Ultra-Processed Food vs. Fruit and Vegetable Consumption before and during the COVID-19 Pandemic among Greek and Swedish Students.

BACKGROUND: The COVID-19 pandemic has impacted children's lifestyles, including dietary behaviors. Of particular concern among these behaviors is the heightened prevalence of ultra-processed food (UPF) consumption, which has been linked to the development of obesity and related non-communicable diseases. The present study examines the changes in (1) UPF and (2) vegetable and/or fruit consumption among school-aged children in Greece and Sweden before and during the COVID-19 pandemic. METHODS: The analyzed dataset consisted of main meal pictures (breakfast, lunch, and dinner) captured by 226 Greek students (94 before the pandemic and 132 during the pandemic) and 421 Swedish students (293 before and 128 during the pandemic), aged 9-18, who voluntarily reported their meals using a mobile application. The meal pictures were collected over four-month periods over two consecutive years; namely, between the 20th of August and the 20th of December in 2019 (before the COVID-19 outbreak) and the same period in 2020 (during the COVID-19 outbreak). The collected pictures were annotated manually by a trained nutritionist. A chi-square test was performed to evaluate the differences in proportions before versus during the pandemic. RESULTS: In total, 10,770 pictures were collected, including 6474 pictures from before the pandemic and 4296 pictures collected during the pandemic. Out of those, 86 pictures were excluded due to poor image quality, and 10,684 pictures were included in the final analyses (4267 pictures from Greece and 6417 pictures from Sweden). The proportion of UPF significantly decreased during vs. before the pandemic in both populations (50% vs. 46%, p = 0.010 in Greece, and 71% vs. 66%, p < 0.001 in Sweden), while the proportion of vegetables and/or fruits significantly increased in both cases (28% vs. 35%, p < 0.001 in Greece, and 38% vs. 42%, p = 0.019 in Sweden). There was a proportional increase in meal pictures containing UPF among boys in both countries. In Greece, both genders showed an increase in vegetables and/or fruits, whereas, in Sweden, the increase in fruit and/or vegetable consumption was solely observed among boys. CONCLUSIONS: The proportion of UPF in the Greek and Swedish students' main meals decreased during the COVID-19 pandemic vs. before the pandemic, while the proportion of main meals with vegetables and/or fruits increased.

Factors Associated with the Intake of Ultra-Processed Cariogenic Foods by Preschoolers During the COVID-19 Pandemic

Objective: To evaluate the characteristics and factors associated with the intake of ultra-processed cariogenic foods (UFC) by preschoolers during the COVID-19 pandemic. Material and Methods: This is a cross-sectional study involving parents of 672 children from two to five years old enrolled at public schools in Curitiba, Brazil. Parents answered a questionnaire about socioeconomic and demographic data, their behavior regarding the dietary education of their children (Parent Mealtime Action Scale-translated and validated for use in Brazil), and children's food intake (qualitative food frequency questionnaire-list of foods based on a report from the Pan American Health Organization). The data were analyzed using Poisson regression analysis (α=0.05). Results: About 43% of parents/guardians reported changes in their children's diet during the pandemic, being that diet got worse and better in 19% and 24% of the cases, respectively. The ultra-processed cariogenic foods with the highest daily intake frequencies were sweetened juices/sweetened drinks (0.52), followed by cookies (0.37), and candies (0.35). Parents with a lower level of education reported a daily frequency of UCF intake 1.36 times higher (PR=1.359;CI 95%: 1.106-1.669) in their children compared to those with a higher level of education. On the other hand, parents'/guardians' report of higher intake and greater offer of fruits and vegetables to children was associated with low UCF intake (PR=0.716;CI 95%: 0.592-0.866). Conclusion: The lower level of formal education of parents/guardians and lower availability of fruits and vegetables were related to higher consumption of ultra-processed cariogenic foods by children. © 2023, Association of Support to Oral Health Research (APESB). All rights reserved.

Determinants and consequences of obesity - contribution of the French NutriNet-Sante cohort

Large-scale observational epidemiological studies provide essential information for the development of prevention policies for chronic diseases such as obesity. Since 2009, the French NutriNet-Sante cohort has been used as the basis for 29 empirical studies on obesity. The aim of this review is to present a summary of the findings of those studies and to deduce the contribution of NutriNet-Sante to the understanding of obesity. Among the 29 studies, 5 analyzed obesity as an exposure variable, 23 - as an outcome, and 1 - as a moderator. When modelled as a determinant (or exposure), obesity was cross-sectionally and positively associated with migraine and functional dyspepsia, respectively. In turn, when modelled as a consequence (or outcome), obesity was positively associated with different dietary factors, such as the proportion of ultra-processed foods in the diet and preference for fatty food. Other factors were inversely associated with obesity, such as following an organic diet. Some psychological factors were positively (e.g. impulsivity) or inversely associated (e.g. optimism) with obesity risk. In NutriNet-Sante, further studies on obesity are underway, dealing with its association with COVID-19 and mental disorders.Copyright © 2022 Societe francaise de nutrition

Impact of Ultra-Processed Food Consumption on Quality of Diet among Brazilian Pregnant Women Assisted in Primary Health Care.

The quality of diet and nutritional status during pregnancy are crucial to optimize maternal and fetal health. Ultra-processed foods (UPFs) are increasingly prevalent in pregnancy groups despite being nutritionally unbalanced and associated with adverse perinatal outcomes. This cross-sectional study, conducted with data from 229 pregnant women, aimed to investigate the association between UPFs consumption and dietary nutrient intake of pregnant women assisted by Primary Health Care (PHC) in Federal District (DF), Brazil. Food consumption was assessed through two non-consecutive 24-h food records and categorized by the extent of processing using the NOVA classification. Multivariate linear regression models were used to analyze the association between the quintiles of UPF consumption and the total energy and nutrients intake. Mean daily energy intake was 1741 kcal, with 22.6% derived from UPFs. Greater UPF consumption was associated with reduced intake of unprocessed and minimally processed food. The highest quintile of UPFs was positively associated with higher total energy, trans fat, and sodium intake; and inversely associated with the diet content of protein, fiber, iron, magnesium, potassium, copper, zinc, selenium, and folate. Greater UPFs intake negatively impacts the nutritional quality of the diet and impoverishes the nutrient intake of pregnant women. Reducing UPF consumption may broadly improve dietary guidelines adherence in pregnant women and promote maternal and neonatal health.

Digital marketing of online food delivery services in a social media platform before and during COVID-19 pandemic in Brazil.

OBJECTIVE: To describe the promotion of food and beverage and marketing strategies used by online food delivery services (OFDS) in a social media platform before and during the pandemic in Brazil. DESIGN: Publicly available data were extracted from OFDS Instagram accounts. Posts published 6 months immediately before and after the first case of COVID-19 in Brazil were randomly sampled. Two independent authors coded the posts' content. Food and beverage items featured in posts were classified according to the NOVA food system classification. Marketing strategies were coded according to protocols from previous studies. SETTING: Top three OFDS Instagram accounts in Brazil. PARTICIPANTS: Posts published in the period studied (n 304). RESULTS: During the pandemic, the proportion of posts featuring at least one food item decreased from 71·6 % to 40·2 %, and the proportion of ultra-processed foods decreased from 57·6 % to 27·9 %. Before the pandemic, the most widely used marketing strategies were branding elements (80·7 %), product imagery (unbranded) (48·9 %) and partnerships/sponsorship (35·2 %). While during the pandemic, branding elements (62·2 %) continued to be the most applied, but were followed by the use of videos/graphics interchange format/boomerangs (34·1 %) and corporate social responsibility (31·7 %). The most frequent COVID-19 marketing strategies were 'social responsibility in the pandemic' (30·5 %), 'combatting the pandemic' (28·0 %) and 'accelerating digitalisation' (20·7 %). CONCLUSIONS: OFDS advertisements on a social media platform placed less emphasis on food items, but improved the nutritional quality of foods and beverages featured in posts. A COVID-washing approach was highlighted, especially through the use of social responsibility marketing during the pandemic.

Impact of ultra-processed food intake on the risk of COVID-19: a prospective cohort study.

PURPOSE: Nutrition plays a key role in supporting the human immune system and reducing the risk of infections. However, there is limited evidence exploring the relationship between diet and the risk of COVID-19. This study aimed to assess the associations between consumption of ultra-processed foods (UPF) and COVID-19 risk. METHODS: In total, 41,012 participants from the UK Biobank study with at least 2 of up to 5 times 24-h dietary assessments were included in this study. Dietary intakes were collected using an online 24-h dietary recall questionnaire and food items were categorized according to their degree of processing by the NOVA classification. COVID-19 infection was defined as individuals tested COVID-19 positive or dead of COVID-19. Association between average UPF consumption (% daily gram intake) and COVID-19 infection was assessed by multivariable logistic regression adjusted for potential confounders. RESULTS: Compared to participants in the lowest quartile of UPF proportion (% daily gram intake) in the diet, participants in the 2nd, 3rd, and highest quartiles were associated with a higher risk of COVID-19 with the odds ratio (OR) value of 1.03 (95% CI: 0.94-1.13), 1.24 (95% CI: 1.13-1.36), and 1.22 (95% CI: 1.12-1.34), respectively (P for trend < 0.001), after adjusting for potential confounders. The results were robust in a series of sensitivity analyses. No interaction effect was identified between the UPF proportions and age groups, education level, body mass index, and comorbidity status. BMI mediated 13.2% of this association. CONCLUSION: Higher consumption of UPF was associated with an increased risk of COVID-19 infection. Further studies are needed to better understand the underlying mechanisms in such association.

Proposing A New 'Gateway Food Model' For Adolescent Eating Behavior And Its Implications For Modifiable Hypertension Risk Factors

Background: During COVID-19, this study examined data on adolescents' eating habits. It proposes a new 'gateway food model' for ultra-processed foods (UPF). This model shows that certain UPFs when increased (decreased) drive consumption of other UPFs as well. This has important implications for managing hypertension risk factors since studies show that those in the highest tertile of UPF consumption have a higher risk of hypertension (adjusted HR, 1.21;CI, 1.06, 1.37;p = 0.004) (Mendonca, 2016). Method(s): The study enrolled 315 participants aged 13-19 years in Florida, U.S. Participants' PIE scores (Processed Intake Evaluation scores, scale 0-100), were calculated based on averaged consumption of 12 ultra-processed food products. PIE scores, before COVID-19 in 2019, and after COVID-19 restrictions were eased in 2022, were assessed in the study. Result(s): The participants' mean age was 16.2+/-1.4 years. The study classified participants into UPF+ (n=135) and UPF- (n=180) groups according to whether they increased or decreased their UPF intake during COVID-19. For both groups, a stepwise regression was employed to identify significant factors for change in UPF intake. In the UPF+ group, increased intake of candy, store pastries, or frozen desserts was associated with increased UPF intake across all other UPFs as well (+31.2, +12.0, or +10.5 respective change in PIE score, p<0.01). Correspondingly, in the UPFgroup, reduced intake of biscuits, white bread, or processed meat was associated with decreased overall UPF intake across all other UPFs as well (-9.6, -9.4, -8.6 respective change in PIE score, p<0.01). Conclusion(s): Hypertension can begin during childhood and may be mediated by a focus on modifiable risk factors such as high UPF intake. These results indicate that for adolescents whose consumption of UPFs has not yet been established, certain gateway UPFs (candy, store pastries, and frozen desserts) should be given priority for preventive dietary interventions since increased intake in these UPFs leads to consumption of all other UPFs as well. In contrast, if an adolescent's UPF eating is already established, other UPFs (biscuits, white bread, or processed meat) can be targeted by dietary interventions as they decrease intake across all other UPFs.

Determinants and consequences of obesity – contribution of the French NutriNet-Santé cohort

Large-scale observational epidemiological studies provide essential information for the development of prevention policies for chronic diseases such as obesity. Since 2009, the French NutriNet-Santé cohort has been used as the basis for 29 empirical studies on obesity. The aim of this review is to present a summary of the findings of those studies and to deduce the contribution of NutriNet-Santé to the understanding of obesity. Among the 29 studies, 5 analyzed obesity as an exposure variable, 23 – as an outcome, and 1 – as a moderator. When modelled as a determinant (or exposure), obesity was cross-sectionally and positively associated with migraine and functional dyspepsia, respectively. In turn, when modelled as a consequence (or outcome), obesity was positively associated with different dietary factors, such as the proportion of ultra-processed foods in the diet and preference for fatty food. Other factors were inversely associated with obesity, such as following an organic diet. Some psychological factors were positively (e.g. impulsivity) or inversely associated (e.g. optimism) with obesity risk. In NutriNet-Santé, further studies on obesity are underway, dealing with its association with COVID-19 and mental disorders.

Linking the Sensory Taste Properties of Chocolate-Based Biscuits to Consumers’ Emotions: A Cross-Cultural Study

This research measured consumers’ emotions and change in emotion to the specific sensory taste properties and attitudes of chocolate-based biscuits. The sample size involved 216 respondents from South Africa (n = 106) and Switzerland (n = 110). Respondents tasted chocolate-based biscuits and completed an online questionnaire. The increase in consumers’ levels of guilt after chocolate-based biscuit consumption and the contribution of a chocolate taste and craving attitude to consumers’ subsequent positive emotions and change in positive emotions could help food and consumer scientists to understand the link between emotions and the sensory descriptors of chocolate-based biscuits. Investigating the association between the emotional responses and sensory attributes of sweet baked products could benefit product developers when formulating food products for specific target markets and aid in the understanding of the emotional profile of food products.

Cregg Report – the Major Messages for 2021 in IBD

SARS-CoV-2 is not the only news! In IBD, the year 2021 has been rich in novelties. The SEAVUE study, although negative, appears to show that ustekinumab is as effective as adalimumab as first line treatment in Crohn’s disease. The STARDUST study studying the interest of treat-to-target under ustekinumab is also negative, but above all teaches us that treat-to-target is almost becoming a “standard of care”. Of course, the subcutaneous forms of infliximab and vedolizumab are there and will profoundly change our practice. Ultra-processed foods are definitely not only of no interest, but are also associated with an increased risk of developing IBD! Finally, ultrasound continues to prove, if needed, its value in the diagnosis and monitoring of IBD. And let’s not forget that a first episode of proctitis is an STI until proven otherwise.

Poor sleep quality is associated with an impaired eating pattern during the pandemic: a population-based study, COVIDInconfidentes

Introduction: During the pandemic, changes resulting from social and routine restrictions may have led to a change in sleep quality patterns. Furthermore, poor sleep quality may result in increased hunger and food intake, especially of ultraprocessed foods. Objective: To evaluate the association of sleep quality with food consumption pattern during the COVID-19 pandemic. Methods: Cross-sectional, population-based study, between October and December 2020 in two medium-sized cities in Minas Gerais. Sleep was assessed by the Pittsburgh Sleep Quality Index, with a global score from 0 to 21. Scores of 5-10 indicate poor sleep quality and greater than 10, a possible sleep disorder. The unhealthy eating indicator was designed according to food processing, unprocessed (fruits, vegetables and legumes, milk, and beans) and ultra-processed (processed meats, sweets, instant noodles, and soft drinks). Unprocessed foods consumed daily, and ultra-processed foods consumed never received the lowest score (zero). The highest score (four points) was received by unprocessed foods never, and ultraprocessed foods daily. The total score ranged from 0 (best) to 32 points (worst quality). It was subsequently categorized into quartiles and grouped to dichotomized variable: unhealthy food (2nd to 4th quartile;> 5 points) and healthy (1st quartile;< 4 points). Multiple logistic regression was used to verify the association of sleep quality with dietary consumption pattern. Results: Of the individuals evaluated, most were female (51.9%), black or brown (67.9%), with minimum high school education (56.5%), and family income below 5 minimum wages (60.4%). The food score ranged from 0 to 24 points, and 76.8% had an unhealthy eating pattern. Regarding sleep, 38.6% had poor quality, and 13.9% sleep disorder. In multivariate analysis, adjusted for sex, age, and income, subjects with poor sleep quality had 1.81 times the chance of having an unhealthy eating pattern (OR=1.81;95% CI 1.25- 2.62), and those with sleep disturbance had 2.28 times the chance of having an unhealthy eating pattern (OR=2.28;95% CI: 1.27-4.10). Conclusion: Individuals with poor quality and sleep disorders are more likely to have unhealthy eating during the pandemic of COVID-19. This study demonstrates the importance of investigating the repercussion of the pandemic on sleep and eating habits, and worsening health status of these individuals.

Changes in sleep and diet of adolescent during COVID-19 pandemic

Introduction: In addition to the challenges commonly observed in adolescence, it is noteworthy that the COVID-19 pandemic may have caused even more changes in the routine of young people. It is known that lack of physical activity, inadequate nutrition and excessive use of screens can impair sleep quality, which can cause poor school performance and even compromise physical and mental health. Objective: To evaluate whether there was any change in the diet and sleep of adolescent schoolchildren during the COVID-19 pandemic. Methods: This is an observational, prospective field study, in which students were subjectively evaluated with an online anamnesis. We evaluated 75 students (63% girls), with an average of 15.9 (±1.0) years old, which were studying at the first (36%), second (23%) or third year (41%) of high school (HS) from a private school in Americana-SP. Results: When asked about changes during the COVID-19 pandemic, 52 (69%) students said that they had noticed changes in diet. Of these, 15 (29%) indicated increased consumption of ultra-processed foods with higher caloric density, 13 (25%) indicated feeling less hungry and consequently eating less, 12 (23%) improved the quality of food and 9 (17%) increased food consumption compared to before the pandemic. As for sleep, 42 students (56%) observed changes during the pandemic, with 8 (19%) students noticing that they are sleeping less, 7 (17%) are sleeping more, 7 (17%) observed that sleep is unregulated and 7 (17%) that sleep is affected by anxiety and insomnia. The 2nd year HS students were the ones who most observed changes in sleep (71%) and diet (82%) during pandemic, followed by 3rd year students (55% changes in sleep and 71% in diet). When asked about the quality of sleep, 14 (33%) students said they do not sleep well because they sleep for a short time and have “unregulated” sleep, seven (17%) said they sleep well only sometimes, four (10%) said they did not sleep well because of anxiety, two (5%) because of insomnia and one student (2%) said that he didn't sleep well because he woke up several times during the night. When we evaluated the usual time for going to bed and waking up before and after the pandemic, it was noted that most students went to sleep and woke up later in the pandemic. Conclusion: It is concluded that there were changes in sleep and diet habits during the pandemic, with changes in sleep reflecting a lower sleep quality, while positive and negative changes were reported in diet.

Food promoted on an online food delivery platform in a Brazilian metropolis during the COVID-19 pandemic: a longitudinal analysis.

OBJECTIVE: To analyse food advertised on an online food delivery (OFD) platform during 16 weeks of the COVID-19 pandemic in Brazil. DESIGN: Longitudinal study. We randomly selected foods advertised on the OFD app's home page, classifying the food items into water; natural juices and smoothies; vegetables; fruits; traditional meals and pasta; ultra-processed beverages; ice cream and candies, and salty packaged snacks; sandwiches; savoury snacks; and pizza. We also registered the marketing strategies used to promote the food items, such as photos, discounts, 'combo deals', and messages on healthiness, value for the money, tastiness, and pleasure. SETTING: Belo Horizonte, Minas Gerais, Brazil. PARTICIPANTS: 1,593 food items. RESULTS: In general, the OFD platform most commonly promoted traditional meals and pasta, ultra-processed beverages, and sandwiches-these food groups were offered 20-25% of the time during the 16 weeks. There were no promotions for water during the whole period, and the least common promotions were those for natural juices and smoothies, vegetables, and fruits (<5%). The most common food promotion strategies were photos (>80%) and discounts (>95%), while approximately 30% of the offers featured combo deals. Messages on tastiness, pleasure, and value for the money varied from 15% to 40%. CONCLUSION: Although the OFD platform offered traditional meals and pasta, most of the foods and beverages advertised were unhealthy and promoted with persuasive strategies. This finding highlights a growing public health concern: an increase in unhealthy eating patterns during the pandemic.

Food insecurity and ultra-processed food consumption: the modifying role of participation in the Supplemental Nutrition Assistance Program (SNAP).

BACKGROUND: Ultra-processed foods contribute to risks of obesity and cardiometabolic disease, and higher intakes have been observed in low-income populations in the United States. Consumption of ultra-processed foods may be particularly higher among individuals experiencing food insecurity and participating in the Supplemental Nutrition Assistance Program (SNAP). OBJECTIVES: Using data from the 2007-2016 NHANES, we examined the associations between food insecurity, SNAP participation, and ultra-processed food consumption. METHODS: The study population comprised 9190 adults, aged 20-65 y, with incomes ≤300% of the federal poverty level (FPL). Food insecurity was assessed using the Household Food Security Survey Module and SNAP participation over the past 12 mo was self-reported. Dietary intake was measured from two 24-h dietary recalls. Ultra-processed food consumption (percentage of total energy intake) was defined using the NOVA food classification system. Linear regression models were used to examine the associations between food insecurity, SNAP participation, and ultra-processed food consumption, adjusting for sociodemographic and health characteristics. RESULTS: More severe food insecurity was associated with higher intakes of ultra-processed foods (P-trend = 0.003). The adjusted means of ultra-processed food intake ranged from 52.6% for adults with high food security to 55.7% for adults with very low food security. SNAP participation was also associated with higher intakes of ultra-processed foods (adjusted mean: 54.7%), compared with income-eligible participants (adjusted mean: 53.0%). Furthermore, the association between food insecurity and ultra-processed foods was modified by SNAP participation (P-interaction = 0.02). Among income-eligible nonparticipants and income-ineligible nonparticipants, more severe food insecurity was associated with higher consumption of ultra-processed foods. Among SNAP participants, the association between food insecurity and consumption of ultra-processed foods was nonsignificant. CONCLUSION: In a nationally representative sample of adults, food insecurity and SNAP participation were both associated with higher levels of ultra-processed food consumption.

The relationship between diet quality and the severity of household food insecurity in Canada.

OBJECTIVE: To examine the relationship between the dietary quality of Canadian children and adults and household food insecurity status. DESIGN: Dietary intake was assessed with one 24-h recall. Households were classified as food secure or marginally, moderately or severely food insecure based on their responses to the Household Food Security Survey Module. We applied multivariable analyses of variance to determine whether % energy from ultra-processed foods, fruit and vegetable intake, Healthy Eating Index (HEI) scores, macronutrient composition and micronutrient intakes per 1000 kcal differed by food insecurity status after accounting for income, education and region. Analyses were run separately for children 1-8 years and 9-18 years and men and women 19-64 years of age. SETTING: Ten provinces in Canada. PARTICIPANTS: Respondents to the 2015 Canadian Community Health Survey-Nutrition, aged 1-64 years, with complete food insecurity data and non-zero energy intakes, N 15 909. RESULTS: Among adults and children, % energy from ultra-processed foods was strongly related to severity of food insecurity, but no significant trend was observed for fruit and vegetable intake or HEI score. Carbohydrate, total sugar, fat and saturated fat intake/1000 kcal did not differ by food insecurity status, but there was a significant negative trend in protein/1000 kcal among older children, a positive trend in Na/1000 kcal among younger children and inverse associations between food insecurity severity and several micronutrients/1000 kcal among adults and older children. CONCLUSIONS: With more severe household food insecurity, ultra-processed food consumption was higher, and diet quality was generally lower among both adults and children.

Changes to eating and activity behaviors during the COVID-19 pandemic in persons with food addiction

Background: Prior studies have demonstrated the effects of the COVID-19 pandemic on weight management and lifestyle behaviors, though identification of who may be at greatest risk for negative consequences has not been fully explored. Addictive-like eating behavior, or food addiction, has been associated with an array of problematic eating behaviors, which may suggest heightened susceptibility to poorer outcomes. Methods: Participants (n = 288) in this online, cross-sectional study completed questionnaires in February, 2021 assessing food addiction and reported changes to their weight, eating, and physical activity before and during the COVID-19 pandemic. Results: Individuals with food addiction gained an average of 12.42 lb (5.63 kg) since March 2020, compared to an average weight gain of 2.14 lb (.97 kg) for those without food addiction (p < .001). Linear regression analyses controlling for age and body mass index (BMI) showed that food addiction was independently associated with higher weight gain (B = 9.28, t = 4.97, p < .001), greater intake of ultra-processed foods before and during COVID-19 (B = 1.08, t = 5.71, p < .001;B = 1.18, t = 6.42, p < .001, respectively), greater attribution of their overall current eating behaviors to COVID-19 circumstances (B = 23.19, t = 4.62, p < .001), and higher distress about their overall current eating behaviors (B = -22.12, t = -2.50, p = .01). Interaction effects demonstrated that individuals with food addiction who are older may be at particularly high risk for weight gain and distress. Conclusions: The present research suggests that food addiction is a uniquely meaningful phenotype, beyond the effects of BMI, to identify risk for the negative consequences of the COVID-19 pandemic. Individuals with food addiction, particularly those who are older, may benefit from support with weight management and addictive-like eating as the COVID-19 pandemic persists and resolves.

The Influence of the COVID-19 Pandemic on the Food Supply in the Emergency Food System: A Case Study at 2 Food Pantries.

BACKGROUND: The onset of the coronavirus disease 2019 (COVID-19) pandemic increased demand for emergency food assistance and has caused operational shifts in the emergency food system. OBJECTIVE: This research explored how the initial phase of the COVID-19 pandemic influenced the food supply of 2 food pantries. METHODS: A case study approach was applied to collect data during the initial phase of the COVID-19 pandemic. Food supply data were collected weekly at 2 food pantries in southwest Montana for 17 wk in 2020. Surveys and interviews were conducted with food pantry clients and staff, respectively. Descriptive statistics and inferential statistics were applied to analyze quantitative data. Food supply data were analyzed using the Healthy Eating Index (HEI)-2015, NOVA system, and Unprocessed Pantry Project (UP3) Framework. Thematic analysis was applied to qualitative data. RESULTS: The food boxes collected between the 2 food pantries (n = 43) had a mean (± SD) total HEI-2015 score of 76.41 ± 7.37 out of a possible score of 100. According to both the NOVA and the UP3 Framework, 23.4% of the total food distributed was ultra-processed food. Of the food distributed, 50.0% and 48.3% was fresh, unprocessed food according to NOVA and UP3 Frameworks, respectively. From staff interviews, 3 themes arose that describe the food pantry operations that experienced change during the COVID-19 pandemic, including food procurement, distribution preparation, and food distribution. Nine supporting subthemes describing the causes and consequences of the operational themes were identified. Staff perceived that the nutrient quality of the food boxes increased from food distributed previously to the COVID-19 pandemic, whereas over one-third (39.4%) of food pantry clients who responded to surveys preferred the food box model. CONCLUSIONS: The COVID-19 pandemic has caused enormous operational challenges within food pantries. Food pantries overcame these challenges by swiftly and effectively altering operations so as to continue to distribute nutritious food boxes to pantry clients.

Changes in ultra-processed food consumption during the first Italian lockdown following the COVID-19 pandemic and major correlates: results from two population-based cohorts.

OBJECTIVE: To evaluate changes in ultra-processed food (UPF) intake and its major correlates during the first Italian lockdown (9 March-3 May 2020). DESIGN: Retrospective observational study. SETTING: Italy. PARTICIPANTS: We analysed 2992 subjects (mean age 57·9 ± 15·3 years, 40·4 % men). Individual participant data were pooled from two retrospective cohorts: (1) The Moli-LOCK cohort consists of 1501 adults, a portion of the larger Moli-sani study (n 24 325; 2005-2010) who were administered a phone-based questionnaire to assess lifestyles and psychological factors during confinement and (2) the Analysis of Long Term Risk of Covid-19 Emergency is a web-based survey of 1491 individuals distributed throughout Italy who self-responded to the same questionnaire by using Google forms.UPF was defined according to NOVA classification based on degree of food processing. An UPF score was created by assigning 1 point to increased consumption, -1 to decreased and 0 point for unchanged intakes of nineteen food items, with higher values indicating an increase in UPF during confinement. RESULTS: Overall, 37·5 % of the population reported some increase in UPF (UPF score ≥1). Adults were more likely to decrease UPF (multivariable regression coefficient ß = -1·94; 95 % CI -2·72, -1·17 for individuals aged >75 years as compared with 18-39 years) as did individuals from southern Italian regions as compared with Northern inhabitants (ß = -1·32; 95 % CI -1·80, -0·84), while UPF lowering associated with increased exercise (ß = -0·90; 95 % CI -1·46, -0·35) and weight loss (ß = -1·05; 95 % CI -1·51, -0·59) during confinement. CONCLUSIONS: During the first Italian lockdown, about 40 % of our population switched to unfavourable eating as reflected by increased UPF intake and this may have long-term effects for health.

Nutritional Inadequacies Among Post-bariatric Patients During COVID-19 Quarantine in Sao Paulo, Brazil.

Post bariatric control of food intake is influenced by psychological and behavioral factors. We investigated dietary habits and food intake during COVID-19 quarantine among recently operated patients. Patients were assessed for total and per meal energy and macronutrient intake as well as frequency of food consumption per processing level. Patients were also classified according to adherence to nutritional recommendations from our outpatient clinic. Main results are indicative of inappropriate nutritional intake during COVID-19 quarantine in postoperative bariatric patients. We observed that many patients failed to meet the recommended protein intake (89.2%) along a relatively high intake of ultra-processed foods (~1/4 of the diet). Our data suggest the need for the implementation of strategies to extend nutritional care to at-risk patients during social distancing.