Changes in Ultra-Processed Food Consumption and Lifestyle Behaviors Following COVID-19 Shelter-in-Place: A Retrospective Study

Abstract

Ultra-processed food (UPF) consumption poses a potential risk to public health and may be related to shelter-in-place orders. This study utilized the level of food processing as a lens by which to examine the relationships between diet, weight change, and lifestyle changes (including cooking, snacking, and sedentary activity) that occurred during regional shelter-in-place orders. This study used a cross-sectional, retrospective survey (n = 589) to assess baseline demographics, changes in lifestyle behaviors using a Likert scale, and changes in dietary behaviors using a modified food frequency questionnaire from mid-March to May 2020; data were collected in the California Bay Area from August to October 2020. Foods were categorized by level of processing (minimally processed, processed, and ultra-processed) using the NOVA scale. Stepwise multiple linear regression and univariate linear regression models were used to determine the associations between these factors. Increased snacking was positively associated with a change in the percent of the calories derived from UPF and weight gain (β = 1.0, p < 0.001; β = 0.8 kg, p < 0.001) and negatively associated with the share of MPF calories consumed (β = −0.9, p < 0.001). These relationships have public health implications as interventions designed around decreased snacking may positively impact diet and weight management and thereby mitigate negative health outcomes.

Multiple health risk behaviors, including high consumption of ultra-processed foods and their implications for mental health during the COVID-19 pandemic

“…This study revealed a high prevalence of mental disorder symptoms, given the high prevalence of symptoms of anxiety and depression in Brazilian adults during the COVID-19 pandemic. This prevalence may be explained by the fear of the disease and its implications for health, uncertainties about the spread of the virus and its treatment, the high mortality rates, and the loss of family members and relatives, in addition to the disruption of daily routines and lifestyles marked by the imposition of restrictive measures characterized by social distance ( 8 ), the restriction of physical and in-person trade ( 43 ), the decrease in physical activity during leisure time and the increase in sedentary behavior ( 44 , 45 ), increased alcohol consumption ( 46 , 47 ), a decreased purchase of fresh foods, and increased impulse buying ( 48 ), especially of ready-to-eat foods with high durability ( 49 , 50 ), characterizing health risk behaviors. Studies have shown that engaging in these behaviors, especially those related to comfort, may be a way for people to manage psychological distress and stressful situations ( 51 , 52 ).…”

Effects of COVID-19 shelter-in-place confinement on diabetes prevention health behaviors among US adults with prediabetes: A cross-sectional survey

“…These findings contribute to a growing body of research examining the effects of the COVID-19 confinement on health promotion behaviors. For example, in a cross-sectional, retrospective survey of 589 California Bay area adults, researchers found that increased snacking activity was strongly related to increases in ultra-processed food consumption and weight gain ( Sobba et al, Oct 23 2021 ) during shelter-in-place confinement. Furthermore, in a longitudinal study assessing changes in body weight and lifestyle behaviors in US adults (n=727) during the pandemic, Bhutani et al found that participants gained significant body weight (0.62 kg) during the pandemic and that those who gained weight engaged in riskier nutritional behaviors (i.e., more frequent snacking and alcohol intake) and were less active during the peak shelter-in-place (April/May 2020) and that these behaviors persisted after confinement ended.…”

“…Furthermore, research has demonstrated that almost 1 in 3 adults in the United States reported delaying or avoiding routine medical care because of COVID-19 concerns. ( Sobba et al, Oct 23 2021 ) This combination of decreased health promotion behaviors and decreased routine healthcare utilization that could promote screening may result in an increase in undiagnosed diabetes.…”

“…( Chew and Lopez, , Park et al, Aug 2020 , Zachary et al, 2020 ) Most of the existing research on shelter-in-place restrictions and health behaviors has been conducted outside of the United States ( Salman et al, , Scarmozzino and Visioli, 2020 , Sidor and Rzymski, ) or with a broadly defined adult study population. ( Bhutani et al, , Park et al, Jan 26 2022; , Sobba et al, Oct 23 2021; ) However, researchers have identified public health challenges related to understanding the impact of the pandemic on chronic disease prevention, explicitly highlighting the need to understand pandemic-related health behaviors for those at high risk for chronic disease. ( Hacker et al, ) Unfortunately, little is known about how patients with prediabetes, who are at a significant risk of developing diabetes, experienced COVID-19.…”

Consumption Patterns of Processed Foods in Singapore—A Cross-Sectional Study

“…Similarly, the influence of the COVID-19 pandemic on the reported intake could not be assessed. Some studies have reported that the COVID-19 pandemic has affected food consumption in certain populations [ 45 , 46 ], while other studies reported that food consumption remained largely the same [ 47 , 48 ]. As this study was conducted during the COVID-19 pandemic, an influence of the pandemic on the reported intake cannot be precluded.…”