Impacts of the COVID-19 Pandemic on Food Security and Diet-Related Lifestyle Behaviors: An Analytical Study of Google Trends-Based Query Volumes

Public and Research Interest in Telemedicine From 2017 to 2022: Infodemiology Study of Google Trends Data and Bibliometric Analysis of Scientific Literature

BACKGROUND

Telemedicine offers a multitude of potential advantages, such as enhanced health care accessibility, cost reduction, and improved patient outcomes. The significance of telemedicine has been underscored by the COVID-19 pandemic, as it plays a crucial role in maintaining uninterrupted care while minimizing the risk of viral exposure. However, the adoption and implementation of telemedicine have been relatively sluggish in certain areas. Assessing the level of interest in telemedicine can provide valuable insights into areas that require enhancement.

OBJECTIVE

The aim of this study is to provide a comprehensive analysis of the level of public and research interest in telemedicine from 2017 to 2022 and also consider any potential impact of the COVID-19 pandemic.

METHODS

Google Trends data were retrieved using the search topics "telemedicine" or "e-health" to assess public interest, geographic distribution, and trends through a joinpoint regression analysis. Bibliographic data from Scopus were used to chart publications referencing the terms "telemedicine" or "eHealth" (in the title, abstract, and keywords) in terms of scientific production, key countries, and prominent keywords, as well as collaboration and co-occurrence networks.

RESULTS

Worldwide, telemedicine generated higher mean public interest (relative search volume=26.3%) compared to eHealth (relative search volume=17.6%). Interest in telemedicine remained stable until January 2020, experienced a sudden surge (monthly percent change=95.7%) peaking in April 2020, followed by a decline (monthly percent change=-22.7%) until August 2020, and then returned to stability. A similar trend was noted in the public interest regarding eHealth. Chile, Australia, Canada, and the United States had the greatest public interest in telemedicine. In these countries, moderate to strong correlations were evident between Google Trends and COVID-19 data (ie, new cases, new deaths, and hospitalized patients). Examining 19,539 original medical articles in the Scopus database unveiled a substantial rise in telemedicine-related publications, showing a total increase of 201.5% from 2017 to 2022 and an average annual growth rate of 24.7%. The most significant surge occurred between 2019 and 2020. Notably, the majority of the publications originated from a single country, with 20.8% involving international coauthorships. As the most productive country, the United States led a cluster that included Canada and Australia as well. European, Asian, and Latin American countries made up the remaining 3 clusters. The co-occurrence network categorized prevalent keywords into 2 clusters, the first cluster primarily focused on applying eHealth, mobile health (mHealth), or digital health to noncommunicable or chronic diseases; the second cluster was centered around the application of telemedicine and telehealth within the context of the COVID-19 pandemic.

CONCLUSIONS

Our analysis of search and bibliographic data over time and across regions allows us to gauge the interest in this topic, offer evidence regarding potential applications, and pinpoint areas for additional research and awareness-raising initiatives.

Trends in Sugar From Packaged Foods and Beverages Purchased by US Households Between 2002 and 2020

BACKGROUND

Excess sugar consumption is a public health concern in the United States. How sugar purchases have changed over time, whether there are disparities across subpopulations, and the contribution of various food groups are unclear.

OBJECTIVE

To assess trends in sugar from packaged foods and beverages purchased by US households between 2002 and 2020.

DESIGN

This is an open cohort study.

PARTICIPANTS/SETTING

We obtained data from the NielsenIQ U.S. Homescan Consumer Panel, which collects data on household purchases of all consumer packaged goods in 52 metropolitan and 24 non-metropolitan markets across the United States. We assessed data on food and beverage purchases for 1,163,447 household-years.

MAIN OUTCOME MEASURES

The primary outcomes are the total sugar in grams purchased per capita per day and percentage of calories from sugar, by sociodemographic group.

STATISTICAL ANALYSES PERFORMED

We used linear regression to estimate trends in total grams of sugar per capita per day, percentage of calories from sugar, and percentage of total sugar purchases by food or beverage group. We estimated means for select years and tested for significance compared with 2002 and with the previous timepoint and calculated the overall P-value for the linear trend using time series regression.

RESULTS

Total sugar purchases decreased over the study period, both in absolute terms (-37.2 g/capita/day; 95% confidence interval [CI], -38.7, -35.6) and as a percentage of total calories purchased (-5.3 percentage points; 95% CI, -5.5, -5.2). Sugar purchases declined for all sociodemographic groups, but disparities have persisted or widened, particularly among individuals who are non-Hispanic Black, low-income, and with lower educational attainment. Beverages' contributions to sugar purchases decreased 8.1 percentage points (95% CI, -8.4, -7.8).

CONCLUSION

In the United States, purchases of sugar declined, but disparities by socioeconomic status and race or ethnicity persisted or widened. Policies to further reduce sugar consumption and the burden of diet-related disparities are needed.

Variations in Food Safety Concerns, Hygiene Practices, and Purchasing Behaviors During Pandemic Era: What We Learnt from Coronavirus Disease 2019

The purpose of the study is to evaluate the food safety concerns, purchasing behaviors, and hygiene practices of individuals who contracted and did not contract the severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection. A total of 2393 individuals 18-65 years years of age, 760 who contracted and 1633 who did not contract SARS-CoV-2 infection, participated in the study. Participants were administered a questionnaire to assess demographic information, food safety concerns, hygiene practices, purchasing behavior, and fear of the coronavirus disease 2019 (COVID-19). Results indicated that 56.3% of participants expressed concern about food safety, and 67% were concerned about infected individuals while shopping. Participants who did not contract COVID-19 had higher levels of food safety concerns and generally adhered to better hygiene practices such as handwashing, hygienic food preparation, sanitizer use, and cleaning and disinfection practices (p < 0.05). Overall, purchasing behaviors did not significantly differ by the infection status, except for a significant difference in reduced purchase frequency (p < 0.001). In addition, purchasing behavior varied in relation to fear levels (p < 0.05). As the pandemic appears to be increasingly controlled, the insights gained from managing outbreaks might contribute to improved understanding and preparedness for global pandemics and food safety education in the future.

Using Natural Language Processing to Explore Social Media Opinions on Food Security: Sentiment Analysis and Topic Modeling Study

BACKGROUND

Social media has the potential to be of great value in understanding patterns in public health using large-scale analysis approaches (eg, data science and natural language processing [NLP]), 2 of which have been used in public health: sentiment analysis and topic modeling; however, their use in the area of food security and public health nutrition is limited.

OBJECTIVE

This study aims to explore the potential use of NLP tools to gather insights from real-world social media data on the public health issue of food security.

METHODS

A search strategy for obtaining tweets was developed using food security terms. Tweets were collected using the Twitter application programming interface from January 1, 2019, to December 31, 2021, filtered for Australia-based users only. Sentiment analysis of the tweets was performed using the Valence Aware Dictionary and Sentiment Reasoner. Topic modeling exploring the content of tweets was conducted using latent Dirichlet allocation with BigML (BigML, Inc). Sentiment, topic, and engagement (the sum of likes, retweets, quotations, and replies) were compared across years.

RESULTS

In total, 38,070 tweets were collected from 14,880 Twitter users. Overall, the sentiment when discussing food security was positive, although this varied across the 3 years. Positive sentiment remained higher during the COVID-19 lockdown periods in Australia. The topic model contained 10 topics (in order from highest to lowest probability in the data set): "Global production," "Food insecurity and health," "Use of food banks," "Giving to food banks," "Family poverty," "Food relief provision," "Global food insecurity," "Climate change," "Australian food insecurity," and "Human rights." The topic "Giving to food banks," which focused on support and donation, had the highest proportion of positive sentiment, and "Global food insecurity," which covered food insecurity prevalence worldwide, had the highest proportion of negative sentiment. When compared with news, there were some events, such as COVID-19 support payment introduction and bushfires across Australia, that were associated with high periods of positive or negative sentiment. Topics related to food insecurity prevalence, poverty, and food relief in Australia were not consistently more prominent during the COVID-19 pandemic than before the pandemic. Negative tweets received substantially higher engagement across 2019 and 2020. There was no clear relationship between topics that were more likely to be positive or negative and have higher or lower engagement, indicating that the identified topics are discrete issues.

CONCLUSIONS

In this study, we demonstrated the potential use of sentiment analysis and topic modeling to explore evolution in conversations on food security using social media data. Future use of NLP in food security requires the context of and interpretation by public health experts and the use of broader data sets, with the potential to track dimensions or events related to food security to inform evidence-based decision-making in this area.

The association between interest of nutritional supplements and COVID-19 pandemic - evidence from Google Trends

BACKGROUND

Due to the spread of the coronavirus disease 2019 (COVID-19) pandemic in 2020, the interest of nutritional supplements has emerged. Limited data are available on how the COVID-19 pandemic affects the search interest in nutritional supplements in Taiwan and worldwide. The study aims to investigate changes in public search interest of nutritional supplements pre- and during the COVID-19 pandemic.

METHODS

Our World in Data dataset was used to collect both global and local (Taiwan) number of COVID-19 newly confirmed cases and deaths. Google Trends search query was being used to obtain relative search volumes (RSVs) covering a timeframe between 2019 to 2022. Spearman's rank-order correlation coefficients were used to measure relationships between confirmed new cases and deaths and RSVs of nutritional supplements. Multivariate analysis was conducted to examine the effect of domestic and global new cases and deaths on the RSVs of nutritional supplements.

RESULTS

The mean RSVs for nutritional supplements were higher during the COVID-19 pandemic period (between 2020 to 2022) compared to the pre-pandemic period (year of 2019) for both Taiwan and worldwide. In terms of seasonal variations, except for vitamin D, the mean RSVs of probiotics, vitamin B complex, and vitamin C in winter were significantly lower compared to other seasons in Taiwan. The RSVs of nutritional supplements were not only affected by domestic cases and deaths but also by global new cases and deaths.

CONCLUSIONS

The interests in nutritional supplements had substantially increased in response to the COVID-19 pandemic. The RSVs of nutritional supplements in Taiwan were not only influenced by global and domestic pandemic severity but also by seasons.

Functional Food Consumption and Its Associated Factors among University Students in Malaysia during COVID-19 Pandemic

Background

In the current situation of COVID-19, dietary intake that incorporates functional foods may potentially be a preventive measure for defence against viral infection. This study aimed to determine the consumption of functional foods and its associated factors among university students during COVID-19.

Methods

This was a cross-sectional study conducted among 284 Malaysian university students in Kuala Lumpur, Malaysia. An online self-administered questionnaire was employed to assess subjects' nutrition knowledge, dietary habits, attitude towards functional foods, recognition and consumption of functional food products.

Results

Out of 284 respondents, 41.9% had poor level of nutrition knowledge and 57% had moderate level of functional food-related attitude, with seven types of functional foods consumed on average (57.0%). Binary logistic regression showed that university students who consumed fruits at least three times per day (aOR = 11.18; 95% CI: 1.46, 80.17), salty snacks (aOR = 2.90; 95% CI: 1.43, 5.86), soft drinks/sugar-sweetened beverages (SSB) (aOR = 3.12; 95% CI: 1.53, 5.26) and pure juice (aOR = 2.80; 95% CI: 1.48, 5.30) were more likely to consume functional foods during COVID-19 (P < 0.05).

Conclusion

The findings could provide information to public and private sectors in terms of creating a supportive environment to encourage and promote the awareness and consumption of functional foods and their associated health benefits.

Impact of food insecurity and food environment on the diet quality of older African Americans during the COVID-19 pandemic

Introduction

A high quality diet is vital in promoting wellbeing and ensuring good health, particularly for those living with chronic conditions. Older African Americans, already burdened with a higher prevalence of chronic conditions, also face a higher risk for suboptimal diets. The COVID-19 pandemic had lasting effects on access to healthy food for all Americans, but some demographic groups were disproportionately affected. Older African Americans, who already experienced reduced access to healthy food pre-pandemic, were particularly afflicted, but the full extent of the pandemic's impact on their food insecurity and food environment remains unclear.

Methods

To address this gap, we conducted a study among 102 older African Americans in South Los Angeles between October 2021 and July 2022 during the COVID-19 pandemic. Participants completed surveys on dietary intake, food insecurity, and neighborhood food environment. We measured dietary quality using the healthy eating index (HEI)-2015. The analysis included descriptive, bivariate chi-square, t-tests, analysis of variance, and multiple linear and logistic regression.

Results

While overall dietary quality was suboptimal, most participants met the guidelines for fruit and vegetable consumption. Food insecurity was associated with lower overall diet quality and lower total fruit and whole fruit intake. However, there was no association between food environment and diet quality.

Discussion

In light of our findings, further intervention is critical to improving diet quality, especially among older African Americans living with chronic conditions in the post-pandemic era.

Online Reputation for Food Sector Exporters in the B2B Context: The Importance of Sustainability

Food exporting companies play a fundamental role in the development of international trade. However, the conceptualization and measurement of their online corporate reputation has not been extensively studied in Business to Business markets, unlike in Business to Consumer contexts. The aim of this research is to identify the variables that determine the online reputation of food companies operating in B2B markets, and to analyze their relationship with the volume of food exports. For this purpose, a three-stage quantitative and qualitative study has been developed, based on in-depth interviews with experts from export organizations and managers of Peruvian food exporting companies, the estimation of an Advanced Sentiment Analysis, the construction of a Total Online Reputation Index (TOR), and the development of regression analysis. The study has identified 13 variables that affect the online reputation of food exporting companies and indicates that the presence of sustainability content on their website and the number of pages visited positively affect the volume of food exports. Moreover, the TOR could have a significant explanatory capacity with respect to company exports. These results constitute a reference guide for both companies in the sector and official export agencies, highlighting the critical aspects to promote their exports.

Anti-SARS-CoV-2 receptor binding domain antibodies after the second dose of Sinovac and AstraZeneca vaccination

Purpose

The Sinovac and AstraZeneca vaccines are the primary coronavirus disease 2019 vaccines in Indonesia. Antibody levels in vaccine-injected individuals will decline substantially over time, but data supporting the duration of such responses are limited. Therefore, this study aims to quantitatively evaluate antibody responses resulting from the completion of Sinovac and AstraZeneca administration in Indonesian adults.

Materials and Methods

Participants were divided into two groups based on their vaccine type. Both groups were then assessed on the anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor binding domain (anti-SRBD) concentrations. The anti-SRBD level was measured using Elecsys anti-SARS-CoV-2 S assay and analyzed every month until 3 months after the second vaccination.

Results

The results presented significant differences (p=0.000) in immunoglobulin G (IgG) titers among the vaccines' measurement duration, where all samples observed a decrease in IgG titers over time. The mean titer levels of anti-SRBD IgG in the group given Sinovac were high in the first month after vaccination and decreased by 55.7% in 3 months. AstraZeneca showed lesser immune response with a slower decline rate. Adverse effects following immunization (AEFI) showed that systemic reactions are the most reported in both vaccines, with a higher percentage in the second dose of AstraZeneca type vaccines.

Conclusion

Sinovac induced more significant titers of anti-SRBD IgG 1 month after the second dose but generated fewer AEFIs. In contrast, AstraZeneca generated more AEFIs, in mild to moderate severity, but provided lower levels of anti-SRBD IgG.

Lifestyle and Dietary Patterns during the COVID-19 Lockdown in Bahrain: A Web-Based Cross-Sectional Study

Lifestyle factors such as dietary habits, perceived weight, sleep, and physical activity worsened during the COVID-19 pandemic. Through this study, we aimed to understand the impact of COVID-19 on these lifestyle factors in Bahrain. A cross-sectional study was conducted among 1005 adult Bahrainis. Data were collected online using a structured and validated questionnaire for the assessment of eating habits, physical activity, and lifestyle during the COVID-19 pandemic. Participants were snowballed through those who agreed to answer the online questionnaire. There was a higher consumption of fast food, and a higher dependence on takeaways during the COVID-19 pandemic. About 63.5% of the participants consumed >4 meals per day, compared to 36.5% before the COVID-19. About 30% reported consumption of sugar sweetened beverages from two to three times a day. Weight loss was predominantly observed in persons exercising 1-3 times a week. The consumption of sugar-sweetened beverages was also high, with about 19% reporting drinking sweet beverages once every day, 10.6% from two to three times a day, and 40.4% from one to four times a week. A higher proportion of the participants reported poor sleep quality during the pandemic (31.2%) compared to before (12.2%), and 39.7% of the participants reported feeling lazy. Screen time use also doubled during the pandemic, with participants spending more than five hours per day on screens for entertainment, which went from 22.4% before to 51.9% during the pandemic. The lifestyle and dietary habits changed drastically for our study participants during the pandemic. The increased reliance on processed fast food instead of healthier options is a challenge to be tackled in any future pandemic situation. Future research needs to focus on strategies to promote healthier lifestyle modifications during situations such as the COVID-19 pandemic.

The Effect of Fear of COVID-19 on Women's Attitudes toward Cancer Screening and Healthy Lifestyle Behaviors: A Cross-Sectional Study

Purpose

The study was conducted to evaluate the effect of fear of COVID-19 on women's attitudes toward cancer screening and healthy lifestyle behaviors.

Method

The study is of descriptive and cross-sectional type. The sample of the study consisted of 221 women living in Turkey. Research data were collected using Introductory Information Form, Attitude Scale for Cancer Screening, The Fear of COVID-19 Scale and Healthy Lifestyle Behaviors Scale II (HLBS-II).

Results

It was found out that 92.3% of the women did not have cancer screening during the pandemic period, 33.0% of the women who did not have it because they were afraid of the contamination, 33.0% thought they were healthy, 13.1% did not have screening tests because they thought that screening tests were not easy and accessible during the pandemic period. While no significant relationship was found between women's attitudes toward cancer screenings and fear of COVID-19 (P > 0.05), a positive significant relationship was found between women's attitudes toward cancer screenings and spiritual growth, health responsibility and interpersonal relations scores, which are sub-dimensions of the HLBS-II scale (P > 0.05). In addition, it was found out that women's fear of COVID-19 affected interpersonal relations and stress management (P < 0.05).

Conclusion

In our study, it was concluded that most of the women did not have cancer screening during the pandemic, and that the fear of COVID-19 affected such healthy lifestyle behaviors as interpersonal relations and stress management.

Factors Influencing Consumers' Organic Food Continuous Purchase Intentions during the Post-Pandemic Era: An Empirical Investigation in China

During the evolutionary phases of the COVID-19 pandemic, consumers' eating habits and spending behaviours have progressively shifted to the pursuit of the safer and healthier food products, such as organic food. Therefore, this study investigated the factors affecting Chinese buyers' organic food continuous purchase intentions (CPI) during the post-pandemic era. To better adapt to the current consumption context in China, this study proposed a modified TPB framework (M-TPB), by replacing subjective norms with Chinese cultural variables, such as face consciousness and group conformity, and adding constructs of perceived value of organic food (PVOF), health consciousness, and the impact of COVID-19 (IOC). Convincingly, experimental results from a structural equation model analysis of 460 usable responses indicate that M-TPB has superior explanatory power (R² = 65%) compared with the TPB model (R² = 40%) for explaining organic food CPI during the post-pandemic period. The path analysis demonstrated that perceived behavioural control, attitude, face consciousness, group conformity, health consciousness, IOC, and PVOF had substantial positive effects on CPI, while subjective norms were not significantly related. Moreover, IOC exhibited a positive and significant relationship with health consciousness and PVOF. These findings can be useful for stakeholders in the Chinese organic food industry to generate timely promoting strategies during the post-pandemic period.

Dietary supplement use and its related factors among Chinese international and Korean college students in South Korea

BACKGROUND/OBJECTIVES

The consumption of dietary supplements has shown an increase among young people in their 20s. We aimed to compare the use of dietary supplements and related factors between Chinese international and Korean college students living in South Korea.

SUBJECTS/METHODS

We conducted online surveys of 400 Chinese international students and 452 Korean college students from January to February 2021. We analyzed the factors related to the use of dietary supplements by these students using multi-group structural equation modeling and logistic regression analysis.

RESULTS

Approximately 65% of the Chinese international students and 93% of the Korean college students consumed dietary supplements at least once in the year preceding the survey. The common types of dietary supplements consumed by both groups of students were vitamin and mineral supplements, Lactobacillus products, and red ginseng products. Structural equation modeling showed that perception of the consumption of dietary supplements by family and friends positively influenced attitude toward dietary supplements. This effect was higher for Korean college students than for Chinese international students (P < 0.01). Attitude toward dietary supplements positively influenced their use, and this effect was higher for Chinese international students than for Korean college students (P < 0.001). Logistic regression analysis showed that the use of dietary supplements by Chinese international students was significantly associated with age, self-reported health status, interest in health, perception of and attitude toward dietary supplements, and length of residence in South Korea. Among Korean college students, it was associated with exercise frequency and attitude toward dietary supplements.

CONCLUSION

This study showed significant differences in the use of dietary supplements and related factors between Chinese international and Korean college students. Therefore, nutrition education programs on dietary supplements need to have differentiated content for each group. Such differences also suggest that the industry should consider the relevant characteristics of college students while developing and marketing dietary supplements.

Diet Quality of Older African Americans: Impact of Knowledge and Perceived Threat of COVID-19

Confusing health messages and environmental changes intended to prevent the spread of the COVID-19 virus have affected the dietary behavior of older African Americans. We investigated the impact of COVID-19-related factors on diet quality and the relationship between food access and diet quality. We surveyed 150 African Americans aged 55 years and above during the COVID-19 pandemic. The data obtained included socio-demographic and health information, and COVID-19-related knowledge and perceptions. Dietary intake data was obtained using the Diet History Questionnaire III. Analyses included bivariate and multivariable statistics. Overall, based on United States Department of Agriculture guidelines, the diet quality of older African Americans was poor. Lower knowledge and a lower perceived threat of COVID-19 were significantly associated with poor diet quality. Additionally, older African Americans with chronic diseases and food insecurity had poor diet quality. The COVID-19 pandemic has highlighted the fragility of diet quality. The combined impact of poor knowledge and perceived threat of COVID-19, chronic disease, and food insecurity contribute to poor diet quality in this population. This study adds to the well-known need for strategies to support the right to a healthy diet, particularly during COVID-19 and future pandemics. Proactive interventions to counteract the potential consequences of poor diets are needed.

Culinary Medicine as Innovative Nutrition Education for Medical Students: A Scoping Review

PURPOSE

Lifestyle-related disease substantially impacts health, but physicians lack adequate nutrition education to discuss behavioral change with patients. Many medical schools have developed culinary medicine programs as a nutrition education strategy, but common elements of success have not been defined.

METHOD

The authors conducted a scoping review of the literature on culinary medicine programs for medical students. They searched PubMed, Ovid MEDLINE, and MedEdPORTAL databases to identify English-language studies published between January 1, 2012, and October 15, 2021. Multiple search terms were used to identify medical student-focused culinary medicine programs. The authors focused inclusion criteria on medical student learners, curricular description, hands-on cooking components, reflection or application to patient care, and assessment. Additionally, the authors reviewed 2 online databases which list programs delivering culinary medicine education for U.S. medical students.

RESULTS

Authors identified 251 studies, of which 12 met inclusion criteria. These studies described programs that used a kitchen or similar space adaptable for food preparation to enable hands-on learning, and some programs provided opportunities for practical application. Most programs administered surveys to assess course impact, but the type of survey and cohort size varied. Culinary medicine programs for medical students varied in learner level, number of participants, course length and structure, and instructor background but consistently improved student knowledge in key areas of nutrition application and changed knowledge and attitudes about food and nutrition. Funding was often noted as a barrier to program sustainability. When funding source was provided, it derived from philanthropic or academic sources. When the authors reviewed the 2 online databases, they identified 34 programs offering medical student-focused culinary medicine courses.

CONCLUSIONS

As culinary education programs emerge across academic centers, standardizing programmatic and curricular elements, best practices, and assessment strategies will be vital for quality control, sustainability, and optimal population health impact.

How COVID-19 Pandemic Has Influenced Public Interest in Foods: A Google Trends Analysis of Italian Data

Controversy exists about the impact of the COVID-19 pandemic on dietary habits, with studies demonstrating both benefits and drawbacks of this period. We analyzed Google Trends data on specific terms and arguments related to different foods (i.e., fruits, vegetables, legumes, whole grains, nuts and seeds, milk, red meat, processed meat, and sugar-sweetened beverages) in order to evaluate the interest of Italian people before and during the COVID-19 pandemic. Joinpoint regression models were applied to identify the possible time points at which public interest in foods changed (i.e., joinpoints). Interestingly, public interest in specific food categories underwent substantial changes during the period under examination. While some changes did not seem to be related to the COVID-19 pandemic (i.e., legumes and red meat), public interest in fruit, vegetables, milk, and whole grains increased significantly, especially during the first lockdown. It should be noted, however, that the interest in food-related issues returned to prepandemic levels after the first lockdown period. Thus, more efforts and ad hoc designed studies should be encouraged to evaluate the duration and direction of the COVID-19 pandemic's influence.

Susceptibility to COVID-19 Nutrition Misinformation and Eating Behavior Change during Lockdowns: An International Web-Based Survey

To understand the susceptibility to nutrition-health misinformation related to preventing, treating, or mitigating the risk of COVID-19 during the initial lockdowns around the world, the present international web-based survey study (15 April-15 May 2020) gauged participants' (n = 3707) level of nutrition-health misinformation discernment by presenting them with 25 statements (including unfounded or unproven claims circulated at the time), alongside the influence of information sources of varying quality on the frequency of changes in their eating behavior and the extent of misinformation held, depending on the source used for such changes. Results revealed widespread misinformation about food, eating, and health practices related to COVID-19, with the 25 statements put to participants receiving up to 43% misinformed answers (e.g., 'It is safe to eat fruits and vegetables that have been washed with soap or diluted bleach'). Whereas higher quality information sources (nutrition scientists, nutrition professionals) had the biggest influence on eating behavior change, we found greater misinformation susceptibility when relying on poor quality sources for changing diet. Appropriate discernment of misinformation was weakest amongst participants who more frequently changed their eating behavior because of information from poor quality sources, suggesting disparities in the health risks/safety of the changes performed.

Exploring restaurant and customer needs, barriers, interests, and food choices induced by the COVID-19 pandemic in Tarragona Province (Catalonia, Spain): A cross-sectional study

Background

COVID-19 has harmed restaurants, but customer preferences remain unknown. This study aims to determine the needs, barriers, interests, and food choice changes in restaurants and customers before and during the COVID-19 pandemic in Tarragona Province (Spain).

Methods

An observational cross-sectional study conducted in spring 2021 collected Mediterranean offerings, food safety, and hygiene information about the pandemic through online surveys and focus group interviews with restaurateurs and customers about the changes in their needs and new barriers.

Results

Fifty-one restaurateurs (44 survey, 7 focus group) and 138 customers (132 survey, 6 focus group) were included. In relation to the economic, emotional, and uncertainty restaurateurs' barriers detected, they implemented measures to tackle it: buy less and more often, reduce restaurant staff and reduce the restaurants offer, among others. Some customers reported changes in their restaurant orders, specifically increasing their takeaway orders. The Mediterranean diet offer (AMed criteria) remained without noticeable changes in any of the criteria. After lockdown, compared to before lockdown, restaurateurs increased their takeaway offerings by 34.1% (p < 0.001) and their use of digital menus by 27.3% (p < 0.001) because of customer demand. The use of local products in the menus remained high. The cleaning and disinfection tasks increased by 21.1% (p = 0.022), and the use of hydroalcoholic solutions increased by 13.7% (p = 0.031).

Conclusion

In restaurants, the first COVID-19 lockdown increased takeaway orders, sanitation, and digital communication. This study provides valuable information for adapting gastronomic offerings during challenging situations.

Hemp Protein Hydrolysates Modulate Inflammasome-Related Genes in Microglial Cells

A prolonged inflammatory response can lead to the development of neurodegenerative diseases such as Alzheimer's disease. Enzymatic hydrolysis is a sustainable way to increase the value of protein sources by obtaining peptides that can exert bioactivity. Hemp (Cannabis sativa L.) protein hydrolysates have been proven to exert anti-inflammatory activity. In this study, two hemp protein hydrolysate (HPHs), obtained with Alcalase as sole catalyst, or with Alcalase followed by Flavourzyme, were evaluated as inflammatory mediators (TNFα, IL-1β, IL-6, and IL-10), microglial polarization markers (Ccr7, iNos, Arg1, and Ym1), and genes related to inflammasome activation (Nlrp3, Asc, Casp1, and Il18), employing the lipopolysaccharide (LPS)-induced neuroinflammation model in murine BV-2 microglial cells. A significant decrease of the expression of proinflammatory genes (e.g., Tnfα, Ccr7, inos, and Nlrp3, among others) and increase of the expression anti-inflammatory cytokines in microglial cells was observed after treatment with the test HPHs. This result in the cell model suggests a polarization toward an anti-inflammatory M2 phenotype. Our results show that the evaluated HPHs show potential neuroprotective activity in microglial cells via the inflammasome.

Knowledge, practice and attitude associated with SARS-CoV-2 Delta Variant among adults in Jordan

COVID-19 infection is a global pandemic health emergency. This contagious disease was caused by the Severe Acute Respiratory Syndrome Coronavirus‑2 (SARS‑CoV-2) which is mutating over time. In 2021, the Delta variant became the most dominant transmissible form. During the crisis, human practice and knowledge were critical in the overall efforts to encompass the outbreak. A cross-sectional, web-based approach was conducted among adults in Jordan to quantify knowledge, attitude, and practices towards SARS-CoV-2 (Delta variant). This research was carried out between 15th April and 15th of May 2021. The study questionnaire consisted of four sections including the participant's demographics, knowledge, practices and attitude. Comparative evaluation of responses was accomplished using a scoring system. Respondents who scored above the mean score (60%) on the item measured were categorized as knowledgeable, having a positive attitude, and good practices. Participants were allocated to one of the three groups; medical, non-medical and others (unemployed and housewives). Data collected was analyzed using Statistical Package for Social Sciences (SPSS) version 23.0 software. A variance test to assess the statistical difference between groups was used. Pearson's chi-squared test was applied to compare the variables and identify significant predictors. Of the participants, 308 (66%) were in the age group of 18-25yrs, 392 (84.1%) females, 120 (25.8%) employed and 346 (74.2%) unemployed. The principle source of knowledge was social media (291, 62.4%). Interestingly, participants had adequate overall knowledge. The mean knowledge score was 22.6 (± 0.19), 20.6 (± 0.19), and 21.3 (± 0.18) for the medical, the non-medical and the others group, respectively. Also, participants showed a positive attitude and good practices towards SARS-CoV-2 (Delta variant). The mean practice score for medical, the non-medical and the others groups was 7.35 (± 0.25), 7.38 (± 0.24), 7.35 (± 0.24) and the mean attitude score was 10.8 (± 0.16), 9.4 (± 0.21), 9.5 (± 0.22), respectively. The studied groups generally had good knowledge, positive attitudes and good practices about SARS-CoV-2 (Delta variant). This was expected due to the authorities' successful management of the pandemic and the high educational level of the Jordanian society, bearing in mind the economic and social impact of COVID-19 disease.

Factors Influencing Motivation to Perform Mental and Physical Tasks During the Initial Lockdown Period of the COVID-19

Drastic changes to lifestyles have occurred during the COVID-19 pandemic. An unintended consequence of stay at home orders is increased isolation and less social interaction for many people. For overall wellbeing it is important to stay both physically and mentally active; however, for many individual's motivation may be a barrier. There are non-modifiable (e.g. sex, age, personality, infection rates in the area) and modifiable factors (e.g. physical activity, diet, sleep) that may be associated with motivation to perform physical and mental tasks. We collected data from 794 subjects using an online survey between April 13th to May 3^rd of 2020. Survey questionnaires included demographics, personality traits, diet, sleep, physical activity levels, mental workload and motivation to perform mental and physical tasks. Multiple linear regression analyses were used to assess the association between non-modifiable and modifiable variables on motivation to perform mental and physical tasks. The results of our analyses suggest that those who reported a higher quality of diet (REAP-S score), exercised vigorously, and reduced their sedentary time, reported higher motivation to perform both mental and physical tasks. Those who were employed and had higher grit were more motivated to perform physical tasks. Lower trait physical energy was associated with greater motivation to perform mental tasks. Our findings support that during challenging times, such as the COVID-19 pandemic, it is important for healthcare practitioners to emphasize the importance healthy lifestyle behaviors to prevent individuals from experiencing a lack of motivation to perform both mental and physical tasks. Future research should focus on trying to determine the directionality of the relationship between specific healthy lifestyle behaviors and motivation.

A new face of food security: A global perspective of the COVID-19 pandemic

COVID-19 has impacted the world economy and food system in many aspects. We conducted a comprehensive examination of global food security during the COVID-19 pandemic by considering the food security index and its four key pillars (affordability, availability, quality and safety, and natural resources and resilience) for 102 countries. In addition to the fixed effect panel data estimator, the Method of Moments Quantile regression is useful for disaggregating the impact of the COVID-19 pandemic in relation to inflation, economic growth, urbanization, and agricultural land on global food security among countries with different levels of food security. We found that COVID-19 has negatively affected food security globally, especially in countries with a low food security level. The effect of income per capita and urbanization rate on the food security index is positive and statistically significant across all quantiles. Inflation rate and agricultural land, however, adversely affect food security, and this effect is stronger for countries with lower levels of food security. The results of affordability, availability, quality, and safety, and natural resources and resilience models provide meaningful implications for governments and policymakers to build resilience in food systems and to be better prepared for future crises and disruptions in the food supply.

COVID-19 Changes Public Awareness about Food Sustainability and Dietary Patterns: A Google Trends Analysis

The COVID-19 pandemic has not only affected healthcare systems and global economies but also directly impacted food security and purchasing behaviors. The aim of this study is to investigate if COVID-19 has induced changes in public interest regarding Food Sustainability and healthy-sustainable dietary patterns across Europe and in European regions. A Google Trends search was performed using the search terms "Food Sustainability + Sustainable Diet + Sustainable Food" (grouped as "Food Sustainability") and the topics "Sustainability", "Healthy Diet", "Mediterranean Diet", and "Flexitarianism" for the years 2010 to 2022. Data were obtained for 12 countries in Europe. The trends in interest after the COVID-19 outbreak were forecast based on previous data. After the COVID-19 outbreak, an increase in Food Sustainability interest was observed and was higher than forecast based on the previous data. A significant interest increase in Sustainability was observed; nevertheless, this increase was smaller than the forecast increase. Mixed results were obtained for dietary patterns across European regions, yet, considering the mean interest for Europe, it seems that the COVID-19 pandemic outbreak dampened the interest in dietary patterns such as the Healthy Diet and Flexitarianism and promoted an interest in the Mediterranean Diet. Understanding consumers' beliefs and behaviors toward food choices is crucial for the transition towards sustainable diets, and definitions of educational and behavioral interventions are essential to this transition.

Analysis of Food Delivery Using Big Data: Comparative Study before and after COVID-19

This study examined consumers' change in perception related to food delivery using big data before and after the COVID-19 crisis. This study identified words closely associated with the keyword "food delivery" based on big data from social media and investigated consumers' perceptions of and needs for food delivery and related issues before and after COVID-19. Results were derived through analysis methods such as text mining analysis, Concor analysis, and sentiment analysis. The research findings can be summarized as follows: In 2019, frequently appearing dining-related words were "dining-out," "delivery," "famous restaurant," "delivery food," "foundation," "dish," "family order," and "delicious." In 2021, these words were "delivery," "delivery food," "famous restaurant," "foundation," "COVID-19," "dish," "order," "application," and "family." The analysis results for the food delivery sentimental network based on 2019 data revealed discourses revolving around delicious, delivery food, lunch box, and Korean food. For the 2021 data, discourses revolved around delivery food, recommend, and delicious. The emotional analysis, which extracted positive and negative words from the "food delivery" search word data, demonstrated that the number of positive keywords decreased by 2.85%, while negative keywords increased at the same rate. In addition, compared to the pre-COVID-19 pandemic era, a weakening trend in positive emotions and an increasing trend in negative emotions were detected after the outbreak of the COVID-19 pandemic; sub-emotions under the positive category (e.g., good feelings, joy, interest) decreased in 2021 compared to 2019, whereas sub-emotions under the negative category (e.g., sadness, fear, pain) increased.

Monitoring of cherry flowering phenology with Google Trends

Google Trends (GT) is an online tool designed for searching for changes over time. We assessed its use for evaluating changes in the timing of cherry flowering phenology, which is of intense interest to Japanese people. We examined the relationship between time-series of relative search volume (RSV: relative change in search requests over time obtained from the GT access engine) and cherry flowering information published on websites (as ground truth) in relation to three famous ancient cherry trees. The time-series of RSV showed an annual bell-shaped seasonal variability, and the dates of the maximum RSV tended to correspond to the dates of full bloom. Our results suggest that GT allows monitoring of multiple famous cherry flowering sites where we cannot obtain long-term flowering data to evaluate the spatiotemporal variability of cherry flowering phenology.

Impacts of COVID-19 on Nutritional Intake in Rural China: Panel Data Evidence

The COVID-19 pandemic introduced risks and challenges to global food and nutrition security. In this paper, we examine the impact of the COVID-19 pandemic on the nutritional intake of China’s rural residents using panel data and a fixed effects model. The data were collected in 2019 and 2020 and covered nine provinces and 2631 households in rural China. The results reveal that an increase of 100 confirmed cases in a county resulted in a 1.30% (p < 0.01), 1.42% (p < 0.01), 1.65% (p < 0.01), and 1.15% (p < 0.01) decrease in per capita intake of dietary energy, carbohydrates, fats, and proteins, respectively. Moreover, the COVID-19 pandemic had a significant and negative effect on dietary macronutrient intake in the low-income group at the 5% level of significance. Our study indicates that the potential insufficient nutrition situation, nutritional imbalance, and dietary imbalance of low-income rural residents should be addressed appropriately.

Mapping the landscape and structure of global research on nutrition and COVID-19: visualization analysis

BACKGROUND

Coronavirus disease 2019 (COVID-19) has had a significant influence on nutritional status. There have been several studies on dietary habits and nutritional status in connection with COVID-19. However, there has been no research on the bibliometric analysis of these papers. Therefore, our objective was to assess the most relevant scientific research on nutrition and COVID-19, as well as to assess current hot themes.

METHODS

We obtained data from the Scopus database on June 30, 2021. Qualitative and quantitative analyzes were conducted based on the Scopus. Collaboration and term analysis was performed using VOSviewer software version 1.6.16.

RESULTS

At the time of data collection, there were 177,946 documents in COVID-19. Scopus found 1885 articles related to nutrition and COVID-19 after narrowing the search to those terms. This includes 1309 (69.44%) research articles, 268 (14.22%) review papers, and 308 other types of document. The USA was the largest producer, with 24.83% of the documents, followed by Italy with 11.88% (n = 224), the UK with 10.82% (n = 204), and China with 7.59% (n = 143). The most active institution was Sapienza Università di Roma (n = 30, 1.59%). The leading journal in COVID-19 nutrition research was Nutrients (n = 115, 6.10%). The article with 310 citations published by Di Renzo et al. in 2020 was the most influential reference. The hot topics were stratified into three clusters: (1) "Food security in the COVID-19 pandemic"; (2) "nutritional determinants and COVID-19 outcomes"; and (3) "changes in dietary habits during the COVID-19 pandemic and its consequences".

CONCLUSIONS

This is the first bibliometric research to offer comprehensive information on COVID-19 and nutrition in the published literature. Research will likely be helpful to scholars and policymakers. This study sheds light on the growth and development of nutrition and covid-19-related research and should contribute to the expansion of the global frontier in the major hot topics, including "food security in the COVID-19 pandemic"; "nutritional determinants and COVID-19 outcomes"; and "changes in diet habits during the COVID-19 pandemic and its consequences".

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

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

Effect of Mobility Restrictions During the Coronavirus Disease Epidemic on Body Composition and Exercise Tolerance in Patients With Obesity: Single Institutional Retrospective Cohort Study

BACKGROUND

This study investigated the effects of mobility restrictions (MRs) during the COVID-19 epidemic on physical activity, body composition, and exercise tolerance in patients with obesity.

METHODS

We analyzed data of obesity patients participating in a 6-month weight loss program in February 2020, and after, when the epidemic was considered to have had some effect on outdoor activity in Osaka, Japan (MR group). MR group patients were compared to patients with obesity attending the program in 2018 and 2019 (non-MR group) who had a similar number of months as MR group. Changes in physical activity, body composition, and exercise tolerance (O2 consumption; VO2) owing to the weight loss program were analyzed between both groups using analysis of covariance and logistic regression analysis.

RESULTS

Decreases in body fat were significantly higher in MR group than in non-MR group. However, increases in physical activity, VO2 at anaerobic threshold, and peak VO2 were significantly lower in MR group; however, increases in peak VO2 owing to the weight loss program were less likely to be achieved in MR group (odds ratio, 0.21; 95% confidence interval, 0.06-0.81).

CONCLUSION

MR during the COVID-19 epidemic may have affected the exercise tolerance of patients with obesity.

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

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

Urban Informal Food Traders: A Rapid Qualitative Study of COVID-19 Lockdown Measures in South Africa

Globally, the adoption of COVID-19 containment measures, such as lockdowns, have been used to curb the rapid spread of the pandemic. However, these action regulations have caused substantial challenges to livelihoods. We explored the perceptions and experiences of COVID-19 implications for urban informal food traders in South Africa during the initial lockdown period that lasted five weeks. A rapid qualitative study was conducted during October–November 2020. Twelve key informants (seven men and five women) categorized into informal traders and food system expert groups were interviewed. Data were analyzed thematically using MAXQDA software. Participants perceived informal trading as a main source of livelihood for many individuals. Negative lockdown impacts described included forced business closure, increased food costs and reduced demand. The consensus among participants was that the government’s lack of formal recognition for informal food traders pre-COVID-19 contributed to challenges they faced during the pandemic, as evidenced by their exclusion as “essential service providers’’ at the start of lockdown. Policies that fail to recognize and consider informal food traders during ‘normal’ times lead to widened social inequality gaps among already vulnerable groups during natural disasters and disease outbreaks. In the case of COVID-19 in South Africa, this caused severe hunger, food insecurity and income loss.

COVID-19 patient accounts of illness severity, treatments and lasting symptoms

First-person accounts of COVID-19 illness and treatment can complement and enrich data derived from electronic medical or public health records. With patient-reported data, it is uniquely possible to ascertain in-depth contextual information as well as behavioral and emotional responses to illness. The Novel Coronavirus Illness Patient Report (NCIPR) dataset includes complete survey responses from 1,584 confirmed COVID-19 patients ages 18 to 98. NCIPR survey questions address symptoms, medical complications, home and hospital treatments, lasting effects, anxiety about illness, employment impacts, quarantine behaviors, vaccine-related behaviors and effects, and illness of other family/household members. Additional questions address financial security, perceived discrimination, pandemic impacts (relationship, social, stress, sleep), health history, and coping strategies. Detailed patient reports of illness, environment, and psychosocial impact, proximal to timing of infection and considerate of demographic variation, is meaningful for understanding pandemic-related public health from the perspective of those that contracted the disease.

The Effects of the COVID-19 Pandemic Lockdown on Eating, Body Image, and Social Media Habits Among Women With and Without Symptoms of Orthorexia Nervosa

The COVID-19 pandemic is negatively impacting people's mental health worldwide. The current study examined the effects of COVID-19 lockdown on adult women's eating, body image, and social media habits. Furthermore, we compared individuals with and without signs of orthorexia nervosa, a proposed eating disorder. Participants were 143 women, aged 17-73 years (M = 25.85, SD = 8.12), recruited during a COVID-19 lockdown in Canada from May-June 2020. Participants completed self-report questionnaires on their eating, body image, and social media habits during the pandemic. The Eating Habits Questionnaire (EHQ) assessed symptoms of orthorexia nervosa. Compared to the period prior to lockdown, women with higher total orthorexia nervosa scores reported eating a lot more than usual, feeling greater pressure to diet and lose weight, thinking about food more often than usual, experiencing greater weight gain, and perceiving more pressure from social media specifically to lose weight and to exercise, compared to their healthy counterparts. We examined associations between individual EHQ subscales and perceived changes to eating and weight. Women who scored high on EHQ-Problems reported seeing more weight loss content on their social media than those who reported fewer orthorexia nervosa symptoms. Conversely, those who scored low on EHQ-Feelings reported feeling a lot less pressure to lose weight, somewhat less or a lot less pressure to lose weight or to exercise from social media specifically, and trended toward less laxative use during lockdown, compared to those who scored higher on orthorexia nervosa. And those who scored low on EHQ-Knowledge reported feeling somewhat less or a lot less pressure to lose weight than those who reported more orthorexia nervosa symptoms. Together, the findings suggest that women with symptoms of orthorexia nervosa are experiencing an exacerbation of disordered eating thoughts and behaviors during COVID-19, and that social media may be a contributing factor.

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.

The Impact of the Fear of COVID-19 on Purchase Behavior of Dietary Supplements: Integration of the Theory of Planned Behavior and the Protection Motivation Theory

This study aimed at assessing the impacts of the fear of COVID-19 on consumer buying behavior toward dietary supplements. This investigation was a cross-sectional study in which literate adults regardless of gender over the age of 20 were recruited from three pharmacies in three different districts of Wuhan City, China. A total of 598 questionnaires were analyzed after excluding 10 with incomplete information. The current study demonstrated that attitudes, subjective norms, and perceived behavioral control had a positive impact on the intention of purchasing dietary supplements. Fear of COVID-19 was related to an enhanced purchase intention toward dietary supplements. Attitudes, subjective norms, and perceived behavioral control were significant factors that mediated the association between the fear of COVID-19 and the purchase intention of dietary supplements. This study helps provide practical advice for stakeholders in the pharmaceutical and healthcare industries to tailor appropriate strategies for improving product promotion or healthcare-related interventions.

Food insecurity associated with higher COVID-19 infection in households with older adults

OBJECTIVES

As a well-documented social determinant of health, food insecurity may be associated with COVID-19 infection in households with older adults. We examined whether older adults were vulnerable to COVID-19 infection during the early pandemic if they were food insecure versus food secure.

STUDY DESIGN

A cross-sectional study using a nationally representative population-based survey of US older adults.

METHODS

We used a random subsample of Health and Retirement Study (HRS) drawn in June 2020 (N = 3212). We compared the odds of reporting COVID-19 infection in a household, COVID-19 infection and mortality among acquaintances, and respondent's perceived fair or poor health across household food insecurity status resulted from financial or non-financial barriers. Baseline health and socioeconomic circumstances were adjusted in the models.

RESULTS

Results showed a higher COVID-19 infection rate among food-insecure households than among their food-secure counterparts during the pandemic. Food insecurity due to non-financial obstacles was associated with greater likelihood of COVID-19 infection both within respondents' households (adjusted odds ratio [aOR] = 1.73, 95% confidence interval [CI]: 1.03-2.90) and among their acquaintances (aOR = 1.32, 95% CI: 1.05-1.65). Food insecurity caused by both non-financial and financial constraints was associated with twice the likelihood of knowing someone who died from COVID-19 than their food-secure counterparts (aOR = 2.14, 95% CI: 1.27-3.61).

CONCLUSIONS

Food insecurity driven by non-financial constraints played an important role in the ongoing pandemic among US older adults. Policies addressing COVID-19 need to recognize the vulnerability of food-insecure older adults beyond lack of monetary resources.

A Study on Dining-Out Trends Using Big Data: Focusing on Changes since COVID-19

This study examined consumers’ emotions and needs related to dining-out experiences before and during the COVID-19 crisis. This study identifies words closely associated with the keyword “dining-out” based on big data gleaned from social media and investigates consumers’ perceptions of dining-out and related issues before and after COVID-19. The research findings can be summarized as follows: In 2019, frequently appearing dining-related words were dining-out, family, famous restaurant, recommend, and dinner. In 2020, they were dining-out, family, famous restaurant, and Corona. The analysis results for the dining-out sentimental network based on 2019 data revealed discourses revolving around delicious, nice, and easily. For the 2020 data, discourses revolved around struggling, and, cautious. The analysis of consumers’ dining-out demand network for 2019 data showed discourses centered around reservation, famous restaurant, meal, order, and coffee. However, for 2020 data, discourses were formed around delivery, price, order, take-out, and social distance. In short, with the outbreak of the pandemic, delivery, takeout, and social distance emerged as new search words. In addition, compared with before the COVID-19 pandemic, a weakening trend in positive emotions and an increasing trend in negative emotions were detected after the outbreak of the COVID-19 pandemic; specifically, fear was found to be the fear emotion.

“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.

Association of COVID-19 with lifestyle behaviours and socio-economic variables in Turkey: An analysis of Google Trends

This study aims to examine the relationship between COVID‐19 cases/deaths and Google data on lifestyle behaviours and socio‐economic variables in Turkey. The data of the research are composed of Google Trends search volume for various words related to socio‐economic conditions, nutritional attitudes, indoor behaviour, outdoor activities and confirmed COVID‐19 case and death data from the Ministry of Health from 31 December 2019 to 31 January 2021. Spearman correlation analysis was conducted to evaluate the relationship between the Google search volumes of selected keywords and COVID‐19 case and deaths. In addition, repeated ANOVA and Bonferroni post‐hoc tests were performed to compare the differences in search volumes of selected keywords before and during the COVID‐19 outbreak. Correlation analysis showed that the strongest variables in each category were vitamin C, zinc, Zoom, online shopping, hotel, market, gym, unemployment and unemployment benefit. Compared to previous years, during the pandemic, there was a significant increase or decrease in the search volumes of almost all words. These results showed that the COVID‐19 significantly changed people's online interests regarding lifestyle behaviours and socio‐economic conditions. It is thought that the findings can guide health policies to be followed in reducing the effects of both behavioural changes and negative socio‐economic consequences.

Effects of the COVID-19 Pandemic on Food Security and Agriculture in Iran: A Survey

The consequences of COVID-19 on the economy and agriculture have raised many concerns about global food security, especially in developing countries. Given that food security is a critical component that is affected by global crises, beside the limited studies carried out on the macro-impacts of COVID-19 on food security in Iran, this paper is an attempt to address the dynamic impacts of COVID-19 on food security along with economic and environmental challenges in Iran. For this purpose, a survey was conducted with the hypothesis that COVID-19 has not affected food security in Iran. To address this fundamental hypothesis, we applied the systematic review method to obtain the evidence. Various evidences, including indices and statistics, were collected from national databases, scientific reports, field observations, and interviews. Preliminary results revealed that COVID-19 exerts its effects on the economy, agriculture, and food security of Iran through six major mechanisms, corresponding to a 30% decrease in the purchasing power parity in 2020 beside a significant increase in food prices compared to 2019. On the other hand, the expanding environmental constraints in Iran reduce the capacity of the agricultural sector to play a crucial role in the economy and ensure food security, and in this regard, COVID-19 forces the national programs and budget to combat rising ecological limitations. Accordingly, our study rejects the hypothesis that COVID-19 has not affected food security in Iran.

Qualitative Research on Solving Difficulties in Maintaining Continuity of Food Supply Chain on the Meat Market during the COVID-19 Pandemic

Although the pandemic phenomenon is not the first of its kind in human history, the common feature of COVID-19 is its rapid impact on the global economy. The challenge for the national economy on the world stage is to maintain a continuous food supply. The scientific purpose of the study is to report, analyze and evaluate backgrounds, causes of instabilities and their effects of the COVID-19 pandemic on supply and demand side of the meat market in the United States of America, China and Russia. The practical purpose of the study is to present implemented measures and recommendations on how to return to meat market equilibrium. In the theoretical part of the study, the revised public source of information coming from well-known organizations such as: EC, FAO, OECD, and WB, are used. In the practical part of the manuscript, qualitative research on the People’s Republic of China, Russian Federation, and the United States of America, along with semi-structured in-depth interviews with experts and Ishikawa diagram are presented. The primary data come from authors’ own research and collection of multiple sources. The article indicates the use of qualitative systematic review, supported by a creation of a prototype of the issues of maintaining continuity of the food supply chain during the COVID-19 pandemic in the secondary sources, intensified by a keyword search. The results of the research are diverse and oriented toward the needs of the analyzed meat markets. In the case of the People’s Republic of China, the solution is to develop a system of subsidies and preferential rates for the use of rail transport in exports. In the case of Russia, the solution is to provide support to the meat and poultry farmers for cold storage of slaughtered animals. In the case of the USA, the solution is to develop technical and technological facilities in order to speed up the supply chain between local livestock with meat and poultry farmers. Moreover, the outcomes indicate that sustainability of the food supply chain needs well-thought-out support on agri-food supply production.

Consumer versus Organic Products in the COVID-19 Pandemic: Opportunities and Barriers to Market Development

The main objective of this study was to determine the behavior of the Polish consumer of organic products during the COVID-19 pandemic and to identify preferred channels of distribution of organic products in the situation of restricted freedom of movement as well as to assess what information displayed on the labels of organic food was most important to the customer. The research was conducted on a sample of 1108 respondents with the use of CAWI technique collected in an online survey carried out in February–August 2020. To analyze the obtained results, cluster analysis, linear regression model and duplication method were used to verify the substitute channels for purchasing organic goods. The pandemic has intensified the health value of consumers when making decisions about choosing food products. Consumers are sensitive shoppers who read the content of the labels and pay attention to the ingredients of the products they buy. The price is also of significant importance for consumers; however, it is less important than, for example, the expiration date of the purchased product. With the use of PCA analysis, it was possible to identify 18 factors that could be divided into three segments: marketing, practical and sensory. The proposed factors, according to the respondents, had an effect on the purchase of organic products by Polish consumers. Regarding the preferred purchasing channels, the Internet is becoming more and more important. Almost one-quarter of the respondents confirmed that they bought organic products via the above-mentioned distribution channel. Nearly 17% of the surveyed consumers considered the Internet to be an alternative way of doing their shopping. The results obtained in the research can be used in the sector of organic food producers to design marketing strategies and to adapt their offer to the proposed four groups of purchasers of organic products: eco-activists, eco-dietitians, eco-traditionalists, eco-innovators.

Persistent effects of the COVID-19 pandemic on diet, exercise, risk for food insecurity, and quality of life: A longitudinal study among U.S. adults

COVID-19 has affected the health and well-being of almost every American. The aim of this study was to examine the sustained impacts of COVID-19 prevention measures on the diet and exercise habits, risk for food insecurity, and quality of life among adults in the U.S. We conducted a longitudinal study using a convenience sample of participants recruited via Amazon's Mechanical Turk (MTurk) platform between March 30 and April 7, 2020, and 8 months into the outbreak, from November 2 to November 21, 2020. We compared self-reported diet and exercise habits and risk for food insecurity shortly after the pandemic began, in April, to those reported in November. We also measured changes in quality-of-life using the PROMIS-29 + 2 (PROPr) scale. A total of 636 respondents completed both surveys. Compared to reports in April, respondents ate lunch and dinner out more frequently in November and consumed more take-out and fast food. Weekly frequencies of consuming frozen food and the number of daily meals were slightly lower in November than they were in April. 54% of respondents screened positively for being at risk for food insecurity in April, reducing to 41% by November. In April, survey respondents were found to have lower quality-of-life relative to U.S. population norms, but by November levels of depression and cognitive function had improved. Our findings underscore how the initial effects of the pandemic on diet, exercise, risk for food insecurity, and quality of life have evolved. As U.S. states re-open, continued efforts to encourage healthy eating and support mental health, especially to reduce feelings of anxiety and social isolation, remain important to mitigate the potential long-term effects of the pandemic.

The increasing hunger concern and current need in the development of sustainable food security in the developing countries

Background

COVID-19 has affected millions of people worldwide. Recently, international agencies have revealed that poverty and hunger could kill more people than COVID-19 victims. Many global workforces have lost their jobs during this pandemic situation. In developing countries, most of the workers and their families live hand to mouth, depending on daily wage, and loss of income would be a hunger pandemic. Globally, the proportion of undernourished and hungry people have been on an upswing due to climate changes and violent conflicts. The millions of people are facing chronic malnourishment and COVID-19 menaces undermining the endeavour of philanthropic and food security. COVID-19 has increased the risk of livelihood by the shortage of food and distraction of the supply chain especially in the developing countries where rural expanses depend on agriculture production and seasonal jobs. So, if they are forced to limit their activities, their livelihoods will be demolished.

Scope and approach

COVID-19 is increasing the jeopardy of food prices over the world, which would prompt a crisis in several developing countries. The government organizations in developing countries are doing well to protect people from the current pandemic. But they are also in critical situation regarding food supply chains and are facing difficulties in providing nutrient-rich foods. The susceptible people are fraught to secure household income and manage their food. In this review, we have explored the food security approach, food supply chain and risk of food shortage. Every country in the world needs to implement effective interventions to maintain open trade and food supply chains, ensure access to nutrients for all at affordable prices and develop co-operation to preserve the flexibility of universal food markets.

Predictors of COVID-19-Related Perceived Improvements in Dietary Health: Results from a US Cross-Sectional Study

The COVID-19 pandemic resulted in substantial lifestyle changes. No US study has identified predictors of perceived dietary healthfulness changes during the pandemic period. This study included analyses of lifestyle and dietary healthfulness changes using 958 survey responses from US primary household food purchasers. Information was collected related to demographics, COVID-19-related household changes, and health-related habits before and during the pandemic. Binary logistic regression identified predictors of perceived increase in dietary healthfulness during the pandemic period. Overall, 59.8%, 16.4%, and 23.4% of participants reported that their eating habits likely changed, may have changed, and likely did not change, respectively. Of the participants whose dietary habits likely or may have changed, 64.1%, 16.8%, and 19% reported healthier, neither healthier nor less healthy, and less healthy eating habits, respectively. COVID-19-related income loss, more meals consumed with household members in front of the television, an increase in food advertisement exposure, increased perceived stress, and better perceived current health were significant predictors of a perceived increase in dietary healthfulness. Overall, dietary habits were perceived to become healthier during the pandemic. The predictors of perceived improvement in dietary healthfulness were surprising and indicate the need for further study of these factors in crisis and noncrisis situations.

Analyzing Public Interest in Metabolic Health-Related Search Terms During COVID-19 Using Google Trends

Background

In late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a novel virus and initiated a series of events that culminated in the global coronavirus disease 2019 (COVID-19) pandemic. Throughout 2020 and the first half of 2021, massive investigational efforts towards identifying, treating, preventing, and slowing the spread of COVID-19 were carried out. Several predictors for clinical outcomes relating to metabolic health were identified.

Aim and methods

This study aimed to investigate how public interest in search terms associated with metabolic health has changed throughout and during the course of the COVID-19 pandemic. Google Trends was utilized as a tool to gather and compare public interest data in a variety of search phrases. The relative search values were plotted over time, compared pre-and post-COVID-19, analyzed for correlation, assessed for trend directionality, and checked for trend inclusion.

Results

The public interest measured by relative search volume in “metabolic health,” “exercise,” “home exercise," “health,” and “how to improve fitness” significantly increased from pre- to post-COVID-19 pandemic onset while “diet” and “fitness” significantly decreased. The search terms “COVID” and “coronavirus” made up more than 95% of screen queries incorporating COVID-19. During the COVID-19 pandemic, “diabetes” and “weight loss” had the most significant increases in search volume.

Conclusions

Given the changes in public interest observed throughout the course of the COVID-19 pandemic, it is clear that the association between metabolic health and COVID-19 is being successfully disseminated to the public. However, these changes also warrant increased public education surrounding diet and fitness to align public interest with measures proven to improve the clinical outcomes of COVID-19.

Adherence to COVID-19 Nutrition Guidelines Is Associated with Better Nutritional Management Behaviors of Hospitalized COVID-19 Patients

Good nutritional support is crucial for the immune system to fight against coronavirus disease 2019 (COVID-19). However, in the context of a pandemic with a highly transmissible coronavirus, implementation of nutrition practice may be difficult. A multicenter electronic survey involving 62 dieticians was conducted, in order to understand barriers associated with dieticians’ adherence to nutrition guidelines for hospitalized COVID-19 patients in Indonesia. 69% of dieticians felt under stress when performing nutrition care, and 90% took supplements to boost their own immunity against the coronavirus. The concerns related to clinical practice included a lack of clear guidelines (74%), a lack of access to medical records (55%), inadequate experience or knowledge (48%), and a lack of self-efficacy/confidence (29%) in performing nutritional care. Half (52%) of the dieticians had performed nutrition education/counseling, 47% had monitored a patient’s body weight, and 76% had monitored a patient’s dietary intake. An adjusted linear regression showed that guideline adherence independently predicted the dieticians’ nutrition care behaviors of nutrition counselling (ß: 0.24 (0.002, 0.08); p = 0.04), and monitoring of body weight (ß: 0.43 (0.04, 0.11); p = 0.001) and dietary intake (ß: 0.47(0.03, 0.10); p = 0.001) of COVID-19 patients. Overall, adherence to COVID-19 nutrition guidelines is associated with better nutritional management behaviors in hospitalized COVID-19 patients.

COVID-19 patient accounts of illness severity, treatments and lasting symptoms

First-person accounts of COVID-19 illness and treatment complement and enrich data derived from electronic medical or public health records. With patient-reported data, it is uniquely possible to ascertain in-depth contextual information as well as behavioral and emotional responses to illness. The Novel Coronavirus Illness Patient Report (NCIPR) dataset includes complete survey responses from 1,592 confirmed COVID-19 patients ages 18 to 98. NCIPR survey questions address symptoms, medical complications, home and hospital treatments, lasting effects, anxiety about illness, employment impacts, quarantine behaviors, vaccine-related behaviors and effects, and illness of other family/household members. Additional questions address financial security, perceived discrimination, pandemic impacts (relationship, social, stress, sleep), health history, and coping strategies. Detailed patient reports of illness, environment, and psychosocial impact, proximal to timing of infection and considerate of demographic variation, is meaningful for understanding pandemic-related public health from the perspective of those that contracted the disease.