Susceptibility to increased high energy dense sweet and savoury food intake in response to the COVID-19 lockdown: The role of craving control and acceptance coping strategies

Psychopathological risk stability and change in a sample of mothers and preschool children before, during and after the peak of COVID-19 pandemic

Numerous studies have found that the COVID-19 epidemic and the measures to stop it have had a substantial impact on the mental health of the general population. Nevertheless, the majority of this research only looked at the variations in the degree of psychopathological symptoms in individuals before and after the first wave of the pandemic. In a sample of N = 380 preschoolers and their mothers assessed through the Symptom Check-List/90-R and of the Child Behaviour Check-List, the present study aimed at exploring psychopathological risk in mothers and their offspring's dysregulation levels before (T1), during (T2) and after (T3) the peak of COVID-19 pandemic. Our main results showed that mothers' relational distress increased from T1 to T2 and then increased again from T2 to T3. Moreover, maternal aggressiveness, hostility, and anxiety scores significantly decreased from T1 to T2 but slightly increased from T2 to T3. In children, dysregulation levels increased from T1 to T2 but decreased from T2 to T3. Children of mothers with clinical scores at the SCL-90/R showed significantly higher dysregulation problems at T1, T2 and T3 than children of mothers with scores below the clinical threshold. This study adds to previous literature in that it evaluates stability or change in maternal and offspring scores not only in the pre-pandemic period and during the first wave of the pandemic, but it also considers the subsequent months, focusing on a broad range of maternal symptoms, rather than assessing depressive and anxiety symptoms as most of previous research did.

Evaluation of depression, anxiety, risky eating behaviors, eating habits and physical activity after the COVID-19 pandemic among adolescents in Mexico City

INTRODUCTION

during the pandemic, an increase in symptoms of depression and anxiety, as well as lifestyle changes in adolescents has been reported.

OBJECTIVES

to evaluate anxiety and depression symptoms, risky eating behaviors (REB), eating habits and physical activity after the COVID-19 pandemic in Mexican adolescents; to associate the study variables with the development of REB.

METHODS

a study was performed with a sample of 2,710 adolescents. The Hospital Anxiety and Depression Scale (HADS) and the Questionnaire to measure Risky Eating Behaviors were applied; eating habits and physical activity were evaluated. A Multivariate Logistic Regression analysis was performed to evaluate an association between study variables and REB.

RESULTS

it was found that 34.4 % and 47.2 % of the adolescents presented symptoms of depression and anxiety, respectively. Furthermore, 10.6 % had REB and 18.1 % were at risk of REB. The combined prevalence of overweight and obesity was 46.5 %; only 13.1 % of the participants had healthy eating habits and 18.2 % adequate physical activity. Symptoms of depression (p < 0.0001), anxiety (p < 0.0001), higher BMI (p < 0.0001), female sex, excessive consumption of sugary drinks, eating outside the home (p < 0.0001), and lifestyle (p = 0.001) were associated with REB.

CONCLUSIONS

confinement caused chaos on the lifestyle of adolescents as well as their psychological health. It is essential to develop educational programs that involve government authorities, parents and health agencies to reinforce the topics of healthy eating, physical activity and mental health in the country's secondary schools.

Childhood abuse and craving in methamphetamine-dependent individuals: the mediating role of alexithymia

Individuals with a history of childhood abuse (CA, including neglect and abuse by caregivers before the age of 18 years) have more severe substance dependence problems than those without a history of childhood abuse. However, whether a history of CA exacerbates craving and the mechanism of this effect remain largely unknown. The aim of this study was to explore the role of alexithymia in the effects of CA on craving in a large sample of methamphetamine-dependent individuals based on latent vulnerability theory. A total of 324 methamphetamine-dependent individuals who met DSM-5 criteria for substance use disorder were recruited. CA, alexithymia, and craving data were collected from the Childhood Trauma Questionnaire, the Toronto Alexithymia Scale-20, and the Obsessive Compulsive Drug Use Scale, respectively. t tests and ANCOVA were conducted to compare variables between the CA and non-CA groups, while partial correlation and mediation analyses were conducted to examine the potential mediating role of alexithymia in the relationship between CA and craving. Abused methamphetamine-dependent individuals reported higher levels of craving and higher levels of alexithymia than those of non-abused methamphetamine-dependent individuals. Alexithymia partially mediated the link between CA and craving, especially the effect of CA on craving frequency was fully mediated by alexithymia. Our findings reveal that a history of childhood abuse has a lasting effect on craving in stimulant-dependent individuals, and alexithymia contributes to some extent to the severity of substance abuse problems in abused methamphetamine-dependent individuals.

Impacts of the SARS-CoV-2 pandemic on the dietary practices of university students in Germany

Purpose

The dietary practices (DPs) of university students are influenced by many external factors. Therefore, we investigate how the DPs of students in Germany changed during the SARS-CoV-2 pandemic, what the main motivations were for those changes, and what effect the closure of university catering had on the DPs of students.

Methods

A total of 560 students from two universities in Lübeck (Germany) were surveyed online during a pilot phase. The final online questionnaire was subsequently administered at 10 other German universities (399 respondents). The questionnaire surveyed sociodemographic factors, dietary habits, food consumption frequencies, and the relevance of university catering before and during the SARS-CoV-2 pandemic.

Results

Regarding changes in DPs, similarities to previous studies were found, especially positive eating behaviors and an increasing interest in health- and nutrition-related sustainability. Students prepared meals freshly more often during the pandemic; consumed legumes, plant-based meats and dairy alternatives more often; and reduced their consumption of meat and milk compared to before the pandemic. The consumption frequency of sweets also decreased. It was observed that students consider eating communal in the university canteen to be highly relevant for their social interactions, which was only possible to a limited extent during the pandemic.

Conclusion

In Germany, the DPs of university students as well as criteria regarding health and sustainability changed during the first 2 years of the SARS-CoV-2 pandemic. The social aspect of DPs became evident due to closed university catering. Still, changes in dietary patterns and eating habits were positively related to health and revealed some differences in the cross section of the population.

Associations between body mass index and episodic memory for recent eating, mindful eating, and cognitive distraction: A cross-sectional study

Objectives

Eating while distracted has been associated with a higher body mass index (BMI), whereas mindful eating and episodic memory for recent eating have shown the opposite pattern. This pre-registered, global study (https://osf.io/rdjzk) compared the relative association between these variables (and four "positive controls": restraint, disinhibition, emotional eating, plate clearing) and self-reported BMI. The timing of data collection (April-May 2020) during the SARS-CoV-2 pandemic enabled an investigation of the impact of stay-at-home restrictions imposed on the UK population on the measures of eating behavior.

Methods

An online survey was completed, including: (i) demographic data (e.g., self-reported BMI), (ii) Likert ratings assessing episodic memory for recent eating, mindful eating, cognitive distraction, restrained eating, emotional eating, disinhibition and plate clearing over the last 12 months and the last 7 days (during the first UK COVID-19 lockdown), and (iii) the Mindful Eating Questionnaire (MEQ).

Results

A large adult sample participated (N = 846; mean (SD) age = 33.0 (14.3) years; mean (SD) BMI = 24.6 (5.6) kg/m2). Mindful eating (MEQ-total score) was associated with a lower self-reported BMI (β = -0.12; 95% CI = -0.20, -0.04; p = 0.004), whereas disinhibited eating was associated with a higher self-reported BMI (β = 0.30; 95% CI = 0.21, 0.38; p < 0.001). In UK participants (n = 520), consistent changes in eating behavior during lockdown were not found. For those that did experience change, decreases were reported in; emotional eating, disinhibited eating, focusing on taste during a meal (a measure of mindful eating), and using a smart phone while eating.

Conclusions

These findings provide evidence in a large global sample for associations between BMI and (i) mindful eating, and (ii) disinhibited eating. Future research should evaluate whether mindful eating demonstrates a prospective association with body weight and should consider mechanisms of action.

Adaptive and maladaptive emotion regulation skills are associated with food intake following a hunger-induced increase in negative emotions

Many individuals would like to lose weight and often attempt to do so by dieting. However, dieting attempts often backfire and contribute to the risk of weight gain and obesity. Food restriction inevitably leads to hunger and hunger, in turn, induces negative emotions. The inability to regulate such a hunger-induced increase in negative emotions in an adaptive way may be responsible for overeating. The current study aimed to gain a better understanding of this potential psychological mechanism underlying failed dieting attempts. Adaptive and maladaptive emotion regulation (ER) were assessed with an online questionnaire in women with a healthy weight. Subsequently, participants were assigned to the fasted condition (fasting for 14h, n = 49) or the satiated condition (eating between 2 h and 30 min before the lab session, n = 59) and attended a lab session in which they completed tasks while given the opportunity to eat chips and M&M's. We did not find an association between any ER variable and the likelihood to begin eating. Among those who began eating, higher scores on adaptive cognitive ER and on maladaptive behavioral ER were associated with lower caloric intake in fasted individuals. Higher scores on adaptive behavioral ER were associated with higher caloric intake in fasted individuals. Utilizing adaptive cognitive ER when experiencing a hunger-induced increase in negative emotions may help individuals manage their food intake and maintain a healthy weight.

Validity and reliability of Turkish version of the Adult Eating Behaviour Questionnaire for adult participants

OBJECTIVE

The aim of this study is to assess the validity and reliability of the Adult Eating Behaviour Questionnaire (AEBQ-TR) for adults.

DESIGN

Hunot et al. (2016) developed the original questionnaire, which was modified and translated into Turkish. On data collected from adults, construct validity was assessed using exploratory factor analysis and confirmatory factor analysis. Pearson's and Cronbach's correlation coefficients were used to evaluate reliability and validity (P < 0·05).

SETTING

This research was carried out in Ankara, Turkey.

PARTICIPANTS

A total of 311 adults from Ankara (148 men and 163 women) took part in the study. Seventy-two of these adults take the retest.

RESULTS

In the present study, 311 adults with a mean age of 29·3 ± 11·3 years participated. Factor loadings ranged from 0·404 to 0·907. In general, food approach and food avoidance scales showed a positive correlation within themselves. According to the results of confirmatory factor analysis and goodness-of-fit indicators, the seven-factor model showed a better model fit in the Turkish data (chi-square/degrees of freedom = 2·137, root mean error of approximation: 0·061, comparative fit index: 0·884, and normed fit index: 0·850). Higher BMI was associated with higher Emotional Over-eating, higher Enjoyment of the Food, lower Food Satiety and lower Emotional Under-eating.

CONCLUSIONS

The Turkish AEBQ is a valid and reliable tool for 20- to 65-year adults to determine appetitive properties related to the aetiology of weight change and especially obesity risk. Besides, AEBQ testing is required for validation in early and late adulthood.

Nutritional Behavior in European Countries during COVID-19 Pandemic-A Review

COVID-19 is highly linked with hyperinflammation and dysfunction of the immune cells. Studies have shown that adequate nutrition, a modifiable factor affecting immunity and limiting systemic inflammation, may play an adjunct role in combating the negative consequences of SARS-CoV-2 infection. Due to the global lockdown conditions, the COVID-19 pandemic has contributed, among others, to restrictions on fresh food availability and changes in lifestyle and eating behaviors. The aim of this paper was to review the data regarding eating habits in European countries within the general population of adults and some specific subpopulations, including obese, diabetic, and psychiatric patients, during the COVID-19 pandemic. The PubMed database and the official websites of medical organizations and associations were searched for the phrases "COVID" and "eating habits". Papers regarding the pediatric population, non-European countries, presenting aggregated data from different countries worldwide, and reviews were excluded. During the COVID-19 pandemic, unhealthy lifestyles and eating behaviors were commonly reported. These included increased snacking, intake of caloric foods, such as sweets, pastries, and beverages, and a decline in physical activity. Data suggest that poor eating habits that create a positive energy balance have persisted over time as an additional post-COVID negative consequence.

Increased consumption despite fewer occasions: A longitudinal analysis of COVID-19 lockdown effects on soft drink consumption in England

We examined the impact of a COVID-19 lockdown in England on the frequency of consumption occasions and amount of soft drinks consumed. Beverage consumption is strongly associated with specific, often social, consumption situations (e.g., going out). We reasoned that lockdown would affect consumption behaviour because it removed typical soft drink consumption situations. Specifically, we hypothesised that soft drink consumption occasions and amount would be reduced during lockdown compared to before and after lockdown, especially in typical soft drink consumption situations. In two surveys (Dec. 2020 and May 2021) among the same participants (N = 211, N = 160; consuming soft drinks at least once/week), we assessed the frequency of soft drink and water consumption occasions before, during, and after the Nov./Dec. 2020 lockdown, across typical soft drink and water drinking situations. This presents a detailed picture of the situations in which participants drink soft drinks and water, and how this was affected by a lockdown. We also assessed the daily amount of soft drinks and water consumed in each period, and perceived habitualness of drinking soft drinks and water. As predicted, participants reported fewer occasions of drinking soft drinks during lockdown compared to before and after, especially in typical soft drink consumption situations. Unexpectedly, however, the daily amount of soft drinks consumed increased during lockdown, compared to before and after, especially among participants with stronger perceived habitualness of soft drink consumption. Exploratory analyses suggest that during lockdown, participants increased their soft drink consumption at home. Water consumption, on the other hand, was not systematically affected by the lockdown. These findings suggest that even if some typical consumption situations disappear, consumption may be hard to disrupt if the behaviour is rewarding.

The impact of the first COVID-19 lockdown on weight management practices in UK adults: A self-regulation perspective

This study aimed to identify the impact of the first UK COVID-19 lockdown on individuals' weight management attempts (WMA). A self-regulation theoretical framework was used to identify predictors of continuing with a WMA, and weight change during the lockdown. An online retrospective cross-sectional study was conducted after the first UK COVID-19 lockdown. The sample consisted of 166 UK adults (M:31.08, SD:12.15) that were trying to manage their weight before the lockdown started. The survey assessed changes in WMA and practices, and measured perceived stress, flexible/rigid restraint, uncontrolled eating, craving control, and self-compassion. Results showed that 56% of participants reported disruption to their WMA during the lockdown. Participants with lower levels of perceived stress and higher flexible restraint were more likely to continue their WMA. Flexible restraint was a significant predictor of weight change. Interventions that promote flexibility in weight management may be beneficial for at-risk individuals under lockdown conditions.

Effects of a Web-Based Lifestyle Intervention on Weight Loss and Cardiometabolic Risk Factors in Adults With Overweight and Obesity: Randomized Controlled Clinical Trial

BACKGROUND

The high proportion of people with overweight and obesity has become a worldwide problem in recent decades, mainly due to health consequences, such as cardiovascular diseases, neoplasia, and type 2 diabetes mellitus. Regarding effective countermeasures, the digitization of health services offers numerous potentials, which, however, have not yet been sufficiently evaluated. Web-based health programs are becoming increasingly interactive and can provide individuals with effective long-term weight management support.

OBJECTIVE

The purpose of this randomized controlled clinical trial was to evaluate the effectiveness of an interactive web-based weight loss program on anthropometric, cardiometabolic, and behavioral variables and to compare it with a noninteractive web-based weight loss program.

METHODS

The randomized controlled trial included people who were aged between 18 and 65 years (mean 48.92, SD 11.17 years) and had a BMI of 27.5 to 34.9 kg/m² (mean 30.71, SD 2.13 kg/m²). Participants (n=153) were assigned to either (1) an interactive and fully automated web-based health program (intervention) or (2) a noninteractive web-based health program (control). The intervention program focused on dietary energy density and allowed for dietary documentation with appropriate feedback on energy density and nutrients. The control group only received information on weight loss and energy density, but the website did not contain interactive content. Examinations were performed at baseline (t0), at the end of the 12-week intervention (t1), and at 6 months (t2) and 12 months (t3) thereafter. The primary outcome was body weight. The secondary outcomes were cardiometabolic variables as well as dietary and physical activity behaviors. Robust linear mixed models were used to evaluate the primary and secondary outcomes.

RESULTS

The intervention group showed significant improvements in anthropometric variables, such as body weight (P=.004), waist circumference (P=.002), and fat mass (P=.02), compared with the control group over the course of the study. The mean weight loss after the 12-month follow-up was 4.18 kg (4.7%) in the intervention group versus 1.29 kg (1.5%) in the control group compared with the initial weight. The results of the nutritional analysis showed that the energy density concept was significantly better implemented in the intervention group. Significant differences in cardiometabolic variables were not detected between the 2 groups.

CONCLUSIONS

The interactive web-based health program was effective in reducing body weight and improving body composition in adults with overweight and obesity. However, these improvements were not associated with relevant changes in cardiometabolic variables, although it should be noted that the study population was predominantly metabolically healthy.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00020249; https://drks.de/search/en/trial/DRKS00020249.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.3390/ijerph19031393.

Oxidative Stability of Avocado Snacks Formulated with Olive Extract as an Active Ingredient for Novel Food Production

Analysis of the oxidative stability of novel avocado chips with added natural extracts was carried out with the aim of reducing the chemical additive content in their formulation. Two different natural extracts were initially evaluated and characterized: one obtained from olive pomace (OE) and other from pomegranate seed waste. OE was selected due to its better antioxidant potential according to FRAP, ABTS, and DPPH assays as well as its higher total phenolic content. The formulations used were 0, 1.5 wt.%, and 3 wt.% of OE. A gradual disappearance of the band found around 3009 cm^-1 and related to unsaturated fatty acids was observed in the control sample in contrast to formulations with added OE. The band observed near 3299 cm^-1 widened and intensified with time due to the oxidation degree of samples, with this effect being higher in the control chips. The observed changes in fatty acid and hexanal content with storage time underlined the higher extent of oxidation in the control samples. This fact could suggest an antioxidant protectant action of OE in avocado chips during thermal treatment, which was attributed to the presence of phenolic compounds. The obtained chips incorporating OE represent a viable option for the development of a natural, healthy, and clean-label avocado snack at competitive cost and with low environmental impacts.

Associations between area deprivation and changes in the digital food environment during the COVID-19 pandemic: Longitudinal analysis of three online food delivery platforms

Online food delivery services facilitate access to unhealthy foods and have proliferated during the COVID-19 pandemic. This study explores associations between neighbourhood deprivation and exposure to online food delivery services and changes in exposure by deprivation during the first year of the pandemic. Data on food outlets delivering to 661 postcode districts in London and the North of England in 2020 and 2021 were collected from three online delivery platforms. The association between area deprivation and overall exposure to online food delivery services was moderated by region, with evidence of a positive relationship between count of outlets and deprivation in the North of England, and a negative relationship in London. There was no association between area deprivation and growth of online food delivery services. Associations between neighbourhood deprivation and exposure to the digital food environment vary geographically. Consequently, policies aimed at the digital food environment need to be tailored to the local context.

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.

Supporting Weight Management during COVID-19 (SWiM-C): twelve-month follow-up of a randomised controlled trial of a web-based, ACT-based, guided self-help intervention

OBJECTIVES

We developed a guided self-help intervention (Supporting Weight Management during COVID-19, "SWiM-C") to support adults with overweight or obesity in their weight management during the COVID-19 pandemic. This parallel, two-group trial (ISRCTN12107048) evaluated the effect of SWiM-C on weight and determinants of weight management over twelve months.

METHODS

Participants (≥18 years, body-mass-index ≥25 kg/m²) were randomised to the SWiM-C intervention or to a standard advice group (unblinded). Participants completed online questionnaires at baseline, four months, and twelve months. The primary outcome was change in self-reported weight from baseline to twelve months; secondary outcomes were eating behaviour (uncontrolled eating, emotional eating, cognitive restraint of food intake), experiential avoidance, depression, anxiety, stress, wellbeing and physical activity.

INTERVENTIONS

SWiM-C is based on acceptance and commitment therapy (ACT). Participants had access to an online web platform with 12 weekly modules and email and telephone contact with a trained, non-specialist coach. Standard advice was a leaflet on managing weight and mood during the COVID-19 pandemic.

RESULTS

388 participants were randomised (SWiM-C: n = 192, standard advice: n = 196). The baseline-adjusted difference in weight change between SWiM-C (n = 119) and standard advice (n = 147) was -0.81 kg (95% CI: -2.24 to 0.61 kg). SWiM-C participants reported a reduction in experiential avoidance (-2.45 [scale:10-70], 95% CI: -4.75 to -0.15), uncontrolled eating (-3.36 [scale: 0-100], 95% CI: -5.66 to -1.06), and emotional eating (-4.14 [scale:0-100], 95% CI: -7.25 to -1.02) and an increase in physical activity (8.96 [MET-min/week], 95% CI: 0.29 to 17.62) compared to standard advice participants. We found no evidence of an effect on remaining outcomes. No adverse events/side effects were reported.

CONCLUSIONS

Whilst we were unable to conclude that the intervention had an effect on weight, SWiM-C improved eating behaviours, experiential avoidance and physical activity. Further refinement of the intervention is necessary to ensure meaningful effects on weight prior to implementation in practice.

TRIAL REGISTRATION NUMBER

ISRCTN 12107048.

Maternal and Perinatal Outcomes During the COVID-19 Epidemic in Pregnancies Complicated by Gestational Diabetes

Introduction

Gestational diabetes (GDM) is one of the most common complications in pregnancy, with a prevalence that continues to rise. At the time of the COVID-19 epidemic, immediate reorganisation and adjustment of the system was needed. Telemedicine support was offered in order to provide high-quality treatment to pregnant women. However, the success of the treatment is unknown. We therefore aimed to evaluate COVID-19 epidemic effects on pregnancy outcomes in GDM.

Methods

The maternal outcomes (insulin treatment, gestational weight gain, caesarean section, hypertensive disorders) and perinatal outcomes (rates of large and small for gestational age, preterm birth and a composite child outcome) of women visiting a university hospital diabetes clinic from March to December 2020 were compared with those treated in the same period in 2019.

Results

Women diagnosed with GDM during the COVID-19 epidemic (n=417), were diagnosed earlier (23.9 [11.7-26.0] vs. 25.1 [21.8-26.7] gestational week), had higher fasting glucose (5.2 [5.0-5.4] vs. 5.1 [4.8-5.3] mmol/l) and earlier pharmacological therapy initiation, and had achieved lower HbA1c by the end of followup (5.1% (32.2 mmol/mol) [4.9% (30.1 mmol/mol)-5.4% (35.0 mmol/mol)] vs. 5.2% (33.3 mmol/mol) [5.0% (31.1 mmol/mol) - 5.4%·(35.5 mmol/mol)], p<0.001) compared to a year before (n=430). No significant differences in perinatal outcomes were found.

Conclusions

Although GDM was diagnosed at an earlier gestational age and higher fasting glucose concentration was present at the time of diagnosis, the COVID-19 epidemic did not result in worse glucose control during pregnancy or worse pregnancy outcomes in Slovenia.

Effects of a Web-Based Weight Loss Program on the Healthy Eating Index-NVS in Adults with Overweight or Obesity and the Association with Dietary, Anthropometric and Cardiometabolic Variables: A Randomized Controlled Clinical Trial

This randomized, controlled clinical trial examined the impact of a web-based weight loss intervention on diet quality. Furthermore, it was investigated whether corresponding changes in diet quality were associated with changes in measures of cardiovascular risk profile. Individuals with a body mass index (BMI) of 27.5 to 34.9 kg/m2 and an age of 18 to 65 y were assigned to either an interactive and fully automated web-based weight loss program focusing on dietary energy density (intervention) or a non-interactive web-based weight loss program (control). Examinations were performed at baseline (t0), after the 12-week web-based intervention (t1), and after an additional 6 (t2) and 12 months (t3). Based on a dietary record, the Healthy Eating Index-NVS (HEI-NVS) was calculated and analyzed using a robust linear mixed model. In addition, bootstrapped correlations were performed independently of study group to examine associations between change in HEI-NVS and change in dietary, anthropometric, and cardiometabolic variables. A total of n = 153 participants with a mean BMI of 30.71 kg/m2 (SD 2.13) and an average age of 48.92 y (SD 11.17) were included in the study. HEI-NVS improved significantly in the intervention group from baseline (t0) to t2 (p = 0.003) and to t3 (p = 0.037), whereby the course was significantly different up to t2 (p = 0.013) and not significantly different up to t3 (p = 0.054) compared to the control group. Independent of study group, there was a significant negative association between change in HEI-NVS and dietary energy density. A higher total score in HEI-NVS did not correlate with improvements in cardiovascular risk profile. The interactive and fully automated web-based weight loss program improved diet quality. Independent of study group, changes in HEI-NVS correlated with changes in energy density, but there was no association between improvements in HEI-NVS and improvements in cardiovascular risk profile.

Dietary changes among pregnant individuals compared to pre-pandemic: A cross-sectional analysis of the Pregnancy during the COVID-19 Pandemic (PdP) study

Introduction

Dietary changes are common in pregnancy and may affect pregnancy outcomes, yet these changes and the associated contributory factors during the COVID-19 pandemic have been understudied. We aimed to investigate the association between dietary change and socioeconomic variables, pre-pregnancy BMI, and mental health symptoms; the change in intake of seven food categories and their reasons; and the association between intake of these food categories and mental health symptoms.

Materials and methods

In this cross-sectional analysis, we used data from the Pregnancy during the COVID-19 Pandemic (PdP) cohort study that collected data from pregnant Canadian individuals (n = 9,870, gestational age ≤ 35 weeks) on socioeconomic factors, pandemic-related hardships, pre-pregnancy body mass index (BMI), dietary changes compared to pre-pandemic and the reasons for these changes. We assessed depressive and anxiety symptoms using the Edinburgh Postpartum Depression Scale (EPDS) and Patient-Reported Outcomes Measurement Information System (PROMIS)-Anxiety, respectively.

Results

54.3% of the participants reported a change in their diet. Non-white ethnicity (OR = 1.33), job loss (OR = 1.29), clinically elevated depressive and anxiety symptoms (OR = 1.26 and 1.14, respectively), self-isolation (OR = 1.20), pre-pregnancy BMI (OR = 1.19), fear of COVID-19 (OR = 1.15), and pandemic phase at enrolment (OR = 0.90) significantly predicted dietary change. Most participants ate about the same amounts of dairy, meats and canned foods/dried goods as pre-pandemic (61.5, 61.7, and 60.2%, respectively), increased their intake of fresh vegetables/fruits and sweets/snacks (43.2 and 54.5%, respectively), and decreased fast-food and take-out/home delivery (53.2 and 43.1%, respectively). Changes in consumption of the food categories had a curvilinear association with mental health symptoms (except resilience) indicating greater symptoms with either decreased or increased intakes. Changes in craving, having more time for cooking/preparing foods, and being unable to go grocery shopping frequently (but not reduced affordability) were the main reasons driving these dietary changes.

Conclusion

Some factors increase the odds of dietary change among pregnant individuals during the pandemic, with some changes toward a healthy and others toward an unhealthy diet. Given the importance of a healthy diet during gestation, identifying the risk and protective factors might be the first essential step in reducing the detrimental effects of unfavorable dietary changes during the pandemic on this vulnerable population.

Association between lifestyle choices and mental health among medical students during the COVID-19 pandemic: A cross-sectional study

INTRODUCTION

Mental health is recognized as a critical component of public health Given the close relationship between mental health and life style and the importance of students as valuable human resources, the present study aimed at determining the relationship between life style and mental health among medical students in Sousse during COVID-19 pandemic.

METHODS

We conducted a cross-sectional observational study in university students from the first to the fifth grade of the Faculty of Medicine of Sousse during the academic year 2020/2021. Data were collected anonymously via an online questionnaire published on the Facebook groups of each grade, on december 2020. The online survey consisted of three sections. The first one aimed to collect sociodemographic information. The second section of the survey addressed recent lifestyle choices and the third one assessed psychological distress using the French version of 12 items of The General Health Questionnaire (GHQ-12). The significance level was considered 0.05.

RESULTS

Overall 147 were studied. Using the bimodal scoring, the total score was between 0 and 12, to evoke psychiatric disorders, we set the threshold of 4. For our sample, the median scale was 7 [4-9], and more than half of the students (68%; n = 100) had a score higher than 4. Psychiatric disorder was significantly more frequent in female students (73.3% vs 42.3%; p = 0.002). Higher GHQ-scale was found in younger students, foreigners, students who need more than 30 minutes to get to the faculty, unemployed students, and students of fifth grade. However, differences were not statistically significant. Regarding lifestyle choices, we found that physical inactivity, no smoking habits, no alcohol use, no illicit substance use, other substance use, changing in eating habits, and absence of coping methods of stress were higher in students with psychiatric disorders. However, this association was statistically significant only for physical activity (p = 0.016). The results of the regression analysis suggest female gender as an independent predictor of high GHQ-12 scores. Practicing physical activity was found as protective factor for psychiatric disorders.

CONCLUSION

Considering the vital role of medical students in providing and promoting community health, the need for more detailed planning and interventions to improve their life style and mental health is essential.

Coping strategies moderate the effect of perceived stress on sleep and health in older adults during the COVID-19 pandemic

Stress in the context of the COVID-19 pandemic may have a significant impact on health, including sleep health. Older adults may be particularly vulnerable. This study examined associations between perceived stress and sleep health, mental health, physical health, and overall perceived health outcomes among older adults. We also examined whether specific coping strategies moderate these associations. Older adults (n = 115; M_age  = 68.62) reported perceived stress, coping strategies, global sleep quality, depressive symptoms, and perceived mental, physical, and overall health before and during the COVID-19 pandemic. Stress-health relationships were modelled with hierarchical linear regression. Higher perceived stress was associated with greater depressive symptoms and poorer mental health concurrently and longitudinally. Coping strategies moderated the association of perceived stress with physical health and overall perceived health. For example, higher perceived stress was associated with poorer overall perceived health among those with lower problem-focussed coping, but not among those with higher problem-focussed coping. Older adults may benefit from prevention and intervention strategies targeting stress management. Furthermore, identifying people with low problem-focussed coping might be a useful strategy to prevent worsening health in future public health crises.

Longitudinal associations between physical activity and other health behaviours during the COVID-19 pandemic: a fixed effects analysis

Government enforced restrictions on movement during the COVID-19 pandemic are likely to have had profound impacts on the daily behaviours of many individuals, including physical activity (PA). Given the associations between PA and other health behaviours, changes in PA during the pandemic may have been detrimental for other health behaviours. This study aimed to evaluate whether changes in PA during and after the first national lockdown in the United Kingdom (UK) were associated with concurrent changes in alcohol consumption, sleep, nutrition quality, diet quantity and sedentary time. Data were derived from the UCL COVID-19 Social Study, in which 52,784 adults were followed weekly across 22 weeks of the pandemic from 23rd March to 23rd August 2020. Fixed effects regression models showed that greater PA was positively associated with improved sleep and nutrition quality. However, increases in PA also showed modest associations with increased alcohol consumption and sedentary time. Encouraging people to engage in PA may lead to wider changes in other health behaviours in times of adversity. These associations could be a result of increases in available leisure time for many people during COVID-19 restrictions and are of ongoing importance given the emerging long-term changes to lifestyle and working patterns.

Time estimation and passage of time judgment predict eating behaviors during COVID-19 lockdown

Poor eating habits often lead to health concerns. While mental health conditions such as stress and anxiety have been linked as predictors for eating behaviors, cognitive factors may also contribute to eating practices during the early stages of the mandatory COVID-19 lockdown. In the current study, participants responded to a survey that asked them to judge the passing of time (PoTJ) and to produce short intervals (via a time production task) as an index of the internal clock speed. Additionally, they responded to questions about snacking frequency and the tendency to overeat during lockdown. We observed that those who judged time to pass slowly also reported a greater tendency to snack and overeat during the pandemic. Additional analysis also revealed that the effect of PoTJ on snacking is moderated by the internal clock speed such that those who felt time was passing by slowly, and in combination with a faster internal clock (as indexed by shorter duration production), had a greater tendency to snack. The results suggest that different aspects of temporal cognition play potential roles in influencing different types of eating behaviors. Our findings therefore have implications for eating disorders, along with the potential of time-based intervention or behavioral modification approaches.

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.

Weight loss outcomes achieved by adults accessing an online programme offered as part of Public Health England's 'Better Health' campaign

Effective use of health technology may offer a scalable solution to the obesity pandemic. Online digital programmes provide a convenient and flexible way for more people to access regular support. This service evaluation aims to determine whether adults accessing an online weight management programme via a national campaign are successful in losing weight.

Data was analysed for adults registering with Slimming World’s online programme using a discounted membership offered as part of PHE’s ‘Better Health’ campaign between July and December 2020. Last-weight carried forward was used to calculate weight outcomes for participants who had the opportunity to complete 12-weeks and recorded ≥ one weight besides baseline. Engagement was determined using number of online weekly weights recorded with high engagers having weight data for ≥ 9 occasions. Socioeconomic status was assessed using postcode data. Resubscription and uploaded weight data were used to determine numbers who continued beyond the offer period.

Twenty-seven thousand two hundred forty-eight adults (5.3% males) with mean age 41.0 ± 11.4 years met inclusion criteria. Mean baseline BMI was 33.4 ± 6.8 kg/m² (29.2% 30–34.9, 18.3% 35–39.9 and 15.1% > 40 kg/m²). Mean weight loss at 12 weeks was 2.7 (± 3) kg representing a mean loss of 3% (± 3.1) body weight with 42.3% achieving ≥ 3% and 22.1% weight loss ≥ 5%. Median number of weigh-ins was six. Men had greater weight losses compared to women (p < 0.001). High engagers, both men and women, achieved greater weight losses (p < 0.001). Absolute weight loss was associated with joining BMI (r_s = -0.15, p < 0.001) but for % weight change only small differences were seen (max effect size = 0.03) with no differences in weight change for high engagers between different baseline BMI categories (p > 0.05). 30.9% were in the lowest two IMD quintiles and absolute and percentage weight change did not differ across deprivation quintiles (p > 0.05). 34.9% continued to access the online support after the offer period.

This service evaluation shows that an online programme, offered as part of a national campaign, can offer effective support to a large number of people with different starting BMIs and from different socioeconomic backgrounds. An increased level of engagement leads to better weight losses.

Change of Dietary and Lifestyle Habits during and after the COVID-19 Lockdown in Cyprus: An Analysis of Two Observational Studies

Background: People’s dietary and lifestyle habits appeared to be influenced by restrictive measures imposed in response to the COVID-19 pandemic. This study examines the differences in dietary and lifestyle habits during and after the lockdown measures in Cyprus. Methods: Two online cross-sectional surveys were conducted, using a self-administered, anonymous questionnaire to collect information on sociodemographic and anthropometric characteristics, smoking habits, physical activity, and dietary habits. The first survey was conducted between 6 April 2020 and 20 June 2020 (during national lockdown) while the second survey was conducted between 27 October 2021 and 20 January 2022 (post-lockdown). Results: A total of 2503 individuals participated in the study. A higher consumption of fruits, vegetables, legumes/pulses, fish, and poultry was identified during lockdown compared to the period after the lockdown. Moreover, a greater daily intake of olive oil and a lower consumption of alcohol was found during the confinement period compared to the post-confinement period. During lockdown, most participants (43.0%) never or rarely used delivery services, while the largest proportion of the participants after lockdown used delivery services 1−3 times per month (37.0%) (p < 0.001). During lockdown, around 66% of the participants were physically active, compared to 55.5% after lockdown (p < 0.001). Furthermore, when compared to those with a normal BMI, more overweight and obese respondents ordered food 1−2 times per week in both periods (p < 0.001). Conclusions: Dietary and lifestyle habits of the participants were healthier throughout the lockdown period than after the end of the restrictive measures due to the COVID-19 pandemic. It is critical to encourage the Cypriot population to maintain the healthy dietary and lifestyle habits established during the lockdown in their daily lives after the confinement.

Subjective socioeconomic disadvantage is indirectly associated with food portion selection through perceived disruption of personal resources during a nationwide COVID-19 stay-at-home order

In addition to its public health implications, the global COVID-19 pandemic has also produced significant disruptions to individuals' socioeconomic resources and opportunities. Prior research has suggested that low subjective socioeconomic status (SSES) may stimulate appetite and motivate increased energy intake. Here, we tested whether individuals experiencing lower levels of SSES (SSES disadvantage) during a nationwide stay-at-home order for COVID-19 exhibited preferences for larger food portion sizes through perceived disruptions to personal financial and material resources. Data was collected near the conclusion of a nationwide partial lockdown (Singapore's “Circuit-Breaker” from April to June 2020). Participants (N = 295) completed an online survey involving a measure of SSES, the Coronavirus Impacts Questionnaire, and a food portion selection task where participants estimated the portion size they prefer to consume for a range of common foods. SSES disadvantage was associated with selection of smaller average portion sizes. Yet, a significant indirect effect of coronavirus impact was observed in this relationship, such that participants experiencing greater SSES disadvantage selected larger portion sizes through the effect of greater perceived impacts of COVID-19 to one's financial/material resources (controlling for one's actual level of income). These findings further support the idea that perceived deprivation and insecurity of important resources (financial, social, material) may influence intentions to consume greater amounts of energy. Consequently, systematic societal disruptions to such resources may reinforce and perpetuate potentially obesogenic eating behaviors of populations that are especially vulnerable to such shocks (i.e., people experiencing SSES disadvantage).

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.

Impacts of COVID-19 Sanitary Cues on Hedonic Appreciation of Foods

The COVID-19 pandemic led to several lifestyle changes, including eating behavior. Herein, we aimed to evaluate how pandemic-related sanitary cues presented in food videos impact food appraisal and desire to eat, and their priming after-effects on subsequent food pictures presented without such cues. In two online sessions, separated by 4 to 7 days, participants watched either a Non-Pandemic or a Pandemic video of a woman eating, the latter containing sanitary elements adopted during the pandemic. The order of the videos was counterbalanced across participants over the two experimental sessions. Videos were followed by images of food from different categories. After observing both videos and each picture, participants were instructed to evaluate the visual aspect, expected smell and flavor, and rate their desire to eat. Our study demonstrated (1) higher hedonic responses to the Non-Pandemic compared to the Pandemic video, (2) a priming effect showing higher appreciation for sweet foods after the Non-Pandemic compared to the Pandemic video, (3) that food exposure gradually increases one's desire to eat, but such effects are impacted by pandemic sanitary cues, and (4) greater hedonic responses are given for sweet and high-calorie foods compared to salty and low-calorie ones, irrespective of pandemic priming. Finally, depression and anxiety symptoms were associated with lower smell evaluations only in the Pandemic condition.

Association between food addiction and time perspective during COVID-19 isolation

PURPOSE

The concept of time perspective (TP) implies that a mental focus on past, present, or future affect a person makes decisions and take action. Inability to plan their life for a sufficiently long time perspective due to the COVID-19 pandemic appeared to have a pronounced impact on a human's lifestyle influencing their thoughts, feelings, and behaviors, including eating behavior. This study tested two hypotheses: (a) that during COVID-19 isolation, the incidence rate of food addiction is increased, and (b) people with present TP are more likely exhibited signs of food addiction (FA).

METHODS

The final study sample included 949 people, mean age 21.8 ± 7.8 years (range: 17-71 years, women: 78.3%). Each participant indicated their personal data and completed Yale Food Addiction Scale and the Zimbardo Time Perspective Inventory.

RESULTS

There was an increased incidence rate of FA (OR = 1.678, 95% CI = 1.324, 2.148, p = 0.000) during COVID-19 isolation. Individuals with balanced, future, and past positive TP were less likely to exhibit symptoms of FA. Persons with past negative, and present hedonistic TP were more likely to exhibit signs of FA.

CONCLUSION

There was an increased incidence rate of FA during COVID-19 isolation. Persons with shortened time horizon are more likely to exhibit symptoms of FA.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

The Association of COVID-19 Stressors and Family Health on Overeating before and during the COVID-19 Pandemic

Prior studies have examined how stress and the family environment affect overeating, but less is known about how COVID-19 stressors and family health may affect overeating during the COVID-19 pandemic. The research questions included: (1) Did COVID-19-related stressors increase the risk for overeating among adults in the United States? (2) Did family health protect against overeating during a pandemic? The sample included 443 participants aged 18 years and older living in the United States who were recruited via Amazon Mechanical Turk. Stata version 16 was used to analyze the data using multiple linear regression. The results indicate that one year into the pandemic, COVID-19 stressors were associated with increased overeating, even after adjusting for overeating before the pandemic. More family health resources were associated with less overeating. These results indicate that although COVID-19 stressors were associated with overeating, greater family health resources helped prevent overeating. Interventions and policies that aim to increase health resources for families may be particularly beneficial at preventing overeating and obesity in the face of long- and short-term stress.

Gender differences in bodyweight change following COVID-19 lockdown measures in the Netherlands: a prospective longitudinal study

BACKGROUND

The current study aimed to prospectively assess bodyweight change following the implementation of lockdown measures to contain the COVID-19 pandemic in the Netherlands and to explore the potentially moderating role of gender in this association.

DESIGN

Using Dutch DNB Household Survey panel data collected between 1993 and 2020, we estimated fixed-effects regression models of bodyweight change. Models were stratified by gender and formal tests of gender differences in coefficient estimates were performed.

PARTICIPANTS

4365 women and 4583 men aged 18-65 were included in the study. The total number of observations was 41 330.

OUTCOME MEASURES

The outcome of interest was self-reported bodyweight in kilograms. Additional analyses were performed using body mass index (self-reported weight in kilograms divided by self-reported height in metres squared) as the outcome.

RESULTS

The implementation of Dutch lockdown measures in 2020 was associated with bodyweight gain of approximately 800 g in working-age women compared with the 3 prior years. Bodyweight gain in 2020 relative to the prior years was significantly stronger for women than for men (F(4, 8947)=3.9, p<0.01). No evidence of bodyweight gain in working-age men was found.

CONCLUSION

Results indicate that bodyweight gain following COVID-19 lockdown measures in the Netherlands was more pronounced among women than among men. Although necessary to contain the COVID-19 pandemic, lockdown measures may contribute to a different public health challenge in the rising prevalence of overweight and obesity.

A Qualitative Study Exploring Management of Food Intake in the United Kingdom During the Coronavirus Pandemic

The coronavirus pandemic has impacted dietary quality through increased emotional eating and extended time spent at home, as well as instances of panic buying due to uncertainty over food availability. We recruited an opportunistic sample of 40 adults living in the United Kingdom (Female = 25; Mean age = 41.9 years) (SD = 14.4) without any prior history of eating disorders. Semi-structured interviews were conducted in June 2020 and focused on the impacts of the COVID-19 lockdown on eating habits and experiences of panic buying. The data were transcribed and organized using the softwares Otter and Quirkos, respectively. Reflexive thematic analysis identified positive and negative changes to eating habits. Overall, themes highlighted that effective organization was vital to manage food purchases and consumption due to a reduced shopping frequency. However, overconsumption frequently occurred due to boredom and ease of accessing energy dense foods, which had negative implications for weight and body image. After indulging, participants attempted to revert to prior eating habits and adhere to a nutritious diet. Many also expressed the importance of having enough food to feed families, which was often reported as a reason for buying extra supplies. Understanding the long-term impacts of changes to eating habits that account for the novel coronavirus context is required to preserve health and prevent unintended changes to weight.

Something to chew on: technological aspects for novel snacks

Snacks have accompanied people for a long time, meeting our needs for something fast and filling between meals. Societies and technologies have changed, and so have snacks, adapting to people's daily lives, concerns, and demands. Although traditional snacks, such as potato chips, are still ubiquitous and popular worldwide, there is not unanimity around them anymore, since many people have been looking for healthier snacks. Studies have been carried out to propose healthier snack options by changing their composition and/or techniques to produce them, minimizing contents of energy-dense components and/or maximizing the retention or bioavailability of nutrients. This mini-review presents the main trends on development of snacks and future perspectives. © 2021 Society of Chemical Industry.

A Systematic Review of the Impact of the First Year of COVID-19 on Obesity Risk Factors: A Pandemic Fueling a Pandemic?

Obesity is increasingly prevalent worldwide. Associated risk factors, including depression, socioeconomic stress, poor diet, and lack of physical activity, have all been impacted by the coronavirus disease 2019 (COVID-19) pandemic. This systematic review aims to explore the indirect effects of the first year of COVID-19 on obesity and its risk factors. A literature search of PubMed and EMBASE was performed from 1 January 2020 to 31 December 2020 to identify relevant studies pertaining to the first year of the COVID-19 pandemic (PROSPERO; CRD42020219433). All English-language studies on weight change and key obesity risk factors (psychosocial and socioeconomic health) during the COVID-19 pandemic were considered for inclusion. Of 805 full-text articles that were reviewed, 87 were included for analysis. The included studies observed increased food and alcohol consumption, increased sedentary time, worsening depressive symptoms, and increased financial stress. Overall, these results suggest that COVID-19 has exacerbated the current risk factors for obesity and is likely to worsen obesity rates in the near future. Future studies, and policy makers, will need to carefully consider their interdependency to develop effective interventions able to mitigate the obesity pandemic.

Adherence to the Mediterranean Diet and COVID-19: A Segmentation Analysis of Italian and US Consumers

The COVID-19 pandemic has led many countries to implement restrictions on individual freedom to stop the contagion. The imposition of lockdowns has affected many socio-economic aspects and, in particular, eating habits, highlighting the need to analyse the healthiness of new consumption patterns. The aim of our study was to investigate the changes in adherence to the Mediterranean diet, a dietary model universally recognized as healthy, that have occurred both during and since the lockdown. The subsequent profiling of consumers allowed us to understand which sociodemographic and psychographic factors favoured the development of more or less adherence to Mediterranean diet consumption patterns. The study was conducted by administering a questionnaire to a representative sample of Italians and New Yorkers. Both groups, defined by deep socio-economic differences and by their own eating habits compared to the Mediterranean diet model, were affected by similar lockdown measures. The data collected were processed by cluster analysis that allowed to identify four homogeneous groups with respect to the adherence to the Mediterranean diet model. The results highlight a worrying situation with respect to the impacts of the pandemic on maintaining a proper dietary style according to the principles of the Mediterranean diet. In fact, there has been a general worsening trend due to an increase in consumption, in part linked to emotional eating, which is a cause for concern about the potential future impacts on the health of consumers. The study highlights the need, therefore, to implement actions by public decision-makers aimed at raising the awareness of citizens on the issue of correct eating habits and at developing adequate food policies to stem the trend towards unhealthy diets.

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.

Changes in Food Purchasing Practices of French Households During the First COVID-19 Lockdown and Associated Individual and Environmental Factors

Background

To limit the spread of COVID-19, a strict lockdown was imposed in France between March and May 2020. Mobility limitations and closure of non-essential public places (restaurants, open-air markets, etc.) affected peoples' food environment (FE) and thus their food purchasing practices (FPPs). This study aimed to explore changes in FPPs of French households during lockdown and associations with individual and environmental factors.

Methods

In April of 2020 households from the Mont'Panier cross-sectional study (n = 306), a quota sampling survey conducted in the south of France, were asked to complete an online questionnaire about their FPPs during lockdown and related factors, including perceived FE (distance to closest general food store, perception of increased food prices, etc.). Objective FE (presence, number, proximity, and density of food outlets) was assessed around participant's home using a geographical information system. Multiple correspondence analysis based on changes in frequency of use and quantity of food purchased by food outlet, followed by a hierarchical cluster analysis, resulted in the identification of clusters. Logistic regression models were performed to assess associations between identified clusters and household's sociodemographic characteristics, perceived, and objective FE.

Results

Five clusters were identified. Cluster “Supermarket” (38% of the total sample), in which households reduced frequency of trips, but increased quantity bought in supermarkets during lockdown, was associated with lower incomes and the perception of increased food prices. Cluster “E-supermarket” (12%), in which households increased online food shopping with pickup at supermarket, was associated with higher incomes. Cluster “Diversified” (22%), made up of households who reduced frequency of trips to diverse food outlet types, was associated with the perception of increased food prices. Cluster “Organic Food Store” (20%), in which households did not change frequency of trips, nor quantity purchased in organic food stores, was associated with being older (35–50 y vs. <35 y). Finally, cluster “Producer” (8%), which includes households who regularly purchased food from producers, but mostly reduced these purchases during lockdown, was associated with the presence of an organic food store within a 1-km walking distance around home.

Conclusion

This study highlighted diverse changes in FPPs during lockdown and overall more significant associations with perceived than with objective FE indicators.

Can “Free-From” Food Consumption Be a Signal of Psychological Distress during COVID-19?

During the last year, feelings of anxiety and depression were registered among the Italian population and affected food consumption. Among the research that explored people’s dietary inclinations during the current pandemic, no previous studies have explored psychological factors associated with the “free-from” dietary pattern. Our study is aimed at understanding if free-from food consumption orientations can be associated with negative psychological distress. We conducted a web-based survey between 27/10/2020–03/12/2020 on a representative sample of 963 Italians. Psychometric scales and ad hoc items were used to measure people’s levels of anxiety, depression, fear for contagion and consumption orientation towards “free-from” foods. Of the sample, 18.2% frequently purchased gluten-free food products and 22.5% purchased lactose-free foods. Most of the population (44.1%) feels very at risk of contagion from COVID-19 and suffers from anxiety (52.8%) and depression (55.0%). Free-from consumers are more anxious, depressed, have higher risk of contagion, and are younger than the non-consumers. During the COVID-19 pandemic, free-from foods can represent for the people a way to restore control over their lifestyle, which was denied during the emergency. However, we highlight possible negative long-term effects of this dietary choice.

Exploring perceptions about Mindfulness and Mindful Eating Programs for low-income women with overweight in primary health care

Background: Obesity and overweight are public health problems of multifactorial etiology, aggravated by the challenge that is maintaining weight loss. Used in the context of general health, mindfulness-based interventions (MBIs) have also showed positive effects when targeting changes to overweight-related eating behaviors. Methods: This study consists of a pragmatic randomized controlled trial conducted with 284 women from primary health care units. Data were collected from the last session with 16 focus groups, considering each intervention group (mindfulness or mindful eating) Aim: This article aims to present the perceptions of low-income overweight women who participated in Mindfulness and Mindful Eating intervention groups in primary health care according to each type of intervention. Results: Seven themes were identified: course challenges; valorization of the teacher's attitudes; mindfulness understanding; self-awareness development; change of expectations; development of a different food-weight relationship; and discover of a wide range of benefits. Conclusion: Mindfulness and Mindful eating interventions affect not only an individual's relationship with body and food, but also life and human relations. The results indicate the feasibility of the intervention, which addresses a large number of patients who lack treatment options for overweight or emotional and psychological issues associated with this condition. MBIs such as mindful eating are applicable in primary health care facilities, targeting overweight women and supporting treatment by addressing a repressed demand in the system. Similar to mind-body therapies, these interventions allow for comprehensive care.ClinicalTrials.gov, (NCT02893150) on 30 March 2017.

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.

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.

Health-promoting behaviors in the United States during the early stages of the COVID-19 pandemic

The potential negative effects of the COVID-19 pandemic on health-compromising behaviors including overeating, processed food intake, and alcohol use have been well documented. However, it is possible the COVID-19 pandemic has had positive effects on some health-promoting behaviors like cooking and fruit and vegetable intake. The current study was a preregistered secondary data analysis using data from a U.S. national, crowdsourced study (n = 868) on eating behaviors during the early stages of the COVID-19 pandemic. The objectives of the current study were to compare levels of cooking, fruit and vegetable intake, and physical activity among U.S. adults during the early stages of the COVID-19 pandemic to pre-pandemic levels in reference groups of U.S. adults, and test whether subjective stress from the pandemic was associated with health-promoting behaviors by obesity status. During the early stages of the COVID-19 pandemic, participants cooked more often and ate 0.23 more cups of fruits and vegetables per day, but 28.8% fewer participants met federal physical activity guidelines. Greater COVID-19 stress was minimally to moderately associated with greater cooking, fruit and vegetable intake, and physical activity. The positive association between COVID-19 stress and fruit and vegetable intake was stronger for individuals with obesity. The COVID-19 pandemic might have encouraged U.S. adults, especially those at risk for complications, to engage in some health-promoting behaviors while creating barriers for other behaviors.

Impact of Nationwide Lockdowns Resulting from The First Wave of the COVID-19 Pandemic on Food Intake, Eating Behaviours and Diet Quality: A Systematic Review

The lockdowns resulting from the first wave of the COVID-19 pandemic impacted deeply on all life activities, including diet. We performed a systematic review to investigate changes in food intake, eating behaviours and diet quality during lockdown as compared to before. A literature search was performed using three electronic databases from inception until June 13, 2021. Observational studies evaluating changes in general populations during the COVID-19 pandemic lockdown were eligible. Out of 1,963 studies achieved from the search strategy, 95 met inclusion criteria (85 on adults, 10 on children/adolescents), and the majority were of high quality (72.6%). Most of the studies were web-based surveys using convenience sampling, mainly focused on variations in the consumption of foods and eating behaviours during lockdown, whereas only 15 studies analysed diet quality through dietary indices. On the basis of the definition of a healthful diet as reflected by a traditional Mediterranean diet, an increase in recommended foods such as fruit and vegetables, legumes, cereals and olive oil was observed, although a sharp decrease in fish intake and an increase in dairy products were documented. Accordingly, a reduction in foods that should be eaten less frequently was reported, namely, red and processed meat. However, a higher consumption of unhealthy foods (e.g., snacks and sweets) was also observed. Results indicated improved diet quality in Europe, especially among Mediterranean countries, with the exception of France, while a switching to poor nutrient patterns was observed in Colombia and Saudi Arabia. Analyses of eating behaviours suggest an increase in food intake, number of daily meals and snacking. In conclusion, changes in intake of major food groups, apart from fish intake, were in line with the definition of a traditional Mediterranean diet, indicating a consistent moderate improvement of dietary habits worldwide. This review protocol was registered at https://www.crd.york.ac.uk/prospero/ as CRD42020225292.

Mediterranean Diet a Potential Strategy against SARS-CoV-2 Infection: A Narrative Review

Mediterranean Diet represents the traditional eating habits of populations living around the Mediterranean Sea, and it is associated with a lower risk of overall mortality and cancer incidence and cardiovascular diseases. Severe acute respiratory syndrome coronavirus 2 is a new pandemic, and represents a significant and critical threat to global human health. In this study, we aimed to review the possible effects of Mediterranean Diet against the risk of the coronavirus disease 2019. Several vitamins, minerals, fatty acids, and phytochemicals with their potential anti-COVID-19 activity are presented. Different risk factors may increase or reduce the probability of contracting the disease. Mediterranean Diet has also a positive action on inflammation and immune system and could have a protective effect against severe acute respiratory syndrome coronavirus 2. Further studies are needed to corroborate the benefits of the Mediterranean Diet protective role on infection with SARS-CoV-2.

Impact of COVID-19 lockdown on the perception of home meals and meal-related variables: a large-scale study within the Italian population during the acute phase of the pandemic

Italy was the first European country struck by the COVID-19 epidemic and experienced a national lockdown. This study explored the effect of lockdown on the perception of any meals prepared and/or conducted at home (home meals) and investigated which variables played a role in this. A group of Italians (n=3,060) not suspected/diagnosed as having COVID-19 (18-91 years old; 33% males) completed an online survey during the first lockdown (April 2020). Liking for home meals either increased (51% of the population) or did not vary (43%), while it decreased for only 6% of respondents. Total meal intake similarly either increased (51%) or remained unchanged (33%). Core variables describing meal perception (Liking for meal, Pleasure in meal preparation, Meal duration, Meal Time, Overall food intake, Snack intake) were positively associated with each other. Two clusters with different perceptions of home meals were found, characterised by an increased appreciation (Cl1, 61%) and an unchanged appreciation (Cl2, 39%), respectively. In the acute phase of lockdown, increased meal pleasure was associated with home togetherness (not living alone), cooking with others more often, having high cooking dynamism (use of different kitchen tools, engaging in online food-related activities like using online recipe/website for cooking, use of ready-to-eat meal delivery), and being young, a student or a worker (Cl1). Conversely, Cl2 showed an unchanged meal pleasure, and it was mostly associated with living alone (before and during lockdown), being elderly, retired, widowed, having a low degree of cooking-related activities and dedicating a small weekly budget to food. Variables strictly describing the meal were discussed. Lockdown did not homogenously affect the population in terms of meal pleasure, and high enjoyment of meals was related to high meal involvement. Younger subjects seemed to be more resilient and appreciated meals more due to high cooking dynamism, food-related activities and togetherness. Public health policies could consider these outputs to set up interventions that use meal-dedication activities to increase meal pleasure in vulnerable targets or in subjects experiencing poorly appreciated diets in similar future stressful situations.

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.