Diet and COVID-19

This 2022 study aimed to find out how eating processed, or unprocessed foods can affect symptoms of depression and anxiety in Brazil during the COVID-19 pandemic. Past studies have already shown that eating high-nutrient diets is correlated with a lower risk of developing these psychological disorders. A household survey was firstly conducted in two cities in Brazil. Food consumption was evaluated using a qualitative food frequency questionnaire that refers to what the respondents ate in the last 3 months. The foods consumed by these participants were then categorized according to the NOVA classification for fresh/minimally processed food and ultra-processed food. The data ultimately demonstrated that eating fresh or minimally processed foods more frequently than the average person every week was associated with lower prevalence of depression. But conversely, consuming ultra-processed foods above the weekly average frequency was related to higher prevalence of depression as well as anxiety. Thus, this study recommends eating fresh or minimally processed foods.[NPID: processed foods, diet, unhealthy diets, anxiety, depression, Brazil, COVID-19, pandemic, ultra-processed foods]

This 2021 study investigated sleep disorders during this COVID-19 pandemic since sleep disturbances are a major health issue connected to a higher prevalence of metabolic syndrome, obesity, and psychological problems. This study planned to determine the prevalence of sleeping disorders among people with different dietary patterns during this COVID-19 pandemic. While a survey was distributed to 1987 people, 1956 of these respondents met all of the study conditions. Insomnia and sleepiness were assessed using the Athens Insomnia Scale (AIS) and Epworth Sleepiness Scale (ESS), respectively. Around 36% of the sample population reported experiencing a change in the quality of their sleep during the last year. The data also revealed that non-vegetarians suffered from insomnia or sleepiness more often than vegetarians. The prevalence of insomnia and sleepiness were both higher in respondents consuming fruits and vegetables less frequently than once a day, relative to people who included fruits and vegetables in their daily diets. Moreover, individuals with BMIs within the recommended limit (18.5-24.99) suffered from insomnia less often than underweight and obese respondents. Public health workers and healthcare professionals may find these figures useful in establishing new methods of treating sleep disorders. [NPID: sleep disorders, sleeping, COVID-19, pandemic, diet, BMI, body weight, obesity, insomnia, sleep disturbances, fruits and vegetables, nutrition, vegetarian]

This 2020 study examined the eating behaviors, and depressive and anxiety symptoms of people in Spain during the COVID-19 pandemic and compared the outcomes with the residents of Greece. These two countries have different confinement strategies and infection severities. The method of data collection was a web-based survey, which was completed by 1002 inhabitants of Spain and 839 residents in Greece. These surveys were administered during and shortly after the COVID-19 lockdown in Spain and Greece. The data showed lower mean scores of restraint and external eating in the Spanish participants, compared with Greek respondents, although there was no difference in emotional eating scores between the two countries. Moderate to severe depressive and anxiety symptoms were reported in 13.6% and 12.3% of respondents in Spain, respectively. Whereas 18.8% of Greek participants showed moderate-severe depressive signs and 13.2% had moderate or severe anxiety symptoms. But regarding anxiety symptoms in general, there was a higher prevalence in Spain compared with Greece. No difference was seen for depressive symptoms. To summarize, the people living in these 2 Mediterranean countries demonstrated high scores of inappropriate eating behaviors and a high frequency of depressive and anxiety symptoms during the COVID-19 outbreak. Compared to Greek participants, the Spanish respondents encountered more severe pandemic and stricter lockdown measures, and were associated with lower restraint and external eating, and increased anxiety symptoms. [NPID: depression, anxiety, COVID-19, pandemic, Spain, Greece, eating behaviors, lockdown]

This randomized clinical trial published in 2021 assessed the effect of culinary interventions on home cooking practices, coping strategies, and resiliency during the first wave of the COVID-19 pandemic in March/April 2020. The participants, aged 25-70 years with a BMI of 27.5–35, were either assigned to the intervention or control group. The intervention consisted of 12 weekly one-on-one remote culinary coaching sessions each lasting 30 minutes. More of the intervention group were found to use self-care as a coping strategy than the control group. Moreover, the individuals that took part in the cooking sessions showed greater resiliency than those that did not, although the differences were not found to be statistically significant. During the pandemic, these subjects in the intervention group utilized their home cooking skills such as meal planning and time-saving techniques. To summarize these findings, remote culinary coaching may be effective in teaching home cooking skills and promoting the use of self-care as a coping strategy during stressful periods, including the COVID-19 pandemic. [NPID: COVID, pandemic, mental health, stress, cooking, coaching, culinary, self-care, meal planning, meal plans]

The aim of this 2020 study was to analyze how dietary patterns changed during COVID-19 confinement in adolescents aged 10 to 19 years, and to determine variables that may have influenced these alterations. Ruiz-Roso et al. believe that the confinement may affect diet and nutrition, particularly in adolescents who are susceptible to acquiring bad eating habits. Poor dietary habits can then put some people at risk of degenerative diseases such as obesity and diabetes. After collecting the data of 820 adolescents from Spain, Italy, Brazil, Colombia, and Chile (through online questionnaires), the COVID-19 confinement was not found to affect dietary habits in this sample. The team of researchers looked at changes in intakes of fried food, sweet food, legumes, vegetables, and fruits. Furthermore, there were no significant correlations between adequate nutrition with gender, family members at home, watching TV during mealtime, country of residence, or maternal education. Better understanding of adolescents' nutrition behavior during the COVID-19 lockdown would allow public health authorities to be more prepared, on their nutritional recommendations, for another pandemic. [NPIDs: COVID, coronavirus, pandemic, immunity, the immune system, COVID-19, degenerative diseases, obesity, diabetes, TV, maternal education]

Since it is known that social isolation can influence one’s dietary behaviors, Elmacıoğlu et al. (2021) decided to explore the possible effects of the COVID-19 pandemic and social isolation process on individuals' nutritional behaviours and body weight changes. The 827 women and 209 men (18 years +) who volunteered for this experiment were administered with the Three Factor Nutrition Questionnaire (evaluates nutritional behaviors) during the social isolation process. These results were then compared with answers obtained before the pandemic. Although there was no significant change in cognitive restriction behaviour, there was an increase in emotional eating and uncontrolled eating behaviours during the pandemic and social isolation process. Through monitoring of the volunteers’ weights throughout the study, the researchers found that 35% of the participants gained weight during the isolation. These findings indicate that dietary behaviors may be modified as a result of the self-isolation process practiced during this COVID-19 pandemic. It is vital that the public take precautions to prevent this modification in nutritional behavior as it could lead to further negative impacts in the future. [NPIDs: COVID, coronavirus, pandemic, immunity, the immune system, COVID-19, social isolation, cognitive restriction, emotional eating]

Since the intake of vitamin C has been proposed as a possible treatment for COVID-19 hospitalized patients, this 2020 review aims to demonstrate its potential application in acute SARS-CoV2 infections. Taking vitamin C has been linked with the boosting of immunity and reduction of susceptibility to infections, although there is no data that backs up this claim. Currently, the consumption of vitamin C supplements for the purpose of decreasing respiratory infection risk is not clinically recommended in a well-nourished general population. Only the subgroups such as athletes, the military or people with low plasma vitamin C levels are advised to take supplements when appropriate. Also in categories at high risk of infection such as the obese, diabetics, and the elderly, vitamin C can affect inflammation and potentially provide benefits to the immune system. This review summarizes the studies on respiratory disease prevention and treatment that are most closely related to the potential use case of vitamin C in critical illness conditions. [NPIDs: COVID, coronavirus, pandemic, immunity, the immune system, COVID-19, vitamin C, respiratory infection, military, athletes, obesity, diabetes]

Since COVID-19 can put individuals at high risk of malnourishment due to the debilitating effects of its acute respiratory failure symptoms, this 2021 study aimed to develop an approach to reduce the risk for malnutrition and improve patients' clinical outcomes. Formisano et al. recruited 49 patients from the intensive care unit (ICU) and 94 non-ICU patients of the Giovanni Borea Civil Hospital in Sanremo. The non-ICU patients were given a personalized diet that considered their conditions and included high-protein and high-calorie pureed diet, oral nutritional supplements, and/or artificial nutrition. The ICU patients were considered at risk for malnutrition without screening and were fed with enteral nutrition plus supplemental parenteral nutrition. Although the dietary treatments were well tolerated by all patients, 53.1% of the ICU patients and 19.1% of the non-ICU patients died. The deaths recorded outside of the ICU were mostly women who were older and with higher body mass indices. As a matter of fact, most of the non-ICU patients were greater than 70 years of age. The protein and energy needs of these older patients were not met. This group of older participants had a higher death rate than patients whose needs were met. Apart from age, 72 of the 94 non-ICU patients scored positive on at least one nutritional risk screening item. It was deduced that nutritional strategies need to be developed to prevent worsening of the clinical outcomes of patients with COVID-19. [NPIDs: COVID, coronavirus, pandemic, immunity, the immune system, COVID-19, respiratory, high protein, ICU, hospital nutrition]

This 2021 study examined whether food choice motives changed following the national lockdown imposed in France between March 17th and May 10th in 2020. The 938 French adult participants completed online questionnaires asking about their food choice motives and food consumption during the month before and in the first month of the lockdown. The study focused on the following nine food choice motives: health; convenience; sensory appeal; natural content; ethical concern; weight control; mood; familiarity; and price. While food intake was measured through a food frequency questionnaire including 110 foods, 12 non-alcoholic beverages and 4 alcoholic beverages. The results showed that the nutritional value of diets dropped during the lockdown compared to before. A significant change in food choice motives was also observed. Other findings included associations between importance of weight control with nutritional quality, and between increased importance of mood with decreased nutritional quality. The lockdown was thus linked with the alterations in food choice motives, especially with regards to mood as a food choice motive (reported by 48% of the respondents). In addition, there was a rise in consideration for ethical concerns, health, and natural contents in connection with the food, suggesting a growing awareness of how crucial sustainable foods are for some French participants. [NPIDs: COVID, coronavirus, pandemic, immunity, the immune system, COVID-19, France, food convenience, sensory appeal, price]

The COVIDiet Study (2020) utilized social media and snowball sampling to propagate an online questionnaire measuring dietary and socio-demographic data, and evaluated whether eating behaviors changed during the COVID-19 outbreak confinement among a Spanish adult population. A total of 7514 participants (37% aged below 35 years, 70.6% female, 77.9% university-level education or higher) completed the questionnaire, which used the Mediterranean diet (MedDiet) Adherence Screener (MEDAS) to define a healthy diet, and determine processed foods intake, alterations in their usual food choices and weight gain. During the confinement, the overall MEDAS score among the population increased significantly from 6.53 ± 2 to 7.34 ± 1.93. Multivariate logistic regression models adjusted for multiple variables also marked a significant shift towards an increase in adherence to the MedDiet. Rodríguez-Pérez and her team (2020) arrived at the conclusion that the studied Spanish population have adopted healthier dietary behaviors/habits under COVID-19 confinement, a change that, if sustained in the long-term, could benefit the nation in its prevention of chronic diseases and COVID-19-related complications. [NPIDs: COVID, coronavirus, pandemic, immunity, the immune system, COVID-19, Spain, Med diet, Mediterranean diet, eating behavior]

This 2020 review summarizes how diet and infection are related, as well as the long-term impacts associated with COVID-19 infection. Butler & Barrientos (2020) explains that consumption of diets that contribute to obesity and type-2 diabetes such as the Western Diet (WD), with its high-fat, sugars and refined carbohydrates nature, can increase a person’s vulnerability to severe COVID-19 pathology and possibly death. WD intake is said to impair adaptive immunity, leading to chronic inflammation and impaired host defense against viruses. Even in those that recover, the peripheral inflammation caused by the novel virus may even result in chronic medical conditions in the future such as dementia and neurodegenerative disease. It was proposed these conditions would arise through neuroinflammatory mechanisms, which can be worsened by poor diet. The writers therefore request greater access to healthy foods and urge the population to adopt healthy eating habits to reduce susceptibility to and long-term complications from COVID-19. [NPIDs: COVID, coronavirus, pandemic, immunity, the immune system, COVID-19, diabetes, Western-style diet, WS diet, inflammation, viruses, viral infection, dementia, neurodegenerative disease]

This 2020 review demonstrates how important optimal intake of the relevant nutrients is to strengthen the immune system during the COVID-19 crisis. Deficiencies in micronutrients such as vitamin A and zinc have been linked to higher infection risk, while sufficient consumption of proteins is required for optimal antibody production. It is also commonly said that poor nutrient status is associated with inflammation and oxidative stress, which in turn can impact the immune system. Iddir et al. (2020) states that vitamins C and E, and phytochemicals such as carotenoids and polyphenols show great anti-inflammatory and antioxidant capacity, while there is also evidence that the short-chain fatty acids that form via the fermentation of dietary fiber by the gut microbiota may possess anti-inflammatory effects. Moreover, vitamin D may be able to disturb viral cellular infection by interacting with cell entry receptors (angiotensin converting enzyme 2). [NPIDs: COVID, coronavirus, pandemic, immunity, the immune system, COVID-19, micronutrients, nutrient deficiencies, antibodies, oxidative stress, inflammation, phytochemicals, carotenoids, polyphenols, fiber, vitamin D]

Calder et al. (2020) details the role of nutrition in supporting the immune system, including the important and complementary functions of vitamins A, B6, B12, C, D, E, and folate, trace elements such as zinc, iron, selenium, magnesium, and copper, as well as omega-3 fatty acids like eicosapentaenoic acid and docosahexaenoic acid. It is said that deficiencies in the intakes of these nutrients are widespread and have resulted in decreased resistance to infections and increased disease burden. The researchers close with the following conclusions: supplementation with the above micronutrients and omega-3 fatty acids is a safe, effective, and low-cost strategy to help support optimal immune function; supplementation above the Recommended Dietary Allowance (RDA), but within recommended upper safety limits, for specific nutrients such as vitamins C and D is warranted; and public health officials are encouraged to include nutritional strategies in their recommendations to improve public health. [NPIDs: COVID, coronavirus, pandemic, immunity, the immune system, vitamin A, vitamin B6, vitamin B12, vitamin C, vitamin D, vitamin E, folate, zinc, iron, selenium, magnesium, copper, omega-3s, eicosapentaenoic acid, docosahexaenoic acid, DHA, EPA, COVID-19]

This 2020 study reported the impact of the COVID-19 lockdown on appetite and overeating in Australian adults during the first month of emergency measures (began 22 March 2020). An anonymous self-reported survey was released collecting data on sociodemographic characteristics, symptoms of anxiety and depression, and the effect of COVID-19 and the lockdown. The main outcome measure was an item from the Patient Health Questionnaire 9 asking: ‘Over the past 2 weeks, how often have you been bothered by poor appetite or overeating?’. Of the 13,829 adult Australian residents (aged 18+), 53.6% felt bothered by poor appetite or overeating in the past 2 weeks, and 11.6% reported poor appetite or overeating nearly every day. The risk factors for poor appetite or overeating were high levels of anxiety, concern about contracting COVID-19, being in lockdown with children and reporting a severe impact of the lockdown. Given the widespread prevalence of being bothered by poor appetite or overeating, universal public health interventions addressing emotion-focused or situational eating during periods of lockdown may be appropriate. [NPIDs: COVID, coronavirus, pandemic, appetite, overeating, Australia, March 2020, anxiety, depression, anxiety, lockdown, emotional eating, COVID-19]

While emotional eating and food choices are influenced by the perceived stress of an individual, Shen et al. (2020) investigated the role of emotional eating in the relationship between perceived stress levels and food choice motives (health, mood, convenience, natural content, price, sensory appeal, familiarities, weight control, and ethical concerns) among citizens of the United States, during the coronavirus disease 2019 pandemic. A total of 800 participants were assessed on their perceived stress, emotional eating, and food choice motives using the Perceived Stress Scale, Dutch Eating Behavior Questionnaire, and Food Choice Questionnaire. While moderate to high levels of stress were quite prevalent (73.6%), this perceived stress was found to correlate significantly with emotional eating (r = 0.26) and with five out of nine food choice motives: mood (r = 0.32), convenience (r = 0.28), natural content (r = −0.14), price (r = 0.27), and familiarity (r = 0.15). Emotional eating was also related with four of the food choice motives including mood (r = 0.27), convenience (r = 0.23), price (r = 0.16), and familiarity (r = 0.16). This study uncovered evidence suggesting that emotional eating mediates the associations between perceived stress and the food choice motives: mood, convenience, sensory appeal, price, and familiarity. [NPIDs: COVID, coronavirus, emotional eating, stress, perception, mood, sensory, ethical concerns, food convenience, price, familiarity, pandemic, COVID-19]