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Objective: To evaluate changes in ultra-processed food (UPF) intake and its major correlates during the first Italian lockdown (March 9 -May 3 2020). Design: Retrospective observational study. Setting: Italy. Participants: We analysed 2,992 subjects (mean age 57.9±15.3 y, 40.4% men). Individual participant data were pooled from 2 retrospective cohorts: 1) The Moli-LOCK cohort consists of 1,501 adults, a portion of the larger Moli-sani Study (n=24,325; 2005-2010) who were administered a phone-based questionnaire to assess lifestyles and psychological factors during confinement; 2) the ALT RISCOVID-19 is a web-based survey of 1,491 individuals distributed throughout Italy who self-responded to the same questionnaire by using Google forms. UPF was defined according to NOVA classification based on degree of food processing. An UPF score was created by assigning 1 point to increased consumption, -1 to decreased and 0 point for unchanged intakes of 19 food items, with higher values indicating an increase in UPF during confinement. Results: Overall, 37.5% of the population reported some increase in UPF (UPF score ≥1). Adults were more likely to decrease UPF (multivariable regression coefficient β=-1.94; 95%CI: -2.72,-1.17 for individuals aged >75 y as compared to 18-39 y) as did individuals from southern Italian regions as compared to Northern inhabitants (β=-1.32; -1.80,-0.84), while UPF lowering associated with increased exercise (β=-0.90; -1.46,-0.35) and weight loss (β=-1.05; -1.51, -0.59) during confinement. Conclusions: During the first Italian lockdown, about 40% of our population switched to unfavourable eating as reflected by increased UPF intake and this may have long-term effects for health.

Mushroom cell walls are rich in β-glucans, long or short-chain polymers of glucose subunits with β-1,3 and β-1,6 linkages, that are responsible for the linear and branching structures, respectively. β-glucans from cereals, at variance, have no 1,6 linkages nor branching structures. Both immunomodulatory and anti-inflammatory effects of mushrooms have been described using purified β-glucans or fungi extracts on cellular and experimental models; their potential clinical use has been tested in different conditions, such as recurrent infections of the respiratory tract or complications of major surgery. Another promising application of β-glucans is on cancer, as adjuvant of conventional chemotherapy. β-glucans may protect the cardiovascular system, ameliorating glucose, lipid metabolism, and blood pressure: these activities, observed for oat and barley β-glucans, require confirmation in human studies with mushroom β-glucans. On the other hand, mushrooms may also protect the cardiovascular system via a number of other components, such as bioactive phenolic compounds, vitamins, and mineral elements. The growing knowledge on the mechanism(s) and health benefits of mushrooms is encouraging the development of a potential clinical use of β-glucans, and also to further document their role in preserving health and prevent disease in the context of healthy lifestyles.

Household income in 2019 (EUR/y) ≤10.000 >10.000≤25.000 >25.000≤40.000 >40.000≤60.000 >60.000≤100.000 >100.000 Refused/I do not know Housing tenure Rent 1 dwelling ownership > 1 dwelling ownership Refused/I do not know Number of rooms in the house (bathrooms and additional rooms excluded) lockdown? (multiple choice) Blood pressure medications Cholesterol medications Diabetes drugs Anti-cancer drugs Corticosteroids Thyroid medications Anti-inflammatory drugs Anxiolytics Antidepressants Immunomodulators None Refused/I do not know Did you get flu vaccination last autumn (2019)? Yes/No/Refused/I do not know Did you get anti pneumococcal vaccine last autumn (2019)? Yes/No/Refused/I do not know Moli-LOCK Study Investigators