COVID-19 Stress and Food Intake: Protective and Risk Factors for Stress-Related Palatable Food Intake in U.S. Adults

Encouraging online consumers into making better food choices: The power of nature exposure on healthy food choices

BACKGROUND

online environments can influence food desire and choices. We tested if online calming nature and stressful street environments can affect desire for healthy and unhealthy foods.

METHOD

we asked 238 participants (40 ± 14 yrs) to rate their desire (100 mm VAS) for 7 low calorie nutrient rich foods (Healthy) and 7 high calorie nutrient poor foods (Unhealthy), and perceived stress (state anxiety in STAI), before and after imagining themselves in a control, nature park, or busy street condition.

RESULTS

participants who imagined themselves being in a nature park had a significant higher desire for Healthy foods, than participants in the busy street condition (p < 0.05). Participants in the busy street condition decreased their desire for Healthy foods after they imagined themselves in a busy street (p < 0.05)). However, perceived stress did not impact the association between condition and desire for low calorie foods nor high calorie foods.

CONCLUSION

this study suggests that online environments can have an impact on healthy food desires, which could be of importance for the increased number of food choices which are made in online environments.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Associations between comfort eating and weight change during the COVID-19 pandemic among U.S. adults

Objective

To examine associations between comfort eating in response to loneliness or stress and weight change during the COVID-19 pandemic among U.S. adults.

Design

Quantitative, cross-sectional study.

Setting

The 2021 SummerStyles survey data.

Subjects

U.S. adults (≥18 years; N = 4068).

Measures

The outcome was reported weight changes since the start of the COVID-19 pandemic with four responses: lost weight, weight remained the same, gained weight, and don't know. The exposure variable was frequency of comfort eating in response to loneliness or stress during the past year with three responses: never/ rarely, sometimes, or often/always.

Analysis

We used chi-square analysis to examine the independence of survey variables related to weight changes, and comfort eating in response to loneliness or stress during the COVID-19 pandemic. Next, we used a multinomial logistic regression to estimate adjusted odds ratios for weight changes by comfort eating in response to loneliness or stress frequency.

Results

Overall, 20.1% of adults reported losing weight, 39.9% remained about the same weight, 30.4% gained weight, and 9.4% did not know about their weight change during the COVID-19 pandemic. Taking comfort by eating in response to loneliness or stress was reported by over 33% of participants (often/always = 8.3%; sometimes = 25.3%). Weight change and comfort eating during the COVID-19 pandemic significantly varied by sociodemographic factors. Respondents that sometimes or often/always reported taking comfort by eating in response to loneliness or stress were more likely to report losing weight (Adjusted Odds Ratio ranges: 1.62-2.99) or gaining weight (Adjusted Odds Ratio ranges: 3.10-4.61) than those who never/rarely took comfort by eating in response to loneliness or stress.

Conclusions

Taking comfort by eating when stressed/lonely was significantly associated with reported weight changes during the COVID-19 pandemic. Weight changes may lead to additional health complications. Implementing evidence-based strategies to reduce loneliness or stress and support healthy eating during the COVID-19 pandemic may benefit weight management and future well-being.

The Impact of the First and Second Wave of the COVID-19 Pandemic on Eating Symptoms and Dysfunctional Eating Behaviours in the General Population: A Systematic Review and Meta-Analysis

BACKGROUND

The aim of this systematic review and meta-analysis was to examine the prevalence of feeding and eating disorder (FED) symptoms or dysfunctional eating behaviours (DEB) in the general population during the COVID-19 outbreak.

METHOD

We searched eligible articles in biomedical databases from 1 January 2020 to 31 March 2022. Prevalence rates of FED or DEB changes between pre-pandemic and pandemic time and correlation with psychological distress were pooled with a meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I2) statistics. A total of 186 studies with 406,076 participants met the inclusion criteria.

RESULTS

The more prevalent FED or DEB during the COVID-19 outbreak were: body image concerns (52%, 95% CI 0.38, 0.66), binge eating (40%, 95% CI 0.25, 0.55), and overeating (40%, 95% CI = 0.32-0.48). Pooled data of longitudinal studies (k = 8) only showed a significant difference in the prevalence of weight gain from pre-pandemic to the pandemic time. Finally, increased levels of psychological distress (k = 35) positively correlated with some ED symptoms.

CONCLUSION

This meta-analysis evidenced a negative impact of the pandemic on eating symptoms and DEB in the general population.

Physical Activity Levels, Eating Habits, and Well-Being Measures in Students of Healthcare Degrees in the Second Year of the COVID-19 Pandemic

BACKGROUND

When the first cases of COVID-19 (caused by SARS-CoV-2 virus infection) were discovered, exceptional norms to fight the spread of the virus were established by applying movement restrictions (lockdown) in many countries. These unprecedented norms led to sedentary behaviours and less healthy diets which could persist for much longer after lockdown. The aim of this study was to analyse the physical activity, eating habits, self-perceived well-being, and toxic habits, as well as the perceived changes of these habits with respect to the pre-pandemic period, in a population of university students in the second year of the COVID-19 pandemic.

METHODS

A single-centre, cross-sectional study was conducted in a population of university students of healthcare degrees. A total of 961 students (639 (66.5%) women and 322 (33.5%) men) signed the informed consent and completed the questionnaire. The study was conducted through an anonymous survey, which was voluntarily self-completed by the students on an online platform. The questionnaire was based on the Spanish Health Survey and it was divided into six main parts: demographic and anthropometric characteristics, physical activity, eating habits, well-being measures (sleeping habits, health state, and stress), toxic habits, and perception of the influence of the COVID-19 pandemic on the variables described.

RESULTS AND CONCLUSIONS

The results showed that, during the second year of the pandemic, statistically significant dependence was identified for those students that showed higher levels of physical activity with greater perceived physical activity (p < 0.05), healthier eating habits (p < 0.05), and a better self-perceived health state (p < 0.05), with respect to the 12 months before the COVID-19 pandemic. On the other hand, there was a negative correlation between the sedentary students and greater perceived physical activity (p < 0.05). With regard to toxic habits and physical activity, a significant correlation was only detected between sedentary behaviour and cocaine consumption (p < 0.05). Analysing eating habits, it was observed that the students who smoked, consumed alcohol, and binge drank had low adherence to the Mediterranean diet (p < 0.05). In addition, those students with high stress levels slept less than 7 h (p < 0.05).

Characteristics Associated with Being a High Consumer of Sweet Foods and Sugar-Sweetened Beverages among US Adults during the COVID-19 Pandemic, 2021

BACKGROUND

The COVID-19 pandemic impacted some dietary habits of Americans.

OBJECTIVE

We examined characteristics associated with a high intake of sweet foods and sugar-sweetened beverages (SSB) during the COVID-19 pandemic among US adults.

DESIGN

This was a cross-sectional study.

PARTICIPANTS/SETTINGS

The SummerStyles survey data were collected in 2021 among 4034 US adults (≥18 years).

MAIN OUTCOME MEASURES

The frequencies were measured of consuming various sweet foods (chocolate/candy, doughnuts/sweet rolls/Danish/muffins/Pop-Tarts, cookies/cake/pie/brownies, and ice cream/frozen desserts) and SSB (regular sodas, sweetened coffee/tea drinks fruit drinks, sports drinks, and energy drinks) during the COVID-19 pandemic. The responses were categorized into 0, >0 to <1, 1 to <2, and ≥2 times/day. The descriptive variables were sociodemographics, food insecurity, weight status, metropolitan status, census regions, and eating habit changes during the COVID-19 pandemic.

STATISTICAL ANALYSES PERFORMED

Multinomial regressions were used to estimate adjusted odds ratios (AOR) for being a high consumer of sweet foods and SSB after controlling for characteristics.

RESULTS

During 2021, 15% of adults reported consuming sweet foods ≥2 times/day, and 30% reported drinking SSB ≥2 times/day. The factors that were significantly associated with greater odds of high sweet food intake (≥2 times/day) were lower household income (AOR = 1.53 for <$35,000 vs. ≥$100,000), often/sometimes experiencing food insecurity (AOR = 1.41 vs. never), and eating more sweet foods than usual since start of the pandemic (AOR = 2.47 vs. same as usual). The factors that were significantly associated with greater odds of high SSB intake (≥2 times/day) were males (AOR = 1.51), lower education (AOR = 1.98 for ≤high school; AOR = 1.33 for some college vs. college graduate), currently having children (AOR = 1.65), living in nonmetropolitan areas (AOR = 1.34), and drinking more SSB than usual since the pandemic began (AOR = 2.23 vs. same as usual). Younger age, Black race, and reductions in consumption during COVID-19 were related to lower sweet food and SSB intakes.

CONCLUSIONS

Our findings, which identified high consumers of sweet foods or SSB, can be used to inform efforts to reduce consumers' added sugars intake during pandemic recovery and support their health.

Snacking and anxiety during the coronavirus disease (COVID-19) pandemic: A prospective cohort study

Anxiety and snacking increased during the initial coronavirus disease 2019 (COVID-19) lockdowns, but it remains unknown whether this change in snacking persisted and if it related to anxiety levels. We used prospective data to examine changes in snacking frequency from t1 (eased restrictions in England in May-June 2020) to t2 (national lockdown in December 2020-March 2021), the association of anxiety (assessed by the Generalised Anxiety Disorder-7 questionnaire at t1) with the snacking change, and the mediating and moderating effects of disinhibition and flexible restraint (assessed by the Three Factor Eating Questionnaire in 2016-17). Analyses including 2128 adults (mean age 28.4 y) residing in England from the Avon Longitudinal Study of Parents and Children showed that snacking frequency increased over time (mean change 1.23 (95% CI 0.81, 1.65) snacks/wk). Linear regressions of snacking adjusted for sociodemographic covariates showed that having clinical levels of generalised anxiety at t1, versus not, was associated with 1.22 (95% CI 0.07, 2.37) more snacks/wk at t2. Disinhibition partially mediated the association between Generalised Anxiety Disorder and snacking (β_indirect = 0.15, 95% CI 0.01, 0.32), while there was no evidence that flexible restraint moderated the association (β = 0.05, 95% CI -0.57, 0.66). Our longitudinal findings highlight a detrimental anxiety-snacking association partly operating via disinhibition, suggesting future research could target mitigating anxiety and disinhibited eating behaviours to benefit diet-related outcomes following the pandemic.

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

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

Dietary behaviours during COVID-19 among households at risk for food insecurity

The objective of the present study was to examine associations between variables of COVID-19-related concerns and changes in fruit and vegetable (FV) consumption among a sample of participants from the Brighter Bites program at risk for food insecurity. Cross-sectional data were collected during April-June 2020 using a rapid-response survey to understand social needs, COVID-19-related concerns and diet-related behaviours among families with children participating in Brighter Bites (n 1777) in the 2019-2020 school year at risk for food insecurity, within the surrounding Houston, Dallas, Austin, Texas area; Southwest Florida; Washington, D.C., United States. Of the 1777 respondents, 92 % of households reported being at risk for food insecurity. Among those from food insecure households, the majority were of Hispanic/Mexican-American/Latino (84⋅1 %) ethnic background, predominantly from Houston, Texas (71⋅4 %). During the pandemic, among individuals from food insecure households, 41 % (n 672) reported a decrease in FV intake, 32 % (n 527) reported an increase in FV intake, and 27 % (n 439) reported no change in FV intake. Those who reported concerns about financial stability had a 40 % greater risk of decreased FV intake compared to those not concerned about financial stability (RR 1⋅4; 95 % CI 1⋅0, 2⋅0; P = 0⋅03). The present study adds to this current body of sparse literature on how the initial phase of the pandemic impacted FV consumption behaviours among food insecure households with children. Effective interventions are needed to diminish the negative impact of COVID-19 on the population's health.

Aggressive behavior, boredom, and protective factors among college students during closed-off management of the COVID-19 pandemic in China

Background

Chinese colleges have implemented strict closed-off management in response to the outbreak of a new variant of the new coronavirus, Omicron. But such management measures may lead to more aggressive behavior. The study aimed to determine the associations between boredom and aggressive behavior with aggression and to examine the impact of boredom on aggression through the moderating role of cognitive flexibility.

Methods

The Multidimensional State Boredom Scale, the Reactive-Proactive Aggression Questionnaire, and the Cognitive Flexibility Inventory were applied to a sample of 719 college students who were in a closed-off management environment.

Results

For individuals with high cognitive flexibility, the relationship between state boredom and proactive aggression was not significant. The relationship between state boredom and proactive aggression was significantly positively correlated for individuals with low cognitive flexibility, especially low substitutability. Cognitive flexibility has no significant moderating effect on the relationship between state boredom and reactive aggression.

Conclusion

The findings highlighted the importance of boredom as a potential risk factor for aggression, while cognitive flexibility appears as a potential protective factor.

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

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

Changes in appetite during quarantine and their association with pre-COVID-19 mental and physical health

BACKGROUND

The COVID-19 Pandemic resulted in high levels of fear, anxiety, and stress. People with pre-existing physical and mental health conditions may have been more affected by the sudden changes in daily habits during the initial months of global quarantine imposed during the COVID-19 pandemic.

METHODS

We designed the Quarantine, Anxiety, and Diet (QUAD) Survey to investigate the effect of pre-existing health conditions on the relationship of COVID-19 stress and food behavior. The anonymous survey was distributed online and only adults were eligible to participate.

RESULTS

The results showed that responders with pre-existing health conditions differed from healthy participants in eating behavior during this time of stress. Compared to those classified as healthy, fewer people with pre-existing physical illness showed an increase in appetite with stress during the COVID-19 pandemic. Responders with pre-existing psychiatric illness were more likely to show increases or decreases in appetite with stress compared to healthy responders. Furthermore, higher BMI was associated with higher rate of increased appetite, whereas low BMI showed a higher rate of decreased appetite, both compared to normal BMI.

CONCLUSION

The QUAD Survey demonstrated that individuals with pre-COVID-19 psychiatric conditions are at a higher risk of maladaptive food behavior under stress. Since pre-existing psychiatric illnesses and acute stressors are known risk factors for eating disorders, special attention should be placed on those at risk to mediate the psychological and physical effects of stress and anxiety.

Associations of mothers' and fathers' structure-related food parenting practices and child food approach eating behaviors during the COVID pandemic

BACKGROUND

During the COVID-19 pandemic, many mothers and fathers have spent more time at home with their children, warranting consideration of parenting practices around food during the pandemic as influences on obesogenic eating behaviors among children. Structure-related feeding practices, particularly around snacking, may be particularly challenging yet influential in the pandemic setting. Parent sex and levels of feeding-related co-operation among parents (co-feeding) are understudied potential influences on parent-child feeding relationships.

METHODS

We investigated relationships between structure-related parent feeding and child food approach behaviors during the COVID-19 pandemic, while considering potential moderating influences of parent sex and co-feeding levels. An online survey was completed by 318 parents (206 mothers and 112 fathers) of 2-12-year-olds who were living in states with statewide or regional lockdowns in May/June 2020 within the US. Mothers and fathers were drawn from different families, with each survey corresponding to a unique parent-child dyad. Parental stress/mental health, co-feeding (Feeding Coparenting Scale), structure-related food and snack parenting (Feeding Practices and Structure Questionnaire and Parenting around SNAcking Questionnaire), and child eating behaviors (Child Eating Behaviour Questionnaire) were assessed. Relationships of parents' structure-related food and snack parenting practices with their child's emotional overeating and food responsiveness behaviors were examined using structural equation modelling. Further, we investigated whether these relations were moderated by parent sex or level of co-feeding.

RESULTS

Parent sex differences were seen in parental stress, mental health, and co-feeding, but not in structure-related food and snack parenting or child food approach eating behaviors. Structure-related food parenting was negatively associated with emotional overeating. However, structure-related snack parenting was positively associated with emotional overeating and food responsiveness. While regression paths varied between mothers vs. fathers, as well as by co-feeding levels, neither parent sex nor co-feeding levels significantly moderated relationships between parent feeding and child eating variables.

CONCLUSIONS

Future studies of food and snack parenting and co-operation in relation to feeding among mothers and fathers within a familial unit may be critical to identify intervention strategies that draw on all family resources to better navigate future disruptive events such as the COVID-19 pandemic.

Changes in patterns of eating habits and food intake during the first German COVID-19 lockdown: results of a cross-sectional online survey

Purpose

The COVID-19 pandemic and public measures have a direct impact on the nutrition situation; studies show changes in food consumption, eating behavior or body weight but complex pattern analyses of changes rarely exist.

Methods

During the first German lockdown, a web-based survey was conducted among adults. It included 33 questions about changes in food intake, eating habits and physical activity, as well as anthropometrics and sociodemographic factors. Patterns of change were calculated based on changes in food intake and eating habits using two-step cluster analysis. To identify influencing factors for assignment to the patterns of change, binary logistic regression analyses were performed.

Results

Data from 2103 participants (81% female, 40 ± 14 years) were considered for analysis. Increased stockpiling, cooking, and variation in preparation was reported by 50–70%. The constant pattern (C-P, 36%) reported little change besides the above. The health-oriented pattern (HO-P; 37%) reported eating more healthy foods, avoiding unhealthy foods, and eating less and less frequently. The emotional-driven pattern (ED-P; 28%) exhibits higher influence of emotions on eating behavior, less avoidance of unhealthy foods, and increased consumption of sweets, pastries, and alcohol. The odds of changing eating behavior either to HO-P or ED-P were higher in women, people with migration background, younger participants, and increased with BMI categories.

Conclusion

Both, the ED-P and HO-P, exhibit distinctive reactions in eating habits and food intake when dealing with a distressing experience. In subgroups, these may lead to disturbances in eating behavior and increase the risk for eating disorders and obesity.

Noor N, Mat Ludin AF, Shahar S, Abdul Manaf MR. The Challenges and Strategies towards Healthy Eating during COVID-19 Home Confinement Period among Working Adults with BMI ≥ 25 kg/m2 Enrolled in a Weight Loss Program: Qualitative Findings

The COVID-19 pandemic has been affecting our lifestyles, such as work, living, and health. In Malaysia, the Restriction of Movement Order (RMO) was first announced in March 2020 to curb the spread of the virus. Since then, many Malaysians have been confined to their own home. This new lifestyle can cause a change of eating habits where healthy eating may be a challenge. Hence, our qualitative study explored the challenges and strategies for healthy eating during the first wave of the COVID-19 home confinement period among working adults overweight and obese in Malaysia. Eleven participants were individually interviewed through phone calls. The interviews were audio-recorded, transcribed verbatim, and then coded with NVIVO 12 based on thematic analysis. We found that social pressure, changes in the social setting, more free time to access food, and extra stock of unhealthy foods at home were among the challenges to healthy eating. Some participants countered these perceived challenges by reducing unhealthy food stock, limiting kitchen visits, and utilizing self-monitoring apps to monitor their calorie intake. Social media was not consistently perceived to influence their eating behavior during this period. We conclude that COVID-19 home confinement has created challenges to healthy eating habits among overweight and obese adults with overweight and obesity. Our study provides evidence that vulnerable groups such as overweight and obese individuals require specific nutritional support during pandemic-related confinement to enhance eating self-efficacy.

Chronic Stress and Ovulatory Dysfunction: Implications in Times of COVID-19

Stress is known to be associated with adverse health outcomes. The COVID-19 pandemic and its associated lockdowns are examples of chronic stressors. Lockdown measures inadvertently caused significant psychological distress and became a powerful source of anxiety/stress, sleep disturbances, nutritional changes and weight gain. Stress is known to impact women's health specifically, through hypothalamic-pituitary-gonadal (HPG) axis dysfunction and resultant ovulatory dysfunction. Such dysfunction may manifest in menstrual irregularities and/or infertility due to hypothalamic hypogonadism. Here, we review the key physiological mediators of stress and associated ovulatory dysfunction. The kisspeptinergic system is comprised of sets of neurons located in the hypothalamus, the rostral periventricular region of the third ventricle (RP3V) and the arcuate nucleus (ARC). This system links nutrition, reproductive signals and stress. It plays a key role in the function of the HPG axis. During chronic stress, the kisspeptinergic system affects the HPG axis, GnRH pulsatility, and, therefore, ovulation. Leptin, insulin and corticotrophin-releasing hormone (CRH) are thought to be additional key modulators in the behavioral responses to chronic stress and may contribute to stress-related ovulatory dysfunction. This mini-review also summarizes and appraises the available evidence on the negative impact of chronic stress as a result of the COVID-19 pandemic lockdowns. It proposes physiological mechanisms to explain the observed effects on women's reproductive health and well-being. The review suggests areas for future research.

Coronavirus stress and overeating: the role of anxiety and COVID-19 burnout

BACKGROUND

This study examined the role of anxiety and coronavirus disease 2019 (COVID-19) burnout in the relationship between coronavirus stress and overeating among Chinese college students during the COVID-19 pandemic.

METHODS

Chinese college students (N = 2926; M_age = 19.90, SD = 1.47, range = 18-25 years old; 54.34% female) completed self-reported online questionnaires regarding coronavirus stress, anxiety, COVID-19 burnout, and overeating.

RESULTS

Anxiety showed partially indirect effect on the association between coronavirus stress and overeating. COVID-19 burnout exacerbated the indirect pathway between coronavirus stress and overeating via anxiety.

DISCUSSION AND CONCLUSION

This is the first study, to our knowledge, that examines the underlying mechanisms of the coronavirus stress and overeating behavior association among Chinese college students. The results support several existing theories on stress and problematic eating behaviors and provide practical implications for prevention and intervention programs of overeating during the COVID-19 pandemic.

Age, Education, and Stress Affect Ageing Males' Symptoms More than Lifestyle Does: The Wroclaw Male Study

An increasing number of subjects are affected by health problems related to the advanced involutional processes. It is extremely important to identify the determinants of the rate of occurrence of physiological, psychological, and social manifestations of aging. The aim was to determine how factors such as lifestyle, level of education, or severity of stressful life events indicate the appearance of aging symptoms in adult men. The material consisted of data of ethnically homogeneous group of 355 men (32−87 years), invited to the study as a part of the Wroclaw Male Study research project. The analyzed features included (1) socioeconomic status: age, educational level, marital status, and having children; (2) elements of lifestyle: alcohol drinking, cigarette smoking, and physical activity; (3) major and most important stressful life events—the Social Readjustment Rating Scale; (4) symptoms related to male aging—the Aging Males’ Symptoms. The backward stepwise regression models, the Kruskal−Wallis test, and multiple comparisons of mean ranks were used. Noncentrality parameter δ (delta), two-tailed critical values of the test, and test power with α = 0.05 were calculated. Among the analyzed variables, age was most strongly associated with the intensity of almost all groups of andropausal symptoms in men (p = 0.0001), followed by the level of education (p = 0.0001) and the intensity of stressful life events (p = 0.0108). Selected lifestyle elements turned out to be much less important (p > 0.01). Preventive actions aimed at slowing down the intensification of involutional processes, including teaching strategies for coping with stressful life events, should be implemented in groups of men with specific risk factors from an early age.

Public Health Response to the SARS-CoV-2 Pandemic: Concern about Ultra-Processed Food Consumption

Introduction: There is scientific consistency in the concept of ultra-processed foods (UPFs) as a descriptor of an unhealthy diet. The most recent literature points to troubling evidence that policies adopted to address the SARS-CoV-2 pandemic may have contributed to diverting eating habits toward a poorer diet. Considering the historically unique SARS-CoV-2 pandemic lockdown scenario, and the health burden imposed by UPFs on human health, it is critical to investigate how the epidemic has influenced UPF intake directly. Reviewing the literature, we aimed to assess the changes in the consumption of UPFs during the pandemic lockdown compared to previous habits in the general population. Methods: Consulting six databases, we examined articles investigating the consumption of UPFs according to the NOVA classification both before the SARS-CoV-2 pandemic and during lockdowns. In total, 28 reports were included in the final analysis. Results: A clear trend of an increasing consumption of sweets (chocolate, candy, cookies, pastries, cakes, desserts, and confectionery, 31.75% increase vs. 21.06% decrease), packaged fatty or salty snacks (23.71% increase vs. 20.73% decrease), and baked goods (bread products, pizza, and sandwiches, 28.03% increase vs. 13.5% decrease) emerged, versus a decrease in ready-to-eat dishes (16.2% increase vs. 22.62% decrease) and ready-made meals (10.6% increase vs. 31.43% decrease), such as instant soups, canned foods, fast food, and chips, as well as sugary drinks in general (14.55% increase vs. 22.65% decrease). No trend was observed for processed meat consumption. Conclusion: The current pandemic scenario raises concerns about the increased consumption of UPFs, especially sweets, snacks, and baked goods, and points to an urgent need to implement policy strategies to manage the trade in these foods from a preventive perspective.

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

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

Impact of the COVID-19 Pandemic on Diet Behaviour Among UK Adults: A Longitudinal Analysis of the HEBECO Study

COVID-19 pandemic restrictions impacted dietary habits during the initial months of the pandemic, but long-term effects are unclear. In this longitudinal study, self-selected UK adults (n = 1,733, 71.1% female, 95.7% white ethnicity) completed three online surveys (May-June, August-September, and November-December 2020, with a retrospective pre-pandemic component in the baseline survey), self-reporting sociodemographics, lifestyle, and behaviours, including high fat, salt, and sugar (HFSS) snacks, HFSS meals, and fruit and vegetable (FV) intake. Data were analysed using generalised estimating equations. Monthly HFSS snacks portion intake increased from pre-pandemic levels (48.3) in May-June (57.6, p < 0.001), decreased in August-September (43.7, p < 0.001), before increasing back to pre-pandemic levels in November-December (49.2, p < 0.001). A total of 48.5% self-reported increased [25.9 (95% confidence interval: 24.1, 27.8)] and 47.7% self-reported decreased [24.1 (22.4, 26.0)] monthly HFSS snacks portion intakes in November-December compared with pre-pandemic levels. Monthly HFSS meals portion intake decreased from pre-pandemic levels (7.1) in May-June (5.9, p < 0.001), was maintained in August-September (5.9, p = 0.897), and then increased again in November-December (6.6, p < 0.001) to intakes that remained lower than pre-pandemic levels (p = 0.007). A total of 35.2% self-reported increased [4.8 (4.3, 5.3)] and 44.5% self-reported decreased [5.1 (4.6, 5.6)] monthly HFSS meals portion intakes in November-December compared with pre-pandemic levels. The proportion meeting FV intake recommendations was stable from pre-pandemic through to August-September (70%), but decreased in November-December 2020 (67%, p = 0.034). Increased monthly HFSS snacks intake was associated with female gender, lower quality of life, and - in a time - varying manner - older age and higher HFSS meals intake. Increased monthly HFSS meals intake was associated with female gender, living with adults only, and higher HFSS snacks intake. Reduced FV intake was associated with higher body mass index (BMI) and lower physical activity. These results suggest large interindividual variability in dietary change during the first year of the pandemic, with important public health implications in individuals experiencing persistent increases in unhealthy diet choices, associated with BMI, gender, quality of life, living conditions, physical activity, and other dietary behaviours.

Stress Level to Dietary Habits among Adolescent in Indonesia during COVID 19 Outbreak: A Nationwide Survey

BACKGROUND: To suppress the COVID-19 transmissions, almost all activities related to physical and social activities between individuals are restricted. Activity restrictions such as lockdowns or physical-social distancing can trigger an elevation in stress. AIM: This study aimed to determine the correlation between stress levels and food habits among adolescents in Indonesia. METHODS: This cross-sectional study was conducted through an online questionnaire involving 5924 adolescents in all regions in Indonesia using the snowball sampling technique. RESULTS: The survey showed that most adolescents experienced high stress (55.6%). During the COVID-19 outbreak, they seemed rarely consumed or had an intake frequency of fewer than 3 times a day on carbohydrates (89.1%), animal protein (87.5%), vegetable protein (88.9%), vegetables (84.8%), fruit (90.6%), and snacks (86.3%). Statistically, their stress level did not significantly correlate to the consumption of those carbohydrates, animal protein, vegetable protein, vegetables, and fruit (p > 0.05), except for snacks (p < 0.002) at α = 0.05. Thus, the high-stress level was 1.267 times more at risk of snacking habit more often (more than 3 times a day) among adolescents in Indonesia during the COVID-19 outbreak. CONCLUSION: Stress level did not significantly correlate to the consumption of those carbohydrates, animal protein, vegetable protein, vegetables, and fruit. However, stress levels did not significantly correlate to snacks consumption.

Association between Free Sugars Intake and Excessive Daytime Sleepiness among Chinese Adolescents

This study aimed to investigate the prevalence of excessive daytime sleepiness (EDS) and explore the association between free sugars intake and EDS. In this cross-sectional study, a total of 1517 middle school students (808 boys and 707 girls) aged 12~14 years were recruited. The study was conducted in Changsha city, China. Adolescents completed an online questionnaire, including the Epworth Sleepiness Scale (ESS), sleep characteristics, a 12-item Food Frequency Questionnaire (FFQ), and other self-reported information. The ESS score ≥ ten was defined as EDS. The anthropometric indices, including height, weight, and waist circumference, were measured and recorded by uniformly trained assistants. Statistical analyses included the Chi-square test and binary logistic regression model. The mean ESS score and free sugars consumption were 6.8 ± 3.9 points and 53.1 ± 44.7 g/d, respectively. The prevalence of EDS among adolescents was 22.5%, and more girls than boys had EDS (26.1% vs. 19.4%, p < 0.05). An exceeded free sugars intake was positively associated with EDS, with the adjusted Odds Ratio (OR) with its 95% Confident Interval (95% CI) of 1.366 (1.060~1.761, p < 0.05). EDS and excessive consumption of free sugars are commonly found among Chinese adolescents. Further studies are needed to confirm whether free sugars restriction can be meaningful to improve daytime drowsiness in those with EDS.

Effects of COVID-19 lockdown on the dietary habits and lifestyle in a population in southern Spain: a cross-sectional questionnaire

Background/Objective

Few studies have assessed the effect of lockdown on physical activity and eating behaviours in a population from the Autonomous Community of Andalusia in southern Spain. The aim of our study was to describe the effect of COVID-19 pandemic home lockdown on eating habits and lifestyle in the Andalusian population.

Subjects/Methods

A cross-sectional observational study was carried out on a population from southern Spain, Andalusian population. An online questionnaire was shared through social networks and snowball sampling. A total of 1140 people filled in the questionnaire. The questionnaire consisted of 34 items classified into three sections: sociodemographic data, work and leisure activities and questions on food consumption. Each item offered pre- and post-lockdown information.

Results

The participants were classified into three age groups: 18–35, 36–65 and over 65. Statistically significant differences were found between the three groups, with the younger age group undergoing greater changes, increasing their physical activity and consumption of fresh food, and decreasing both their consumption of fast food at home and alcohol intake.

Conclusions

These findings suggest that, in the current social and health crisis, the citizens of southern Spain have become aware of the importance of maintaining an appropriate lifestyle to remain healthy, particularly the younger population with less well-consolidated habits.

Binge Watching during COVID-19: Associations with Stress and Body Weight

Binge watching is becoming increasingly common and may impact energy balance and body weight. The COVID-19 pandemic has created conditions conducive to binge watching and increased stress. We investigated relationships between COVID-related stress and binge watching behaviors, and potential variation in this relationship by body weight. Adults (n = 466) completed a cross-sectional online survey assessing binge watching behaviors during and before the pandemic, COVID-related stress, and body weight. Participants reported an increase in binge watching frequency from before to during the pandemic (F1,401 = 99.970, p < 0.001), with rates of high binge watching ("3-4 times per week" to "3 or more times per day") increasing from 14.6% to 33.0%. Binge watching episode duration increased from 3.26 ± 1.89 h to 3.92 ± 2.08 h (p < 0.001). The increase in binge watching frequency was greatest in individuals with obesity and high stress (F 4,401 = 4.098, p = 0.003). Participants reporting high stress reported higher frequency of eating while binge watching, as well as higher levels of negative emotional triggers, consequences to binge watching, and lack of control over binge watching (all p < 0.001). Our results show that binge watching increased during the pandemic, with greater increases among individuals reporting higher COVID-related stress, especially those with obesity, and concomitant effects on eating, and highlight a need for interventions to minimize the obesogenic impact of binge watching during the pandemic.

Use of Food Services by Consumers in the SARS-CoV-2 Pandemic. How the Eating Habits of Consumers Changed in View of the New Disease Risk Factors?

The SARS-CoV-2 pandemic in 2020–2021 changed the eating habits of people around the world. The aim of this study is to understand the effects of COVID-19 on changing consumers’ eating habits, including their concerns about food service nutrition in case of new disease risk factors. The survey conducted using the computer-assisted web-based interviewing method on a group of 1021 adult respondents in Poland. We collected information about consumer choices and habits related to use of food services during the pandemic. This research found that COVID-19 had an impact on consumers’ use of food services, both on-site and take-away. Using cluster analysis, we identified five main groups of food service consumers. It was found that almost half of the respondent group did not change their diet during the pandemic, 20% of respondents changed their diet to a positive one, and 20% to a diet that was negative. For respondents the most important forms of protection against COVID-19 in catering establishments were hand disinfection (70.3%), table disinfection (70.4%), wearing of masks and visors by staff (68.2%), and the possibility of cashless payments (64.6%). Based on cluster analysis (eight consumer clusters), we stated that majority of respondents did not see any threats to using catering service during the pandemic. Only a small group (8.1%) of respondents were afraid of the possibility of getting sick with COVID-19. This study presented the effects of COVID-19 on consumer eating behavior in catering and their concerns with food services uses. Discovering consumer concerns can reduce risk, increase food safety and improve eating habits.