Perceived Diet Quality, Eating Behaviour, and Lifestyle Changes in a Mexican Population with Internet Access during Confinement for the COVID-19 Pandemic: ESCAN-COVID19Mx Survey

Effects of social confinement during the first wave of COVID-19 in Mexico City

Background

The COVID-19 pandemic led to global social confinement that had a significant impact on people's lives. This includes changes such as increased loneliness and isolation, changes in sleep patterns and social habits, increased substance use and domestic violence, and decreased physical activities. In some cases, it has increased mental health problems, such as anxiety, depression, and post-traumatic stress disorder.

Objective

The objective of this study is to analyze the living conditions that arose during social confinement in the first wave of COVID-19 within a group of volunteers in Mexico City.

Methods

This is a descriptive and cross-sectional analysis of the experiences of volunteers during social confinement from 20 March 2020 to 20 December 2020. The study analyzes the impact of confinement on family life, work, mental health, physical activity, social life, and domestic violence. A maximum likelihood generalized linear model is used to determine the association between domestic violence and demographic and health-related factors.

Results

The findings indicate that social confinement had a significant impact on the participants, resulting in difficulties within families and vulnerable conditions for individuals. Gender and social level differences were observed in work and mental health. Physical activity and social life were also modified. We found that suffering from domestic violence was significantly associated with being unmarried (OR = 1.4454, p-value = 0.0479), lack of self-care in feeding habits (OR = 2.3159, p-value = 0.0084), and most notably, having suffered from a symptomatic COVID-19 infection (OR = 4.0099, p-value = 0.0009). Despite public policy to support vulnerable populations during confinement, only a small proportion of the studied population reported benefiting from it, suggesting areas for improvement in policy.

Conclusion

The findings of this study suggest that social confinement during the COVID-19 pandemic had a significant impact on the living conditions of people in Mexico City. Modified circumstances on families and individuals, included increased domestic violence. The results can inform policy decisions to improve the living conditions of vulnerable populations during times of social confinement.

Diet Quality Changes by Educational Level among Adults in Spain from 2017 to 2021

Despite increasing attention on addressing socioeconomic disparities in diet quality, longitudinal studies are scarce. Furthermore, the effects of the COVID-19 pandemic on diet-related outcomes are yet to be fully understood. We examined changes in diet quality by educational level among adults in Madrid, Spain. We used data from recruitment (in 2017) and from 2021. At baseline, our sample included 1358 adults aged 40-75 years who were free of cardiovascular disease and completed a validated diet quality screener. Of them, 931 answered the survey in the follow-up visit in 2021. We used participants' diet quality index scores (range: 18-54; higher scores indicate better diet quality) as the dependent variable. As our independent variable, we assessed participants' educational levels (low, medium, and high). We fitted a multinomial regression using the categories of educational level as the main predictor, adjusting for age, sex, country of origin, and household composition. During the study period, 78.0% of participants sustained their diet quality, 11.6% improved it, and 10.4% moved away from a healthier dietary pattern. In descriptive analyses, we observed an increase in diet quality among less-educated females. Unadjusted multinomial models showed that a lower educational level predicted both increases and decreases in diet quality over the period. Even though the median diet quality scores did not change significantly, we observed heterogeneous changes over the four years. Variability within diet, with some improving and some worsening, seems to have increased among participants with lower educational levels. Future studies should look at the determinants of change in these population subgroups.

Effect of Laparoscopic Sleeve Gastrectomy on HbA1C Level in Children with Type 2 Diabetes Mellitus

Background and Objectives: A third of the American adult population is currently pre-diabetic/morbidly obese and is, therefore, at an elevated risk for developing type 2 diabetes. Unfortunately, such a condition does not spare children from also developing morbid obesity, where incidence rates of childhood obesity—coupled with type 2 diabetes—are markedly elevated. Laparoscopic sleeve gastrectomy (LSG) is gradually becoming the novel benchmark in bariatric surgery for the treatment of morbid obesity and associated co-morbidities, also within pediatric cases. However, no comprehensive study has been conducted in children that emphasizes the effect of LSG on HbA1C levels within such a patient population suffering from type 2 diabetes. Aim: Since HbA1C is a major biomarker for type 2 diabetes progression, this study aimed to identify any dysregulated serum levels for this key molecular player (together with other parameters), for post-surgical monitoring of the beneficial metabolic effects of LSG surgery on type 2 diabetes amelioration/remission within pediatric patients. Materials and Methods: A total of 64 pediatric patients, ranging in age from 5 to 14 years old, were enrolled in this retrospective study. Multiple laboratory-based analyses datasets were also collected from individual study participants, including HbA1C and random blood sugar (RBS). All participating patients were designated for undergoing laparoscopic sleeve gastrectomy, as per standardized surgical protocols and each participant was followed-up for two years post-surgery. Laboratory investigations were re-performed in order to identify any major variations in clinical parameters. Results: HbA1c was significantly reduced among children, from 6.0 ± 0.8 (pre-LSG) to 5.4 ± 0.4 post-surgery, with a reduction rate of 10.9% (p = 0.001). Furthermore, RBS significantly decreased from 102.9 ± 34.0 (pre-LSG) to 87.1 ± 17.3 post- surgery, with a reduction rate of 15.4% (p = 0.036). Conclusions: This study provides further concrete evidence for the beneficial metabolic influence provided by LSG surgery on morbidly obese, childhood-aged patient populations, with effectiveness in reducing co-morbidity progress, in the form of type 2 diabetes, through the reduction in HbA1c levels within such patients post-surgery.

The Association of Internet Use Intensity and Lifestyle Behaviors During the COVID-19 Pandemic: A Cross-Sectional Study in Chinese Adults

The COVID-19 pandemic substantially increased the intensity of internet use in humans, which has made public opinion around health and public perceptions of it more vital, and this phenomenon has had a significant impact on human lifestyle behavior. This study used cross-sectional data during the COVID-19 pandemic to explore how internet use intensity influenced lifestyle behaviors among adults, and compared the differences between samples of different ages. The findings showed that the internet use intensity among adults increased the probability of physical activity, staying up late, and high-quality eating behaviors, and that they had a statistically significant positive association. Such associations were also found in independent younger, middle-aged, and older samples. However, the internet use intensity elevated the probability of body weight gain only in the independent samples of younger, middle-aged, and older adults. Besides, internet use intensity was able to increase the probability of smoking & drinking only among the younger sample. Notably, the effect of internet use intensity on lifestyle behaviors, including body weight gain, physical activity, staying up late, and a high-quality diet, was strongest among the elderly, followed by the middle-aged, and weakest among the younger. In the process of rural and urban governance regarding citizens' health, public health agencies should remind citizens to spend a reasonable amount of time on internet use to reduce the probability of unhealthy lifestyle behaviors and improve their physical health.

The Impact of the COVID-19 Pandemic on Food Consumption Behavior: Based on the Perspective of Accounting Data of Chinese Food Enterprises and Economic Theory

Since the outbreak of the COVID-19 pandemic, the rapid spread of COVID-19 around the world has become one of the main focuses of concern in almost every country, and governments have taken numerous measures to prevent/mitigate the spread of the disease. As an essential social determinant, COVID-19 has significantly impacted consumers' food consumption behavior and healthy eating habits/behaviors. The purpose of this study is to analyze the impact of COVID-19 on food consumption behavior, and the main goal was to assess the possible problems (such as food waste and weight gain) caused by changes in food consumption behavior during the pandemic. Based on the accounting data of Chinese enterprises found in the China Stock Market and Accounting Research (CSMAR) database, this study uses economic theory and the translog function to conduct an average partial effect (APE) analysis of the pandemic, and finds that the COVID-19 pandemic has increased Chinese people's overall food consumption, and the consumption of food from large food enterprises has increased even more (APE = 0.11 vs. APE = 0.31). This study suggests that food waste and weight gain in the Chinese population may be more severe during the pandemic, and it is necessary to enhance food management and weight management through multiple pathways.