Dietary Behaviors in the Post-Lockdown Period and Its Effects on Dietary Diversity: The Second Stage of a Nutrition Survey in a Longitudinal Chinese Study in the COVID-19 Era

Diet quality and associations with motivation and ability to consume a healthy diet among adolescents from urban low-income households in Bangladesh

In low- and middle-income countries, particularly in urban areas, adolescent diets consist mainly of energy-dense and nutrient-poor foods, putting them at risk of malnutrition and non-communicable diseases (NCD). In Bangladesh, little is known about the diet quality of adolescents, their food choices and the drivers of such choices. This study assessed motivations and ability to consume a healthy diet among adolescent girls and boys from low-income urban families and how these drivers were associated with dietary diversity and diet quality. A cross-sectional survey was conducted among 299 adolescents (15-19 years) from low-income households in Dhaka city during September-October 2020. The Diet Quality Questionnaire was used to collect non-quantitative food intake in the previous day or night to calculate diet quality indicators of food group diversity score, % of adolescents achieving minimum dietary diversity, NCD-Protect and NCD-Risk and the Global Dietary Recommendations score. Motivation was measured by 11 food choice motives. Ability was measured by belief in own ability to engage in healthy eating behaviors (self-efficacy). Adolescent diets showed a mean food group diversity of 4.9 out of 10, with 60% of adolescents achieving minimum dietary diversity, but lacked health-promoting foods (average of 2.7 out of 9 food groups) yet included few foods to avoid and limit (1.6 out of 9). Adolescents valued food choice motive 'safety' the most, followed by 'health', 'taste', 'price', 'convenience' and 'local or seasonal'. A higher motivation to consume 'local or seasonal' and a lower motivation driven by 'price', and a higher perceived self-efficacy were associated with better diet quality. Future interventions should address self-efficacy, concerns about food price and increase local and seasonal foods availability in the urban poor food environment of Dhaka to improve overall diet quality.

Use of online food retail platforms throughout the COVID-19 pandemic and associated diet-related chronic disease risk factors: A systematic review of emerging evidence

Food accessibility was considerably impacted by restrictions during the coronavirus disease 2019 (COVID-19) pandemic, leading to growth in the online food retail sector, which offered contact-free delivery. This systematic review aimed to assess the change in use of online food retail platforms during COVID-19. The secondary aim was to identify diet-related chronic disease risk factors including dietary intake, eating behaviors, and/or weight status associated with the use of online food retail platforms during the pandemic. The review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42022320498) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Nine electronic databases were searched between January 2020 and October 2023. Studies that reported the frequency or change in use of online groceries, meal delivery applications, and/or meal-kit delivery services before and during the pandemic were included. A total of 53 studies were identified, including 46 cross-sectional studies, 4 qualitative studies, 2 longitudinal cohort studies, and 1 mixed-methods study. Overall, 96% (43/45) of outcomes showed an increase in the use of online groceries during COVID-19, while 55% (22/40) of outcomes showed a decrease in meal delivery applications. Eight of nine outcomes associated the use of online food retail with weight gain and emotional eating. Further research is needed to investigate the links between online food retail and obesity.

Exploring the Role of Traditional Chopstick Culture and Interpersonal Communication in Health Campaign-Targeted Behavior

Traditional chopstick culture is widely recognized as a vital factor associated with health behavior. After the outbreak of COVID-19 in China, the Gongkuai campaign aims to change long-held traditions of communal eating habits. Little is known about the effect of individuals' perception of traditional chopstick culture and other factors on Gongkuai campaign-targeted goal. This study investigates how social-environmental and cognitive factors motivate individuals to use serving chopsticks (the Chinese Gongkuai campaign-targeted goal) and how such effects are moderated by traditional chopstick culture. Data was collected using a nationwide online survey and analyzed using structural equation modeling. The findings revealed that campaign-generated interpersonal communication positively affects individual cognitive factors. Furthermore, cognitive factors promote behavioral intentions to use serving chopsticks. While traditional chopstick culture does not directly influence an intention to use serving chopsticks, it plays a different role in the relationships between three cognitive factors and serving chopsticks use intention. Based on the results, policy implications about how to motivate individuals to use serving chopsticks are discussed.

Nutritional knowledge, attitudes, and practices among residents in the Northeast areas of China during the COVID-19 epidemic

Background

The coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 infection continues to affect the daily life of communities worldwide. Nutrition is a vital determinant of overall health. Given the lack of specific drugs for COVID-19 and incomplete vaccination coverage, optimizing nutrition appears to be one of the most cost-effective means of enhancing immunity. Therefore, this study was designed to evaluate nutrition-related knowledge, attitudes, and practices (KAP) to offer insights into the personal determinants of dietary behavior during COVID-19 pandemic in four major cities within the Northeast region.

Methods

This cross-sectional study was conducted between January and December 2022 using a self-administered questionnaire. The data were entered in EpiData V-3.02 and analyzed using SPSS version 26. Binary logistic regression analysis was also employed to examine the association between dependent and independent variables.

Results

A total of 4,092 respondents were included in the study. Most of the respondents demonstrated had inadequate nutrition knowledge, 26% of them provided ≥60% of correct answers. About one-third of the respondents were knowledgeable about the daily levels of oil, salt, milk, water, vegetables and fruits for adults. Furthermore, our results showed that 60.6% of participants held positive attitudes toward healthy eating. Additionally, only 54.6% of the participants have heathy dietary practices during COVID-19 pandemic. Binary logistic regression analysis showed that the following characteristics were associated with displaying unhealthy dietary behaviors: being men, having a lower education level, having a family income of 10,000-19,999 and more than 20,000, being resided in Harbin, Shenyang, and Changchun. Importantly, the strongest associations were observed between poor dietary knowledge and unhealthy eating behaviors. Similarly, dietary attitudes were strongly associated with healthy dietary behaviors when the effects of other factors were excluded; responders with negative attitudes were more likely to exhibit unhealthy eating behaviors.

Conclusion

Our findings suggest that residents in the Northeast China possessed a relatively low level of nutritional knowledge, which directly influenced their dietary practices during the COVID-19 pandemic. This study provides valuable insights into the cross-sectional description and key factors related to nutrition-related KAP, serving as a basis for future policymaking to respond more effectively to health crises.

Food safety-related practices among residents aged 18-75 years during the COVID-19 pandemic: a cross-sectional study in Southwest China

BACKGROUND

Good food safety practices are essential to minimizing foodborne diseases. The present study explored the food safety-related practices of residents during the COVID-19 pandemic in Southwest China and identified the impacting factors.

METHODS

Residents aged 18-75 years from Guizhou, Yunnan, Sichuan, and Chongqing, China, were included in our study. The convenience sampling method was used to select participants, and face-to-face surveys were conducted in households and communities to collect data. Descriptive statistics including sociodemographic characteristics of respondents and weighted percentages were obtained and the log-binomial regression was used to evaluate the influencing factors associated with food safety-related practices.

RESULTS

Overall, 7,848 respondents were involved, with 97.5% efficacy. Disparities in food safety-related practices were observed between males and females, with the former performing poorer practices than the latter (70.5% vs. 68.0%, respectively). Notably, paying attention to nutrition labels when shopping for prepackaged foods was the worst practice. Age, ethnicity, region, occupation, education level, and income were identified as significant determinants of food safety-related practices. Moreover, in comparison to males, females were more likely to acquire pertinent knowledge from diverse sources, including social media, family members/ friends, books/ newspapers/ magazines, experts, and food sales staff (p < 0.05).

CONCLUSIONS

Males performed inferior food safety-related practices than females during the COVID-19 pandemic in Southwest China. It is suggested that future food safety education programs should incorporate diverse targeted approaches, with emphasis on males. The role of mainstream media in promoting food safety practices should be expanded and prioritized in the forthcoming initiatives.

Governing for food security during the COVID-19 pandemic in Wuhan and Nanjing, China

The global COVID-19 pandemic has elicited a range of public health governance responses. One common result has been an associated disruption of food supply chains and growing urban food insecurity. Policy responses to this situation have not yet received sufficient research attention. This paper therefore focuses on the urban food security implications of China's zero-COVID public health measures and the response of central, provincial and municipal government to the governance challenge of ensuring a stable and sufficient food supply to urban consumers. During the COVID-19 outbreak in early 2020 in China, zero-COVID lockdown measures aimed to contain and eliminate the spread of the virus. This paper examines the associated policy responses around urban food security in early 2020, with a particular focus on two cities: Wuhan (where SARS-CoV-2 was first identified) and Nanjing (a neighbouring city). The analysis is based on an inventory of policy-related documents providing a wide range of information about governance responses to the pandemic. Four major governance challenges are addressed: agricultural production, food transportation, stabilization of food prices, and new contactless methods in purchasing foods. Key recommendations for post-pandemic policy responses around urban food security include: ensuring consistency throughout all levels of government, strengthening existing food reserves to leverage emergency responses, addressing the root causes of pandemic-related food insecurity by focusing on access at the household level, and improving food utilization.

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.

Excess Weight in Relation to Lifestyle Habits in Spanish First-Year University Students: Differences between Pre- and Post-COVID-19-A Serial Cross-Sectional Study Based on uniHcos Project

The objective of this research was to study the relationship between the body weight and diet, physical activity, and other habits among freshmen students by sex, and to determine whether these habits have changed during the post-era of the COVID-19 pandemic. A serial cross-sectional study with data from 11 Spanish universities was carried out. In total, 10,096 first-year university students (73.2% female, mean age = 19.0 ± 1.5 years) completed an online self-administered questionnaire between 2012 and 2022. For some analyses, questionnaires were categorized by the year in which the survey was filled out as Before COVID-19, Lockdown, and New Normal. In total, 72.9% of participants were within the normal weight range, and 17.7% of men and 11.8% of women were overweight (p < 0.001). The students who did not meet the WHO criteria of physical activity, spent more than 7 h per day sitting, and skipped breakfast had a higher prevalence of obesity (p < 0.05). According to the period of study, the prevalence of overweight/obesity Before COVID-19 was 16.1% (95% CI: 15.4-16.9%), while in Lockdown the prevalence was significantly higher (20.2, 95% CI: 17.1-23.8) and in New Normal it was 18.9% (CI: 15.7-22.5). Moreover, the study suggests that during the Lockdown period, there was a reduction in the practice of physical activity and an increase in the prevalence of a healthy diet. For all these, it is necessary to propose public health interventions that improve the lifestyles of university students.

Psychological responses and dietary changes of residents during the local outbreak of COVID-19 in the post-epidemic era: A cross-sectional study

The coronavirus disease 2019 (COVID-19) pandemic has had a dramatic impact on the psychological state and dietary behavior of individuals. Many previous studies have discussed the psychological and dietary problems during the first COVID-19 pandemic. However, few papers have discussed them during the local COVID-19 outbreak in the post-epidemic era. To explore the psychological responses and the influencing factors, dietary changes and the relationship with psychological responses during the local COVID-19 outbreak in the post-epidemic era. Methods: A total 3790 residents were surveyed by online questionnaire to collect information about social demography, health status, local outbreak related information, lifestyle changes, anxiety and depression. Binary logistic regression was used to discuss the influencing factors of anxiety and depression. Kendall tau-b correlation coefficient was used to discuss the relationship between anxiety, depression and dietary changes. Self-perceived physical condition, chronic disease, lockdown or quarantine, fear of COVID-19, changes in smoking, drinking and physical activity were the influencing factors of anxiety and depression. The top 3 foods with increased intake were drinking water, fresh fruits and fresh vegetables, while the top 3 foods with reduced intake were puffed foods, fried foods and sugary foods. Dietary changes were correlated with generalized anxiety disorder-7 and patient health questionnaire-9 scores. These findings provide experience and clues for local governments to improve the psychological status and dietary habits of residents during the local COVID-19 outbreak in the post-pandemic era.

Changes in food and nutrient intakes in Korean adults before and during the COVID-19 pandemic: data from the 2011-2020 Korea National Health and Nutrition Examination Survey

OBJECTIVES

This study was to examine the changes in dietary habits and food and nutrient intakes between before (2019) and during (2020) the coronavirus disease 2019 (COVID-19) pandemic from the Korea National Health and Nutrition Examination Survey (KNHANES).

METHODS

A total of 54,995 participants aged ≥19 years who participated in the 2011-2020 KNHANES were included. The 10-year trend (2011-2020) and differences between 2019 and 2020 for dietary habits and food and nutrient intakes were estimated using SAS.

RESULTS

In the past 10 years (2011-2020), the dietary habits (increase in skipping meals and eating out), food intake (increase in meats and decrease in fruits and vegetables), and nutrient intake (increase in fat and decrease in sodium) in adults have changed. When comparing between 2019 and 2020, there were 4.6%p decrease in the eating out more than once a day. On the other hand, there were no significant differences in the intakes of food, energy and most of nutrients between 2019 and 2020, except for the proportion of energy intake from fat (1.0%p increase) and carbohydrate (1.0%p decrease).

CONCLUSIONS

Although a change in dietary habits from before to during the COVID-19 pandemic was observed, food and nutrient intakes have not deteriorated markedly and appear similar to the trends in the past 10 years. Throughout the COVID-19 pandemic, it is necessary to monitor the effects of changes in dietary habits on health as well as food and nutrient intakes.

Online on-demand delivery services of food and alcohol: A scoping review of public health impacts

The increase in availability of online on-demand food and alcohol delivery services has changed the way unhealthy commodities are accessed and understood. We conducted a systematic scoping review of academic and grey literature to map the current knowledge of public health and regulatory/policy outcomes arising from on-demand food and alcohol delivery (defined as delivery within 2 h). We systematically searched three electronic databases and completed supplementary forward citation searches and Google Scholar searches. In total, we screened 761 records (de-duplicated) and synthesised findings from 40 studies by commodity types (on-demand food or alcohol) and outcome focus (outlet, consumer, environmental, labour). Outlet-focused outcomes were most common (n = 16 studies), followed by consumer (n = 11), environmental (n = 7), and labour-focused (n = 6) outcomes. Despite geographical and methodological diversity of studies, results indicate that on-demand delivery services market unhealthy and discretionary foods, with disadvantaged communities having reduced access to healthy commodities. Services that deliver alcohol on-demand can also subvert current alcohol access restrictions, particularly through poor age verification processes. Underpinning these public health impacts is the multi-layered nature of on-demand services and context of the COVID-19 pandemic, which creates ongoing complications as to how populations access food and alcohol. Changing access to unhealthy commodities is an emerging issue in public health. Our scoping review considers priority areas for future research to better inform policy decisions. Current regulation of food and alcohol may not appropriately cover emerging on-demand technologies, necessitating a review of policy.

Changes in Adults' Eating Behaviors During the Initial Months of the COVID-19 Pandemic: A Narrative Review

Factors such as regulations and health concerns shifted daily habits, including eating behaviors, during the early months of the coronavirus disease 2019 (COVID-19) pandemic. This comprehensive narrative review synthesizes research on eating behavior changes during the early months of the pandemic (February to June 2020), including changes in amount, rate, and timing of food consumption, types and healthfulness of foods consumed, the occurrence of other specified eating behaviors (eg, restrained eating or binging), and reasons for eating (eg, stress or cravings), among adults. A literature search using three EBSCOhost databases and Google Scholar was conducted to identify relevant articles made available in 2020. A total of 71 articles representing 250,715 individuals from more than 30 countries were reviewed. Findings show eating behaviors changed little during the early COVID-19 pandemic for most participants. Among those whose eating behaviors changed, increases in both intake and frequency of eating meals and snacks were more common than decreases. Findings on timing of eating and healthfulness of food consumed showed mixed results. However, when changes occurred in the type of food consumed, increases were more common for snacks, homemade pastries, white bread/pasta, legumes, and fruits/vegetables; decreases were more common for meats, seafood/fish, frozen foods, fast food, dark breads/grains, and dark leafy green vegetables. During the pandemic, binging, uncontrolled eating, and overeating increased, meal skipping decreased, and restrictive eating had mixed findings. Changes in factors such as emotions and mood (eg, depression), cravings, and environmental factors (eg, food insecurity) were related to changes in eating behaviors. Findings can inform clinical practitioners in efforts to mitigate disruptions to normal, healthy eating patterns among adults both in and outside of global health catastrophes.

Post-lockdown changes in diet in Italy and the USA: Return to old habits or structural changes?

This study analyses the impacts of the COVID-19 pandemic on food consumption at the end of the first lockdown in the New York State (USA) and in Italy (spring 2020). The results of our study show that important changes occurred in food habits in these two countries, in which lockdown was very similar. Three models of response to the shock of the lockdown were noted in both countries. The first model (40%) includes individuals who largely increased their food consumption, the second model (26%) showed a more virtuous and responsible behaviour, while the third model (34%) displayed no change in food consumption. Diet quality in terms of healthiness and sustainability declined in the USA, while in Italy, approximately one-third of the sample showed an improvement in diet in these same areas. The use of sociodemographic, motivational, and behavioural variables to profile subjects who adhered to each food model has made it possible to obtain information that can be used to develop communication campaigns and policies for a healthier and more sustainable diet.

Positive effects of COVID-19 on food preparation and expenditure habits: A comparative study across three countries

OBJECTIVE

This study seeks to empirically investigate how the changing eating habits affect health habits within three countries with entirely different cultures and diets to understand to what extent the pandemic may be responsible for these changes.

DESIGN

Specifically, a questionnaire was conducted in China, Portugal, and Turkey in early 2021. A series of statistical analyses were performed to identify how changes in individuals' eating habits have influenced their diets, considering the pandemic context and the varying cultural contexts where this research was performed.

SETTING

A structured questionnaire form was developed and uploaded to an online platform with unique links for automatic distribution to respondents in each country. Data for the main survey were gathered between 3 January and 1 February 2021.

PARTICIPANTS

Using snowball sampling, the authors leveraged their social networks by asking friends and colleagues to distribute the survey to potentially interested individuals. This distribution was stratified accordingly to the distribution of the population. The authors ultimately collected 319 useable surveys from China, 351 from Portugal, and 449 from Turkey.

RESULTS

The pandemic inspired healthier food habits, mostly because people have additional time to cook, shop differently for food, and spend more money on groceries.

CONCLUSIONS

The study suggests that aside from cultural values and dietary habits, the available time and the fear of the pandemic most explained the new eating habits. Several implications are provided for researchers and overall society in these three countries.

From Health Campaign to Interpersonal Communication: Does Traditional Diet Culture Hinder the Communication of the Chinese Gongkuai Campaign?

Interpersonal communication is beneficial in promoting individuals' tendency to accept health-campaign-targeted behavior. Based on the protective action decision model, this study investigated the key factors underlying individual's interpersonal communication on the Gongkuai campaign, which was carried out during Coronavirus disease 2019 (COVID-19). The main goal of the Gongkuai campaign was to change traditional communal eating habits and reduce public health risks. An online questionnaire survey involving 618 respondents was conducted in China after the 2020 Gongkuai campaign propagated, and the data were analyzed by using the structural equation modeling technique. The results indicated that health campaign exposure is a critical determinant of perceived campaign-related knowledge and health risk perception, which are significant predictors of interpersonal communication. Meanwhile, campaign-related knowledge can elicit risk perception. Furthermore, campaign exposure influenced interpersonal communication in ways that traditional diet culture did not predict. Risk perception was also unaffected by traditional diet culture. It is worth noting that individuals' agreement with traditional diet culture does not hinder health campaign-generated interpersonal communication in the context of public health crisis. Based on the findings, theoretical and policy implications for motivating interpersonal communication were discussed, and research limitations were pointed out.

A cross-sectional assessment of food practices, physical activity levels, and stress levels in middle age and older adults' during the COVID-19 pandemic

Aim

This cross-sectional study examined how the COVID-19 pandemic impacted the food practices, physical activity (PA) levels, and stress levels of aging adults ages 40 years and older from seven states. It also explored to what extent the COVID-19 outcomes were affected by the social determinants of health (SDH).

Subject and methods

Respondents (n = 1250) completed an online survey. Descriptive statistics were used to analyze the sociodemographic attributes and COVID-19 responses while the multiple llinear regression (MLR) test evaluated to what extent the SDH variables measured were associated with the reported COVID-19 impacts food practices, PA levels, and stress levels.

Results

Respondents were mostly White (75.9%), married (58.7%), age 60 years and older (61.8%), with a high school education or higher (97.4%). Most of the respondents (85.8%) live in areas that respondents perceived as supportive of health and well-being opportunities for older adults. Nearly one-half of the respondents reported maintaining their pre-pandemic grocery shopping/food buying frequency (44.7%) and PA levels (48.1%). However, 48.6% reported being "somewhat or very stressed" due to the pandemic. Findings revealed that the COVID-19 impacts on food-buying, PA levels, and stress levels were significantly influenced by age, gender, race, education, location, community, nutritional risk, quality of life, food security, and income (p < 0.05).

Conclusion

These findings provide valuable information as we continue to confront the impact the COVID-19 pandemic has had on the health and well-being of aging adults. We can use this information to inform future public health programming interventions and opportunities.

The Role of Selected Psychological Factors in Healthy-Sustainable Food Consumption Behaviors during the COVID-19 Pandemic

The COVID-19 pandemic and the consequent precautions and dispositions adopted have triggered substantial changes in daily health-related behaviors, including food consumption habits. The psychological impact of the pandemic has been considered one of the factors affecting this transition and requiring consideration when targeting healthy-sustainable behavior preservation. The present study describes the results of a survey conducted on a convenience sample of Italian residents (n = 2272) during the first phases of pandemic. The aim was to explore the daily nutritional choices and behaviors and their transformations that occurred along with the associations with psychological factors (i.e., subjective well-being, and depression, anxiety and stress symptoms). An indicator for healthy-sustainable transition (HST index) was constructed and revealed diffused transformation in dietary habits, with a large segment of the sample adopting healthier and more sustainable dietary behaviors and others showing reduced healthy-sustainable food choices. Informative relationships with the psychological variables were then found from the correlational and regression analyses. Lower levels of anxiety, depression and stress symptomatology and higher perceived subjective well-being were significantly associated with healthier-sustainable food consumption behaviors. These findings shed light on the crucial areas to be considered in future institutional interventions, ultimately ensuring favorable conditions for both healthy diet behaviors and sustainable food consumption choices.

Behavioral and Emotional Changes One Year after the First Lockdown Induced by COVID-19 in a French Adult Population

(1) Background: The lockdown had various consequences on physical activity and food consumption behaviors. The post-lockdown has been much less studied. The aim of this study is to compare behaviors one year after the first lockdown in a group of normal-weight (NW) or overweight French adults (OW). (2) Methods: Over a period of 4 days, both at the beginning of May 2020 (lockdown) and in June 2021 (free living post-lockdown), the same French adults used the WellBeNet smartphone application to record their sedentary behavior, physical activity (PA), food consumption and emotions. (3) Results: One year post first lockdown, the weight and body mass index increased (+1.1 kg; +0.4 kg.m−2, p < 0.01), and sedentary behaviors increased (+5.5%, p < 0.01) to the detriment of light-intensity activities (−3.3%, p = 0.10) in the whole group. Some food categories, such as alcohol, tended to be consumed more (+0.15 portion/day, p = 0.09), while fatty, salty and sugary products decreased (−0.25 portion/d, p = 0.02) but without a change in the food balance score. A higher number of both positive and negative emotions were scored per day (+9.5, p < 0.0001; +2.9, p = 0.03), and the positive ones were perceived stronger (+0.23, p = 0.09). Simultaneously, the desire to eat was lower (−11.6/100, p < 0.0001), and the desire to move remained constant. Sedentary/active behaviors and the desire to eat changed differently in NW and OW adults after the lockdown. (4) Conclusions: In general, the post-lockdown period was less favorable for physical activity practice and resulted in a similar food balance score but was more conducive to mental wellbeing.

Impact of COVID-19 Vaccination Status and Confidence on Dietary Practices among Chinese Residents

Healthy diets promote immune functions and have been shown to reduce COVID-19 severity. In 2021, COVID-19 vaccines have become available to the general public. However, whether vaccination status could affect individual and populational health behaviors is unknown. This study aimed to investigate the impacts of vaccination status and confidence on dietary practices. An online survey was conducted in August 2021. We collected data on dietary intake, diversity and behaviors, vaccination status and confidence and socio-demographic characteristics. Among the 5107 responses received, a total of 4873 study participants were included in the final analysis. Most of our participants aged between 18 and 45 years and 82% of them were fully vaccinated against COVID-19. Household level dietary diversity was found to be higher among people who were fully vaccinated (β = 0.321, 95%CI: 0.024 to 0.618) or who were more confident in the protectiveness of the vaccine (β for tertile 3 comparing with lowest tertile = 0.544, 95%CI: 0.407, 0.682). Vaccination promoted the intake of seafood, but it was also positively associated with the consumption of sugar, preserved, fried and barbequed foods and reduced vegetable intake. Higher vaccination confidence was associated with increased consumption of seafood, bean, fruits and vegetables and reduced fat intake. Changes in dietary behaviors compared with early 2021 (when vaccination was not common) were observed and differed by vaccination status and confidence level. Conclusion: COVID-19 vaccination status and confidence had varied, and possibly negative, impacts on dietary intake and behaviors. Our results suggest that vaccination status and confidence might be significant influencing factors affecting people’s health behaviors and highlight that healthy eating should be consistently promoted to prevent poor dietary practices during global health crisis.

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.

Adherence to the United States Department of Agriculture Dietary Recommendations Pre- and During the Coronavirus Disease-19 Pandemic Among Pregnant Women in Arab Countries

During pregnancy, woman’s diet is one of the most preeminent factors affecting mother and child’s health. Prior to the coronavirus disease-19 (COVID-19) pandemic, inadequate maternal diet and low adherence to dietary guidelines was reported among pregnant women in the Arab countries. Nowadays, COVID-19 infection during pregnancy is widely discussed among literature. However, there is limited data on the health impacts of the COVID-19 pandemic on non-infected pregnant women. This substantially larger group also suffered significant lifestyle changes during the lockdown period. The aim of the study is to characterize dietary patterns, intake and adherence to the United States Department of Agriculture (USDA) pregnancy guidelines before and during the COVID-19 pandemic in Arab pregnant women. Using a specially designed questionnaire and using the snowball sampling method, the survey was carried out among a convenient sample of 1,939 pregnant women from five Arab countries. Our study found an increment in the consumption of cereals, fruits, vegetables, dairy products, meats, and nuts that occurred during the pandemic compared to the preceding period. Despite this noticeable increase during the pandemic, the Arab pregnant women in this study had significantly lower adherence to the USDA pregnancy guidelines. The daily consumption of almost all food groups was lower than the USDA’s daily recommendations, except for fruits intake, which was higher than the daily standard. Demonstrated poor adherence to prenatal USDA dietary guidelines by Arab pregnant women can lead to numerous deficiencies and health risks among their offspring. In conclusion, our study showed that before and during the COVID-19 pandemic, poor adherence to dietary recommendations occurred in a considerable number of Arab pregnant women. The findings emphasize the need for nutritional education and intervention during prenatal visits.

Contribution to the Evaluation of Physicochemical Properties, Total Phenolic Content, Antioxidant Potential, and Antimicrobial Activity of Vinegar Commercialized in Morocco

Vinegar is a natural product widely used in food and traditional medicine thanks to its physicochemical properties and its richness in bioactive molecules. However, its direct use by consumers can have complications and undesirable effects. Therefore, this study contributes to investigating the physicochemical and biological properties of eleven vinegars marketed in Morocco. Determination of pH, acetic acid, conductivity, total soluble solids and alcohol content in vinegar was carried out. The polyphenols (TP), flavonoids (TF), and condensed tannins (CT) content was determined, and their antioxidant activities were evaluated using 2,2-diphenyl-1-picryl Hydrazyl (DPPH), Ferric Reducing Antioxidant Power (FRAP) and Phosphomolybdenum Reduction Assay (TAC). Then, the antimicrobial activity was studied against four pathogenic bacteria and two fungal strains, using the disk diffusion and the microdilution method. This study showed a wide range of acetic acid values from 0.65 ± 0.29 to 5.15 ± 0.20%. The high value of TP, TF, and CT in our samples V10, V9, and V4 was 655.00 ± 22.2 µgGAE/mL, 244.53 ± 11.32 µgQE/mL and 84.63 ± 1.00 µgTAE/mL, respectively. The tested strains showed variable sensitivities to the different samples with inhibition zones ranging from 6.33 ± 2.08 to 34.33 ± 0.58 mm. The lowest minimum inhibition concentrations were recorded against Staphylococcus aureus ATCC29213 ranging from 1.95 to 7.81 µL/mL. While Aspergillus niger ATCC16404 showed resistance against all of the analyzed samples. In general, vinegar commercialized in Morocco presents a variable range of products with variable properties. Indeed, must take into account this diversity when using it. A future study is needed to identify the phytochemical composition that will further the comprehension of this variability and contribute to its valorization.

Self-managed weight loss by smart body fat scales ameliorates obesity-related body composition during the COVID-19 pandemic: A follow-up study in Chinese population

BACKGROUND

Since 2020, longer stay-at-home time in response to the coronavirus disease 2019 (COVID-19) pandemic has changed the weight-related behaviors of Chinese population.

OBJECTIVES

To explore the demographic and basic characteristics of body fat scale users and to investigate the changes in obesity-related body composition of overweight and obese users during COVID-19. Further, we analyzed the factors associated with successful weight loss and improved body composition changes in overweight and obese people.

METHODS

The study included 107,419 Chinese adults registered in the smart app connecting to the body fat scale in 2020 to describe the demographic characteristics of body fat scale users by Unpaired Student's t-test and Chi-Square test. Subsequently, overweight and obese participants with body mass index (BMI) of more than 24 kg/m² were screened to investigate the independent factors associated with effective weight loss and improved body composition changes by multivariable logistic regression analyses.

RESULTS

During the pandemic, the number of body fat scale users increased markedly compared with pre-pandemic. Over half of the participants were women and with normal baseline BMI. Based on BMI classification, multivariable logistic regressions showed that age, gender, measurement frequency classification, baseline BMI, visceral adipose index and skeletal muscle rate were associated with weight loss and fat loss in the overweight and obese population, with the high-frequency measurement being the most important factor for effective weight and fat loss. In the population with normal BMI obesity, younger age was the most significant factor for effective fat loss.

CONCLUSION

During the COVID-19 pandemic, participation in self-monitored weight loss increased markedly compared with pre-pandemic, and women accounted for the majority. We found that many overweight and obese participants achieved weight loss goals by smart body fat scales, and the effectiveness of weight and fat loss was greater in obese participants than in overweight participants, both based on BMI and PBF classification. In addition, promoting the usage of smart body fat scales could contribute to more effective weight and fat loss in the overweight and obese population based on BMI classification. However, in the population with normal BMI obesity, young subjects might be easier to successfully lose fat compared with the elder. Digital self-management by smart body fat scales could become a promising approach for the obese population with high BMI to lose weight and keep healthy.

Associations of Caregiver Cooking Skills with Child Dietary Behaviors and Weight Status: Results from the A-CHILD Study

We examined whether caregiver cooking skills were associated with frequency of home cooking, child dietary behaviors, and child body weight status in Japan. We used cross-sectional data from the 2018 Adachi Child Health Impact of Living Difficulty study, targeting primary and junior high school students aged 9-14 years in Adachi City, Tokyo, Japan (n = 5257). Caregiver cooking skills were assessed using a scale with good validity and reliability modified for use in Japan. Child heights and weights derived from school heath checkup data were used to calculate WHO standard body mass index z-scores. After adjusting for potential confounders, caregivers with low-level cooking skills were 4.31 (95% confidence interval (CI): 2.68-6.94) times more likely to have lower frequency of home cooking than those with high level of cooking skills. Children with low-level caregiver cooking skills were 2.81 (95% CI: 2.06-3.84) times more likely to have lower frequency of vegetable intake and 1.74 (95% CI: 1.08-2.82) times more likely to be obese. A low level of caregiver cooking skills was associated with infrequent home cooking, unhealthy child dietary behaviors, and child obesity.

Potential Impact of Time Trend of Lifestyle Risk Factors on Burden of Major Gastrointestinal Cancers in China

BACKGROUND & AIMS

China has the largest number of incident liver, esophageal, gastric, and colorectal cancer cases in 2020. Examining the time trend of relevant lifestyle risk factors would help project the trend of these gastrointestinal (GI) cancer incidence in China.

METHODS

We estimated the time trend of the lifestyle factors based on the China Health and Nutrition Survey 1991 to 2011. We applied the comparative risk assessment method to estimate the population attributable fraction of GI cancers attributable to each risk factor. We also projected the prevalence of lifestyle factors and the associated burden of GI cancer from 2011 to 2031.

RESULTS

In 2011, 56.5% of colorectal, 59.8% of gastric, 48.5% of esophageal, and 35.2% of liver cancer in China were attributable to the lifestyle risk factors under study. Smoking, sodium intake, low vegetable intake, and low fruit intake have improved over time but remained far from optimal and are expected to be responsible for 170,000, 35,000, 22,000, and 50,000 GI cancer cases in 2031, respectively. High body mass index, red and processed meat consumption, and low physical activity are expected to contribute increasingly more GI cancer, accounting for 142,000, 185,000, 60,000, and 53,000 cases in 2031, respectively. The estimated population attributable fraction for all risk factors in 2031 is 52.1%.

CONCLUSIONS

Lifestyle risk factors have had an impact on the risk of GI cancer in China, and the impact is projected to increase. If everyone could adhere to the optimal lifestyle, half of all GI cancer events would be prevented by year 2031.

Lifestyle changes and mental health during the COVID-19 pandemic: A repeated, cross-sectional web survey

BACKGROUND

This study aimed to compare self-reported changes on lifestyle behaviors during two phases of the COVID-19 pandemic in Spain, and to evaluate clinical and sociodemographic factors associated with lifestyles.

METHODS

Two cross-sectional web surveys were conducted during lockdown (April 15-May 15, 2020) and seven months later (November 16-December 16, 2020). Lifestyle behaviors were self-reported by a multidimensional scale (SMILE-C). Two separate samples of respondents were analyzed. A multivariate regression model was performed to evaluate the association of SMILE-C scores with demographic and clinical variables.

RESULTS

The sample comprised, 3412 participants from the first survey (S1) and in the S1 and 3635 from the second (S2). SMILE-C score decreased across surveys (p < 0.001). The rates of positive screenings for depression and anxiety were similar between the surveys, whereas those for alcohol abuse decreased (p < 0.001). Most participants in S2 reported that their lifestyle had not changed compared to those before the pandemic. Variables independently associated with an unhealthier lifestyle were working as an essential worker, lower educational level, previous mental disease, worse self-rated health, totally/moderate changes on diet, sleep or social support, as well as positive screenings for alcohol abuse, anxiety and depression.

LIMITATIONS

The cross-sectional design and recruitment by non-probabilistic methods limit inferring causality and the external validity of the results.

CONCLUSIONS

Overall lifestyle worsened seven months after the lockdown in Spain. Several demographic and clinical factors were associated with lifestyle scores. The contribution of common mental disorders to unhealthier lifestyles should be considered in order to prevent the negative impact of the pandemic.

Impacts of COVID-19 on changing patterns of household food consumption: An intercultural study of three countries

In light of COVID-19's effects on individuals' social, economic, political, and psychological values, this paper aims to investigate the pandemic's role in possible changes to people's food consumption and meal habits in three countries, namely China, Portugal, and Turkey. The sample includes individuals from the three countries, exploratory factor analysis and non-parametric tests were used to test the differences. Results suggest that coronavirus has played a strong part in altering households' food consumption and meal habits within these countries. The pandemic has particularly led to greater consumption of fresh fruits and vegetables and spending more time eating meals at home. Portugal appears to be consuming more seafood, bread, and butter whereas China features higher consumption of rice and meat products; Turkey is consuming more meat and eggs. The study closes with a set of recommendations for the society and future research.

Associations between Perceived Social Eating Norms and Initiation and Maintenance of Changes in Dietary Habits during the First COVID-19 Lockdown in France

Changes in dietary habits of the French population have been reported during the national lockdown that was enforced due to the COVID-19 pandemic. This study investigated whether perceived social eating norms were associated with the initiation and maintenance of dietary changes that took place as a result of lockdown. An online study collected information on (1) changes in consumption implemented during the lockdown and the maintenance of these changes, and (2) perceptions about changes in consumption implemented during lockdown by household members, relatives out of home, and the general population. The changes in consumption were classified as foods to increase or to decrease according to French national recommendations. The perception of changes to dietary habits by household members and relatives out of home was related to the changes made by individuals for each of the food categories (all p < 0.05) but not to the perception of changes made the general population. Increased consumption of foods to increase was more likely to be maintained when there was a positive perception of the changes made by household members (p = 0.03). These results highlight the influence of the perception of social eating norms, especially by household members and relatives, on the implementation of dietary changes during lockdown and suggest that social eating norms can have a lasting influence.

How COVID-19 Pandemic Affected Urban Trips? Structural Interpretive Model of Online Shopping and Passengers Trips during the Pandemic

Changing people’s shopping behavior from face-to-face to online shopping during the COVID-19 pandemic led to reduced shopping trips, and this decrease directly affects traffic congestion and air pollution. Identifying the factors influencing the increase of online shopping behavior during the pandemic can be helpful for policymakers in the post-COVID-19 era. This study aims to discover the effect of factors related to the COVID-19 pandemic and demographic characteristics on shopping attitude and, consequently, on shopping trips. Based on the interviews of ten experts, factors associated with COVID-19 and demographic characteristics are selected as influential factors on shopping attitude and shopping trips. For pairwise comparisons between these factors, a web-based questionnaire was designed and given to thirty experts. The relationship between all factors is examined using interpretive structural modeling (ISM) and Microscopic–Macroscopic (MICMAC) analysis. In addition, to prioritize factors, the IAHP model is employed. Based on the results, five levels of influential factors affect shopping attitude, which affects shopping trips: level 1, age and gender; level 2, income and education; level 3, the household size and the COVID-19 awareness; level 4, COVID-19 attitude and COVID-19 practice; and level 5, norm subject and shopping personal control.

Eating Behaviour Changes during the COVID-19 Pandemic: A Systematic Review of Longitudinal Studies

Eating behaviour is a complex construct that is liable to be modified by external factors. Due to the outbreak of coronavirus disease 2019 (COVID-19), many restrictive measures were carried out with the aim of reducing the impact of this disease. As a result, lifestyles were disrupted, which could affect eating behaviours. The aim of this systematic review of longitudinal studies was to assess changes in eating behaviour during the COVID-19 pandemic by establishing a comparison of eating behaviours before and after the outbreak of the pandemic. This study followed the PRISMA guidelines (PROSPERO: CRD42020203246), whereas to assess the quality of the studies, the Newcastle-Ottawa Quality Assessment Scale (NOS) was applied. Out of a set of 826 studies, 23 were included in this systematic review. The main findings provided information about a shift towards modified eating behaviours, characterized by an increased snack frequency and a preference for sweets and ultra-processed food rather than fruits, vegetables, and fresh food. Additionally, an increased alcohol consumption was found among different countries. Consequently, adherence to healthy diets decreased. These findings are relevant to future policies and strategies to assess nutrition in cases of alarming situations such as the current COVID-19 pandemic.

The fishing and seafood sector in the time of COVID-19: Considerations for local and global opportunities and responses

This article provides an overview of the impact of the COVID-19 pandemic on the fishing sector over the world, including several economic, social, environmental, and health challenges that the fisheries have had to face during the early days of the health crisis, and some of them still continue today. These problems, in short, are translated into a decrease in seafood demand, loss of jobs, changes in food consumption habits, economic losses, or increased vulnerability of the industry. As a consequence, governments have been forced to implement regulations and measures in support of this sector. However, a positive aspect of the pandemic also stands out, the opportunity to transform the food system to be greener, more inclusive, and resilient against future shocks.

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.

Assessment of Online Food Ordering and Delivery in Singapore During the COVID-19 Pandemic

This cohort study examines patterns of eating habits of people in Singapore during the COVID-19 pandemic.

COVID-19 Self-quarantine and Weight Gain Risk Factors in Adults

PURPOSE OF REVIEW

The COVID-19 pandemic is associated with weight gain in certain individuals. This review highlights the risk factors for weight gain during COVID-19 self-quarantine in adults.

RECENT FINDINGS

Among those who have gained weight during COVID-19 self-quarantine, self-reported body weight has increased between .5 and 1.8 kg (± 2.8 kg) after just 2 months of quarantine. Identified risk factors for weight gain during COVID-19 self-quarantine are the following: increased sedentary behaviors, decreased physical activity, increased snacking frequency (particularly after dinner), increased alcohol intake, decreased water intake, emotional eating, decreased sleep quality, and being overweight/obese. Having identified risk factors for weight gain during the COVID-19 pandemic, practitioners and researchers should devise plans to assist those who have gained weight to re-learn weight management/weight loss strategies.

Challenges in Feeding Children Posed by the COVID-19 Pandemic: a Systematic Review of Changes in Dietary Intake Combined with a Dietitian's Perspective

PURPOSE OF REVIEW

To examine the evidence that the dietary quality of children changed between the period preceding the COVID-19 pandemic and the first year during the pandemic.

RECENT FINDINGS

A systematic review of the evidence for dietary changes occurring as a result of the pandemic-related restrictions, in Part I of this article, yielded 38 original research articles. These articles had conflicting results, some describing improvements in overall quality and some describing deteriorations. As a whole the studies were characterized by a low study quality, and children were poorly represented. Taken together, these studies do not provide enough evidence to draw conclusions about whether dietary habits changed or not as a result of the pandemic. However, in a wider, narrative review of the psychosocial changes occurring as a result of the COVID-19 pandemic, and the known associations of these factors with a dietary intake in Part II, we conclude that there is a reason to expect that the dietary quality of children might have been adversely affected by the COVID-19 pandemic. One the one hand, the literature fails to provide conclusive evidence on changes in the dietary quality of children resulting from the COVID-19 pandemic. On the other hand, the broader literature supports the hypothesis that children's dietary quality will have declined during the pandemic. Taken together, we urgently need more high-quality research on children's changes in dietary intake occurring over the pandemic. This will provide important information on whether any potential long-term consequences of such changes, if they exist, need to be examined and ameliorated.

Impact of the COVID-19 pandemic lockdown on weight status and factors associated with weight gain among adults in Massachusetts

The study aims to examine the impact of the coronavirus disease-2019 (COVID-19) pandemic lockdown on weight, overweight and obesity, and identify factors associated with weight gain. At a safety net health system in Massachusetts, 11 534 adults were retrospectively followed within 3 months of the COVID-19 lockdown. Chi-square and 95% confidence intervals (CI) were reported for categorical and continues variables, respectively. Multivariate analyses were performed to identify factors associated with weight gain (≥0.01 kg and 5%). During the lockdown period, greater proportion of women gained weight compared to men (46.1% vs 40.6%, P < .01). The obesity rate after the lockdown increased among women (40.7%-41.7, P < .01) but decreased among men (39.6%-38.6, P < .01) compared to before the lockdown. Post-lockdown obesity rates increased among Haitian (51.2%-55.0%, P < .01) and Hispanic women (50.7%-51.8%, P < .01). More than 5% weight gain was associated with 18 to 39 vs ≥60 years of age (OR = 1.45, 95% CI = 1.07, 1.97), food and housing insecurity (OR = 1.44, 95% CI = 1.05, 1.97) and tobacco use (OR = 1.38, 95% CI = 1.07, 1.78) among men; and 18 to 39 vs ≥60 years of age (OR = 1.55, 95% CI = 1.25, 1.91), Hispanics (OR = 1.25, 95% CI = 1.01, 1.54), Brazilians (OR = 1.22, 95% CI = 1.03, 1.45), and tobacco use (OR = 1.36, 95% CI = 1.10, 1.69) among women. During the COVID-19 lockdown, significant proportion of participants gained weight, but subgroup variations existed. Our study can inform healthcare professionals about the impact of the lockdown on unhealthy weight gain and identify vulnerable populations. Strategies are needed to combat unhealthy weight gain during and beyond the pandemic.

Comparison of Salt-Related Knowledge and Behaviors Status of WeChat Users between 2019 and 2020

In order to identify the status of salt-related knowledge and behavior of the residents who were active in WeChat software between 2019 and 2020, 10-day salt-related surveys were conducted in 2019 and 2020 based on the WeChat public platform of China Healthy Lifestyle for All Campaign. Distribution and scores of salt-related knowledge, salt reduction behavior and high-salt intake behavior between 2019 and 2020 were compared. Data of 2109 participants in 2019 and 12,732 participants in 2020 were left for analysis. Overall, 88.2% of participants in 2019 had a willingness to reduce the amount of cooking salt in their households, significantly lower than 90.2% in 2020 (p-value < 0.05). In 2019 and 2020, over 80% of the participants knew fine dried noodles contain salt, but less than 30% knew ice cream contains salt. Over 78% of participants chose 5 g or 6 g for the maximum daily salt intake of healthy adults, and about 98% of participants knew that excessive salt intake would increase the risk of hypertension in both years. The percentage of participants who used salt measuring spoons asked restaurants to use less salt, read the sodium content on the nutrition facts table, chose foods with low sodium content and regularly used low-sodium salt, were 36.1%, 45.0%, 44.1%, 40.3% and 35.8% in 2019, and the percentage increased significantly to 46.4%, 49.2%, 50.8%, 47.1% and 43.4% in 2020 (all p-value < 0.05). The percentage of people regularly eating pickled mustard tubers, salted vegetables and sauce foods or using high-salt condiments also increased from 2019 to 2020. The median of salt-related knowledge scores, salt reduction behavior scores and high-salt intake behavior scores were 11, 2, 5 points in 2019, and 10, 3, 5 points in 2020, respectively. Compared to 2019, the salt-related knowledge score was relatively lower, while the salt reduction behavior score and high-salt intake behavior score were relatively higher in 2020. Besides, the score of salt-related knowledge and behaviors differed in different gender, age and hypertension groups. The COVID-19 epidemic may have influenced the salt-related knowledge and behaviors status of WeChat users in China. Promotion and education of salt-related knowledge and online behavior intervention are still needed, particularly for male and hypertension patients in the future.

Body Mass, Physical Activity and Eating Habits Changes during the First COVID-19 Pandemic Lockdown in Poland

The outbreak of the COVID-19 pandemic caused a number of changes in social life around the world. In response to the growing number of infections, some countries have introduced restrictions that may have resulted in the change of the lifestyle. The aim of our study was to investigate the impact of the lockdown on body weight, physical activity and some eating habits of the society. The survey involving 183 people was conducted using a proprietary questionnaire. The mean age of the study participants was 33 ± 11 and mean height 169 ± 8 cm. An average increase in body weight was observed in 49.18% by 0.63 ± 3.7 kg which was the result of a decrease in physical activity and an increase in food consumption. We also observed a decrease in PAL from 1.64 ± 0.15 to 1.58 ± 0.13 and changes in the amount of food and individual groups of products consumption, including alcohol. Among the study participants who did not lose body mass, there was an average weight gain of 2.25 ± 2.5 kg. In conclusion, an increase of weight was shown in about half of the respondents in the study group which was associated with a decrease in physical activity and an increase in the consumption of total food and high energy density products.

Learning from previous lockdown measures and minimising harmful biopsychosocial consequences as they end: A systematic review

Background

Infectious outbreaks, most recently coronavirus disease 2019 (COVID-19), have required pervasive public health strategies, termed lockdown measures, including quarantine, social distancing, and closure of workplaces and educational establishments. Although evidence analysing immediate effects is expanding, repercussions following lockdown measures remain poorly understood. This systematic review aims to analyse biopsychosocial consequences after lockdown measures end according to short, medium, and long-term impacts.

Methods

PubMed, Ovid MEDLINE, Embase, PsycInfo, Web of Science, and Scopus databases were searched from inception to January 12, 2021. Reference lists were manually reviewed. Eligible studies analysed biopsychosocial functioning after lockdown measures secondary to recent infectious outbreaks ended. Lockdown measures were defined as quarantine, isolation, workplace or educational closures, social or physical distancing, and national or local closure of public institutions deemed non-essential. Studies exclusively researching outcomes during lockdown measures, examined infectious participants, or analysed lockdown measures not pertaining to an infectious outbreak were excluded. Two independent reviewers extracted data and assessed bias with a third resolving discrepancies. Data was extracted from published reports with further information requested from authors where necessary. The mixed methods appraisal tool assessed study quality, languages were restricted to English, German, Italian, and French and narrative synthesis was applied.

Results

Of 5149 identified studies, 40 were eligible for inclusion. Psychological distress, economic repercussions, social, biological, and behavioural ramifications were observed. Short to medium-term effects comprised reactions relating to early trauma processing whereas medium to long-term repercussions manifested in maladaptive behaviours and mental health deterioration. Increased alcohol intake, stigmatisation, and economic effects were also identified consequences. High-risk groups included health care workers, children, elderly, inpatients, those with pre-existing psychiatric diagnoses, and socially isolated individuals.

Conclusions

Supporting vulnerable groups and offering education, workplace modifications, financial, and social assistance may mitigate negative repercussions. Establishing a rapid and comprehensive evidence base appraising the efficacy of such interventions and identifying areas for development is essential. This review was limited by study heterogeneity and lack of randomisation in available literature. Given the unprecedented nature and progression of COVID-19, the relevance of previous outcomes remains uncertain.

Protocol registration

PROSPERO registration CRD42020181134

Knowledge, Attitudes, and Practices of Urban Residents Toward COVID-19 in Shaanxi During the Post-lockdown Period

Background: The coronavirus disease 2019 (COVID-19) pandemic in China is essentially under control. Under global scrutiny, China has started reviving the social, cultural, and working lives of its inhabitants. However, localized outbreaks of COVID-19 are occurring, indicating that the country still needs to follow disease prevention and control measures. Previous studies have assessed the knowledge, attitudes, and behaviors of the general public in China regarding COVID-19 during the pandemic. However, little is known about knowledge, attitudes, and practices (KAP) of Chinese residents regarding COVID-19 after periods of lockdown. Therefore, this study was conducted to identify the KAP and other factors among the residents of Shaanxi Province during the post-lockdown period. Methods: A cross-sectional, network questionnaire survey was conducted in Shaanxi Province from October 1-30, 2020. A total of 1,175 urban residents were interviewed via Wen Juan Xing, an online questionnaire tool. A self-developed online KAP COVID-19 questionnaire was developed in this study. The questionnaire consisted of four parts: general information, knowledge, attitude, and practice. Descriptive statistics and binomial logistic regression analysis were used in the statistical analysis. Results: The majority of the participants were knowledgeable about COVID-19. They had optimistic attitudes and behaved appropriately toward COVID-19. Education was an associated factor for the knowledge of residents and the knowledge of COVID-19 was high among people with high academic qualifications. Attitudes were more positive in residents who lived with elderly people, women, and children. The score of practice was higher in residents with positive attitudes and high academic qualifications. There was a positive correlation between age and practice. Conclusion: We found that the KAP of residents in Shaanxi was at a relatively high level during the post-lockdown period. Although the lockdown was lifted, the epidemic is not over. Thus, it is necessary to develop targeted health education programs for residents with different demographic characteristics in Shaanxi.

Dietary Habits before and during the COVID-19 Epidemic in Selected European Countries

During the so-called “second wave of the pandemic” in Europe, the authors conducted a cross-sectional online survey that aimed to examine changes in dietary habits and associated practices, as well as physical activity during the COVID-19 pandemic and before the onset of lockdowns in three European countries: Poland, Austria and the United Kingdom. Methods: The online observational study, both prospective and retrospective, conducted with the use of social media for the distribution of an anonymous online questionnaire, was completed from 1 October to 30 October 2020, during the second wave of the pandemic in Europe. The study encompassed a total of 1071 adults from Poland (n = 407), Austria (n = 353) and the United Kingdom (n = 311). Results: The results of this study indicate that the COVID-19 confinement period influenced eating behavior and the level of physical activity in a group of adult residents of Poland, Austria and the United Kingdom. The general shopping frequency decreased, regardless of the place and manner. However, there was an increased interest in online grocery shopping. The resulting data revealed an increased frequency of the daily consumption of food products such as dairy, grains, fats, vegetables and sweets (p < 0.05). A rise in the frequency of purchasing frozen goods and food with long shelf life has also been observed. The changed workplace and working conditions or unemployment probably affected a perceptible rise in alcohol consumption (p = 0.02). In turn, physical activity levels markedly decreased, which reflected the body mass changes. Conclusion: The dietary habits in the studied countries have changed as a result of the pandemic situation. They contribute to the aggravation of the problem of excess body weight and its health consequences.

Dietary Changes during the COVID-19 Pandemic: A Longitudinal Study Using Objective Sequential Diet Records from an Electronic Purchase System in a Workplace Cafeteria in Japan

As a result of the coronavirus disease 2019 (COVID-19) pandemic-related restrictions, food systems have undergone unprecedented changes, with the potential to affect dietary behavior. We aimed to investigate workers’ dietary changes resulting from the introduction of regulations to combat COVID-19 in a Japanese factory cafeteria. Objective data on daytime dietary intake were automatically collected from electronic purchase system records. The dataset included the weekly data of 890 men from 1 July 2019 to 30 September 2020. The cafeteria regulations came into effect on 10 April 2020; in this context, the purchase of dishes and estimated dietary intake were monitored. The number of cafeteria visits decreased slightly after the introduction of the regulations. The purchase of main and side dishes also decreased, but the purchase of grain dishes was less affected. When compared with summer 2019 (pre-pandemic, no regulations: 1 July to 29 September 2019), in summer 2020 (during the pandemic and with regulations: 29 June to 30 September 2020), the estimated mean grain, meat, fish, and total energy intake was stable; however, vegetable intake decreased by 11%. As the COVID-19 pandemic continues, workplace cafeteria regulations need to be monitored to avoid unfavorable dietary changes in employees.

COVID-19 lockdown and lifestyles: A narrative review

Background: The primary objective worldwide during the coronavirus disease 2019 (COVID-19) pandemic has been controlling disease transmission. However, lockdown measures used to mitigate transmission have affected human behavior and altered lifestyles, with a likely impact on chronic non-communicable diseases. More than a year into the pandemic, substantial peer-reviewed literature has emerged on altered lifestyles following the varying lockdown measures imposed globally to control the virus spread. We explored the impact of lockdown measures on six lifestyle factors, namely diet, physical activity, sleep, stress, social connectedness, and the use of tobacco, alcohol, or other harmful substances. Methods: We comprehensively searched PubMed and the World Health Organization’s global literature database on COVID-19 and retrieved 649 relevant articles for the narrative review. A critical interpretative synthesis of the articles was performed. Results: Most of the articles included in the review identified the negative effect of lockdown measures on each of the lifestyle factors in many parts of the world. Encouraging lifestyle trends were also highlighted in a few articles. Such trends can positively influence the outcome of lifestyle-related chronic diseases, such as obesity and diabetes. Conclusions: The COVID-19 pandemic provides an opportunity to better understand the negative impact of strict lockdown measures on lifestyles. At the same time, it helps us identify and initiate positive behavioral changes, which, if consolidated, could improve chronic disease outcomes. It is up to governments, communities, and healthcare/academic entities to derive benefit from lessons learned from the pandemic, with the ultimate objective of better educating and promoting healthy lifestyles among communities.

Gender differences in global estimates of cooking frequency prior to COVID-19

The frequency of cooking at home has not been assessed globally. Data from the Gallup World Poll in 2018/2019 wave (N = 145,417) were collected in 142 countries using telephone and face to face interviews. We describe differences in frequency of 'scratch' cooking lunch and dinner across the globe by gender. Poisson regression was used to assess predictors of cooking frequency. Associations between disparities in cooking frequency (at the country level) between men and women with perceptions of subjective well-being were assessed using linear regression. Across the globe, cooking frequency varied considerably; dinner was cooked more frequently than lunch; and, women (median frequency 5 meals/week) cooked both meals more frequently than men (median frequency 0 meals/week). At the country level, greater gender disparities in cooking frequency are associated with lower Positive Experience Index scores (-0.021, p = 0.009). Prior to the COVID-19 pandemic, the frequency with which men and women cook meals varied considerably between nations; and, women cooked more frequently than men worldwide. The pandemic, and related 'stay at home' directives have dramatically reshaped the world, and it will be important to monitor changes in the ways and frequency with which people around the world cook and eat; and, how those changes relate to dietary patterns and health outcomes on a national, regional and global level.

The Impact of COVID‐19 on the Dietary Diversity of Children and Adolescents: Evidence from a Rural/Urban Panel Study

This paper offers the first empirical evidence of the impact of COVID‐19 on dietary diversity among children and adolescents in urban and rural families by using panel data collected in 2019 (before COVID‐19) and 2020 (during COVID‐19) in northern China. Our study uses panel data from 2,201 primary school students and 1,341 junior high‐school students to apply the difference in differences (DID) method to estimate the impact of COVID‐19 on dietary diversity among students in urban and rural families. We found that the dietary diversity score (DDS) of rural students decreased by 0.295 points (p < 0.01) compared with that of urban students during COVID‐19. Specifically, COVID‐19 significantly reduced the frequency of rural students' consumption of vegetables by 1.8 percent, protein‐rich foods such as soybean products and nuts by 6.0 percent, meats by 4.0 percent, aquatic products by 6.7 percent, and eggs by 5.3 percent, compared with urban students. Further, COVID‐19 had a significant negative effect on the dietary diversity of students from low‐ and middle‐income groups, with the DDS of the low‐income group decreasing by 0.31 points (p < 0.01) and that of the middle‐income group by 0.12 points (p < 0.1).

Changes in Lifestyle, Behaviors, and Risk Factors for Cognitive Impairment in Older Persons During the First Wave of the Coronavirus Disease 2019 Pandemic in Finland: Results From the FINGER Study

Aims: This study aimed to describe how the first phase of the coronavirus disease 2019 (COVID-19) pandemic affected older persons from the general Finnish population who are at risk of developing or have cognitive impairment, specifically, to describe whether participants experienced a change in risk factors that are relevant for the prevention of cognitive decline including diet, physical activity, access to medical care, socially and cognitively stimulating activities, and emotional health and well-being. Method: A postal survey was sent in June 2020 to 859 participants from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), an ongoing longitudinal study. The survey was developed to assess the effect of the COVID-19 pandemic and related infection-control measures on daily life, specifically commitment to distancing measures, access to health care and social services, daily activities, and changes in cognitive and social activities. Results: By September 2020, 613 (71%) participants responded (mean age = 77.7 years, 32% lived alone, and 80% had at least one chronic condition). Three quarters adopted some distancing practices during the first months of the pandemic. Older participants were more likely to practice total isolation than younger ones (29 vs. 19%; p = 0.003). Non-acute health-care visits were canceled for 5% of the participants who needed appointments, but cancellations in dental health care (43%), home aid (30%), and rehabilitative services (53%) were more common. Pandemic-related changes were reported in social engagements, for example, less contact with friends (55%) and family (31%), or less frequent attendance in cultural events (38%) or associations (25%), although remote contact with others increased for 40%. Feelings of loneliness increased for 21%, particularly those who were older (p = 0.023) or living alone (p < 0.001). Physical activity reduced for 34%, but dietary habits remained stable or improved. Pandemic-related changes in lifestyle and activities were more evident among those living alone. Conclusions: Finnish older persons generally reported less negative changes in lifestyles and behaviors during the pandemic than expected. Older people and those living alone seemed more susceptible to negative changes. It is important to compare how coping strategies may compare with other European countries to identify factors that may help older individuals to maintain healthy lifestyles during future waves of COVID-19.