Eating Behaviors among Online Learning Undergraduates during the COVID-19 Pandemic

Comparison of eating behaviour by relative weight change status of young adults throughout the COVID-19 pandemic

Background and purpose

The enforcement of nationwide lockdowns has worsened the obesity epidemic in Malaysia. Therefore, this study aims to compare eating behaviour by relative weight change status among young adults in Malaysia throughout the COVID-19 pandemic.

Design/methodology/approach

Socio-demographics, body height, pre-pandemic body weight, and post-lockdown body weight were self-reported by the young adults. The eating behaviour was assessed using the validated Three-Factor Eating Questionnaire-Revised 18-item (TFEQ-R18). The mean difference in eating behaviour subscales was analysed using MANCOVA with a Bonferroni-adjusted post-hoc test.

Findings

One-third of the young adults put on body weight due to the lockdowns, with an average relative weight gain of 12.44 ± 9.67%. Conversely, about one-fifth of the young adults reported having lighter body weight in the post-lockdown pandemic phase, with an average relative weight loss of 10.10 ± 4.66%. Young adults in the weight loss category had a significantly higher standardised raw score in cognitive restraints than those in the sustained weight and weight gain categories. In addition, young adults in the weight gain category had statistically higher standardised raw scores in uncontrolled eating and emotional eating compared to those in the sustained weight category. Weight trajectory during the COVID-19 pandemic is linked to disordered eating behaviour among young adults in Malaysia.

Originality/value

The findings presented in this study can be potentially valuable in formulating weight management strategies in the post-COVID-19 era.

Effect of Nutrition Education on Health Science University Students to Improve Cardiometabolic Profile and Inflammatory Status

The inadequate lifestyle associated with university life may have a negative impact on various cardiometabolic factors. The aim of this study was to evaluate the effect of a one-year nutrition education course on cardiometabolic parameters in undergraduate health science students. During the 2021-22 academic year, 1.30 h nutrition sessions were conducted twice a week. Capillary blood samples were collected and centrifuged to measure cardiometabolic and inflammatory biomarkers in serum. The sample studied consisted of 49 students: 20.4% male and 79.6% female. The nutritional intervention resulted in changes in dietary patterns, with increased consumption of vegetables, nuts and legumes. After the course, females showed an increase in HDL-cholesterol levels (p = 0.007) and no change in LDL-cholesterol levels (p = 0.189). On the other hand, males showed significant changes in HDL-cholesterol (p = 0.001) and LDL-cholesterol (p = 0.043) levels. The atherogenic index was also significantly reduced (p < 0.001) in both males (p = 0.009) and females (p = 0.002). Differences were also observed in the increase in vitamin D levels in both males and females, although the magnitude of the increase was greater in the men (Δ = 7.94, p = 0.016 in men vs. Δ = 4.96, p = 0.001 in women). The monocyte-to-HDL ratio (MHR) showed a significant reduction, although these differences were only significant in males. Students with low vitamin D levels had higher LDL-cholesterol values (p = 0.01) and atherogenic index (p = 0.029). Adjusted linear regression analysis showed a significant association between post-course vitamin D MHR (β = -0.42, IC: -0.29, -0.06, p < 0.01). These findings suggest the importance of including nutrition education programs during the university stage for the prevention of long-term health problems.

Call for emergency action to restore dietary diversity and protect global food systems in times of COVID-19 and beyond: Results from a cross-sectional study in 38 countries

Background

The COVID-19 pandemic has revealed the fragility of the global food system, sending shockwaves across countries' societies and economy. This has presented formidable challenges to sustaining a healthy and resilient lifestyle. The objective of this study is to examine the food consumption patterns and assess diet diversity indicators, primarily focusing on the food consumption score (FCS), among households in 38 countries both before and during the first wave of the COVID-19 pandemic.

Methods

A cross-sectional study with 37 207 participants (mean age: 36.70 ± 14.79, with 77 % women) was conducted in 38 countries through an online survey administered between April and June 2020. The study utilized a pre-tested food frequency questionnaire to explore food consumption patterns both before and during the COVID-19 periods. Additionally, the study computed Food Consumption Score (FCS) as a proxy indicator for assessing the dietary diversity of households.

Findings

This quantification of global, regional and national dietary diversity across 38 countries showed an increment in the consumption of all food groups but a drop in the intake of vegetables and in the dietary diversity. The household's food consumption scores indicating dietary diversity varied across regions. It decreased in the Middle East and North Africa (MENA) countries, including Lebanon (p < 0.001) and increased in the Gulf Cooperation Council countries including Bahrain (p = 0.003), Egypt (p < 0.001) and United Arab Emirates (p = 0.013). A decline in the household's dietary diversity was observed in Australia (p < 0.001), in South Africa including Uganda (p < 0.001), in Europe including Belgium (p < 0.001), Denmark (p = 0.002), Finland (p < 0.001) and Netherland (p = 0.027) and in South America including Ecuador (p < 0.001), Brazil (p < 0.001), Mexico (p < 0.0001) and Peru (p < 0.001). Middle and older ages [OR = 1.2; 95 % CI = [1.125-1.426] [OR = 2.5; 95 % CI = [1.951-3.064], being a woman [OR = 1.2; 95 % CI = [1.117-1.367], having a high education (p < 0.001), and showing amelioration in food-related behaviors [OR = 1.4; 95 % CI = [1.292-1.709] were all linked to having a higher dietary diversity.

Conclusion

The minor to moderate changes in food consumption patterns observed across the 38 countries within relatively short time frames could become lasting, leading to a significant and prolonged reduction in dietary diversity, as demonstrated by our findings.

Anxiety, anhedonia, and related food consumption in Israelis populations:An online cross-sectional study two years since the outbreak of COVID-19

Background

The COVID-19 pandemic has significantly impacted daily life. Beyond severe health and economic consequences, psychological consequences have surfaced that require in-depth research to understand the pandemic's effects on mental health. Aims: This study aimed to evaluate the association between anxiety levels and anhedonia with food consumption patterns and changes in body weight over the two years since the COVID-19 outbreak in Israel.

Methods

This cross-sectional study utilized non-randomized sampling through an online survey that included 741 study participants aged 18 to 94. participants were asked to complete the Beck's Anxiety Questionnaire, the Snaith-Hamilton Pleasure Scale for Anhedonia Measurement, the Mediterranean Nutrition Questionnaire, and self-reports of body weight and serving size changes.

Results

Those who reported severe anxiety and anhedonia reported the highest intake of fats, sugars, and carbohydrates and the highest weight gain (e.g., Butter and cream food: severe anxiety (M = 1.342, SEM = 0.217); low anxiety (M = 0.682, SEM = 0.042), Sweet pastries: severe anxiety (M = 4.078, SEM = 0.451); low anxiety (M = 3.175, SEM = 0.436)). Anhedonic participants consumed more sweetened beverages (M = 0.987, SEM = 0.013) than hedonic participants (M = 0.472, SEM = 0.231). Among participants that gained weight, severe anxiety participants consumed significantly more salty pastries (M = 2.263, SEM = 0.550) than those with low anxiety (M = 1.096, SEM = 0.107; p = .003). A significant interaction was found between weight, anxiety, and consuming salty pastries. High anxiety subjects and weight gain declared the highest intake of this food (p = .018); Significant interactions were found between those with severe anxiety and anhedonia, who reported the highest consumption of butter and cream (p = .005) and salty pastries (p = .021). Significant associations were found between weight and anhedonia and weight and anxiety levels (p = .000, p = .006 - respectively).

Conclusions

The outbreak of COVID-19 and its long-term presence strengthen the negative psychological aspects and increase the consumption of foods high in fat and sugar. Further attention to nutritional health is needed since crises may occur, and we must be prepared to prevent adverse consequences.

Changes in dietary habits during Covid-19 lockdown in Egypt: the Egyptian COVIDiet study

PURPOSE

COVID-19 lockdown changed social habits and lifestyle, including dietary habits, of people worldwide. However, limited information is available about these changes in Egypt. This cross-sectional study investigates the effects of COVID-19 lockdown on dietary habits among the Egyptian populations.

METHODS

An online questionnaire, based on sociodemographic data and dietary adherence in accordance with the validated PREDIMED MedDiet Adherence Screener (MEDAS), was used all over the Egyptian governorates. The dietary changes were statistically evaluated for significance in relation to age, gender, body mass index (BMI), education level and governorates.

RESULTS

A total of 1010 participants (76% aged below 36 years, 77% female, 22% obese, and 62% university-level education) answered the questionnaire. Respondents ≤ 20 years had a significant increase in weight and consumption of carbonated beverages, commercial pastries, fried and fast food. Egyptians > 50 years old had a significant decrease in physical activity. Underweight people (less than 3% of participants) increased their fast food intake with a prominent rise in weight. However, obese people increased cooking frequency and increased eating times with a decrease in physical activity. Male participants reported increased intake of carbonated beverages and fast food, while female participants increased the intake of homemade pastries with a significant decrease in physical activity. Approximately 50% of participants with postgraduate education reported decreased intake of fast food and carbonated beverages as well as decreased body weight. Residents of Cairo showed a significant increase in vegetable intake, and fried food intake with a decrease in seafood consumption. Participants from the Delta region had a significant increase in pastries intake.

CONCLUSION

The findings of this study explored the need for increasing awareness about healthy lifestyle in future lockdown periods.

Knowledge, attitudes, and practices towards COVID-19 among undergraduates during emergency remote learning

Background

The coronavirus disease 2019 (COVID-19) pandemic paralyzes the education sector. To minimize the interruption of teaching and learning, most universities in Malaysia shifted to virtual mode during this unprecedented period of the pandemic. With an ever-increasing number of Malaysians fully vaccinated against COVID-19, the education system is expected to switch back to face-to-face mode this year. It is crucial to assess the knowledge, attitudes, and practices (KAP) of COVID-19 among emergency remote learning undergraduates before reverting to physical teaching and learning. Hence, a study was conducted with this aim in mind.

Methods

A total of 299 Malaysian undergraduates were recruited through a snowball sampling approach. The online questionnaire encompassed three main segments: informed consent, sociodemographic information, and KAP questions on COVID-19.

Results

The mean scores for knowledge, attitude, and practice were 4.05/6, 11.14/12, and 5.07/7, respectively. The results of the present study showed that year 1 respondents had significantly higher levels (p < 0.05) of KAP scores than year 4 respondents. In addition, the attitude score of science majors respondents was significantly greater (p < 0.05) than those of nonscience majors. The KAP scores showed no significant difference among groups with different sexes, ethnicities, and COVID-19 histories. Partial correlation analysis revealed that the overall knowledge score was positively correlated with attitude (r = 0.193, p = 0.001) and practice (r = 0.343, p < 0.001) scores whereas the total attitude score was positively correlated with the total practice score (r = 0.149, p = 0.010).

Conclusion

Our current results suggest that COVID-19 workshops, seminars, or training programs for year 4 students could be conducted to enhance their KAP levels.

Changes in Diet, Lifestyle, and Orthorexia Nervosa Tendency During the COVID-19 Pandemic: A Web-Based Study

Objective

During the COVID-19 pandemic, our diet and lifestyle have changed significantly. In this study, it was aimed to determine the changes in diet, body weight and Orthorexia Nervosa (ON) tendency in the pandemic.

Method

This cross-sectional study was carried out among adults (n = 945). An online questionnaire was used to determine nutrition, lifestyle factors and ON tendency (via Google Docs). The questionnaire was also shared on social media groups and pages (instagram, twitter and facebook) managed by registered dietitians.

Results

During the COVID-19 pandemic individuals' body weight and total food consumption increased by 51.0% and 57.2%, respectively. Increased screen time (OR: 1.912, 95% CI: 1.374–2.661 p < 0.001), sleeping time (OR: 3.630, 95% CI: 2.551–5.166 p < 0.001) and decreased physical activity (OR: 2.051, 95% CI: 1.198–3.509 p < 0.01) were associated with weight gain. The ON tendency increased in all groups according to the change in food consumption status (p < 0.05).

Conclusions

Considering the ongoing pandemic, individuals should be provided with adequate nutritional support. It is very important to get that support from nutritionists in order to monitor and control body weight and ON tendency.

The Association between Online Learning and Food Consumption and Lifestyle Behaviors and Quality of Life in Terms of Mental Health of Undergraduate Students during COVID-19 Restrictions

The COVID-19 pandemic caused the abrupt replacement of traditional face-to-face classes into online classes. Several studies showed that online teaching and learning produced adverse mental health for students. However, no research has been conducted so far analyzing the association between the duration of online and food consumption and lifestyle behaviors and quality of life in terms of mental health of undergraduate students. This study aimed to determine the association between the duration of online learning and food consumption behaviors, lifestyles, and quality of life in terms of mental health among Thai undergraduate students during COVID-19 restrictions. A cross-sectional online survey of 464 undergraduate students was conducted at Chulalongkorn University, Bangkok, Thailand, between March and May 2021. The majority of undergraduate students stated that they spent 3–6 h per day on online learning (76.1%) and used their digital devices such as computers, tablets, or smartphones more than 6 h per day (76.9%). In addition, they had 75.4% of skipping breakfast (≥3 times/week) and 63.8% of sleep duration (6–8 h/day). A higher proportion of students who drank tea or coffee with milk and sugar while online learning was observed. The results found that the increased duration of online learning was significantly associated with skipping breakfast and the frequency of sugary beverage consumption. On the other hand, the increased computer, tablet, and smartphone usage for online learning was correlated with lower sleep duration and a poor quality of life in terms of mental health. The findings from this study contribute to a report of the association between online learning and food consumption and lifestyle behaviors and quality of life of undergraduate students, emphasizing the necessity for intervention strategies to promote healthy behaviors.

Changes in Dietary Intake Patterns and Weight Status during the COVID-19 Lockdown: A Cross-Sectional Study Focusing on Young Adults in Malaysia

Introduction: The coronavirus disease 2019 (COVID-19) isolation has altered individuals’ food purchasing behaviour and dietary intake patterns. Therefore, this study aims to investigate the changes in dietary intake patterns and their impacts on the weight status of young adults in Malaysia during the COVID-19 lockdown. Methods: This cross-sectional study involved 1045 young adults in Malaysia. The changes in dietary intake patterns were assessed using the Dietary Diversity Questionnaire with slight modifications, while anthropometric measurements including body height, body weight before the pandemic and current body weight were self-reported. Results: Overall, nearly half of the respondents (48.8%) gained weight during the confinement, with an average increment of 4.06 ± 3.23 kg. Of 1045, 45.3% reported consuming more fruits and 60.2% had higher plain water intake during the pandemic. It is observed that 41.0% to 66.8% of the young adults changed their dietary intake patterns during the pandemic. Increased consumption in cereals and grains (β = 0.084, p = 0.015, 95% CI = 0.017–0.160), as well as oils and fats (β = 0.123, p = 0.001, 95% CI = 0.059–0.241), was positively associated with weight gain during the pandemic. On the contrary, an increased plain water intake was negatively associated with weight gain during the lockdown (β = −0.100, p = 0.003, 95% CI = −0.171–−0.034). Findings in the current study also suggested that cutting back cereals and grains (β = 0.156, p < 0.001, 95% CI = 0.122–0.288), as well as oils and fats (β = 0.091, p = 0.012, 95% CI = 0.022–0.183), contributed significantly to weight loss during the pandemic confinement. Conclusion: In conclusion, the enforcement of the Movement Control Order (MCO) drove up the prevalence of overweight/obesity among young adults in Malaysia. Increased consumption of cereals and grains and oils and fats contributed to weight gain in the pandemic lockdown. Nonetheless, a noticeable proportion of young adults in Malaysia shifted to a healthier food choice by increasing the consumption of fruits and vegetables.