Towards an In-Depth Understanding of Physical Activity and Eating Behaviours during COVID-19 Social Confinement: A Combined Approach from a Portuguese National Survey

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.

Different sedentary behavior domains present distinct associations with eating-related indicators

BACKGROUND

Unhealthful dietary patterns have been consistently associated with low levels of physical activity (PA), but studies dedicated to sedentary behavior (SB) are scarce, especially in adults. The few studies that investigated the association between SB and dietary patterns focused mostly on specific types of SB, such as TV-watching or screen time. SB can be accumulated in distinct domains (i.e., work, transport, and leisure-time), thus, it is key to investigate in depth the impact that different domains of SB can have on eating-related indicators. We aimed to investigate the associations between different SB domains and eating-related indicators, in a sample of adults.

METHODS

Cross-sectional data from students, teachers, and staff from a Portuguese University was collected in November/2021 through an anonymous online survey. Data analyses were performed using the IBM SPSS software (version 28.0) and included descriptive statistics, partial correlations, and group comparisons using one-way ANOVA. Daily average SB at work/study, transport, and in leisure-time were self-reported and eating-related indicators were measured with several items from the Mediterranean Diet Score. Specific eating-related behaviors reflecting a protective eating pattern (e.g., eating breakfast regularly), and eating behavior traits (e.g., external eating) were also assessed. Body mass index (BMI) was calculated as weight (kg)/height(m)2. The International Physical Activity Questionnaire/Short-Form was used to assess PA.

RESULTS

The sample included 301 adults (60.1% women), with a mean age of 34.5 years. Overall, leisure-time SB was inversely associated with adherence to the Mediterranean diet (r = -0.20; p < 0.001) and with a protective eating profile (r = -0.31; p < 0.001). Higher transport SB was also related to lower adherence to the Mediterranean diet (r = -0.20; p < 0.001) and to an unhealthier eating profile (r = -0.22; p < 0.001), but no associations were found for work-related SB (p > 0.05). These results persisted after the adjustment for BMI, sex, and self-reported PA. These results were impacted by the age tertile.

CONCLUSIONS

Our findings suggest that adults with higher levels of SB in leisure-time and transport domains tend to report less healthy eating-related behaviors, irrespective of BMI, sex, and PA level. However, some differences in these associations were found according to the age tertile. This information may assist public health authorities in focusing their efforts in augmenting literacy on SB, namely on how SB can be accumulated via different settings. Furthermore, public health literacy efforts need to extend besides the more known deleterious effects of SB on health (e.g., diabetes, cardiovascular disease), to also include the interplay with eating indicators. Strategies to reduce SB and unhealthy eating should be particularly focused on promoting physically active forms of commuting and reducing SB in the leisure setting.

Internet Addiction and Physical Activity among Polish and Portuguese Students in the Final Year of the COVID-19 Pandemic

AIM

The purpose of this study was to analyze the level of Internet addiction and physical activity, as well as the relationship between internet addiction and physical activity, among Polish and Portuguese students in the final year of the COVID-19 pandemic.

METHODS

A web-based online survey was conducted among students in Poland and Portugal (398 respondents) aged between 17 and 26 in October 2022. The level of internet addiction was assessed by the Kimberly Young questionnaire in Polish and in Portuguese. The level of physical activity was measured by the international physical activity questionnaire in Polish and in Portuguese.

RESULTS

In the study population, the majority of the respondents were mildly addicted to the internet. The average level of addiction was reported by 9.3-23.5% of the respondents. The average level of internet addiction was higher among Portuguese students and among men. Those who had suffered from COVID-19 (especially more than once) and were more physically active showed a higher tendency towards internet addiction.

CONCLUSIONS

Internet addiction is a problem that has to be monitored and given more attention, particularly among male students. The results presented provide the first statistical insight into the problem of internet addiction among students in both countries and form the basis for further studies. They also highlight the severity of the problem and point to the need for early preventive and protective interventions against problematic internet use. It appears that effective strategies should include promoting the benefits of physical activity.

Effect of the COVID-19 pandemic on the proportion of physically active children and adults worldwide: A systematic review and meta-analysis

Introduction

Safety measures implemented to address the COVID-19 pandemic have had a profound impact on the mobility of people worldwide We synthesized the global evidence on physical activity (PA) participation before and during the pandemic.

Methods

We conducted a systematic review, searching PubMed, Embase, WHO Global literature on coronavirus disease (between January 2020 and April 2022), and reference lists. Meta-analysis and meta-regression were conducted to quantitatively synthesize the data.

Results and discussion

Sixty-three primary studies were included. In children, the global pooled prevalence of PA was 46.4% before the pandemic, 40.6% during the pandemic before movement restriction (MR), and 19.5% during MR. A statistically significant decrease in prevalence was observed between the period before the pandemic and the period during which MR was implemented (p < 0.001). In adults, the global pooled prevalence (both sexes) decreased between the periods before the pandemic (64.7%) and during MR (57.0%). During the period of COVID-19 MR, children had significantly lower odds to meet the WHO PA recommendation than adults (19.5%, 95%CI: 15.8-23.8% vs. 57.0%, 95%CI: 43.3-62.5%; OR = 0.21; p ≤ 0.001). Patient populations were less active than the general population, and their PA levels decreased during the pandemic. Mental and physical health benefits of PA have been well-demonstrated. Prioritizing PA in health campaigns and strategies is critical to address health issues exacerbated during this pandemic.

Protocol registration

doi: 10.17605/OSF.IO/GVABX.

Health promotion at work: assessment of lifestyles of administrative assistants in a hospital

OBJECTIVE

To characterize the lifestyles of administrative assistants in a hospital, in order to define health promotion strategies in the workplace.

METHOD

A quantitative, descriptive, cross-sectional study, carried out with administrative assistants (N = 167) of a medium-sized Portuguese hospital. The data were collected through a questionnaire (QEV&PS-SO) for sociodemographic characterization and analysis of health determinants related to lifestyles.

RESULTS

It was observed that 54% of the sample did not practice physical exercise, 52% had four or fewer meals a day, 29% were smokers, 51% had insomnia, and 45% had no health surveillance, as well as 51.5% were overweight or obese and 63% had an increased or very increased risk of developing metabolic complications. No significant differences were identified in relation to weight, physical exercise or stress according to sex or age.

CONCLUSION

The results support the need to develop intervention programs with strategies aimed at promoting healthy lifestyles among workers in health institutions, to be comprehensively integrated within the scope of occupational health.

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.

Eating Habits during the COVID-19 Pandemic and the Level of Antibodies IgG and FRAP-Experiences of Polish School Staff: A Pilot Study

The coronavirus 19 (COVID-19) pandemic has brought many changes in terms of lifestyle, education, stress levels, and social contacts. The aim of our research was to evaluate changes in eating habits, physical activity, and selected lifestyle elements in a group of school staff, as well as their immune response to vaccination against COVID-19, and FRAP (ferric reducing antioxidant power) level. In total, 108 primary school teachers and other school staff with integration departments were included in the study. An original survey was conducted with the school staff. Of the study group, 45.4% chose to be vaccinated against COVID-19. In this group, the level of IgG antibodies was assessed, as well as the level of FRAP before vaccination, and after the first and second dose. An original questionnaire was also carried out. A decrease in physical activity and an increase in the time spent in front of the computer have been demonstrated, but a positive observation was a favorable change in most eating habits. After the second dose of vaccination, all subjects achieved the appropriate level of IgG antibodies (above 22 U/mL), with the maximum level recorded in 51%. There was also a significant increase in FRAP levels in the group after the first and second dose of the vaccine compared to the baseline level; an issue that requires further observation.

Promoção da saúde no trabalho: avaliação dos estilos de vida de assistentes administrativos de um hospital

RESUMO Objetivo: Caracterizar os estilos de vida dos assistentes administrativos de um hospital, para definição de estratégias de promoção de saúde no local de trabalho. Método: Estudo quantitativo, descritivo, de caráter transversal, realizado junto a assistentes administrativos (N = 167) de um hospital português de média dimensão. Os dados foram coletados através de um questionário (QEV&PS-SO), para caracterização sociodemográfica e análise dos determinantes de saúde relacionados com estilos de vida. Resultados: Observou-se que 54% da amostra não praticava exercício físico, 52% fazia quatro ou menos refeições por dia, 29% apresentava hábitos tabágicos, 51% tinha insônia e 45% não fazia vigilância de saúde, assim como 51,5% apresentava excesso de peso ou obesidade e 63% apresentava risco aumentado ou muito aumentado para desenvolvimento de complicações metabólicas. Não se identificaram diferenças significativas em relação ao peso, prática de exercício físico ou estresse em função do sexo ou idade. Conclusão: Os resultados sustentam a necessidade do desenvolvimento de programas de intervenção com estratégias dirigidas à promoção de estilos de vida saudáveis junto aos trabalhadores das instituições de saúde, a serem integradas, de forma compreensiva, no âmbito da saúde ocupacional.

High Adherence to Mediterranean Diet Is Not Associated with an Improved Sodium and Potassium Intake

Prevention and control of hypertension and cerebro-cardiovascular diseases are associated with adequate sodium and potassium intake and adherence to a Mediterranean dietary pattern. The aim of this study was to assess the association between adherence to a Mediterranean diet (MD) and the excretion of sodium and potassium as surrogate measures of intake. This is a cross-sectional analysis as part of a larger study (the iMC SALT randomized controlled trial) among workers of a public university. A food frequency questionnaire was used to assess the adherence to MD, using the alternative Mediterranean diet (aMED) score; sodium and potassium excretions were estimated by 24-h urine collections. Sociodemographic and other lifestyle characteristics were also obtained. The associations between the adherence to MD and Na and K excretion were calculated by logistic regression, adjusting for confounding variables. From the 109 selected participants, seven were excluded considering urine screening and completeness criteria, leaving a final sample of 102 subjects (48% male, average age 47 years). Mean sodium and potassium excretion were 3216 mg/day and 2646 mg/day, respectively. Sodium and potassium excretion were significantly higher in men, but no differences were found according to different levels of MD adherence. In logistic regression analysis, sodium, potassium, and sodium-to-potassium ratio urinary excretion tertiles were not associated with MD adherence (low/moderate versus high), even after adjustment for confounding variables. A high adherence to MD was thus not associated with a different level of sodium and potassium intake.

Impact of COVID-19 Stay-at-Home Restrictions on Employment Status, Physical Activity, and Sedentary Behavior

Background. North Americans report insufficient moderate-to-vigorous physical activity (MVPA) and ample sedentary behaviors (SBs), suggesting possible barriers to an active lifestyle. This study compared self-reported MVPA and SB before and during COVID-19 “Stay-at-Home” restrictions as a potential barrier across North America. Methods: Questionnaires were distributed from 21 April to 9 May 2020. ANOVAs compared data overall and by group (age, sex, race, income, education, employment status). Results: During restrictions, 51.4% (n = 687) of the 1336 responses (991 female, 1187 Caucasian, 634 18–29 years) shifted to work from home and 12.1% (n = 162) lost their job. Overall, during restrictions, 8.3% (n = 110) fewer reported work-related MVPA (−178.6 ± 20.9 min/week). Similarly, 28.0% (n = 374) fewer reported travel-related MVPA, especially females and younger age groups. While the 7.3% (n = 98) fewer reporting recreational MVPA was not statistically significant (−30.4 ± 11.5 min/week), there was an increase in SB (+94.9 ± 4.1 min/week) in all groups, except the oldest age group (70+ years). Locomotive activities and fitness class remained the predominant MVPA mode. Of those reportedly using facilities (68%; n = 709) before COVID, 31.3% (n = 418) would not return due to it “being unsafe”. Conclusion: While barriers related to pandemic restrictions had a negative short-term impact on MVPA and SB in North America, the long-term impact is unknown.

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.