Bhopal (India)
Note. Design: PS: Prospective Study; RS: Retrospective Study. Sample Size at Baseline (Total n/Female (%)): * Other: Non-binary/ Transgender participants.
The twenty-three longitudinal studies included the following countries: India [ 26 ], Australia [ 27 , 28 ], Spain [ 29 , 30 ], Italy [ 31 , 32 , 33 , 34 , 35 ], Brazil [ 36 ], France [ 37 ], China [ 38 , 39 , 40 , 41 ], the United States [ 42 ], Canada [ 43 ], Poland [ 44 ], the United Kingdom [ 45 , 46 ] and Japan [ 47 , 48 ].
Twelve [ 26 , 27 , 28 , 29 , 30 , 36 , 37 , 42 , 43 , 45 , 46 , 48 ] (50%) were prospective studies, and eleven [ 31 , 32 , 33 , 34 , 35 , 38 , 39 , 40 , 41 , 44 , 47 ] (42.86%) were retrospective studies. Additionally, the length of follow-ups varied between 2 [ 32 , 35 , 47 ] and 54 weeks [ 28 , 42 ].
Although studies mainly focused on adult populations over 18 years old with no comorbidities [ 28 , 35 , 36 , 37 , 38 , 42 , 43 , 44 , 46 , 48 ], specific subgroups that might be taken into account were found: people diagnosed with diabetes mellitus [ 26 , 32 , 47 ], young people [ 27 , 29 , 30 , 31 , 34 , 39 , 40 , 41 ], people with obesity [ 33 ] and people in vulnerable situations [ 45 ]. The average of mean ages for twenty-three longitudinal studies was 24.19 years (SD = 15.3).
Due to the differences among the studies, sample sizes varied between 34 [ 47 ] and 37,252 [ 37 ] participants (media n = 4918; IQR 112 to 10,082). However, the experimental mortality was not significant except for one study [ 27 ], which lost almost 44.84% of the participants. In addition, the ratio between males and females was relatively equal, with the exception of five studies in which samples were comprised mainly of females [ 27 , 33 , 36 , 41 , 43 ]. This systematic review evaluated a total of 116,952 participants.
All the studies used different recording measures to assess target eating behaviour changes. In this sense, many of them were standardized validated scales, such as the NSW Centre for Public Health Nutrition [ 27 ], The Mediterranean Diet Quality Index for children and teenagers (KIDMED) [ 29 ], the 12-items lifestyle questionnaire [ 31 ], the House hold Dietary Diversity Score (HDDS) [ 38 ], the COVID-19 Impact on Lifestyle Change Survey (COINLICS) [ 39 ], the Diet Screener Questionnaire, the Dietary Questionnaire for Epidemiological Studies (DQUES and diet v3.2; Cancer Council Victoria) [ 28 ], the Food and Beverages Diet frequency questionnaire [ 40 ], the Modified Food frequency Questionnaire (FFQ-6) [ 44 ], and the Mediterranean diet (Med-Diet) questionnaire [ 30 ]; whereas the others used scales that were created for the specific purpose of their research [ 26 , 32 , 33 , 34 , 35 , 36 , 41 , 47 ]. Additionally, self-reports [ 37 , 43 , 45 , 46 ] were used in order to follow eating changes among participants. One study used ecological momentary assessment through the CALO mama health app for this purpose [ 48 ].
Table 4 summarizes the objectives, outcomes, and results of the studies, as shown below.
Objective, outcomes and results of the included studies.
Authors | Objective | Outcome | Results |
---|---|---|---|
Khare et al. (2020) | To study the effect of lockdown on glycaemic control in diabetic patients and possible factors responsible for this | Dietary changes (secondary outcome) | Dietary changes were observed as a change in the type of diet, change in timing of meals, change in frequency of meals and change in the amount of diet. |
Munasinghe et al. (2020) | To investigate changes in physical activity, dietary behaviours, and well-being during the early period of physical distancing policies | Dietary behaviour (primary outcome) | There were declines in fast food consumption following implementation of physical distancing but no substantial changes in fruit and vegetable consumption. |
Medrano et al. (2020) | To examine the effects of the COVID-19 confinement on lifestyle behaviours and to assess the influence of social vulnerabilities on changes in lifestyle behaviours | Adherence to the Mediterranean Diet (primary outcome) | Children worsened their lifestyle behaviours during the COVID-19 confinement, specifically their adherence to the Mediterranean Diet. No significant differences were found behaviours between primary and secondary students. |
Pietrobelli et al. (2020) | To test the hypothesis that factors contributing to weight gain among children and adolescents with overweight and obesity are exacerbated during a pandemic associated lockdown | (1) Number of meals eaten per day, (2) changes in vegetable and fruit intake (3) potato chips intake, (4) red meat intake and (5) sugary drinks (primary outcomes) | The number of meals eaten per day got increased. There were no changes in vegetable intake, and fruit intake increased. There was an increased consumptions of potato chips, red meat, and sugary drinks during the lockdown. |
Caruso et al. (2020) | To assess lockdown-related changes in glucose control and variability and their association with psychological distress and lifestyle changes in type 1 diabetes mellitus patients | (1) Meals per day, (2) starchy foods, (3) sweets, (4) whole grains and (5) vegetables (secondary outcomes) | Patients increased the frequency of starchy foods and sweets consumption, respectively. |
Pellegrini et al. (2020) | To evaluate the changes in weight and dietary habits in a sample of individuals with obesity after 1 month of enforced lockdown | Changes in dietary habits (primary outcome) | There was an increased consumption of snacks, cereals, and sweets. |
Martínez-Steele et al. (2020) | To describe the dietary characteristic of a cohort immediately before and during the pandemic | Changes in dietary characteristics (primary outcome) | The consumption of vegetables, fruits and legumes increased on daily diet. There was a pattern of stability in the consumption of ultra-processed food, although the number of people who consumed it increased. |
Deschasaux-Tanguy. (2020) | To explore potential changes in dietary intake, physical activity, body weight and food supply during the COVID-19 lockdown and how these differed according to individual characteristics | Determinants of nutrition-related behaviour (primary outcome) | Diet-related practices during COVID-19 lockdown were modified. Trouble to keep a regular mealtime schedule, more frequent snaking (at least 3 times a day, every day) and a decreased consumption of fresh food was reported. Ultra-processed food consumption increased. |
Zhang. (2020) | To explore post-lockdown dietary behaviours and their effects on dietary diversity. | Dietary behaviour (primary outcome) | An increased consumption of seafood and dietary supplements was found. Also, frozen food and raw food consumption decreased, whereas a higher alcohol and vinegar intake was registered. |
Yu. (2020) | To assess changes in dietary patterns among youths in China after COVID-19 lockdown | Dietary patterns (primary outcome) | Significant changes in the weekly frequency of major food intake after lockdown was reported. There was a decrease in rice intake while an increase consumption of other staple food such as fish, eggs, fresh vegetables, preserved vegetables, fresh fruit and dairy products was recorded. There was an increased consumption of wheat products and a decrease in the frequency of beverages intake. |
Barone. (2021) | To study the longitudinal impact of COVID-19 on work practices, lifestyle and well-being among desk workers during COVID-19 lockdown | Dietary habits (primary outcome) | No changes in dietary habits were found, except for a reduced frequency of red meat consumption. |
Curtis. (2021) | To examine changes in activity patterns, recreational physical activities, diet, weight and wellbeing from before to during COVID-19 restrictions | Dietary intake (primary outcome) | Total energy intake did not change, but a slightly lower percentage of energy from protein and a greater percentage of energy from alcohol were recorded. |
Jia. (2021) | To measure changes in diet patterns during the COVID-19 lockdown among youths in China | Diet patterns (primary outcome) | Significant changes in diet patterns associated with more frequent consumption of wheat products, other staple foods, preserved vegetables, and tea and less frequent consumption of rice, meat, poultry, fresh vegetables and fruit, soybean and dairy products and sugar-sweetened beverages were found. |
Lamarche. (2021) | To document the change in diet quality and in food insecurity observed during the COVID-19–related early lockdown | Diet quality (primary outcome) | There were small but significant increases in the following components: whole grains, greens and beans, refined grains (reduced consumption), total vegetables, total dairy, seafood and plant proteins, added sugar (reduced consumption), and total proteins. The overall diet quality slightly improved. |
Czenczek-Lewandowska. (2021) | To assess whether and to what extent the outbreak of the COVID-19 pandemic influenced the health-promoting behaviours of young adults in terms of eating habits, physical activity, sedentary behaviours and sleep. | Eating habits (primary outcome) | Average consumption of sweets, snacks, cereal products increased. A significant higher intake of alcohol and fats was recorded. |
Naughton. (2021) | To provide baseline cohort descriptives and assess change in health behaviours since the UK COVID-19 lockdown | Dietary behaviour (primary outcome) | There were reductions in the mean reported number of daily portions of vegetables and fruit but no change in reported portions of high sugar food consumed. In the case of alcohol consumption, there was an increase in the average intake per month. |
Imaz-Aramburu. (2021) | To understand the influence that the pandemic exerted on the lifestyles of university students, in particular those enrolled in health sciences programs | Eating habits (secondary outcome) | There was a greater adherence to the Mediterranean Diet. The consumption of vegetables increased significantly during the pandemic whereas the consumption of fatty meats tended to increase. An increased consumption of nuts was recorded. |
Segre. (2021) | To analyse the impact of the quarantine on students’ life in Milan, one of the Italian cities most affected by COVID-19 | Eating habits (primary outcome) | The amount of food eaten increased, with a higher consumption of junk food, snacks and sweets. |
Maffoni. (2021) | To investigate lifestyle habits and eating behaviours modifications in a sample of Italian adults during “Phase 1” COVID-19 pandemic home confinement | Eating behaviours (primary outcome) | Negative changes in eating behaviour were found. These included an increased consumption of desserts or sweets at lunch. Craving or eating between meals was reported as well as the higher consumption of unhealthy snacks, beverages and ultra-processed food. |
Hosomi. (2021) | To investigate the effects of the COVID-19 pandemic on the glycaemic control and changes in stress levels and lifestyle in patients with T1D. | Diet (primary outcome) | Average amount of food intake got increased. The consumption of snacks and prepared food were also considerably increased. |
Herle. (2021) | To describe how people’s eating behaviour (eating more, eating less, eating the same) changed over 8 weeks of lockdown in the UK | Eating behaviour (primary outcome) | Many individuals did experience changes to their food intake as well as lower adherence to healthy eating patterns |
Dun. (2021) | To observe weight change in Chinese youth during a 4-month lockdown and the associations between weight change and COVID-19-related stress, anxiety, depression, physical activity, sedentary time and dietary habits. | Dietary habits (secondary outcome) | A higher alcohol consumption was found in particular among men. Daily snack frequency also increased. |
Sato. (2021) | To study dietary changes during the pandemic while considering changes in work and life patterns | Dietary changes (primary outcome) | Working people tended to consume less fruits and dairy products but more meats and alcohol compared with non-workers. In particular, irregular workers consumed less vegetables, mushrooms and fish. The average daily number of self-made meals increased among all participants. |
All of the studies had a common objective, assessing eating behaviour changes caused by the COVID-19 pandemic. In this sense, sixteen studies focused on eating behaviour changes during lockdown conditions [ 26 , 29 , 31 , 32 , 33 , 34 , 35 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 45 , 46 ], while seven studies focused their research into the entire spectrum of the pandemic [ 27 , 28 , 30 , 36 , 44 , 47 , 48 ].
Out of twenty-three studies, eighteen studies pursued eating behaviour as a primary or main outcome [ 27 , 28 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ], while five studies included it as a secondary outcome [ 26 , 29 , 30 , 31 , 41 ].
All of the studies recorded eating behaviour changes during the COVID-19 pandemic in comparison to previous baselines before the pandemic, concluding that there were changes in the type of diet. Two studies found that there were changes in mealtimes [ 26 , 37 ], whereas three reported a more frequent food intake [ 26 , 35 , 39 ] and four an increased amount of food eaten [ 26 , 31 , 46 , 47 ]. In particular, six studies highlighted a greater consumption of snacks [ 33 , 34 , 35 , 41 , 44 , 47 ]. In this sense, five studies established that there was a preference for sweets [ 32 , 33 , 34 , 35 , 44 ] while two concluded that wheat products were more frequently consume after the COVID-19 pandemic [ 39 , 40 ]. In the case of beverages, two studies found a higher daily intake [ 35 , 40 ] while another one reported a decreased intake [ 39 ]. Specifically, for alcohol, six studies reported an increased consumption [ 28 , 38 , 41 , 44 , 45 , 48 ].
Otherwise, four studies reported a decreased consumption of fruit and vegetables [ 39 , 40 , 45 , 48 ], two that there were no substantial changes [ 27 , 31 ], and two that the daily intake got increased [ 30 , 36 ]. Regarding this, three studies found a decreased consumption of fresh food [ 37 , 39 , 40 ] and four other studies reported a higher intake of ultra-processed food [ 35 , 36 , 37 , 47 ]. Meat consumption got decreased according to two studies [ 40 , 42 ], but also got increased regarding three studies [ 30 , 31 , 48 ].
Finally, three studies resolved that negative changes in eating behaviour were found due to a lower adherence to healthy diets [ 29 , 35 , 46 ], meanwhile two reported adherence to healthy diet [ 30 , 43 ] and one study declared no changes in dietary habits just except for a reduction in the amount of meat eaten [ 42 ].
To assess the quality of the studies, the Newcastle-Ottawa Quality Assessment Scale (NOS) [ 49 ] was used. This tool was developed with the aim of being helpful for systematic reviews so that quality criteria can be reached while ensuring a low risk of bias. NOS uses three main categories: selection, comparability and outcome. Each category contains several items about the characteristics of observational studies, each of which includes several answers. Among those answers, at least one is accompanied by a star (☆). As stars symbolize a low risk of bias, once the scale is completed, it is necessary to sum them. If the result is less than 7 stars, there might be a high risk of bias. Additionally, in the case of reviewers selecting answers that do not include a star, it is important to check the possible biases of the study. Therefore, NOS scores might be categorized into three groups: very high risk of bias (0–3 stars), high risk of bias (4–6 stars) and low risk of bias (7–9 stars) [ 50 ].
The quality of each study was evaluated independently by two reviewers. A third reviewer was assigned in case of disagreement. The final consensus is shown in Table 5 .
Quality appraisal studies.
Study ID | Selection | Comparability | Outcome | Total | Score | |||||
---|---|---|---|---|---|---|---|---|---|---|
Representativeness of the Exposed Cohort | Selection of the Non-Exposed Cohort | Ascertainment of Exposure | Demonstration That the Outcome of Interest Was Not Present at the Start of the Study | Comparability of Cohorts on the Basis of the Design or Analysis | Assessment of Outcome | Was Follow-Up Long Enough for Outcomes to Occur | Adequacy of the Follow-Up | |||
Khare et al. (2020) | ☆ | ☆ | ☆ | ☆ | ☆☆ | ☆ | ☆ | ☆ | 9 | Low risk of bias |
Munasinghe et al. (2020) | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | 7 | Low risk of bias | |
Caruso et al. (2020) | ☆ | ☆ | ☆ | ☆ | ☆☆ | ☆ ☆ | ☆ | 9 | Low risk of bias | |
Medrano et al. (2020) | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ ☆ | ☆ | ☆ | 9 | Low risk of bias |
Pietrobelli et al. (2020) | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | 7 | Low risk of bias | |
Pellegrini et al. (2020) | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | 8 | Low risk of bias |
Martínez-Steele et al. (2020) | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | 8 | Low risk of bias |
Deschasaux-Tanguy et al. (2020) | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | 7 | Low risk of bias | |
Zhang et al. (2020) | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ ☆ | ☆ | ☆ | 9 | Low risk of bias |
Yu et al. (2020) | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | 7 | Low risk of bias | |
Barone et al. (2021) | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ ☆ | ☆ | 8 | Low risk of bias | |
Curtis et al. (2021) | ☆ | ☆ | ☆ | ☆ | ☆ ☆ | ☆ | ☆ | 8 | Low risk of bias | |
Jia et al. (2021) | ☆ | ☆ | ☆ | ☆ ☆ | ☆ | ☆ | 7 | Low risk of bias | ||
Lamarche et al. (2021) | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ ☆ | ☆ | ☆ | 9 | Low risk of bias |
Czenczek-Lewandowska et al. (2021) | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | 7 | Low risk of bias | |
Naughton et al. (2021) | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ ☆ | ☆ | ☆ | 9 | Low risk of bias |
Imaz-Aramburu et al. (2021) | ☆ | ☆ | ☆ | ☆ | ☆ ☆ | ☆ | ☆ | 8 | Low risk of bias | |
Segre et al. (2021) | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | 7 | Low risk of bias | |
Maffoni et al. (2021) | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | 7 | Low risk of bias | |
Hosomi et al. (2021) | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | 7 | Low risk of bias | |
Herle et al. (2021) | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | 7 | Low risk of bias | |
Dun et al. (2021) | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | ☆ | 7 | Low risk of bias | |
Sato et al. (2021) | ☆ | ☆ | ☆ | ☆ | ☆ ☆ | ☆ | ☆ | 8 | Low risk of bias |
Note. The following items could gather up to 2 stars (☆ ☆): ‘Representativeness of the exposed cohort’; ‘Ascertainment of exposure’; ‘Comparability of cohorts on the basis of the design or analysis’; ‘Assessment of outcome’; ‘Adequacy of follow-up’.
To quantify the degree of agreement between reviewers regarding overall quality assessment, the Cohen Kappa Index was calculated. The results showed that there was a good agreement level (Cohen Kappa Index = 0.74; 95% CI, 0.60 to 0.89) regarding the specific score of each study. By considering this, it was possible to conclude that there was a low risk of bias in all twenty-three studies.
The current systematic review, which included twenty-three studies, provides a comprehensive overview of eating behaviour characteristics associated with the COVID-19 pandemic. Consistent with previous reviews, several outcomes, such as overeating [ 26 , 31 , 46 , 47 ] and the influence of personal preferences on food choices [ 32 , 33 , 34 , 35 , 44 ], have been observed. However, this systematic review also found that the frequency of meals is not associated with the amount of food eaten [ 32 , 36 , 40 ]. Additionally, variables, such as gender and age, that did not show a correlation with specific eating behaviours [ 29 ], need to be considered, as well as the influence of mental health [ 41 , 45 , 46 ]. In the case of work status, one study found that people who spend more time at home consumed a greater amount of self-made food [ 48 ] something that appears to be correlated with the availability of food delivery services [ 51 ], which are a faster option for people who is in a rush.
However, when referring to population with no comorbidities, results may generate controversy. Three studies reported patterns of stability on eating behaviour despite the outbreak of the pandemic [ 27 , 28 , 42 ], while two studies even reported improvements in the adherence to healthy diets [ 38 , 43 ]. In spite of that, results showed a more frequent intake of food, an increased consumption of ultra-processed food and a higher caloric intake due to a more frequent alcohol consumption [ 35 , 37 , 44 , 46 , 48 ].
Regarding specific subgroups, people with diabetes appeared to increase the daily amount of food eaten. In this sense, unhealthy food products such as sweets and starchy food were common among this population [ 26 , 32 , 47 ]. People with obesity showed similar trends by reporting a significant increase in the amount and frequency of unhealthy food products [ 33 ]. In the case of young people, a lower adherence to healthy diets such as the Mediterranean Diet [ 29 ] was found due to an increased intake of food, a preference for snacks and a lack of fruit and vegetables intake [ 27 , 29 , 30 , 31 , 34 , 39 , 40 , 41 ]. On the contrary, vulnerable population showed a reduced intake of food, contrasting with an increased alcohol consumption [ 45 ]. In all these cases, results did not show changes towards a healthier diet, what may emphasize the need to protect vulnerable population from risk situations that might affect health or, in this case, nutritional status.
By considering all this information, it is possible to confirm the existence of changes in eating behaviour during the COVID-19 pandemic. To the best of our knowledge, this is the first systematic review that examined these trends by considering longitudinal studies. With this design, it is possible to analyse the changes of eating behaviour in comparison with previous baselines before the pandemic, which made it possible to establish the level of significance of this phenomenon. Additionally, the screening process that was applied ensured the quality of this review, as shown in the NOS results of each study. Therefore, it might be possible to accept the relevance of this review on this topic.
Even so, several limitations should be considered when interpreting these results. First, due to the heterogeneity of the designs as well as the small set of papers used, it is important to consider this review as a first approach to eating behaviour changes during the COVID-19 pandemic. Its results may be useful to consider when undertaking future directions of reviews when more studies become available. Second, and according to the above, due to the novelty of this phenomenon, there were no comparators apart from within-subject comparability (prospective and retrospective), which is a limitation when trying to distinguish between the influence of the pandemic (lockdowns, social distance, isolation, uncertainty about the future, etc.) and any other external factor. Longitudinal between-subject studies may be necessary to dismiss possible bias caused by external factors. Third, this systematic review included both clinical and non-clinical population what may disturb results due to additional variables that has not been measured. Consequently, any interpretation should be made carefully, as the effect size might not represent society-wide eating behaviour, although previous studies have established common eating behaviour changes among clinical and non-clinical populations [ 21 , 22 ]. Finally, although one of the strengths of this review is that different countries have been included, it might be important to consider that restrictive measures have been different among countries so that the COVID-19 pandemic might have had a greater or lesser impact depending on the policies of each country [ 36 ].
Keeping all of this in mind, a deep understanding beyond the results is still possible. Therefore, this review is useful as a benchmark that contributes to the current body of knowledge about the impact of the COVID-19 pandemic on daily lifestyles. In addition to confirming the appearance of changes in eating behaviour since the outbreak of the COVID-19 pandemic, this is the first systematic review that has achieved an accurate description of those changes by considering different countries. The results of this study will provide a reference to guide future research directions among those interested not only in this topic but also in specific eating patterns as well as in the differences between ‘amount of food’ and ‘snack frequency’. All of these approaches will lead to a better understanding of eating behaviour during the COVID-19 pandemic as well as contribute to future guidelines about health promotion.
Due to the importance of eating behaviour as criteria on health and safety, it is important for governments to ensure healthy eating patterns among population through health education programmes and suitable access to food supply [ 52 ]. In this sense, nutrition-sensitive policies might seek participation from different social and economic sectors with the aim of reaching a proper change in eating behaviour [ 53 ]. Some examples of these policies would include: (a) access to education, (b) the promotion of healthy local food environments as well as social protection programmes, (c) the regulation of working conditions, (d) the improvement of menus at school cantines and (e) the regulation of advertising through a gender-based perspective that rejects beauty standards and encourages a healthy lifestyle [ 54 ].
This initiative would address the Sustainable Development Goals (SDGs), in particular, the SDG 2 which aims to ‘End hunger, achieve food security and improved nutrition and promote sustainable agriculture’ [ 55 ]. Nutrition plays an important role within international cooperation as hunger elimination together with the development of sustainable food systems might improve several environmental aspects of strategic relevance and interest [ 56 ]. This systematic review provides important information about food choices in case of worldwide alarming situations such as the COVID-19 pandemic that might be responsible for a lack of food supply and negative emotions [ 4 , 9 ]. By considering that, future programmes aimed at mindful eating and healthy habits might include guidelines towards resources of interest during state alarms, examples of balanced diets and their budgets, area-based lists of soup kitchens, and allowances. Not only that but also, educational programmes might be extended beyond health and politic fields by applying multi-strategy campaigns concerned with sustained public awareness on healthy eating [ 53 ]. This kind of approach might be suitable for developed and developing countries as its objective would be ensuring a proper use of resources as well as healthier choices. Evidence-based interventions have demonstrated the efficacy of nutritional education programmes into adaptative eating behaviour [ 57 ], what might involve an urgent call to action for governments and social sectors focused on health promotion. Some implications of this initiative would include a lower demand of healthcare resources [ 58 ], a greater productivity in the workplace [ 59 ], and a better quality of life among countries due to the access to basic needs [ 60 ].
The COVID-19 outbreak led to changes in eating behaviour, which may have become less healthy during the pandemic. Although these changes could be a result of uncertainty and discomfort, adverse effects on health, especially for vulnerable population, would emphasize the need to promote healthy habits through preventive interventions and social actions supported by governments. Additionally, with the aim of assessing a more accurate framework of the stages through which eating behaviour changes evolved during this period, further research should be carried out. In this context, it would be important to focus on food intake but also on alcohol consumption and its consequences. By this, not only may a progression of ‘eating behaviour during a state of alarm’ be developed but also a benchmark for future directions can be established that will help improve guidelines for achieving proper nutrition aimed at the new normality.
Conceptualization, C.G.-M., C.M.O.-S. and E.M.; methodology, C.G.-M., E.M. and I.G.-G.; formal analysis, C.G.-M., C.M.O.-S., I.G.-G. and E.M.; investigation, C.G.-M. and E.M.; writing—original draft preparation, C.G.-M.; writing—review and editing, C.G.-M. and E.M.; supervision, I.G.-G. and C.M.O.-S. All authors have read and agreed to the published version of the manuscript.
Emma Motrico and Irene Gómez-Gómez have received funding from Instituto de Salud Carlos III (PI19/01264) and Junta de Andalucia (PY20 RE 025 LOYOLA).
Informed consent statement, data availability statement, conflicts of interest.
The authors declare no conflict of interest.
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This essay examines key aspects of social relationships that were disrupted by the COVID-19 pandemic. It focuses explicitly on relational mechanisms of health and brings together theory and emerging evidence on the effects of the COVID-19 pandemic to make recommendations for future public health policy and recovery. We first provide an overview of the pandemic in the UK context, outlining the nature of the public health response. We then introduce four distinct domains of social relationships: social networks, social support, social interaction and intimacy, highlighting the mechanisms through which the pandemic and associated public health response drastically altered social interactions in each domain. Throughout the essay, the lens of health inequalities, and perspective of relationships as interconnecting elements in a broader system, is used to explore the varying impact of these disruptions. The essay concludes by providing recommendations for longer term recovery ensuring that the social relational cost of COVID-19 is adequately considered in efforts to rebuild.
Data sharing not applicable as no data sets generated and/or analysed for this study. Data sharing not applicable as no data sets generated or analysed for this essay.
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https://doi.org/10.1136/jech-2021-216690
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Infectious disease pandemics, including SARS and COVID-19, demand intrapersonal behaviour change and present highly complex challenges for public health. 1 A pandemic of an airborne infection, spread easily through social contact, assails human relationships by drastically altering the ways through which humans interact. In this essay, we draw on theories of social relationships to examine specific ways in which relational mechanisms key to health and well-being were disrupted by the COVID-19 pandemic. Relational mechanisms refer to the processes between people that lead to change in health outcomes.
At the time of writing, the future surrounding COVID-19 was uncertain. Vaccine programmes were being rolled out in countries that could afford them, but new and more contagious variants of the virus were also being discovered. The recovery journey looked long, with continued disruption to social relationships. The social cost of COVID-19 was only just beginning to emerge, but the mental health impact was already considerable, 2 3 and the inequality of the health burden stark. 4 Knowledge of the epidemiology of COVID-19 accrued rapidly, but evidence of the most effective policy responses remained uncertain.
The initial response to COVID-19 in the UK was reactive and aimed at reducing mortality, with little time to consider the social implications, including for interpersonal and community relationships. The terminology of ‘social distancing’ quickly became entrenched both in public and policy discourse. This equation of physical distance with social distance was regrettable, since only physical proximity causes viral transmission, whereas many forms of social proximity (eg, conversations while walking outdoors) are minimal risk, and are crucial to maintaining relationships supportive of health and well-being.
The aim of this essay is to explore four key relational mechanisms that were impacted by the pandemic and associated restrictions: social networks, social support, social interaction and intimacy. We use relational theories and emerging research on the effects of the COVID-19 pandemic response to make three key recommendations: one regarding public health responses; and two regarding social recovery. Our understanding of these mechanisms stems from a ‘systems’ perspective which casts social relationships as interdependent elements within a connected whole. 5
Social networks characterise the individuals and social connections that compose a system (such as a workplace, community or society). Social relationships range from spouses and partners, to coworkers, friends and acquaintances. They vary across many dimensions, including, for example, frequency of contact and emotional closeness. Social networks can be understood both in terms of the individuals and relationships that compose the network, as well as the overall network structure (eg, how many of your friends know each other).
Social networks show a tendency towards homophily, or a phenomenon of associating with individuals who are similar to self. 6 This is particularly true for ‘core’ network ties (eg, close friends), while more distant, sometimes called ‘weak’ ties tend to show more diversity. During the height of COVID-19 restrictions, face-to-face interactions were often reduced to core network members, such as partners, family members or, potentially, live-in roommates; some ‘weak’ ties were lost, and interactions became more limited to those closest. Given that peripheral, weaker social ties provide a diversity of resources, opinions and support, 7 COVID-19 likely resulted in networks that were smaller and more homogenous.
Such changes were not inevitable nor necessarily enduring, since social networks are also adaptive and responsive to change, in that a disruption to usual ways of interacting can be replaced by new ways of engaging (eg, Zoom). Yet, important inequalities exist, wherein networks and individual relationships within networks are not equally able to adapt to such changes. For example, individuals with a large number of newly established relationships (eg, university students) may have struggled to transfer these relationships online, resulting in lost contacts and a heightened risk of social isolation. This is consistent with research suggesting that young adults were the most likely to report a worsening of relationships during COVID-19, whereas older adults were the least likely to report a change. 8
Lastly, social connections give rise to emergent properties of social systems, 9 where a community-level phenomenon develops that cannot be attributed to any one member or portion of the network. For example, local area-based networks emerged due to geographic restrictions (eg, stay-at-home orders), resulting in increases in neighbourly support and local volunteering. 10 In fact, research suggests that relationships with neighbours displayed the largest net gain in ratings of relationship quality compared with a range of relationship types (eg, partner, colleague, friend). 8 Much of this was built from spontaneous individual interactions within local communities, which together contributed to the ‘community spirit’ that many experienced. 11 COVID-19 restrictions thus impacted the personal social networks and the structure of the larger networks within the society.
Social support, referring to the psychological and material resources provided through social interaction, is a critical mechanism through which social relationships benefit health. In fact, social support has been shown to be one of the most important resilience factors in the aftermath of stressful events. 12 In the context of COVID-19, the usual ways in which individuals interact and obtain social support have been severely disrupted.
One such disruption has been to opportunities for spontaneous social interactions. For example, conversations with colleagues in a break room offer an opportunity for socialising beyond one’s core social network, and these peripheral conversations can provide a form of social support. 13 14 A chance conversation may lead to advice helpful to coping with situations or seeking formal help. Thus, the absence of these spontaneous interactions may mean the reduction of indirect support-seeking opportunities. While direct support-seeking behaviour is more effective at eliciting support, it also requires significantly more effort and may be perceived as forceful and burdensome. 15 The shift to homeworking and closure of community venues reduced the number of opportunities for these spontaneous interactions to occur, and has, second, focused them locally. Consequently, individuals whose core networks are located elsewhere, or who live in communities where spontaneous interaction is less likely, have less opportunity to benefit from spontaneous in-person supportive interactions.
However, alongside this disruption, new opportunities to interact and obtain social support have arisen. The surge in community social support during the initial lockdown mirrored that often seen in response to adverse events (eg, natural disasters 16 ). COVID-19 restrictions that confined individuals to their local area also compelled them to focus their in-person efforts locally. Commentators on the initial lockdown in the UK remarked on extraordinary acts of generosity between individuals who belonged to the same community but were unknown to each other. However, research on adverse events also tells us that such community support is not necessarily maintained in the longer term. 16
Meanwhile, online forms of social support are not bound by geography, thus enabling interactions and social support to be received from a wider network of people. Formal online social support spaces (eg, support groups) existed well before COVID-19, but have vastly increased since. While online interactions can increase perceived social support, it is unclear whether remote communication technologies provide an effective substitute from in-person interaction during periods of social distancing. 17 18 It makes intuitive sense that the usefulness of online social support will vary by the type of support offered, degree of social interaction and ‘online communication skills’ of those taking part. Youth workers, for instance, have struggled to keep vulnerable youth engaged in online youth clubs, 19 despite others finding a positive association between amount of digital technology used by individuals during lockdown and perceived social support. 20 Other research has found that more frequent face-to-face contact and phone/video contact both related to lower levels of depression during the time period of March to August 2020, but the negative effect of a lack of contact was greater for those with higher levels of usual sociability. 21 Relatedly, important inequalities in social support exist, such that individuals who occupy more socially disadvantaged positions in society (eg, low socioeconomic status, older people) tend to have less access to social support, 22 potentially exacerbated by COVID-19.
Interactional norms are key relational mechanisms which build trust, belonging and identity within and across groups in a system. Individuals in groups and societies apply meaning by ‘approving, arranging and redefining’ symbols of interaction. 23 A handshake, for instance, is a powerful symbol of trust and equality. Depending on context, not shaking hands may symbolise a failure to extend friendship, or a failure to reach agreement. The norms governing these symbols represent shared values and identity; and mutual understanding of these symbols enables individuals to achieve orderly interactions, establish supportive relationship accountability and connect socially. 24 25
Physical distancing measures to contain the spread of COVID-19 radically altered these norms of interaction, particularly those used to convey trust, affinity, empathy and respect (eg, hugging, physical comforting). 26 As epidemic waves rose and fell, the work to negotiate these norms required intense cognitive effort; previously taken-for-granted interactions were re-examined, factoring in current restriction levels, own and (assumed) others’ vulnerability and tolerance of risk. This created awkwardness, and uncertainty, for example, around how to bring closure to an in-person interaction or convey warmth. The instability in scripted ways of interacting created particular strain for individuals who already struggled to encode and decode interactions with others (eg, those who are deaf or have autism spectrum disorder); difficulties often intensified by mask wearing. 27
Large social gatherings—for example, weddings, school assemblies, sporting events—also present key opportunities for affirming and assimilating interactional norms, building cohesion and shared identity and facilitating cooperation across social groups. 28 Online ‘equivalents’ do not easily support ‘social-bonding’ activities such as singing and dancing, and rarely enable chance/spontaneous one-on-one conversations with peripheral/weaker network ties (see the Social networks section) which can help strengthen bonds across a larger network. The loss of large gatherings to celebrate rites of passage (eg, bar mitzvah, weddings) has additional relational costs since these events are performed by and for communities to reinforce belonging, and to assist in transitioning to new phases of life. 29 The loss of interaction with diverse others via community and large group gatherings also reduces intergroup contact, which may then tend towards more prejudiced outgroup attitudes. While online interaction can go some way to mimicking these interaction norms, there are key differences. A sense of anonymity, and lack of in-person emotional cues, tends to support norms of polarisation and aggression in expressing differences of opinion online. And while online platforms have potential to provide intergroup contact, the tendency of much social media to form homogeneous ‘echo chambers’ can serve to further reduce intergroup contact. 30 31
Intimacy relates to the feeling of emotional connection and closeness with other human beings. Emotional connection, through romantic, friendship or familial relationships, fulfils a basic human need 32 and strongly benefits health, including reduced stress levels, improved mental health, lowered blood pressure and reduced risk of heart disease. 32 33 Intimacy can be fostered through familiarity, feeling understood and feeling accepted by close others. 34
Intimacy via companionship and closeness is fundamental to mental well-being. Positively, the COVID-19 pandemic has offered opportunities for individuals to (re)connect and (re)strengthen close relationships within their household via quality time together, following closure of many usual external social activities. Research suggests that the first full UK lockdown period led to a net gain in the quality of steady relationships at a population level, 35 but amplified existing inequalities in relationship quality. 35 36 For some in single-person households, the absence of a companion became more conspicuous, leading to feelings of loneliness and lower mental well-being. 37 38 Additional pandemic-related relational strain 39 40 resulted, for some, in the initiation or intensification of domestic abuse. 41 42
Physical touch is another key aspect of intimacy, a fundamental human need crucial in maintaining and developing intimacy within close relationships. 34 Restrictions on social interactions severely restricted the number and range of people with whom physical affection was possible. The reduction in opportunity to give and receive affectionate physical touch was not experienced equally. Many of those living alone found themselves completely without physical contact for extended periods. The deprivation of physical touch is evidenced to take a heavy emotional toll. 43 Even in future, once physical expressions of affection can resume, new levels of anxiety over germs may introduce hesitancy into previously fluent blending of physical and verbal intimate social connections. 44
The pandemic also led to shifts in practices and norms around sexual relationship building and maintenance, as individuals adapted and sought alternative ways of enacting sexual intimacy. This too is important, given that intimate sexual activity has known benefits for health. 45 46 Given that social restrictions hinged on reducing household mixing, possibilities for partnered sexual activity were primarily guided by living arrangements. While those in cohabiting relationships could potentially continue as before, those who were single or in non-cohabiting relationships generally had restricted opportunities to maintain their sexual relationships. Pornography consumption and digital partners were reported to increase since lockdown. 47 However, online interactions are qualitatively different from in-person interactions and do not provide the same opportunities for physical intimacy.
In the sections above we have outlined the ways in which COVID-19 has impacted social relationships, showing how relational mechanisms key to health have been undermined. While some of the damage might well self-repair after the pandemic, there are opportunities inherent in deliberative efforts to build back in ways that facilitate greater resilience in social and community relationships. We conclude by making three recommendations: one regarding public health responses to the pandemic; and two regarding social recovery.
Effective handling of a pandemic recognises that social, economic and health concerns are intricately interwoven. It is clear that future research and policy attention must focus on the social consequences. As described above, policies which restrict physical mixing across households carry heavy and unequal relational costs. These include for individuals (eg, loss of intimate touch), dyads (eg, loss of warmth, comfort), networks (eg, restricted access to support) and communities (eg, loss of cohesion and identity). Such costs—and their unequal impact—should not be ignored in short-term efforts to control an epidemic. Some public health responses—restrictions on international holiday travel and highly efficient test and trace systems—have relatively small relational costs and should be prioritised. At a national level, an earlier move to proportionate restrictions, and investment in effective test and trace systems, may help prevent escalation of spread to the point where a national lockdown or tight restrictions became an inevitability. Where policies with relational costs are unavoidable, close attention should be paid to the unequal relational impact for those whose personal circumstances differ from normative assumptions of two adult families. This includes consideration of whether expectations are fair (eg, for those who live alone), whether restrictions on social events are equitable across age group, religious/ethnic groupings and social class, and also to ensure that the language promoted by such policies (eg, households; families) is not exclusionary. 48 49 Forethought to unequal impacts on social relationships should thus be integral to the work of epidemic preparedness teams.
A key ingredient for well-being is ‘getting together’ in a physical sense. This is fundamental to a human need for intimate touch, physical comfort, reinforcing interactional norms and providing practical support. Emerging evidence suggests that online ways of relating cannot simply replace physical interactions. But online interaction has many benefits and for some it offers connections that did not exist previously. In particular, online platforms provide new forms of support for those unable to access offline services because of mobility issues (eg, older people) or because they are geographically isolated from their support community (eg, lesbian, gay, bisexual, transgender and queer (LGBTQ) youth). Ultimately, multiple forms of online and offline social interactions are required to meet the needs of varying groups of people (eg, LGBTQ, older people). Future research and practice should aim to establish ways of using offline and online support in complementary and even synergistic ways, rather than veering between them as social restrictions expand and contract. Intelligent balancing of online and offline ways of relating also pertains to future policies on home and flexible working. A decision to switch to wholesale or obligatory homeworking should consider the risk to relational ‘group properties’ of the workplace community and their impact on employees’ well-being, focusing in particular on unequal impacts (eg, new vs established employees). Intelligent blending of online and in-person working is required to achieve flexibility while also nurturing supportive networks at work. Intelligent balance also implies strategies to build digital literacy and minimise digital exclusion, as well as coproducing solutions with intended beneficiaries.
In balancing offline and online ways of interacting, there is opportunity to capitalise on the potential for more localised, coherent communities due to scaled-down travel, homeworking and local focus that will ideally continue after restrictions end. There are potential economic benefits after the pandemic, such as increased trade as home workers use local resources (eg, coffee shops), but also relational benefits from stronger relationships around the orbit of the home and neighbourhood. Experience from previous crises shows that community volunteer efforts generated early on will wane over time in the absence of deliberate work to maintain them. Adequately funded partnerships between local government, third sector and community groups are required to sustain community assets that began as a direct response to the pandemic. Such partnerships could work to secure green spaces and indoor (non-commercial) meeting spaces that promote community interaction. Green spaces in particular provide a triple benefit in encouraging physical activity and mental health, as well as facilitating social bonding. 50 In building local communities, small community networks—that allow for diversity and break down ingroup/outgroup views—may be more helpful than the concept of ‘support bubbles’, which are exclusionary and less sustainable in the longer term. Rigorously designed intervention and evaluation—taking a systems approach—will be crucial in ensuring scale-up and sustainability.
The dramatic change to social interaction necessitated by efforts to control the spread of COVID-19 created stark challenges but also opportunities. Our essay highlights opportunities for learning, both to ensure the equity and humanity of physical restrictions, and to sustain the salutogenic effects of social relationships going forward. The starting point for capitalising on this learning is recognition of the disruption to relational mechanisms as a key part of the socioeconomic and health impact of the pandemic. In recovery planning, a general rule is that what is good for decreasing health inequalities (such as expanding social protection and public services and pursuing green inclusive growth strategies) 4 will also benefit relationships and safeguard relational mechanisms for future generations. Putting this into action will require political will.
Patient consent for publication.
Not required.
Twitter @karenmaxSPHSU, @Mark_McCann, @Rwilsonlowe, @KMitchinGlasgow
Contributors EL and KM led on the manuscript conceptualisation, review and editing. SP, KM, CB, RBP, RL, MM, JR, KS and RW-L contributed to drafting and revising the article. All authors assisted in revising the final draft.
Funding The research reported in this publication was supported by the Medical Research Council (MC_UU_00022/1, MC_UU_00022/3) and the Chief Scientist Office (SPHSU11, SPHSU14). EL is also supported by MRC Skills Development Fellowship Award (MR/S015078/1). KS and MM are also supported by a Medical Research Council Strategic Award (MC_PC_13027).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
The pandemic and resulting shelter-in-place restrictions are affecting everyone in different ways. Tiana Nguyen, shares both the pros and cons of her experience as a student at Santa Clara University.
person sitting at table with open laptop, notebook and pen
Tiana Nguyen ‘21 is a Hackworth Fellow at the Markkula Center for Applied Ethics. She is majoring in Computer Science, and is the vice president of Santa Clara University’s Association for Computing Machinery (ACM) chapter .
The world has slowed down, but stress has begun to ramp up.
In the beginning of quarantine, as the world slowed down, I could finally take some time to relax, watch some shows, learn to be a better cook and baker, and be more active in my extracurriculars. I have a lot of things to be thankful for. I especially appreciate that I’m able to live in a comfortable house and have gotten the opportunity to spend more time with my family. This has actually been the first time in years in which we’re all able to even eat meals together every single day. Even when my brother and I were young, my parents would be at work and sometimes come home late, so we didn’t always eat meals together. In the beginning of the quarantine I remember my family talking about how nice it was to finally have meals together, and my brother joking, “it only took a pandemic to bring us all together,” which I laughed about at the time (but it’s the truth).
Soon enough, we’ll all be back to going to different places and we’ll be separated once again. So I’m thankful for my living situation right now. As for my friends, even though we’re apart, I do still feel like I can be in touch with them through video chat—maybe sometimes even more in touch than before. I think a lot of people just have a little more time for others right now.
Although there are still a lot of things to be thankful for, stress has slowly taken over, and work has been overwhelming. I’ve always been a person who usually enjoys going to classes, taking on more work than I have to, and being active in general. But lately I’ve felt swamped with the amount of work given, to the point that my days have blurred into online assignments, Zoom classes, and countless meetings, with a touch of baking sweets and aimless searching on Youtube.
The pass/no pass option for classes continues to stare at me, but I look past it every time to use this quarter as an opportunity to boost my grades. I've tried to make sense of this type of overwhelming feeling that I’ve never really felt before. Is it because I’m working harder and putting in more effort into my schoolwork with all the spare time I now have? Is it because I’m not having as much interaction with other people as I do at school? Or is it because my classes this quarter are just supposed to be this much harder? I honestly don’t know; it might not even be any of those. What I do know though, is that I have to continue work and push through this feeling.
This quarter I have two synchronous and two asynchronous classes, which each have pros and cons. Originally, I thought I wanted all my classes to be synchronous, since that everyday interaction with my professor and classmates is valuable to me. However, as I experienced these asynchronous classes, I’ve realized that it can be nice to watch a lecture on my own time because it even allows me to pause the video to give me extra time for taking notes. This has made me pay more attention during lectures and take note of small details that I might have missed otherwise. Furthermore, I do realize that synchronous classes can also be a burden for those abroad who have to wake up in the middle of the night just to attend a class. I feel that it’s especially unfortunate when professors want students to attend but don’t make attendance mandatory for this reason; I find that most abroad students attend anyway, driven by the worry they’ll be missing out on something.
I do still find synchronous classes amazing though, especially for discussion-based courses. I feel in touch with other students from my classes whom I wouldn’t otherwise talk to or regularly reach out to. Since Santa Clara University is a small school, it is especially easy to interact with one another during classes on Zoom, and I even sometimes find it less intimidating to participate during class through Zoom than in person. I’m honestly not the type to participate in class, but this quarter I found myself participating in some classes more than usual. The breakout rooms also create more interaction, since we’re assigned to random classmates, instead of whomever we’re sitting closest to in an in-person class—though I admit breakout rooms can sometimes be awkward.
Something that I find beneficial in both synchronous and asynchronous classes is that professors post a lecture recording that I can always refer to whenever I want. I found this especially helpful when I studied for my midterms this quarter; it’s nice to have a recording to look back upon in case I missed something during a lecture.
Overall, life during these times is substantially different from anything most of us have ever experienced, and at times it can be extremely overwhelming and stressful—especially in terms of school for me. Online classes don’t provide the same environment and interactions as in-person classes and are by far not as enjoyable. But at the end of the day, I know that in every circumstance there is always something to be thankful for, and I’m appreciative for my situation right now. While the world has slowed down and my stress has ramped up, I’m slowly beginning to adjust to it.
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A dozen writing projects — including journals, poems, comics and more — for students to try at home.
By Natalie Proulx
The coronavirus has transformed life as we know it. Schools are closed, we’re confined to our homes and the future feels very uncertain. Why write at a time like this?
For one, we are living through history. Future historians may look back on the journals, essays and art that ordinary people are creating now to tell the story of life during the coronavirus.
But writing can also be deeply therapeutic. It can be a way to express our fears, hopes and joys. It can help us make sense of the world and our place in it.
Plus, even though school buildings are shuttered, that doesn’t mean learning has stopped. Writing can help us reflect on what’s happening in our lives and form new ideas.
We want to help inspire your writing about the coronavirus while you learn from home. Below, we offer 12 projects for students, all based on pieces from The New York Times, including personal narrative essays, editorials, comic strips and podcasts. Each project features a Times text and prompts to inspire your writing, as well as related resources from The Learning Network to help you develop your craft. Some also offer opportunities to get your work published in The Times, on The Learning Network or elsewhere.
We know this list isn’t nearly complete. If you have ideas for other pandemic-related writing projects, please suggest them in the comments.
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IMAGES
VIDEO
COMMENTS
1. Introduction. Non-communicable diseases (NCDs) are the leading cause of death globally [], and one of the major health challenges of the 21st century.While 5.60 million deaths are associated with Coronavirus Disease 2019 (COVID-19) worldwide in the two years since the start of the pandemic in December 2019 [], NCDs are associated with the deaths of 41 million people each year (approximately ...
From lifestyle changes to better eating habits, people are using this time to get healthier in many areas. Since the pandemic started, nearly two-thirds of the survey's participants (62%) say ...
Reading time: 3 min (864 words) The COVID-19 pandemic has led to a dramatic loss of human life worldwide and presents an unprecedented challenge to public health, food systems and the world of work. The economic and social disruption caused by the pandemic is devastating: tens of millions of people are at risk of falling into extreme poverty ...
Lessons learned from COVID. Living through the pandemic has changed many people's health habits, sometimes for the better. By Matthew Solan, Executive Editor, Harvard Men's Health Watch. More than three years after COVID emerged, people are anxious to resume their pre-pandemic lifestyle. But don't be too quick to return to old habits.
Regaining Control Through Diet. One key component of maintaining a healthy lifestyle is diet. Across age groups, about half (48%) of adults ages 50-plus say their eating habits have not changed since the start of the pandemic. Further, one-third (32%) of older adults say they eat a little more or more healthy now than before the pandemic.
The COVID-19 pandemic represents a massive impact on human health, causing sudden lifestyle changes, through social distancing and isolation at home, with social and economic consequences. Optimizing public health during this pandemic requires not only knowledge from the medical and biological sciences, but also of all human sciences related to ...
Read these 12 moving essays about life during coronavirus. Artists, novelists, critics, and essayists are writing the first draft of history. A woman wearing a face mask in Miami. Alissa Wilkinson ...
Moreover, the associations between mental health outcomes and lifestyle behaviors as well as lifestyle changes during the COVID-19 pandemic represent a research gap. Therefore, this study aimed to explore the perceived lifestyle changes after the outbreak of COVID-19, and their association with subjective well-being among the general population ...
Background During the Covid-19 pandemic the Dutch government implemented its so-called 'intelligent lockdown' in which people were urged to leave their homes as little as possible and work from home. This life changing event may have caused changes in lifestyle behaviour, an important factor in the onset and course of diseases. The overarching aim of this study is to determine life-style ...
However, the fear of the disease and death, as well as the restrictions of individual freedom, worsened the stress load and produced alteration of habitual behaviors. Accordingly, the lifestyle and eating habits changed during the COVID-19 pandemic period, particularly in 37.3% of respondents, but only 16.7% of them improved their behaviors.
SARS-CoV-2 pandemic generated a profound impact on people's health, emphasizing the relevance of healthy lifestyles. Recommendations on how to maintain adequate physical activity, diet, sleep and social connection have been issued. However, it is worth expanding our look to other possible elements related to lifestyles such as the relationship ...
Alex, a writer and fellow disabled parent, found the freedom to explore a fuller version of herself in the privacy the pandemic provided. "The way I dress, the way I love, and the way I carry ...
This study did five surveys between April 2020 and March 2021 to look at how lifestyle changes during the pandemic affected well-being. These surveys covered all of Japan and were done both before ...
Students can choose to write a full-length college essay on the coronavirus or summarize their experience in a shorter form. To help students explain how the pandemic affected them, The Common App ...
No smoking. Limited alcohol. Lots of fruits and vegetables. Avoid saturated fats and starchy carbohydrates. Exercise regularly. Maintain a healthy weight. Get adequate sleep (8 hours/night) Minimize stress. Talk to your physician to ensure adequate levels of vitamin D, electrolytes and trace metals.
fe have changed immensely due to the COVID-19 pandemic. The most impacted aspects of work life are policies, service delivery, and work environment, especially with a new focus. n what we can do to deliver remote services efectively. The impacts to my personal life include my children's education, our shared work environment, and our health ...
By Mayo Clinic Staff. At the start of the COVID-19 pandemic, life for many people changed very quickly. Worry and concern were natural partners of all that change — getting used to new routines, loneliness and financial pressure, among other issues. Information overload, rumor and misinformation didn't help.
After an hour-and-a-half Zoom meeting, I decided to take a long walk to the post office and grab a fresh bouquet of burnt orange ranunculus flowers. I embrace the warm sun beaming on my face. I ...
Push-ups, sit-ups, jumping-jacks and more exercises are great ways to stay fit away from the gym. Other ideas include: Walk briskly around the house or up and down the stairs for 10-15 minutes 2-3 times per day. Dance to your favorite music. Join a live exercise class on YouTube.
Adults living in the UK during the COVID-19 pandemic: No: n = 22,374 Female = 76% (n = 16,984) ... First, due to the heterogeneity of the designs as well as the small set of papers used, it is important to consider this review as a first approach to eating behaviour changes during the COVID-19 pandemic. ... which may have become less healthy ...
This essay examines key aspects of social relationships that were disrupted by the COVID-19 pandemic. It focuses explicitly on relational mechanisms of health and brings together theory and emerging evidence on the effects of the COVID-19 pandemic to make recommendations for future public health policy and recovery. We first provide an overview of the pandemic in the UK context, outlining the ...
Tiana Nguyen. Tiana Nguyen '21 is a Hackworth Fellow at the Markkula Center for Applied Ethics. She is majoring in Computer Science, and is the vice president of Santa Clara University's Association for Computing Machinery (ACM) chapter. The world has slowed down, but stress has begun to ramp up. In the beginning of quarantine, as the world ...
Pandemic life can be lonely, bleak, and harrowing. From reigniting past traumas to causing entirely new ones, the COVID-19 pandemic has affected the mental, physical, and emotional health of many ...
In this life during pandemic essay, we will discuss how the pandemic has affected various aspects of life including health, work, education, social interaction and mental well-being. we will focus on the changes people have experienced in their routines, how work and learning have moved predominantly online, the challenges of isolation and ...
Future historians may look back on the journals, essays and art that ordinary people are creating now to tell the story of life during the coronavirus. But writing can also be deeply therapeutic.