Socio-Cognitive Factors Associated With Lifestyle Changes in Response to the COVID-19 Epidemic in the General Population: Results From a Cross-Sectional Study in France

Abstract

Background The aims of the present study were to assess changes in lifestyles in the general population in response to coronavirus disease 2019 (COVID-19) lockdown and the influence of COVID-19 perceptions, as assessed by the Extended Parallel Process Model (EPPM), on these changes. Methods Data were collected from 4005 individuals through an online survey conducted 3–4 weeks after the nationwide lockdown implementation in France. Participants were asked whether they practiced five behaviors (i.e., screen watching, snacking, eating fruits and vegetables, exercising, and walking) less often, as often as, or more often than prior to the lockdown. Beliefs and expectations toward the COVID-19 epidemic were also assessed using an adapted version of Witte’s EPPM, together with sociodemographic and environmental variables. Among the respondents consuming regularly alcohol and tobacco, logistic regressions were performed to estimate the Odds ratios (ORs) of increase (yes/no) and decrease (yes/no) in drinking and smoking since the lockdown. Results More than 8 in 10 respondents reported unhealthy changes in lifestyle since the lockdown, mostly in relation to physical activity. The unhealthy changes were positively associated with male sex (RR = 1.17; confidence interval [95% CI] = 1.10–1.24), living urban density, having a garden (RR = 1.16 [1.07–1.26]), financial difficulties because of COVID-19 (RR = 1.09 [1.02–1.18]), and lack of fear control (RR = 1.04 [1.01–1.09]) and negatively with cognitive avoidance (RR = 0.92 [0.89–0.95]). Less than 4 in 10 respondents reported healthy changes over the same period, mostly in relation to better eating habits. They were positively associated with living with more than two persons (RR = 1.22 [1.02–1.45]), having a terrace (RR = 1.14 [1.02–1.29], and perceived efficacy (RR = 1.11 [1.04–1.08]) and negatively with being aged 40 or higher. Alcohol consumption overall declined in regular drinkers, while a slight increase in tobacco use was observed in regular smokers. Discussion The COVID-19 pandemic and lockdown resulted in frequent and mostly unhealthy changes in lifestyle among the general population. These changes were related to individual and environmental characteristics but also to EPPM appraisals in the wake of fear appeal from COVID-19 campaigns. Communication and preventive measures should include messages and initiatives toward the maintenance of healthy lifestyles during pandemics such as the adaptation of physical activity and eating guidelines to the particular contexts of mobility restriction and infection control.

Home Food Procurement Impacts Food Security and Diet Quality during COVID-19

“…Increased fruit and vegetable intake is associated with reduced risk of cardiovascular disease, certain cancers, and all-cause mortality [64], yet even pre-pandemic, most Americans did not meet the national recommendations for fruit and vegetable intake [65]. Our finding of reduced intake are similar to those from studies conducted recently in France (Constant et al 2020) and the United Arab Emirates [37] finding lower fruit and vegetable intake during COVID-19 associated lockdowns. Respondents using AHFP were on average eating ½ cup more each of fruits and vegetables daily; higher fruit and vegetable intake is associated with reduced risk of cardiovascular disease, cancer and mortality [64].…”

“…Chenarides et al (2020) [40] examined urban gardening before and during the COVID-19 pandemic, finding lower participation in community gardens as compared to at-home gardens. Constant et al (2020) found having a garden/terrace positively associated with unhealthy behaviors during the COVID-19 lockdown in France, primarily a reduction in physical activity. Finally, though a few commentaries have discussed the potential benefits of home gardens during COVID-19 (e.g.…”

Changes in health behaviors, mental and physical health among older adults under severe lockdown restrictions during the COVID-19 pandemic in Spain

“…Surveys on non-institutionalized adults have uniformly shown declines in physical activity and increases in sedentary time after confinement (11,19,20,(63)(64)(65), with unhealthier changes observed among those with higher activity and lower sedentariness at baseline (19,63,65), and among those who had follow-up symptoms of loneliness and worse mental health (12,19,63,65). In our study, we corroborated the association between previous levels of activity and sedentariness and changes in these behaviors with confinement, probably reflecting the regression to the mean phenomenon.…”

Not Able to Lead a Healthy Life When You Need It the Most: Dual Role of Lifestyle Behaviors in the Association of Blurred Work-Life Boundaries With Well-Being

“…Dutch observational studies have shown -and newspapers reported -that the COVID-19 lockdown has a non-negligible impact on people's lifestyle in terms of fewer social contacts, changed eating habits, decreased physical activity, decreased sleep quality, and psychological factors (iResearch, 2020). Cross-sectional studies in countries like Australia (Stanton et al, 2020), China (He et al, 2020), Chile (Reyes-Olavarría et al, 2020), Italy (Di Renzo et al, 2020), and France (Constant et al, 2020) confirm that, during the COVID-19 lockdown, people have gained weight, engaged less in physical activity, showed more sedentary behavior, consumed more alcohol, slept less well, and changed their eating habits (both positive and negative changes in healthy nutrition have been observed). A study conducted in Spain showed that changes in health-related behaviors depend on the duration of confinement due to COVID-19 and people may gradually improve their lifestyle during confinement (López-Bueno et al, 2020).…”