes according to the fear of COVID-19 during the pandemic: a cross-sectional study

The coronavirus disease 2019 (COVID-19) has led to the implementation of restrictions to reduce transmission worldwide. The restrictions and measures have affected the psychological health and eating habits. The objective of the present study was to evaluate dietary habits, lifestyle changes, adherence to the Mediterranean diet (MD) and fear of COVID-19 in Turkey during the pandemic. A cross-sectional online survey of socio-demographic characteristics, anthropometric measurements, nutrition, physical activity and lifestyle habits was used for data collection. The fear of COVID-19 levels of the participants was determined by the fear of COVID-19 scale (FCV-19S). The Mediterranean Diet Adherence Screener (MEDAS) was used to evaluate participants' adherence to the MD. The differences between the FCV-19S and MEDAS according to gender were compared. Eight hundred and twenty subjects (76⋅6 % women and 28⋅4 % men) were evaluated within the study. The mean of MEDAS (ranged between 0 and 12) was 6⋅4 ± 2⋅1, and almost half of the participants moderately adhered to the MD. The mean of FCV-19S (ranged between 7 and 33) was 16⋅8 ± 5⋅7, while women's FCV-19S and MEDAS were significantly higher than men's (P < 0⋅001). The consumption of sweetened cereals, grains, pasta, homemade bread and pastries of the respondents with high FCV-19S were higher than in those with low FCV-19S. High FCV-19S was also characterized by decreased take-away food and fast food consumption in approximately 40 % of the respondents (P < 0⋅01). Similarly, women's fast food and take-away food consumption decreased more than men's (P < 0⋅05). In conclusion, the respondents' food consumption and eating habits varied according to the fear of COVID-19.

Evaluation of perceived depression, anxiety, stress levels and emotional eating behaviours and their predictors among adults during the COVID-19 pandemic

OBJECTIVE

This study aimed to (1) evaluate the prevalence and predictors of perceived depression, anxiety, stress (DAS) levels and emotional eating behaviours and (2) determine the correlations between DAS levels and emotional eating behaviours during the pandemic.

DESIGN

An online cross-sectional study included questions about demographic and anthropometric characteristics, dietary habits, Emotional Appetite Questionnaire (EMAQ) and Depression Anxiety Stress Scales. The snowball sampling method was used.

SETTING

Türkiye.

PARTICIPANTS

The study population was 2002 adults aged ≥18 years.

RESULT

The mean age was 27·1 ± 9·52 years (72·1 % females and 27·9 % males). The prevalence of moderate to severe DAS was reported as 27·8 %, 30·5 % and 30·7 %, respectively. Skipping meals (OR = 1·32, 95 % CI (1·14, 1·49)) was associated with depression. Weight gain (OR = 1·43, 95 % CI (1·19, 1·66); OR = 1·30, 95 % CI (1·14, 1·49); OR = 1·39, 95 % CI (1·14, 1·64)), weight loss (OR = 1·45, 95 % CI (1·20, 1·70); OR = 1·37, 95 % CI (1·11, 1·62); OR = 1·46, 95 % CI (1·20, 1·72)), exercising at least 150 min/week (OR = 0·64, 95 % CI (0·46, 0·83); OR = 0·73, 95 % CI (0·55, 0·92); OR = 0·83, 95 % CI (0·63, 1·02)), and maintaining an adequate and balanced diet (OR = 0·52, 95 % CI (0·33, 0·71); OR = 0·53, 95 % CI (0·34, 0·73); OR = 0·63, 95 % CI (-0·15, 0·35)) were associated with DAS, respectively. BMI (r = 0·169, P < 0·001), weight (r = 0·152, P < 0·001), number of snacks (r = 0·102, P = 0·011), depression (r = 0·060, P = 0·007), anxiety (r = 0·061, P = 0·006) and stress (r = 0·073, P = 0·001) levels were positively correlated with EMAQ-negative scores.

CONCLUSION

Approximately one out of every three participants reported moderate to severe DAS levels. Emotional eating was significantly correlated with perceived DAS. The predictors obtained in the study suggest that a healthy diet and lifestyle behaviours are part of psychological well-being and emotional eating.

Food-evoked nostalgia

In three studies, we examined food as an elicitor of nostalgia. Study 1 participants visualised eating either a nostalgic or regularly consumed food. Study 2 participants visualised consuming 12 foods. Study 3 participants consumed 12 flavour samples. Following their food experiences, all participants responded to questions regarding the profile of food-evoked nostalgia (i.e. autobiographical relevance, arousal, familiarity, positive and negative emotions) and several psychological functions (i.e. positive affect, self-esteem, social connectedness, meaning in life). Study 2 and 3 participants also reported their state nostalgia. Results revealed that food is a powerful elicitor of nostalgia. Food-evoked nostalgia has a similar contextual profile to previously examined elicitors, but is a predominantly positive emotional experience. Food-evoked nostalgia served multiple psychological functions and predicted greater state nostalgia.

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

PURPOSE

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

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

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

Lifestyle Changes, Emotional Eating, Gender, and Stress during COVID-19 Lockdown

Emotional eating poses health risks. It is associated with adverse weight gain and a higher body mass index and is frequently triggered by stressful situations such as pandemics. The COVID-19 pandemic was found to cause stress as well as lifestyle changes of different magnitudes. This study examined the relationship between lifestyle changes and emotional eating by focusing on the moderating effect of gender and COVID-19-related stressors. A total of 1969 respondents completed online questionnaires during the first COVID-19 lockdown in Israel. The questionnaires assessed COVID-19-related lifestyle changes concerning eating habits, alcohol consumption, sleep quality, physical activity, and cigarette smoking, COVID-19-related stressors, and emotional eating (Dutch Eating Behavior Questionnaire). People with positive and negative COVID-19-related lifestyle changes demonstrated higher emotional eating compared to people with no lifestyle changes. The relationship between lifestyle changes and emotional eating was moderated by gender and COVID-19-related stressors. In conclusion, health officials should consider recommendations about lifestyle changes given to the public in times of unpredictable changes, with special attention to populations at risk of emotional eating. As emotional eating is related to poor emotional regulation skills, public nutrition recommendations should focus on improving these skills rather than adopting better diets.

The associations among psychological distress, stressors of the COVID-19 pandemic, and disinhibited eating of parents of three- to five-year-old children

Individuals' psychological distress is associated with disinhibited eating (external and emotional eating). The aim of the current study was to examine the moderating associations of COVID-19-related stress on parents' psychological distress (anxiety, hostility, depression) and external and emotional eating. One hundred and sixty U.S. parents of three- to five-year-old children (M_age = 34.08, SD = 6.76; 89 females) completed an online survey. After accounting for participant characteristics (i.e., age, BMI, sex), regression analyses showed that COVID-19 stress moderated the effects of anxiety, hostility, and depression on external eating. Additionally, findings showed that COVID-19 stress moderated hostility (but not anxiety or depression) on emotional eating. These findings suggest that unexpected stressors from the COVID-19 pandemic may exacerbate disinhibited eating among those individuals who experience psychological distress. This presents support for providing interventions that focus on healthy coping strategies and family well-being, support groups, and community resources (e.g., financial assistance) to alleviate external pressures during unprecedented times.

Brief Remote Intervention to Manage Food Cravings and Emotions During the COVID-19 Pandemic: A Pilot Study

As a result of the COVID-19 pandemic people have endured potentially stressful challenges which have influenced behaviors such as eating. This pilot study examined the effectiveness of two brief interventions aimed to help individuals deal with food cravings and associated emotional experiences. Participants were 165 individuals residing in United Kingdom, Finland, Philippines, Spain, Italy, Brazil, North America, South Korea, and China. The study was implemented remotely, thus without any contact with researchers, and involved two groups. Group one participants were requested to use daily diaries for seven consecutive days to assess the frequency of experience of their food cravings, frequency of giving in to cravings, and difficulty resisting cravings, as well as emotional states associated with their cravings. In addition to completing daily food diaries, participants in group two were asked to engage in mindful eating practice and forming implementation intentions. Participants assessed their perceived changes in eating, wellbeing, and health at the beginning and end of the intervention. Repeated measures MANOVAs indicated that participants experienced significantly less food cravings (i.e., craving experience, acting on cravings, difficulty resisting), as well as lower intensities of unpleasant states associated with cravings across time (T1 vs. T7). In contrast to our hypothesis, the main effects of the group (food craving diary vs. food craving diary and mindful eating practice) were not significant. Participants reported less eating and enhanced wellbeing at the end of the study (T7 vs. T1). Our findings can be used to inform future remote interventions to manage food cravings and associated emotions and highlight the need for alternative solutions to increase participant engagement.

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

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

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

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

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.

Individual and Interpersonal Factors Affecting Dietary Intake of Community-Dwelling Older Adults during the COVID-19 Pandemic

OBJECTIVE

As older adults are at higher risk for severe illness and mortality from SARS-CoV-2 infection, social distancing has been a primary means of mitigating risk. However, this lifestyle change may impact eating habits and food choices. The aim of this study was to explore individual and interpersonal factors affecting the eating behaviors and dietary intake of community-dwelling older adults during the COVID-19 pandemic.

DESIGN

Semi-structured individual interviews were conducted. All interviews were audio-recorded and transcribed verbatim. Qualitative data were analyzed using a deductive content analysis approach to identify themes.

SETTING

Southeastern United States.

PARTICIPANTS

Twenty-three men and women, 60 years of age and older (mean age 71.9 ± 7.7, 22% male) completed both the interview and questionnaire.

RESULTS

Themes that emerged at the individual level included changes in eating habits and foods eaten, with most participants reporting healthier food choices during the pandemic. Participants also reported more frequent cooking, improved cooking skills, and cooking as a form of stress relief. Although some older adults described increased snacking and consumption of "comfort foods", others noted no influence of mood on food choices. At the interpersonal level, an increased use of technology for social interaction and the importance of social support were identified as influencing factors.

CONCLUSIONS

Findings provide insight on how to help older adults maintain good nutrition amidst lifestyle changes imposed by social distancing. Nutrition educators may capitalize on positive behavior changes that occurred during the pandemic such as increased cooking and increased use of technology for social interaction.

Gender Differences in the Relationships between Perceived Stress, Eating Behaviors, Sleep, Dietary Risk, and Body Mass Index

Background: Obesity is a growing epidemic among university students, and the high levels of stress reported by this population could contribute to this issue. Singular relationships between perceived stress; engagement in restrained, uncontrolled, and emotional eating; sleep; dietary risk; and body mass index (BMI) have been reported in the current body of literature; however, these constructs interact with each other, and the complex relationships among them are infrequently examined. Therefore, the aim of the present study was to explore the complex relationships between these constructs using mediation and moderation analyses stratified by gender. Methods: A cross-sectional study, enrolling university students from the United States (U.S.), the Netherlands, South Korea, Malaysia, Ireland, Ghana, and China, was conducted between October 2020 and January 2021 during the COVID-19 pandemic. Perceived stress; maladaptive eating behaviors including restrained, uncontrolled, and emotional eating; sleep duration and quality; dietary risk; and BMI were assessed using validated questionnaires, which were distributed through an online platform. Results: A total of 1392 students completed the online survey (379 male, 973 female, and 40 who self-identified as “other”). Uncontrolled and emotional eating mediated the relationship between perceived stress and dietary risk for both males and females; higher sleep quality weakened this relationship among female students but not males. Emotional eating mediated the relationship between perceived stress and BMI for both males and females, but higher sleep quality weakened this relationship only among females. Conclusions: Our findings suggest that students in higher education are likely to benefit from interventions to reduce uncontrolled and emotional eating. Programs that improve sleep quality, especially during highly stressful periods, may be helpful.

Changes in food behavior during the first lockdown of COVID-19 pandemic: A multi-country study about changes in eating habits, motivations, and food-related behaviors

The COVID-19 pandemic resulted in severe, unprecedented changes affecting the world population. Restrictions in mobility, social distancing measures, and the persistent social alarm, during the first period of pandemic, resulted in dramatic lifestyle changes and affected physical and psychological wellbeing on a global scale.

An international research team was constituted to develop a study involving different countries about eating motivations, dietary habits and behaviors related with food intake, acquisition, and preparation. This study presents results of an online survey, carried out during the first lockdown, in 2020, assessing food-related behavior and how people perceived them to change, comparatively to the period preceding the COVID-19 outbreak.

A total of 3332 responses, collected from 16 countries, were considered for analysis [72.8% in Europe, 12.8% in Africa, 2.2% in North America (USA) and 12.2% in South America]. Results suggest that the main motivations perceived to drive food intake were familiarity and liking. Two clusters were identified, based on food intake frequency, which were classified as “healthier” and “unhealthier”. The former was constituted by individuals with higher scholarity level, to whom intake was more motivated by health, natural concerns, and weight control, and less by liking, pleasure or affect regulation. The second cluster was constituted by individuals with a higher proportion of male and intake more influenced by affect-related motivations. During this period, a generalized lower concern with the convenience attributes of foods was noted (namely, choice of processed products and fast-food meals), alongside an increase in time and efforts dedicated to home cooking.

Understanding the main changes and their underlying motivations in a time of unprecedented crisis is of major importance, as it provides the scientific support that allows one to anticipate the implications for the future of the global food and nutrition system and, consequently, to take the appropriate action.

Reported Changes in Eating Habits Related to Less Healthy Foods and Beverages during the COVID-19 Pandemic among US Adults

Background: The COVID-19 pandemic has triggered stress, anxiety, and disruption to many individuals’ daily lives, which might impact eating habits. Objective: To examine changes in eating habits related to less healthy foods and beverages during the early phase of the COVID-19 pandemic among US adults. Design: Cross-sectional study. Participants/setting: Authors used SummerStyles data gathered in June 2020 among 3916 US adults (≥18 years). Main outcome measures: The outcome of interest was the reported frequency of consuming more (1) unhealthy snacks and desserts including chips, cookies, and ice cream and (2) sugar-sweetened beverages (SSBs) like regular soda, fruit drinks, sports/energy drinks, sweetened coffee/teas during the COVID-19 pandemic. Responses were categorized as Never/Rarely, Sometimes, or Often/Always. Explanatory variables were sociodemographics, weight status, and census regions. Statistical analyses performed: We used multinomial regressions to calculate adjusted odds ratios (AOR) for Sometimes or Often/Always consuming more unhealthy snacks/desserts (vs. Never/Rarely); and Sometimes or Often/Always more SSBs (vs. Never/Rarely). Results: Overall, 36% of adults reported sometimes consuming more unhealthy snacks/desserts; 16% did so often/always. Twenty-two percent of adults reported sometimes drinking more SSBs; 10% did so often/always. Factors significantly associated with higher odds of reporting often/always consuming more unhealthy snacks/desserts were younger adults (AOR range = 1.51−2.86 vs. adults ≥65 years), females (AOR = 1.58 vs. males), non-Hispanic Black (AOR = 1.89 vs. non-Hispanic White), lower household income (AOR = 2.01 for <USD 35,000 vs. ≥USD 100,000), and obesity (AOR = 1.56 vs. underweight/healthy weight). Factors significantly associated with odds of Often/Always drinking more SSBs were being younger (AOR range = 2.26−4.39 vs. adults ≥65 years), non-Hispanic Black (AOR = 3.25 vs. non-Hispanic White), Hispanic (AOR = 1.75 vs. non-Hispanic White), non-Hispanic Other race/ethnicity (AOR = 2.41 vs. non-Hispanic White), lower education (AOR = 2.03 for ≤high school; AOR = 1.80 for some college vs. college graduate), lower household income (AOR range = 1.64−3.15 vs. ≥USD 100,000), and obesity (AOR = 1.61 vs. underweight/healthy weight). Conclusions: Consuming more sugary foods and SSBs during the first phase of the pandemic was higher in younger adults, lower-income adults, people of racial/ethnic minority groups, and adults with obesity. Dietary shifts to less healthy foods and drinks may influence metabolic health if sustained long-term. Implementing strategies to support individual’s healthy eating habits during the ongoing pandemic and the pandemic recovery may benefit health and wellness.

Food Purchase Behavior during The First Wave of COVID-19: The Case of Hungary

Coronavirus disease (SARSCoV-2) appeared in 2019 was confirmed as pandemic by the WHO on 11 March 2020. Stay-at-home order had an impact on consumers’ food purchase habits, as people around the world were able to leave their homes solely in extremely severe or urgent cases. In our research, we delve into the impact of COVID-19 pandemic on consumers’ food purchase habits. The research involved 3000 consumers during the first wave of coronavirus. The sample represents the Hungarian population by gender and age. To achieve the research goals, we applied multivariate statistical tools. The findings suggest that the pandemic could not change consumer attitude significantly, but the order of factors influencing purchases changed. Consumer motivation factors were organized into four well-distinguished factors: Healthy, domestic, and environmentally friendly choice; Usual taste and quality; Reasonable price; Shelf life. Due to the lack of outstanding data during segmentation, we developed four segments by hierarchical cluster analysis: Health- and environment-conscious women; Price sensitive young people; Taste-oriented men; Quality-oriented intellectuals. The results confirm that food manufacturers and traders need to be prepared for further restrictions in the future.

A qualitative exploration of the impact of COVID-19 on food decisions of economically disadvantaged families in Northern Ireland

Background

The first UK-wide lockdown to prevent the spread of COVID-19 had a serious financial impact on low-income households, a population already in higher risk of food insecurity and poor dietary choices. Qualitative data on the impact of COVID-19 lockdown on food decisions of UK families are scarce. This study aimed to explore how the measures to control the spread of COVID-19 influenced the food-related decisions of socioeconomically deprived families in Northern Ireland.

Methods

A qualitative study captured data from online individual interviews. Participation was open for parents of children 2–17 years old living on a tight budget in urban and rural areas of Northern Ireland. A sampling matrix enabled equal representation of single- and two-parent households, as well as parents of younger children (<12y) and adolescents (≥12y). Data were collected by using the methods of Photovoice and mapping exercise. Data were analysed through a thematic approach.

Results

Twelve online interviews were conducted and five distinct themes were identified reflecting families’ food-related decisions that were affected by the COVID-19 lockdown: 1) food planning; 2) food purchasing; 3) meal preparation; 4) eating and feeding behaviours and 5) eating food prepared outside the house.

Conclusions

The restrictions put in place to inhibit the spread of COVID-19 influenced all aspects of dietary decisions of low-income families. Changes observed during this period included frequent consumption of homemade meals, but also increased unhealthy snacking. Infrequent food shopping encouraged good meal planning, but was also a barrier to securing adequate fresh food. Food-related support including school meal assistance contributed to families’ food security, particularly those of single parents.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12307-1.

The Nutrition-COVID-19 Interplay: a Review

Purpose of Review

Nutritional status is affected by the COVID-19 pandemic, directly or indirectly. Even with the recent rollout of the coronavirus disease 2019 (COVID-19) vaccines and availability of medicines such as remdesivir, and monoclonal antibodies, host nutritional status is pivotal in the fight against the acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and outcomes. The purpose of this review is to discuss the effects of COVID-19-related lockdown on lifestyle behaviors, and the nutritional consequences, and the direct sequelae of the infection on nutrition including potential nutritional interventions.

Recent Findings

The COVID-19-related lockdown imposed radical changes in lifestyle behaviors with considerable short-term and long-term health and nutritional consequences including weight gain and obesity and increased cardiometabolic risk, consistently linked to worsened prognosis. The extent of the impact was dependent on food insecurity, overall stress and disordered eating, physical inactivity, and exposure to COVID-19-related nutrition information sources. COVID-19 could directly induce inflammatory responses and poor nutrient intake and absorption leading to undernutrition with micronutrient deficiencies, which impairs immune system function with subsequent amplified risk of infection and disease severity. Nutrition interventions through nutrition support, dietary supplementation, and home remedies such as use of zinc, selenium, vitamin D, and omega-3 fatty acids showed the most significant promise to mitigate the course of COVID-19 infection and improve survival rates.

Summary

The nutrition-COVID-19 relationship and related dietary changes mimic a vicious cycle of the double burden of malnutrition, both obesity and undernutrition with micronutrient deficiencies, which promote infection, disease progression, and potential death.

Consumer and food changes in Mexican households during maximal contingency in the COVID-19 pandemic

The Coronavirus disease (COVID-19) rapidly expanded throughout the world affecting human life in the health, social, cultural, economic and environmental aspects. On an international scale, some works have addressed the importance of the agri-food topic during the pandemic, especially about food consumption. The Mexican case is particularly relevant since it is the country with the highest proportion of overweight people. The objective of this work was to know the choices and consumption of foods in Mexican households during the period of maximal contingency. An on-line questionnaire was responded by 867 volunteers who answered about the aspects taken in consideration in their food consumption, the changes in the consumption of certain foods and the socioeconomic and health aspects of the family. Four groups were identified: “Budget consumers”, “Hedonics”, “Price conscious” and “Conscious”. Changes in the attitudes to food are not related to the health state, overweight, or family size; but are related to income level of households and above all, to the education level. Results show an opportunity to change for healthier food habits in Mexico, mainly in the most vulnerable sectors.

Control of type 2 diabetes mellitus during the COVID-19 pandemic

AIMS

Type 2 Diabetes Mellitus (T2DM) is a prevalent chronic condition that can lead to significant complications if not well controlled. The COVID-19 pandemic created disruptions in daily life; however, it is unknown whether the pandemic's disruptions affected the ability for adults with T2DM to control their condition. This study aims to fill the knowledge gap with the experiences of adults with T2DM in Arkansas, U.S. during the COVID-19 pandemic.

METHODS

This study analyzed cross-sectional, observational survey data collected from adults (≥18 years) who live, work, or receive healthcare in Arkansas; self-reported a diagnosis of T2DM; and completed the diabetes module of the Impact of COVID-19 online survey (n = 131) fielded in July-August 2020. Descriptive statistics were used to characterize the sample and survey responses, and multivariate regression was used to identify demographics, self-care behaviors, and access issues associated with uncontrolled T2DM (HbA1c ≥ 9% or 74.9 mmol/mol) or with an increase in HbA1c.

RESULTS

28.2% reported an increase in their HbA1c since the pandemic began, and 18.2% had uncontrolled T2DM. Educational level, eating healthily, and weight gain were negatively associated with uncontrolled T2DM. Eating less healthily and having difficulty accessing diabetes related medication were positively associated with an increase in HbA1c.

CONCLUSIONS

Adults with T2DM in Arkansas were reasonably able to maintain control of their T2DM during the five months post the first case of COVD-19 diagnosed in the state. However, T2DM self-management interventions targeting those with lower educational levels that are focused on eating habits and/or that improve access to diabetes medication should be considered for future public health emergencies.

“Stay at home with bakery products” can be public motto of quarantine days in the early period of COVID-19 outbreak: A nutritional infodemiology study

Aims

The aim of this retrospective infodemiological study is to investigate the public interest to the bakery products in the early period of coronavirus outbreak through Google Trends and open access data banks.

Methods

The category and regions were selected “food and drink”, Turkey, Italy and Sweden, respectively. Keywords were searched in Turkish, Italian and Swedish language by Google Trends. Search spectrums were “1 February 2011-1 September 2020” and “1 February-1 September 2020” to determine the monthly and daily search queries, successively. Sweden was included into study as a control group because there was no strict implementation in the pandemic. Daily case number of coronavirus, stringency index, stay at home requirements value and relative search volume (RSV) scores about selected foods and coronavirus were synthesized.

Results

Search queries of “flour”, “yeast”, “dough” and “bread” were too higher in Turkey and Italy within the outbreak period, corresponding to previous years. The RSV score of bread was higher than vegetable, fruit, fish and meat in all countries, but search profiles were different. It has been determined the potential relationship between RSV scores about some bakery products and stringency index in Turkey and Italy. In addition, daily new case number of coronavirus and RSV score of coronavirus can be related to public interests to bakery products in Italy. Bakery products related top queries were usually about finding a recipe.

Conclusion

Quarantine enforcement can cause the increased web-based search volume of the bakery products in the early period of COVID-19 outbreak. Understanding of search queries about food choices will help to effectively combat against coronavirus. According to followed data, the public should be informed about the outcomes of dietary habits in the quarantine regions.

Finally, the chance to eat healthily: Longitudinal study about food consumption during and after the first COVID-19 lockdown in Italy

With the COVID-19 outbreak, structural constraints and social psychological factors changed the dietary habits of many people. This two-wave longitudinal study performed in Italy aimed to explore people’s perceptions of changes in healthy and unhealthy food consumption before and during the first lockdown and the possible persistence of such changes after its official end, as a function of the number of people cohabiting, negative emotion activation, and individual eating styles. A total of 728 Italian adults completed self-reported food consumption measures and related psychological variables at both time points. In the lockdown period, participants reported an increase in healthy food consumption and involvement in cooking and a decrease in the consumption of junk food. This general pattern was stronger for both young and restrained eaters. The intensity of negative emotions and the number of cohabitants were not associated with the examined behaviour. In the post-lockdown period, the new consumption pattern acquired during the confinement was partially discontinued: participants cut down their healthy food consumption as well as their involvement in food preparation, but they continued to reduce their junk food intake. These results suggest that people’s food consumption patterns can easily improve when the situation is favourable (e.g., more time and opportunities for cooking healthy meals) and offer an interesting theoretical contribution to understanding the factors useful in promoting healthy eating, in the event of a future outbreak.

Evaluation of the Food Choice Motives before and during the COVID-19 Pandemic: A Cross-Sectional Study of 1232 Adults from Croatia

The coronavirus disease 2019 pandemic brought changes to almost every segment of our lives, including dietary habits. We present one among several studies, and the first on the Croatian population, aiming at investigating changes of food choice motives before and during the pandemic. The study was performed in June 2021 as an online-based survey, using a 36-item Food Choice Questionnaire applied for both the periods before and during the pandemic. The final sample consisted of 1232 adults living in Croatia. Sensory appeal was ranked as the number one most important food choice motive before, whereas health was ranked as the number one most important food choice motive during the pandemic. Ethical concern was reported as the least important food choice motive both before and during the pandemic. In women, natural content (p = 0.002), health, convenience, price, weight control, familiarity, and ethical concern (all p < 0.001) became more important during the pandemic, while price (p = 0.009), weight control, familiarity, and ethical concern (all p < 0.001) became more relevant for men. All together, these can be considered favorable changes toward optimal diets and may result in beneficial influences on health and lifestyle. Education strategies and efficiently tackling misinformation are prerequisites for informed food choice, which will ensure long-lasting positive effects of such changes.

Changes in lifestyle, diet, and body weight during the first COVID 19 'lockdown' in a student sample

Changes in lifestyle and body weight were examined retrospectively in students at a German university during the first COVID-19 lockdown period (March 12- May 3, 2020) using an online survey. Data from a total of 827 participants was used. Almost half of the students reported perceived body weight changes with about 27% gaining weight and around 22% losing weight. Regression analyses showed that consumption changes in the following food categories: fruits, sweets and cakes, bread and bakery products, pasta, savoury snacks, and meats and sausages were predictive of weight changes. Additionally, changes in the frequency of cooking with fresh ingredients, physical activity, exercise, smoking, and alcohol consumption as well as pre-lockdown BMI were all predictive of weight changes. Given the continuous global pandemic, increased and innovative public health efforts to support this population group are needed.

Empathy and Language in the Clinician Patient Relationship: Improving the Translation of Evidence to Practice

For clinicians, effective communication goes beyond the delivery of scientific information to include an understanding of who the patient is and what they value; treating them with respect; and acknowledging their emotional and social realities. Recognizing our own implicit biases and cultivating a more mindful approach to the impact of language, especially around weight and food, and using verbal and nonverbal approaches to convey empathic concern can improve our relationships with our patients. Patients who feel seen and respected are more likely to follow through with recommendations including dietary change, leading to improved health and quality of life.

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

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

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

Objective:

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

Design:

Cross-sectional study.

Setting:

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

Participants:

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

Results:

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

Conclusion:

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

Perceived Stress and Increased Food Consumption during the 'Third Wave' of the COVID-19 Pandemic in Spain

The COVID-19 pandemic has impacted the mental health of people worldwide. An increase in perceived stress can lead to unhealthy behaviors such as increased food consumption. The aim of this study was to find the level of perceived stress and its relationship with increased food consumption during the “third wave” of the COVID-19 pandemic in Spain. This was a cross-sectional study that employed anonline self-reported frequency of consumption questionnaire and the Perceived Stress Scale-10. A total of 637 subjects participated and 83.6% of respondents had moderate or high stress—more prevalent in the female and young respondents. Moreover, 36.1% of respondents reported that they had increased the frequency of consumption of some foods, mainly nuts, snacks, and jellybeans, along with coffee, tea, cocoa, and soft drinks. Eating between meals was more pronounced in those with high stress (65.1%) than in those with moderate stress (40.4%) and low stress (20.2%). Furthermore, the respondents with high stress reported greater weight gain. Thus, the results show that the level of perceived stress during the ‘third wave’ of this pandemic increased food consumption.

Adherence to healthy food choices during the COVID-19 pandemic in a U.S. population attempting to lose weight

BACKGROUND AND AIMS

Food preferences are often modified in populations during stressful, unanticipated events. We examined how a U.S. population's food choices changed during the beginning of the COVID-19 stay-at-home orders, specifically during the spring of 2020.

METHODS AND RESULTS

Daily dietary intake data from a digital behavior change weight loss program, which includes an interface for logging meals, beverages, and snacks, were analyzed to assess self-reported food choices from March 5-March 11, 2020 ("Start-COVID") and during the first week of the COVID-19 lockdown (March 12-March 18, 2020; "during-COVID"). The final sample consisted of 381,564 participants: 318,076 (83.4%) females, the majority who were aged 45-65 years (45.2%). Results indicate that self-reported servings of fresh fruit and vegetable intake decreased from start-to during-COVID, while intake of red meat and starchy vegetables increased. More men than women increased their intake of red meat and processed meat. Less overall change in fruit and vegetable consumption was seen in those 66 and older, compared to aged 18-35. Lean meat and starchy vegetable intake increased in older participants, but the change was negligible in younger subjects. More subjects aged 18-35 years reduced their intake of caffeine, desserts, lean meat, and salads compared to older participants. No changes were observed in snack or alcohol intake logged.

CONCLUSION

This study revealed that particular food groups were altered according to age and gender during the first weeks of COVID lockdown. Understanding changes in food choices during a crisis may be useful for preparing supply chains and public health responses.

The Janus-faced effects of COVID-19 perceptions on family healthy eating behavior: Parent's negative experience as a mediator and gender as a moderator

This research examines the effects of COVID‐19 perceptions and negative experiences during the pandemic time on parental healthy eating behavior and whether these relationships interact with a parent’s gender. We ran a survey of parents who had at least one child aged 3 to 17 years old living in the United Kingdom. We received 384 valid responses, which were analysed via a variance‐based structural equation modeling approach to test our hypotheses. The results revealed that COVID‐19 perceptions effects were Janus‐faced. While they indirectly and negatively impact healthy eating behavior mediated by triggering negative experiences during the pandemic, COVID‐19 perceptions, however, directly get parents, especially fathers, more engaged into healthy eating behavior – making COVID‐19 perceptions total effects positive on healthy eating behavior. This explorative model is novel in the sense that it is the first of its kind to cast light on how parental healthy eating behavior can be shaped in pandemic time. The research is particularly timely due to the uncertain times in which the research is situated, that is, the worldwide pandemic (also termed COVID‐19); the paper highlights how family eating practices can undergo dramatic shifts during acute crises.

Increased COVID-19 Lockdown Burden in Italian Adults with Gastrointestinal Diseases

BACKGROUND

Coronavirus disease 2019 (COVID-19) causes not only severe illness but also detrimental effects associated with the lockdown measures. The present study aimed to evaluate reported lifestyle changes in a cohort of adults in Italy, including physical exercise, food choices, and psychological wellbeing, after two months of lockdown.

METHODS

A web survey on social media (Facebook and LinkedIn) of 32 multiple-choice questions aiming to evaluate the impact of the national COVID-19 lockdown in a sample of Italian adults.

RESULTS

We received 1378 complete responses (women 68.3%, mean age 39.5 ± 12.5 years). The percentage of participants reporting regular exercise decreased during lockdown (52 vs. 56.5%). The vast majority of people continued to consume the three traditional meals per day, but the consumption of meat, fish, and eggs significantly decreased. Women reported more frequent anxiety, sadness, fear, and feelings of insecurity than men. The factors predicting the worst outcome during the lockdown were being a woman, low education and income, gastrointestinal diseases.

CONCLUSION

The lockdown has had a limited impact on food choices and physical exercise in Italian adults of our series, since most of them made an effort to improve their lifestyle. However, women with gastrointestinal diseases reported more frequent negative feelings and poor adaptation to the lockdown.

Eating Motives and Other Factors Predicting Emotional Overeating during COVID-19 in a Sample of Polish Adults

We hypothesised that the higher levels of emotion-related predictors (eating motive in the form of affect regulation and COVID-19-related stress) would be associated with higher emotional overeating, after accounting for the effects of demographic variables (gender and BMI) and other eating motives (visual- and attitude-related predictors: liking, pleasure, visual appeal; body- and health-related predictors: need and hunger, health, weight control). Participants (N = 868; Mage = 33.53 years, SD = 11.98) completed: the Eating Motivation Survey, the Emotional Overeating Questionnaire, a COVID-19-related stress measure and a socio-demographic survey. The final step of the regression with emotional overeating was significant; affect regulation and COVID-19-related stress were significantly related to emotional overeating (ΔF p < 0.001, Adj. ΔR2 = 0.13). During the COVID-19 pandemic, eating can, on the one hand, help to cope with the current difficult situation and the negative emotions associated with it; on the other hand, frequent use of this tendency can lead to rigid regulation of affect and use of this mechanism as the dominant mechanism. Therefore, limited social contact, related disruptions in daily activities and stress resulting from COVID-19 should generate appropriate interventions, not necessarily focusing only on emotional eating, but also on the resources of the individual. It is worth encouraging specialists to implement alternative methods of contact with their patients, e.g., online.

Food Security and COVID-19: A Systematic Review of the First-Year Experience

For decades, global food security has not been able to address the structural problem of economic access to food, resulting in a recent increase in the number of undernourished people from 2014. In addition, the FAO estimates that the number of undernourished people drastically increased by 82–132 million people in 2020 due to the COVID-19 pandemic. To alleviate this dramatic growth in food insecurity, it is necessary to understand the nature of the increase in the number of malnourished during the pandemic. In order to address this, we gathered and synthesized food-security-related empirical results from the first year of the pandemic in a systematic review. The vast majority (78%) of the 51 included articles reported household food insecurity has increased (access, utilization) and/or disruption to food production (availability) was a result of households having persistently low income and not having an adequate amount of savings. These households could not afford the same quality and/or quantity of food, and a demand shortfall immediately appeared on the producer side. Producers thus had to deal not only with the direct consequences of government measures (disruption in labor flow, lack of demand of the catering sector, etc.) but also with a decline in consumption from low-income households. We conclude that the factor that most negatively affects food security during the COVID-19 pandemic is the same as the deepest structural problem of global food security: low income. Therefore, we argue that there is no need for new global food security objectives, but there is a need for an even stronger emphasis on poverty reduction and raising the wages of low-income households. This structural adjustment is the most fundamental step to recover from the COVID-19 food crises, and to avoid possible future food security crises.

The COMET study: Examining the effects of COVID-19-related perceived stress on Los Angeles Mothers' dysregulated eating behaviors, child feeding practices, and body mass index

The COVID-19 pandemic and associated restrictions and mandates have had pronounced implications on the well-being of individuals. This study conducted exploratory analyses of the relationship between COVID-19-related life changes and COVID-19-related perceived stress and associations between COVID-19-related perceived stress and dysregulated maternal eating behaviors, child feeding practices, and body mass index (BMI) in Los Angeles mothers. Mothers (M_age = 37.6 ± 6.9) of children aged 5-11 (N = 197, response rate 92.5%) completed an online questionnaire assessing COVID-19-related life changes, COVID-19-related perceived stress, mechanisms used to cope with COVID-19, child feeding practices, their own eating behavior, demographics, and height and weight. The highest proportion of participants reported changes to work, disruptions due to childcare challenges, and increased home responsibilities. Higher COVID-19-related perceived stress was experienced by those who reported loss of work hours (29%), loss of job (15.2%), reduced ability to afford childcare (18.8%), and reduced ability to afford rent/mortgage (19.8%) (ps < 0.05) than those who did not. The most common strategy that mothers indicated using to cope with COVID-19 related stress was eating comfort foods (e.g., candy and chips) (58.7%). COVID-19-related perceived stress was positively associated with mother's BMI and emotional eating (ps < 0.05). Rewarding their child's eating and behavior with food were both positively associated with the number of COVID-19 related life changes (ps < 0.05). This study yields new knowledge of the effects of the COVID-19 pandemic on mothers' dysregulated eating behaviors and child feeding practices. The results highlight the importance of conducting further research to confirm these findings and understand the nature of associations between COVID-19-related perceived stress and health. This is crucial in order to explore ways in which lasting impacts of the pandemic on mental and physical health can be prevented.

Eating in the lockdown during the Covid 19 pandemic; self-reported changes in eating behaviour, and associations with BMI, eating style, coping and health anxiety

The global coronavirus pandemic (Covid 19) resulted in national lockdowns where individuals were asked to isolate in their homes to stop the spread of the disease. Using a cross-sectional survey, the current paper aimed to examine self-reported changes in eating patterns and behaviour during the lockdown in the UK, and associations with BMI, demographic variables, eating styles, health anxiety, food insecurity and coping strategies. Participants (N = 620) were recruited online through social media advertising. The results showed that there were self-reported changes to food consumption during the lockdown across the sample. Increases in consumption of HED (high energy density) snack foods during the lockdown was associated with sex, pre-lockdown eating behaviour (emotional eating and uncontrolled eating), and Covid-specific health anxiety. Increases in positive eating practices such as eating more home prepared foods, and fruits and vegetables, were associated with adaptive coping strategies. Higher emotional eating (EE) during the lockdown was associated with a higher BMI, higher pre-lockdown EE and maladaptive coping strategies. Maladaptive coping strategies moderated the relationship between BMI and EE during the lockdown. In particular a higher BMI was associated with higher EE during the lockdown if an individual also had higher maladaptive coping strategies. These findings suggest that changes to eating behaviour may be part of a wider style of maladaptive or adaptive coping, particularly in those with a history of EE or uncontrolled eating. Preparing individuals to adopt more adaptive coping strategies during lockdown situations may be crucial to improving health during subsequent the lockdown events.

Health Behaviors of Higher Education Students from 7 Countries: Poorer Sleep Quality during the COVID-19 Pandemic Predicts Higher Dietary Risk

Health behaviors of higher education students can be negatively influenced by stressful events. The global COVID-19 pandemic presents a unique opportunity to characterize and compare health behaviors across multiple countries and to examine how these behaviors are shaped by the pandemic experience. Undergraduate and graduate students enrolled in universities in China, Ireland, Malaysia, South Korea, Taiwan, the Netherlands and the United States (USA) were recruited into this cross-sectional study. Eligible students filled out an online survey comprised of validated tools for assessing sleep quality and duration, dietary risk, alcohol misuse and physical activity between late April and the end of May 2020. Health behaviors were fairly consistent across countries, and all countries reported poor sleep quality. However, during the survey period, the COVID-19 pandemic influenced the health behaviors of students in European countries and the USA more negatively than Asian countries, which could be attributed to the differences in pandemic time course and caseloads. Students who experienced a decline in sleep quality during the COVID-19 pandemic had higher dietary risk scores than students who did not experience a change in sleep quality (p = 0.001). Improved sleep quality was associated with less sitting time (p = 0.010). Addressing sleep issues among higher education students is a pressing concern, especially during stressful events. These results support the importance of making education and behavior-based sleep programming available for higher education students in order to benefit students' overall health.