ABSTRACT
Background: The COVID-19 pandemic may have contributed to poorer self-management (ie, diet, physical activity and sleep) of diabetes mellitus (DM), which might predispose individuals to more severe COVID-19 outcomes. Objective: The first objective was to capture perceived changes in diet, physical activity and sleeping during the COVID-19 pandemic in adults with type 1 (T1DM) and type 2 diabetes mellitus (T2DM) in the UK. A second objective was to explore differences between individuals with DM compared with 'no' or 'other' health conditions. Methods: Participants aged >18 years were selected by convenience. Individuals subscribed to the Diabetes.co.uk community were sent a web-based survey including questions about demographics and health, followed by 5-point Likert-type scale questions relating to lifestyle-related behaviours during the COVID-19 pandemic. Individuals were grouped by diagnosis of DM, 'other' or 'no' health condition and responses were compared. Results: 4764 individuals responded, with 2434 (51.3%) being female and 1550 (32.6%) aged 55-64 years. T2DM (2974; 62.7%), hypertension (2147; 45.2%) and T1DM (1299; 27.4%) were most frequently reported. Compared with T1DM, 'no' or 'other' health conditions, respondents with T2DM reported making a less conscious effort to get outside and exercise daily (p<0.001) and spending no time outdoors (p=0.001). Weight loss was more frequently reported in respondents with T2DM (p=0.005). More individuals with T2DM reported consuming convenience foods (p=0.012) and sugary foods (p=0.021), yet eating more fresh foods (p=0.001) and drinking less alcohol than normal (p<0.001). More individuals with T1DM and T2DM reported worse sleep quality (p=0.004). Conclusions: Our study highlighted important differences in lifestyle by individuals with T1DM, T2DM, other and no health conditions in relation to the COVID-19 pandemic. Establishing surveillance systems and conducting repeated assessments are required to analyse how the situation shifted over time and whether adverse collateral effects of the pandemic were sustained in those with chronic health conditions.
ABSTRACT
The COVID-19 pandemic disrupted agri-food and health systems, increasing the risk of food insecurity, malnutrition, and related health problems. To develop a global pandemic impact picture around agri-food and health systems. Cross-sectional web-based survey with closed- and open-ended questions. Food, nutrition, and health researchers/practitioners from an international network were recruited as representatives of populations they serve. Two reminders to complete the survey were sent. Groups vulnerable to food insecurity and government actions were mapped, along with the impact of the pandemic on food production, distribution, and access, and offer of nutrition services. Descriptive statistics and content analysis summarized the data. Thirty individuals from Africa, America, Asia, Oceania, and Europe responded (11.85%). Most were from nutrition and dietetics (43.3%) or medicine (26.7%), working in research (50%) and with >10 years experience (62.1%). Informal/temporary workers (83.3%), older adults with chronic diseases (73.3%) and children eligible for school meals (53.3%) were found to be vulnerable to food insecurity. Commonly cited government actions were support for hand sanitation (53.3%), assistance to school-aged children (46.7%) and direct food provision (43.3%). About 50% saw community-led actions as important solutions. Only 16.7% mentioned remote delivery of nutrition services in primary care. Open-ended questions revealed that economic shocks, reduced investment, lack of staff/staff illnesses, transit restrictions, markets/stores closure or panic buying contributed to food production/distribution constraints. Reduced food availability, with unemployment/reduced purchasing power, increased food costs, lack of food security programmes or food emergency services contributed to food/nutrition insecurity. Nutrition services were reduced, suspended, or deprioritised. Several factors contributed to agri-food systems disruption and various government actions were implemented globally. Nutrition services offered in the healthcare context deserves further exploration. As the pandemic continue this provide a blueprint for a nutrition education/awareness programme to mitigate those risks based on knowledge gaps in policy and practice. NNEdPro Global Centre for Nutrition and Health. [ABSTRACT FROM AUTHOR] Copyright of Journal of Nutrition Education & Behavior is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
ABSTRACT
BACKGROUND: This paper describes the impact of COVID-19 during the first month of containment measures on organisations involved in the emergency food response in one region of the UK and the emerging nutrition insecurity. This is more than eradicating hunger but considers availability of support and health services and the availability of appropriate foods to meet individual requirements. In particular, this paper considers those in rural communities, from lower socioeconomic groups or underlying health conditions. METHODS: Semistructured professional conversations informed the development of a questionnaire which gathered insights from five organisations involved with the emergency food response in the South East, England, UK. Descriptive themes were derived though inductive analysis and are further discussed in relation to UK government food support measures and early published data. RESULTS: Four themes emerged from conversations, including: (1) increasing demand, (2) meeting the needs of specific groups, (3) awareness of food supply and value of supporting local and (4) concerns over sustainability. All organisations mentioned changes in practice and increased demand for emergency food solutions. Positive, rapid and innovative changes helped organisations to adapt to containment restrictions and to meet the needs of vulnerable people. Although concern was raised with regards to meeting the specific needs of those with underlying health conditions and the sustainability of current efforts. CONCLUSION: Considerable gaps in food provision were identified, as well as concerns regarding increased long-term food and nutrition insecurity. The paper makes recommendations to improve nutrition security for the future and considers the lessons learnt from the COVID-19 pandemic. The generalisability of these early insights is unknown but these real-time snapshops can help to direct further research and evaluation.