The health of adolescents returning to face-to-face school activities after two years of the Covid-19 pandemic - school-based cross-sectional study in Pelotas/RS / A saúde de adolescentes na volta às atividades escolares presenciais após dois anos de pandemia do Covid-19 ­ estudo transversal de base escolar em Pelotas/RS / La salud de los adolescentes que retornan a las actividades escolares presenciales después de dos años de la pandemia de Covid-19 - estudio transversal escolar en Pelotas/RS

O objetivo do estudo foi comparar a percepção sobre a massa corporal, comportamentos relacionados à saúde, e a saúde mental de escolares adolescentes durante o período de retorno às atividades escolares presenciais com o período anterior à pandemia de COVID-19. O estudo foi realizado com 425 escolares (16,96±1,39 anos; 60,2% do sexo feminino) selecionados aleatoriamente de escolas das redes pública e privada de Pelotas/RS. Para a coleta dos dados foi utilizado um questionário de autopreenchimento contendo perguntas retrospectivas e atuais sobre as variáveis analisadas. Os resultados indicaram que a percepção sobre a massa corporal, o nível de atividade física, o tempo de sono, e a saúde mental (apenas para as meninas) estão piores (p<0,05) no momento atual quando comparados ao período anterior à pandemia. Por outro lado, hábitos alimentares e tempo de tela recreativo apresentaram melhores resultados (p<0,05) no momento atual do que no período anterior à pandemia. Estes resultados mostram um complexo panorama em relação à saúde de adolescentes no período de retomada das atividades presencias, tornando o retorno às atividades escolares presenciais um desafio para os próprios adolescentes, seus familiares, para professores, e para as escolas.

The aim of this study was to compare the perception of body mass, health- related behaviors and mental health of adolescent schoolchildren during the period of return to face to face school activities with the period before COVID-19 pandemic. The study was carried out with 425 students (16.96±1.39 years; 60.2% female) randomly selected from public and private schools in Pelotas/RS. For data collection, a self-completion questionnaire was used, containing retrospective and current questions about analyzed outcomes. The results indicated that the perception of body mass, level of physical activity, sleep time, and mental health (only for girls) are worse (p<0.05) at present when compared to the period before the pandemic. On the other hand, eating habits and recreational screen time showed better results (p<0.05) at present than in the period before the pandemic. These results show a complex panorama concerning the health of adolescents in the period of resumption of face to face activities, making this return a challenge for the adolescents themselves, their families, teachers and for schools.

El objetivo de este estudio fue comparar la percepción de masa corporal, comportamientos relacionados a la salud y salud mental de escolares adolescentes durante el período de retorno a las actividades escolares presenciales con el período anterior a la pandemia de COVID-19. El estudio fue realizado con 425 alumnos (16,96±1,39 años; 60,2% del sexo femenino) seleccionados aleatoriamente de escuelas públicas y privadas de Pelotas/RS. Para la recolección de datos, se utilizó un cuestionario auto-completado, conteniendo preguntas retrospectivas y actuales sobre los resultados analizados. Los resultados indicaron que la percepción de la masa corporal, el nivel de actividad física, el tiempo de sueño y la salud mental (sólo para las niñas) son peores (p<0,05) en la actualidad en comparación con el período anterior a la pandemia. Por otro lado, los hábitos alimentarios y el tiempo de pantalla recreativo mostraron mejores resultados (p<0,05) en la actualidad que en el periodo anterior a la pandemia. Estos resultados muestran un panorama complejo en relación a la salud de los adolescentes en el período de reanudación de las actividades presenciales, haciendo de este retorno un desafío para los propios adolescentes, sus familias, profesores y para las escuelas.

Health-related factors of the Iraqi adult population during the 2020 COVID-19 pandemic: physical activity, eating behavior, quality of life, general health, and mood states cross-talk.

BACKGROUND: The lockdown and social distancing caused by Coronavirus disease 2019 (COVID-19) may have changed Physical Activity Level (PAL), eating behavior, and health habits due to long-term confinement worldwide. OBJECTIVE: This study aimed to evaluate the PAL, eating behavior, Quality of Life (QoL), General Health (GH), and mood states during COVID-19 confinement in a large sample of Iraqi adults. METHODS: 3738 healthy adults (age 18-70 years) residing in Halabjeh, Iraq answered the online questionnaires including the short form of international physical activity, GH, three-factor eating (TFEQ-R18), and a short form of the profile of mood states (POMS-SF) questionnaires. Data analysis was done by Chi-square, and Spearman's correlation using SPSS statistical software at a significant level of (P < 0.05). RESULTS: The results showed unfavorable PAL, eating behavior, QoL, GH, and mood states in the total population. Low PAL was observed in 69.96% of the men and 75.99% of the women; only 3.60% of the men and 0.77% of the women had a high PAL. There was a significantly positive relationship between low PAL and the incidence of COVID-19 both in men and women (P = 0.801; r = 0.001; and P = 0.682; r = 0.011), respectively; While a significant negative relationship was observed between the moderate and high PAL and the incidence of COVID-19 in men (P = 0.011; r=-0.682 and P = 0.027, r=-0.589), and women (P = 0.001; r=-0.796 and P = 0.018, r=-0.623). No significant relationships were observed between PAL and eating behavior (men: P = 0.086; r = 0.256 and women: P = 0.365, r=-0.121); While, the results show significant positive relationships between PAL with QoL in men (P = 0.012; r = 0.623) and women (P = = 0.001; r = 0.837). based on the results, significant negative relationships between PAL with GH and mood state scores were observed in both men (P = 0.001; r=-0.837 and P = 0.001, r=-0.786) and women (P = 0.010; r=-0.652 and P = 0.001, r=-0.745), respectively. CONCLUSIONS: The Iraqi adult population showed low PAL, GH, QoL, and mood state during COVID-19 which might be due to the confinement. Also, the significant relationships between low PAL with GH, and mood state recommends physical activity as a valuable health optimizing factor during the COVID-19 pandemic.

Analysis of Determinants of Food Preferences in a Polish Population-Based Sample of Primary School Adolescents: Diet and Activity of Youth during COVID-19 (DAY-19) Study.

For the choices of food products, food preferences are crucial, as they influence the intake of nutrients and the resultant quality of diet, but in Poland, no studies of food preferences were conducted during the COVID-19 pandemic on a population of young adolescents. The aim of this study was to analyze the determinants of food preferences in a Polish population-based sample of primary school adolescents as part of the Diet and Activity of Youth during COVID-19 (DAY-19) Study. The DAY-19 Study focused on a national sample of a population of primary school adolescents who were recruited based on cluster sampling of participants from counties and schools, yielding a sample of 5039 individuals. Their food preferences were assessed using the Food Preference Questionnaire (FPQ), and they were compared in subgroups stratified by (1) gender: male and female; (2) age: younger (10-13 years) and older (14-16 years); (3) place of residence: urban and rural; (4) Body Mass Index (BMI): underweight, normal body weight, and overweight/obese (assessed based on Polish growth reference values); and (5) physical activity level: low and moderate (assessed using the International Physical Activity Questionnaire for children aged 10-13 (IPAQ-C) and adolescents aged 14-16 (IPAQ-A)). In the population of adolescents, no statistically significant differences in food preferences between subgroups stratified by gender were observed (p > 0.05). For boys, none of the studied factors (age, place of residence, BMI, physical activity level) was statistically significant determinant of food preferences (p < 0.05), while for girls, all of them were statistically significant determinants (p > 0.05). All the assessed factors (age, place of residence, BMI, physical activity level) in girls were associated with preferences for snacks, and older girls, those from a rural environment, those who were underweight and overweight/obese, as well as those having a low physical activity level declared a higher preference for snacks than younger ones (p = 0.0429), those from an urban environment (p = 0.0484), those of a normal body weight (p = 0.0091), and those having a moderate physical activity level (p = 0.0083). Similarly, girls from rural environments declared a higher preference for starches than those from urban environments (p = 0.0103), and girls having a low physical activity level declared a higher preference for fruit than those having a moderate physical activity level (p = 0.0376). Taking this into account, the population of girls, in particular, needs dedicated educational actions to support proper nutritional habits. Additionally, older age, living in a rural environment, being underweight and overweight/obese, and having a low physical activity level may be indicated as factors predisposing one to food preferences potentially promoting unhealthy dietary habits.

"If I start panicking over having enough, then I start eating too much": Understanding the eating behaviors of SNAP recipients in larger bodies during COVID-19.

BACKGROUND/OBJECTIVE: Living in a food-insecure household may increase the risk for disordered eating. Though the Supplemental Nutrition Assistance Program (SNAP) was designed to reduce food insecurity, it may increase risk for disordered eating with the frequency in which benefits are distributed. Limited research has explored the lived experiences of managing eating behaviors while on SNAP, particularly among SNAP participants in larger bodies, and during COVID-19. Thus, the purpose of this study is to examine the experiences with eating behaviors among adults with a BMI ≥ 25 kg/m2, and who received SNAP benefits during the COVID-19 pandemic. METHODS: Eligible adults were recruited to participate in a semi-structured interview. Interviews were transcribed verbatim and analyzed using thematic analysis and content analysis. RESULTS: Participants (N = 16), had a mean (±SD) age of 43.4 ± 10.9 years, and overwhelmingly identified as female (86 %). One-third of the participants were Black. We identified 4 main themes: (1) not having enough money/benefits to cover needs; (2) navigating loss of control and emotional eating; (3) making sure the kids are alright; and (4) still feeling the pressure to manage weight. CONCLUSION: Managing eating behaviors while also navigating SNAP benefits is complex and may exacerbate risk of disordered eating.

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.

Lifestyle Changes during the SARS-CoV-2 Pandemic as Predictors of BMI Changes among Men and Women in Poland.

BACKGROUND: Social isolation during the SARS-CoV-2 pandemic affected people's body weight, therefore, this study was designed to evaluate the association between lifestyle elements and the change in BMI during lockdown. METHODS: This retrospective observational study involved 290 questionnaires completed by adult participants divided into three groups according to BMI change during isolation. The structured questionnaire included a general description of the study objective and collected data regarding sociodemographics, anthropometrics, physical activity, sedentary behaviour, sleep duration, and food intake pre- and during COVID-19 lockdown. RESULTS: A decrease or increase in BMI was found in 23.6% and 47.8% of women and 18.5% and 42.6% of men, respectively. Among those who lost weight, 46.5% of women and 40% of men followed a diet of their own choice, 30.2% of women and 25% of men changed their product mix and reduced their intake, 40% of men stopped eating outside the home. An increase in BMI was associated with increased food intake (32.2% of women and 28.3% of men), increased sleep duration on weekdays (49.2% of women and 43.5% of men) and, in more than 50% of subjects, decreased physical activity. In women, increased BMI was associated with the highest frequency of snacking (p = 0.0003), the highest intake of sweets (p = 0.0021), and in men with the highest intake of alcohol (p = 0.0017). CONCLUSIONS: The observed changes in BMI during social isolation were the result of lifestyle modifications including dietary behaviour and differed by gender.

Lifestyle and Dietary Patterns during the COVID-19 Lockdown in Bahrain: A Web-Based Cross-Sectional Study.

Lifestyle factors such as dietary habits, perceived weight, sleep, and physical activity worsened during the COVID-19 pandemic. Through this study, we aimed to understand the impact of COVID-19 on these lifestyle factors in Bahrain. A cross-sectional study was conducted among 1005 adult Bahrainis. Data were collected online using a structured and validated questionnaire for the assessment of eating habits, physical activity, and lifestyle during the COVID-19 pandemic. Participants were snowballed through those who agreed to answer the online questionnaire. There was a higher consumption of fast food, and a higher dependence on takeaways during the COVID-19 pandemic. About 63.5% of the participants consumed >4 meals per day, compared to 36.5% before the COVID-19. About 30% reported consumption of sugar sweetened beverages from two to three times a day. Weight loss was predominantly observed in persons exercising 1-3 times a week. The consumption of sugar-sweetened beverages was also high, with about 19% reporting drinking sweet beverages once every day, 10.6% from two to three times a day, and 40.4% from one to four times a week. A higher proportion of the participants reported poor sleep quality during the pandemic (31.2%) compared to before (12.2%), and 39.7% of the participants reported feeling lazy. Screen time use also doubled during the pandemic, with participants spending more than five hours per day on screens for entertainment, which went from 22.4% before to 51.9% during the pandemic. The lifestyle and dietary habits changed drastically for our study participants during the pandemic. The increased reliance on processed fast food instead of healthier options is a challenge to be tackled in any future pandemic situation. Future research needs to focus on strategies to promote healthier lifestyle modifications during situations such as the COVID-19 pandemic.

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.

Post-Pandemic Feeding Patterns and Mediterranean Diet Adherence in Spanish Toddlers.

During the last decade, feeding patterns, more specifically those of children, have worsened-affecting dietary habits and Mediterranean diet adherence. Here, we examine the post-pandemic feeding habits of Spanish toddlers. A total of 2465 parents of children aged between 12 and 36 months completed an online 25-item multiple-choice survey asking about dietary habits and Mediterranean diet adherence. Only 34 children (1.38%) had an adequate intake of all of the food groups included in the questionnaire. Adherence worsened as toddlers grew (p < 0.0001). Further, lower compliance was found in children with a higher intake of fast food (p < 0.001), those with siblings (p = 0.0045), and children who were the second or third child (p = 0.0005). The food group with the most commonly reported adequate intake was fish (88% of children), followed by pulses (80%), water (79%), and meat (78%). Cow's milk was the most commonly consumed dairy product among all age groups analyzed. Half of the children exhibited a low consumption of milk and dairy products. These results showed that a lack of adherence to a balanced diet is common among Spanish toddlers in the post-pandemic period and that greater parent education could improve the nutrition of toddlers.

Nutrition, physical activity and psychological status during lockdown due to Covid-19

Aim of the present study was to assess physical activity, nutrition and psychological status of the population during lockdown due to covid-19. Online survey was conductedamong 534 participants within the age range of 16-78 years using convenient sampling. Participantsfrom varied regions within India and abroad were enrolled for the present study. Volunteered participants were solicited to take part in a survey that has to be carried out by filling an online questionnaire form available to them as a URL link in the invitation through WhatsApp/Messenger. The gathered data has been compiled, coded and cleaned using Microsoft Excel. Analysis has been carried out employing descriptive and inferential statistics in SPSS 17.0.Majority of participants in the studied population showed significant change in their nutrition and physical activity status due to lockdown. Covid-19 lockdown did limit their daily activities. It also had impacted their psychological status.The current investigation accentuates the need to pursue suitable life style for the maintenance of optimum metabolism and physiology. Sticking to more regular timetable of meals, effective management of stress levels and continued physical activity during the quarantine and in all the following phases of living is desirable.

Impact of Final Phase Social Isolation and the COVID-19 Pandemic on Eating Behavior, Sleep Quality, and Anxiety Level.

The coronavirus disease 2019 (COVID-19) pandemic has resulted in economic, social, and behavioral changes in people, which may favor several long-term consequences. This study evaluated the effects of the COVID-19 pandemic on eating behavior and mental health in the final phase of social isolation. This cross-sectional study included 756 adults that completed an online questionnaire. Individuals were stratified into those who had been infected with COVID-19 (GCOV) and those who did not (GNCOV). The GCOV group had higher weight (p = 0.013), body mass index (BMI) (p = 0.005), anxiety levels (p = 0.040), sleep disorders (p = 0.009), and poorer sleep quality (p = 0.0028). In the GCOV, the consumption of ultra-processed foods was associated with higher anxiety levels and poorer sleep quality. A higher proportion of individuals who consumed more than five servings of in natura food was observed in the group with taste and olfactory dysfunction than in the group without. Obesity contributes to uncontrolled and emotional eating disorders, increased anxiety, and worsened sleep. Therefore, COVID-19 impaired mental health and eating behavior even in the long term. These changes were potentiated by the presence of obesity and consumption of ultra-processed foods, evidencing the importance of monitoring these individuals even after the resolution of COVID-19.

Weight Gain, Lifestyle, and Cognition During the COVID-19 Pandemic in Southern Brazil.

BACKGROUND: During the COVID-19 pandemic, the world experienced social distancing that resulted in changes in habits and lifestyle. Such changes can compromise healthy eating habits and the practice of physical activities, known risk factors for developing weight gain and obesity. OBJECTIVE: The main objective of this study was to describe the change in eating habits, lifestyle, and cognition of the population of Rio Grande do Sul, a state in Southern Brazil, during social distancing due to COVID-19. METHODS: The study was conducted from July 21 to August 10, 2020, through a structured online questionnaire that asked for sociodemographic information (age, gender, and education), anthropometric (reported weight and height), change in eating habits, lifestyle (sleep quality and physical activity), and cognition. Chi-square, McNemar tests, and univariate and multivariate analysis were used to evaluate the variables. Confidence intervals were calculated with a significance level of 5%. RESULTS: Of a total of 1072 participants, 57.3% of respondents reported weight gain, and an increased percentage of people were classified as obese. Nearly half of the participants (46%) reported changes in their eating habits for the worse. Body mass index (BMI) was significantly associated with increased consumption of unhealthy foods. Our results identified high physical inactivity (46.9%) and obesity (19%) during social distancing. The changes in eating habits and lifestyle also increased the risk for decreased cognition. CONCLUSIONS: These findings highlighted that social distancing impacted eating habits and lifestyle, which increased obesity rates and might predispose to decreased cognition.

Changes in food and nutrient intakes in Korean adults before and during the COVID-19 pandemic: data from the 2011-2020 Korea National Health and Nutrition Examination Survey.

OBJECTIVES: This study was to examine the changes in dietary habits and food and nutrient intakes between before (2019) and during (2020) the coronavirus disease 2019 (COVID-19) pandemic from the Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: A total of 54,995 participants aged ≥19 years who participated in the 2011-2020 KNHANES were included. The 10-year trend (2011-2020) and differences between 2019 and 2020 for dietary habits and food and nutrient intakes were estimated using SAS. RESULTS: In the past 10 years (2011-2020), the dietary habits (increase in skipping meals and eating out), food intake (increase in meats and decrease in fruits and vegetables), and nutrient intake (increase in fat and decrease in sodium) in adults have changed. When comparing between 2019 and 2020, there were 4.6%p decrease in the eating out more than once a day. On the other hand, there were no significant differences in the intakes of food, energy and most of nutrients between 2019 and 2020, except for the proportion of energy intake from fat (1.0%p increase) and carbohydrate (1.0%p decrease). CONCLUSIONS: Although a change in dietary habits from before to during the COVID-19 pandemic was observed, food and nutrient intakes have not deteriorated markedly and appear similar to the trends in the past 10 years. Throughout the COVID-19 pandemic, it is necessary to monitor the effects of changes in dietary habits on health as well as food and nutrient intakes.

Changes in Food Consumption Trends among American Adults since the COVID-19 Pandemic.

The quality and quantity of food consumption have changed due to the COVID-19 pandemic. In this study, we examined how the COVID-19 pandemic has changed the consumption of different food groups in order to close the research gap by providing current evidence that reflects a later stage of the pandemic compared to other circulating research conducted at earlier stages. Data collection for this cross-sectional study was performed via an online Qualtrics survey from 10,050 adults aged 40-100 years. Nutritional status was measured using the 24-item short-form Dietary Screening Tool (DST) twice: before and since the COVID-19 pandemic. The DST questions were categorized based on MyPlate items, along with fat, sugar, and sweet items, as well as nutritional supplement intake. In addition, the total DST score was calculated for each participant, which categorized them into one of three groups: "at risk", "possible risk", and "not at risk". The results revealed that the consumption of grains, fruit, lean protein, and dairy decreased significantly, while the consumption of fat, sugar, and sweet items increased significantly due to COVID-19. The biggest decreases in consumption of food subcategories were related to whole grain bread and cereal, followed by fruit as a snack, in comparison with other types of grain and fruit. No changes in the consumption of vegetables, processed meat, or supplement intake were seen. The total DST score showed that, before and since COVID-19, the overall nutrition status of adult Americans has been at risk. In addition, of those participants who were not at risk before COVID-19, 28.5% were either at risk or at possible risk since COVID-19; moreover, of those participants who were at possible risk before COVID-19, 21% were at risk since COVID-19. As a good nutritional status can reduce the risk of severe illness or even mortality rate in times of crisis, the findings of this study can help policymakers and health educators to develop heath-protecting behavior sessions against future pandemics to manage crises.

Impact of the COVID-19 Pandemic on Nutrition, Sleep, Physical Activity, and Mood Disorders of Polish Children.

The harmful consequences of the COVID-19 pandemic on children are its impact on eating habits, physical activity, sleep, and mood disorders. In the future, this may result in a higher prevalence of obesity and diet-related diseases. Therefore, this study aimed to assess the impact of the COVID-19 pandemic on children's eating behavior and lifestyle. The study was conducted using a proprietary questionnaire on dietary and lifestyle habits before and during the pandemic, and the reasons for changes due to the pandemic. The study involved 294 parents of children in grades 1-8 in elementary schools in two regions of Poland. The survey showed that during the pandemic, the percentage of children eating five regular meals daily, including fruits and vegetables, and engaging in daily physical activity decreased. However, the percentage of children spending more than 4 h a day in front of a screen increased (p < 0.05). The main reasons for changes in eating habits and physical activity were less eating out, lack of motivation, obstruction, and lack of access to sports facilities (p < 0.05). The pandemic had a significant impact on reduced levels of physical activity and increased time spent in front of a screen. In summary, among the reasons for changes in children's dietary and lifestyle habits, factors related to the pandemic itself, i.e., social restrictions, restrictions, closure of schools and other facilities, and fear of coronavirus infection, had the greatest impact.

[Evolution of the diet and physical activity of university students after the COVID-19 pandemic]. / Evolución de la dieta y la actividad física de los estudiantes universitarios tras la pandemia de COVID-19.

Introduction: Objective: to assess the evolution of adherence to Mediterranean diet and level of physical activity of university students of Health Sciences in Castilla-La Mancha during the COVID-19 lockdown and one year afterwards. Methods: a cross-sectional observational study using questionnaires on adherence to the Mediterranean diet and level of physical activity. A total of 893 students enrolled in Health Sciences degrees at the University of Castilla la Mancha participated, 575 in the first survey (during the lockdown) and 318 in the second (one year later). By sex, 672 women and 221 men (in the first survey 77.7 % were women and 22.3 % men while in the second survey these were 70.8 % and 29.2 %, respectively). Adherence to the Mediterranean diet was assessed with the Mediterranean Diet Adherence Screener (MEDAS) questionnaire and the modified Prevention with Mediterranean Diet (PREDIMED) questionnaire. The level of physical activity was assessed with the Rapid Assessment of Physical Activity Scale (RAPA). Results: one year after the COVID-19 confinement, consumption of olive oil has almost tripled. Daily fruit consumption has also doubled. Similarly, the consumption of wine and alcoholic beverages has doubled. Conversely, there was a reduction in the consumption of butter and margarine, as well as of carbonated drinks and sweetened beverages. Likewise, the percentage of university students with high adherence to the Mediterranean diet increased significantly (from 26 % to 34.3 %). Regarding physical activity level, there was a significant increase in the percentage of university students who engaged in light, moderate and even intense physical activity on an irregular basis. This increase was not found in the case of muscular strength and flexibility training activities. Conclusion: the results of the study indicate that, although the levels of adherence to the Mediterranean diet and physical activity have improved after the COVID-19 confinement, adherence to Mediterranean diet and physical activity level among the university population analyzed is still low. It is necessary to implement strategies for the achievement or maintenance of a healthy lifestyle in this population.

Introducción: Objetivo: valorar la evolución de la adherencia a la dieta mediterránea y el nivel de actividad física de los estudiantes universitarios de Ciencias de la Salud de Castilla-La Mancha durante la pandemia de COVID-19 y un año después de la misma. Método: estudio observacional transversal mediante cuestionarios sobre la adherencia a la dieta mediterránea y el nivel de actividad física. Participaron 893 alumnos matriculados en grados de Ciencias de la Salud de la Universidad de Castilla-La Mancha, 575 en la primera encuesta (durante la pandemia) y 318 en la segunda (un año después). Por sexos, 672 mujeres y 221 hombres (en la primera encuesta, el 77,7 % eran mujeres y el 22,3 % hombres, mientras que en la segunda lo eran el 70,8 % y 29,2 %, respectivamente). La adherencia a la dieta mediterránea se valoró con el cuestionario Mediterranean Diet Adherence Screener (MEDAS) y el cuestionario de Prevención con Dieta Mediterránea (PREDIMED), modificado. El nivel de actividad física se valoró con el cuestionario Rapid Assessment of Physical Activity Scale (RAPA). Resultados: tras un año desde el confinamiento por la COVID-19, el consumo de aceite de oliva casi se ha triplicado. Se ha duplicado también el consumo de frutas diario. De igual modo, se ha duplicado el consumo de vino y bebidas alcohólicas. Por el contrario, se encontró una reducción del consumo de mantequilla y margarina, al igual que de bebidas carbonatadas y azucaradas. Asimismo, aumentó significativamente el porcentaje de estudiantes universitarios con adherencia alta a la dieta mediterránea (del 26 % al 34,3 %). En cuanto al nivel de actividad física, ha aumentado significativamente el porcentaje de estudiantes universitarios que realizan actividad fisica ligera, moderada e incluso intensa de forma irregular. Este aumento no se ha encontrado en el caso de las actividades de fuerza muscular y flexibilidad. Conclusión: los resultados del estudio nos indican que, aunque los niveles de adherencia a la dieta mediterránea y de actividad física han mejorado tras el confinamiento por la COVID-19, la adherencia a la dieta mediterránea y el nivel de actividad física de la población universitaria analizada siguen siendo bajos. Es necesario aplicar estrategias para la consecución o mantenimiento de un estilo de vida saludable en dicha población.

COVID-19 and early puberty-An unintended consequence of COVID-19 lockdown?

The novel coronavirus (SARS-CoV-2) causes the disease COVID-19, also termed as acute atypical pneumonia leading to respiratory failure. Children were more likely to spend time at home due to the lockdown mandated by governments as a preventive measure, which led to alterations in dietary habits and sleeping patterns which could have had a substantial influence on their sexual development, including but not limited to faster onset of puberty. Existing data suggested a plausible relationship between COVID-19 and early puberty. Obesity, physical activity, mental health, and birth weight are major risk factors that have further contributed to the early onset of puberty. In order to address such health crises affecting children, comprehensive solutions are urgently required. As COVID-19 continues to have multiple unpredictable health consequences, spreading awareness regarding this specific problem is of paramount importance.

Eating habits and lifestyle behaviors during COVID-19 lockdown: The Lebanese experience.

OBJECTIVES: This study aimed to assess dietary intake and lifestyle habits followed during the COVID-19 pandemic and subsequent lockdowns, as well as the level of adherence to the Mediterranean diet (MD), among a sample of the Lebanese population. METHODS: A cross-sectional study was conducted during the government-enforced lockdown. A validated, online, questionnaire was used to collect information about dietary and lifestyle habits. The Mediterranean diet adherence screener (MEDAS) was used to assess adherence to the MD. RESULTS: A total of 1684 participants responded to the survey. Their mean age was 23.92 ± 7.62 years, and 70.4% were females. Approximately a third of the participants reported that their dietary habits did not change and 42.3% acknowledged that their eating habits deteriorated during the lockdown. Participants smoked less and slept more during the lockdown compared to before it. Approximately 19.2% of the sample reported low adherence to the MD whereas 63.9% and 16.9% described moderate and high adherence respectively. Only age was significantly associated with higher MD adherence. CONCLUSION: Dietary intake and MD adherence were suboptimal during the COVID-19 lockdown among the sample of the Lebanese population. It is critical that the Lebanese government implements public health programs in order to promote awareness about the importance of adhering to a healthy lifestyle and making appropriate dietary and lifestyle choices.

Too much is too much: Influence of former stress levels on food craving and weight gain during the COVID-19 period.

The COVID-19 pandemic and associated social restrictions had an extensive effect on peoples' lives. Increased rates of weight gain were widely reported, as were declines in the general populations' mental health, including increases in perceived stress. This study investigated whether higher perceived levels of stress during the pandemic were associated with greater levels of weight gain, and whether poor prior levels of mental health were a factor in higher levels of both stress and weight gain during the pandemic. Underlying changes in eating behaviours and dietary consumption were also investigated. During January-February 2021, UK adults (n = 179) completed a self-report online questionnaire to measure perceived levels of stress and changes (current versus pre-COVID-19 restrictions) in weight, eating behaviours, dietary consumption, and physical activity. Participants also reported on how COVID-19 had impacted their lives and their level of mental health prior to the pandemic. Participants with higher levels of stress were significantly more likely to report weight gain and twice as likely to report increased food cravings and comfort food consumption (OR = 2.3 and 1.9-2.5, respectively). Participants reporting an increase in food cravings were 6-11 times more likely to snack and to have increased consumption of high sugar or processed foods (OR = 6.3, 11.2 and 6.3, respectively). Females reported a far greater number of COVID-19 enforced lifestyle changes and both being female and having poor mental health prior to the pandemic were significant predictors of higher stress and weight gain during the pandemic. Although COVID-19 and the pandemic restrictions were unprecedented, this study suggests that understanding and addressing the disparity of higher perceived stress in females and individuals' previous levels of mental health, as well as the key role of food cravings, is key for successfully addressing the continuing societal issue of weight gain and obesity.

Indian food habit & food ingredients may have a role in lowering the severity & high death rate from COVID-19 in Indians: findings from the first nutrigenomic analysis.

Background & objectives: During the COVID-19 pandemic, the death rate was reportedly 5-8 fold lower in India which is densely populated as compared to less populated western countries. The aim of this study was to investigate whether dietary habits were associated with the variations in COVID-19 severity and deaths between western and Indian population at the nutrigenomics level. Methods: In this study nutrigenomics approach was applied. Blood transcriptome of severe COVID-19 patients from three western countries (showing high fatality) and two datasets from Indian patients were used. Gene set enrichment analyses were performed for pathways, metabolites, nutrients, etc., and compared for western and Indian samples to identify the food- and nutrient-related factors, which may be associated with COVID-19 severity. Data on the daily consumption of twelve key food components across four countries were collected and a correlation between nutrigenomics analyses and per capita daily dietary intake was investigated. Results: Distinct dietary habits of Indians were observed, which may be associated with low death rate from COVID-19. Increased consumption of red meat, dairy products and processed foods by western populations may increase the severity and death rate by activating cytokine storm-related pathways, intussusceptive angiogenesis, hypercapnia and enhancing blood glucose levels due to high contents of sphingolipids, palmitic acid and byproducts such as CO2 and lipopolysaccharide (LPS). Palmitic acid also induces ACE2 expression and increases the infection rate. Coffee and alcohol that are highly consumed in western countries may increase the severity and death rates from COVID-19 by deregulating blood iron, zinc and triglyceride levels. The components of Indian diets maintain high iron and zinc concentrations in blood and rich fibre in their foods may prevent CO2 and LPS-mediated COVID-19 severity. Regular consumption of tea by Indians maintains high high-density lipoprotein (HDL) and low triglyceride in blood as catechins in tea act as natural atorvastatin. Importantly, regular consumption of turmeric in daily food by Indians maintains strong immunity and curcumin in turmeric may prevent pathways and mechanisms associated with SARS-CoV-2 infection and COVID-19 severity and lowered the death rate. Interpretation & conclusions: Our results suggest that Indian food components suppress cytokine storm and various other severity related pathways of COVID-19 and may have a role in lowering severity and death rates from COVID-19 in India as compared to western populations. However, large multi-centered case-control studies are required to support our current findings.