Changes in Ultra-Processed Food Consumption and Lifestyle Behaviors Following COVID-19 Shelter-in-Place: A Retrospective Study

Trajectories of Nutritional Quality, Diet-Related Environmental Impact, and Diet Cost in China: How Much Does Ultra-Processed Food and Drink Consumption Matter?

BACKGROUND

Rapid socio-economic developments confront China with a rising consumption of ultra-processed foods (UPFs) and ultra-processed drinks (UPDs). This study aims to evaluate their potential impact on diet transformation towards sustainability including nutrition, environmental sustainability, and diet-related cost.

METHODS

Dietary intake was assessed by 24 h recalls in 27,311 participants (age: 40.5 ± 19.7; female, 51.1%) in the China Health and Nutrition Survey 1997-2011. The nutrient quality, environmental sustainability (greenhouse gas emission (GHGE), total water use (TWU), land use (LU), and diet cost were assessed as diet-related sustainability indicators. Foods and drinks were classified according to the degree of processing based on NOVA. Two-level mixed effects models were applied to explore the secular trends of the sustainability indicators being nested within random effect (individual level).

RESULTS

UPFs and UPDs are less nutrient-dense, containing more energy, sodium, and added sugar compared to unprocessed or minimally processed foods and drinks (MPFs and MPDs). UPFs and UPDs were higher for GHGE and TWU but lower for LU. Costs of UPDs tripled those of MPDs. In the period of 1997-2011, the percentage of UPFs and UPDs per 2000 kcal increased for both sexes. The increase in UPFs and UPDs was associated with a lower nutrient quality but a higher environmental impact and diet cost.

CONCLUSIONS

From 1997 to 2011, there was a significant increase in the consumption of UPFs and UPDs in China. This trend had negative impacts on both the nutrient quality and environmental impact; meanwhile, it led to increased diet costs. Policies to reduce the production and consumption of UPFs and UPDs should be reinforced by making alternatives for ultra-processed breakfast cereals, snacks, and alcoholic beverages available and acceptable. Additionally, instead of only focusing on high-UPFD consumers, attention is needed on the currently low-UPFD consumers as their consumption has been growing rapidly in the last decades.

Did COVID-19 influence fruit and vegetable consumption? Explaining and comparing pandemic peak and post-peak periods

The COVID-19 pandemic, one of the worst global health crises in the last century, impacted nearly every aspect of people's lives, including their dietary choices and food consumption patterns. It arrived during a long shift in American diets featuring increasingly large portions of processed foods as well as fruit and vegetable consumption that is well below recommended levels. Improving the latter has been a key part of policymakers' efforts to improve consumers' diets. This study surveyed individuals in the US South to determine the factors influencing their consumption of fruit and vegetables during the pandemic peak and how these have changed post-peak. During the peak, food venue, demographics, and concerns about diet and the seriousness of the virus heavily affected consumption. Greater amounts of fresh fruit and vegetables were consumed post-peak pandemic. Changes post-peak were predicted by food venue. Cooking meals at home was the main positive predictor for consumption. US policymakers should try and leverage the changes since the peak to promote greater consumption of fruit and vegetables.

Changes in eating habits and lifestyle during the first year of the COVID-19 pandemic across metropolitan regions in Brazil and Germany: A survey-based cross-sectional study

COVID-19 caused profound societal changes to cope rapidly with the new circumstances. The food market changed its quantity, quality, form, and frequency dynamics. Consequently, food-eating habits and lifestyles like physical exercise likely experienced changes. An online-based survey was conducted between June 2020 and January 2021 in the metropolitan regions of Rhine Ruhr Metropolis (RRM), Greater São Paulo (GSP), other metropolitan regions in São Paulo state (oMRSP), other Brazilian metropolitan regions (oBRMR), and the remaining urban areas in both countries (oUA), representing different contexts of Brazil and Germany. We assessed self-reported changes in physical activity level, diet quality, self-reported eating habits, and buying groceries during the first year of the pandemic. In Germany, indoor and outdoor activities increased for 34% of the respondents, while in Brazil, there was a decrease in physical activity for 50% of the participants. The Healthy Eating Index (HEI) scored higher among Brazilians (16.8) than Germans (15.2) on a 0-29 HEI scale. Increased awareness of healthy and sustainable eating habits was observed in GSP (0.7), oMRSP (0.63), oBRMR (0.7), and oUA (0.68) on a scale from no change (0) to change (1). In RRM, an increase in convenience foods was noticed (0.86). Participants reported discomfort with food purchasing due to hygiene measures and avoided going to the supermarket (0.7 on average in Brazil and 0.58 for females using the same 0-1 scale). Also, food supply at the grocery shops was reported to be often unavailable and in lower quantities. A real-time assessment of self-reported changes in eating habits and lifestyle during the lockdown in 2020 in different contexts is insightful for rethinking strategies to improve conditions in the post-COVID-19 era and prepare for future pandemics.

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

Objective

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

Design

Quantitative, cross-sectional study.

Setting

The 2021 SummerStyles survey data.

Subjects

U.S. adults (≥18 years; N = 4068).

Measures

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

Analysis

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

Results

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

Conclusions

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

Effects of COVID-19 shelter-in-place confinement on diabetes prevention health behaviors among US adults with prediabetes: A cross-sectional survey

The coronavirus disease 2019 (COVID-19) pandemic has resulted in significant lifestyle changes due to shelter-in-place confinement orders. The study's purpose was to assess if the COVID-19 pandemic affected self-reported diabetes prevention behaviors among American adults with prediabetes. As part of a randomized clinical trial among adults with prediabetes and overweight/obesity, questions were added to existing study surveys to assess the effect of the COVID-19 pandemic on diabetes prevention behaviors and stress. Survey responses were summarized using frequencies. 259 study participants completed seven COVID-19 survey questions from June 2020 to June 2021. Participants were 62.9% female, 42.5% White, 31.3% Black, 11.6% Asian, 8.1% Hispanic, and 6.6% Other. Over 75% of participants reported that the COVID-19 pandemic affected physical activity levels, with 82.1% of those affected reporting decreased physical activity; 70.3% reported that the pandemic affected their eating habits, with 61.7% of those affected reporting their eating habits became less healthy; 73.7% reported that the pandemic affected their level of stress, with 97.4% of those affected reporting that their level of stress had increased; 60% reported that the pandemic affected their motivation to adopt/maintain healthy habits, with 72.9% of those affected reporting their motivation decreased. A high percentage of study participants with prediabetes reported decreases in health promotion behaviors and increases in stress due to the COVID-19 pandemic. Consequently, the pandemic could lead to increased diabetes incidence. Strategies to improve diabetes prevention behaviors and address mental health concerns among those at-risk for diabetes are critical during and after the COVID-19 pandemic.

Multiple health risk behaviors, including high consumption of ultra-processed foods and their implications for mental health during the COVID-19 pandemic

Background and aim

The growing increase in diet- and behavior-related illnesses has drawn the attention of many epidemiologists who attribute such changes to the epidemiological and nutritional transition. Thus, this study aims to evaluate the association between the combined occurrence of health risk behaviors, such as sedentary lifestyles, high weekly consumption of ultra-processed foods (UPFs), and non-daily consumption of fruits and vegetables, and symptoms of anxiety or depression in adults.

Methods

This is a cross-sectional study based on an epidemiological survey in two Brazilian cities. The outcome, anxiety, and depression symptoms were assessed using the Generalized Anxiety Disorder 7-item (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). Food consumption was assessed using a qualitative food frequency questionnaire (FFQ) with reference to consumption in the last 3 months and categorized into the consumption of fruits and vegetables and the consumption of UPFs according to the NOVA classification. Sedentary behavior was assessed by considering the amount of sitting or reclining time per day reported by participants and categorized as less than 9 h of sitting or reclining and 9 h or more. For the analysis, adjusted Poisson regression (PR) was used to estimate the prevalence ratio and the 95% confidence interval (CI).

Results

Those with the health risk behaviors, non-daily consumption of fruits and vegetables, and high consumption of UPFs had a 2.6 higher prevalence ratio for symptoms of mental disorder (PR: 2.6 and 95%CI: 1.1–6.5), as well as those with all three health risk behaviors, had a 2.8 higher prevalence ratio for symptoms of mental disorder (PR: 2.8 and 95%CI: 1.3–6.1).

Conclusion

This study revealed that the existence of a combination of two and three health risk behaviors led to a higher prevalence of symptoms of anxiety or depression.

Consumption Patterns of Processed Foods in Singapore-A Cross-Sectional Study

The consumption of processed foods is increasingly widespread and could have an impact on diet quality and health. Understanding the factors influencing people's eating habits is useful for assessing such impact. There are limited data on the consumption patterns of processed foods and associated factors influencing the dietary patterns in Singapore. This cross-sectional study based on a food frequency questionnaire aimed to examine how the consumption of processed foods among 2079 Singapore residents aged 18 to 89 years varies with sociodemographic factors. The analysis of the consumption by processed food groups showed that the studied factors, i.e., age, gender, ethnicity, housing and health status, all contributed to differences in processed food consumption to varying extents, with ethnicity being the key factor driving the variation. Such differences were also confirmed to a limited degree by determining another measure of consumption, i.e., a processed food variety score. The findings in this study could inform further work in relation to dietary risks.

Ultra-processed foods and health: a comprehensive review

Dramatically increasing trends in consumption of ultra-processed foods have been reported across the globe. Public concern about the health consequences of ultra-processed foods is high. This manuscript provides a comprehensive review of trends in global consumption of ultra-processed foods, dietary nutrient profile of ultra-processed foods, demographic, socioeconomic, psychological, and behavioral characteristics of ultra-processed food consumers, current evidence from longitudinal studies at the population level on the association between ultra-processed foods consumption and major health outcomes (including all-cause and cause-specific mortality, cardiovascular disease, overweight and obesity, body composition and fat deposition, diabetes, cancer, and gastrointestinal and other diseases), potential mechanisms linking ultra-processed foods with these outcomes (nutrient displacement, factors that influence adiposity, and processing), and challenges and future research directions. The global trends in consumption of ultra-processed foods, the generally unfavorable nutrient profile of ultra-processed foods, the characteristics of ultra-processed food consumers, the accumulating longitudinal studies associating ultra-processed foods with major health outcomes, and the uncertainties and complexities in putative mechanisms all highlight the need for future high-quality epidemiologic and mechanistic investigations on this topic. It is critical to interpret findings in the light of the totality of evidence.