Changes in ultra-processed food consumption during the first Italian lockdown following the COVID-19 pandemic and major correlates: results from two population-based cohorts

Abstract

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.

Impact of Nationwide Lockdowns Resulting from the First Wave of the COVID-19 Pandemic on Food Intake, Eating Behaviors, and Diet Quality: A Systematic Review

“…Due to pandemic status limitations, with difficulty in performing person-to-person questionnaires or interviews, all of the studies included data collected through online questionnaires or, on a few occasions, through telephone or web interviews ( 22 , 23 , 25 , 31 , 56 ).…”

“…Most of the studies were carried out during the first 3 mo of lockdown (March to May 2020), when containment measures were stricter worldwide. Otherwise, the recruitment period of some surveys lasted until September ( 23 , 25 , 113 ) ( Table 1 ).…”

Effects of Covid-19 Home Confinement on Eating Behavior: A Review

“… 20 Other study found an increase in sugar drinks and ultra processed food during the pandemic. 21 , 22 Therefore, the objective of the present review is to evaluate the effect of quarantine on dietary habits during enforced lockdowns.…”

Impact of COVID-19 pandemic on diet behaviour among UK adults: a longitudinal analysis of the HEBECO study

“…These changes in diet behaviours during the pandemic are associated with several factors including age, gender, body mass index (BMI), physical activity and experiencing a larger psychological impact and larger shifts in lifestyle as a result of lockdown restrictions [4,14,[21][22][23][24][25][26][27]. Given the relationship between a sub-optimal diet and relative risk of cardiovascular disease, cancer and allcause mortality, there could be serious long-term public health consequences if the initial unfavourable changes in dietary behaviours during the pandemic are maintained [28,29].…”