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      Impact of COVID-19 confinement on eating behaviours across 16 European countries: The COVIDiet cross-national study

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      a , b , c , d , 1 , e , 1 , a , b , a , a , a , f , f , f , f , g , g , g , h , g , i , i , j , k , l , m , n , m , m , o , p , q , o , o , r , s , s , t , u , v , v , v , v , a , b , 2 , b , c , w , 2 , *
      Food Quality and Preference
      Elsevier Ltd.
      COVID-19 confinement, Eating behaviours, Mediterranean diet, Stringency index, Nutritional survey, COVID-19, SARS-CoV-2 coronavirus, MedDiet, mediterranean diet, MEDAS, validated 14-items mediterranean diet adherence screener, SI, stringency index, OxCGRT, Oxford COVID-19 government response tracker, SD, standard deviations

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          Abstract

          We aimed to evaluate the changes in eating behaviours of the adult population across 16 European countries due to the COVID-19 confinement and to evaluate whether these changes were somehow related to the severity of the containment measures applied in each country. An anonymous online self-reported questionnaire on socio-demographic characteristics, validated 14-items Mediterranean diet (MedDiet) Adherence Screener (MEDAS) as a reference of a healthy diet, eating and lifestyle behaviours prior to and during the COVID-19 confinement was used to collect data. The study included an adult population residing in 16 European countries at the time of the survey. Aggregated Stringency Index (SI) score, based on data from the Oxford COVID-19 Government Response Tracker, was calculated for each country at the time the questionnaire was distributed (range: 0–100). A total of 36,185 participants completed the questionnaire (77.6% female, 75.2% with high educational level and 42.7% aged between 21 and 35 years). In comparison to pre-confinement, a significantly higher adherence to the MedDiet during the confinement was observed across all countries (overall MEDAS score prior to- and during confinement: 5.23 ± 2.06 vs. 6.15 ± 2.06; p < 0.001), with the largest increase seen in Greece and North Macedonia. The highest adherence to MedDiet during confinement was found in Spain and Portugal (7.18 ± 1.84 and 7.34 ± 1.95, respectively). Stricter contingency restrictions seemed to lead to a significantly higher increase in the adherence to the MedDiet. The findings from this cross-sectional study could be used to inform current diet-related public health guidelines to ensure optimal nutrition is followed among the population, which in turn would help to alleviate the current public health crisis.

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          Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population

          Summary Background The potential impact of the COVID-19 pandemic on population mental health is of increasing global concern. We examine changes in adult mental health in the UK population before and during the lockdown. Methods In this secondary analysis of a national, longitudinal cohort study, households that took part in Waves 8 or 9 of the UK Household Longitudinal Study (UKHLS) panel, including all members aged 16 or older in April, 2020, were invited to complete the COVID-19 web survey on April 23–30, 2020. Participants who were unable to make an informed decision as a result of incapacity, or who had unknown postal addresses or addresses abroad were excluded. Mental health was assessed using the 12-item General Health Questionnaire (GHQ-12). Repeated cross-sectional analyses were done to examine temporal trends. Fixed-effects regression models were fitted to identify within-person change compared with preceding trends. Findings Waves 6–9 of the UKHLS had 53 351 participants. Eligible participants for the COVID-19 web survey were from households that took part in Waves 8 or 9, and 17 452 (41·2%) of 42 330 eligible people participated in the web survey. Population prevalence of clinically significant levels of mental distress rose from 18·9% (95% CI 17·8–20·0) in 2018–19 to 27·3% (26·3–28·2) in April, 2020, one month into UK lockdown. Mean GHQ-12 score also increased over this time, from 11·5 (95% CI 11·3–11·6) in 2018–19, to 12·6 (12·5–12·8) in April, 2020. This was 0·48 (95% CI 0·07–0·90) points higher than expected when accounting for previous upward trends between 2014 and 2018. Comparing GHQ-12 scores within individuals, adjusting for time trends and significant predictors of change, increases were greatest in 18–24-year-olds (2·69 points, 95% CI 1·89–3·48), 25–34-year-olds (1·57, 0·96–2·18), women (0·92, 0·50–1·35), and people living with young children (1·45, 0·79–2·12). People employed before the pandemic also averaged a notable increase in GHQ-12 score (0·63, 95% CI 0·20–1·06). Interpretation By late April, 2020, mental health in the UK had deteriorated compared with pre-COVID-19 trends. Policies emphasising the needs of women, young people, and those with preschool aged children are likely to play an important part in preventing future mental illness. Funding None.
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            Effects of COVID-19 Home Confinement on Eating Behaviour and Physical Activity: Results of the ECLB-COVID19 International Online Survey

            Background: Public health recommendations and governmental measures during the COVID-19 pandemic have resulted in numerous restrictions on daily living including social distancing, isolation and home confinement. While these measures are imperative to abate the spreading of COVID-19, the impact of these restrictions on health behaviours and lifestyles at home is undefined. Therefore, an international online survey was launched in April 2020, in seven languages, to elucidate the behavioural and lifestyle consequences of COVID-19 restrictions. This report presents the results from the first thousand responders on physical activity (PA) and nutrition behaviours. Methods: Following a structured review of the literature, the “Effects of home Confinement on multiple Lifestyle Behaviours during the COVID-19 outbreak (ECLB-COVID19)” Electronic survey was designed by a steering group of multidisciplinary scientists and academics. The survey was uploaded and shared on the Google online survey platform. Thirty-five research organisations from Europe, North-Africa, Western Asia and the Americas promoted the survey in English, German, French, Arabic, Spanish, Portuguese and Slovenian languages. Questions were presented in a differential format, with questions related to responses “before” and “during” confinement conditions. Results: 1047 replies (54% women) from Asia (36%), Africa (40%), Europe (21%) and other (3%) were included in the analysis. The COVID-19 home confinement had a negative effect on all PA intensity levels (vigorous, moderate, walking and overall). Additionally, daily sitting time increased from 5 to 8 h per day. Food consumption and meal patterns (the type of food, eating out of control, snacks between meals, number of main meals) were more unhealthy during confinement, with only alcohol binge drinking decreasing significantly. Conclusion: While isolation is a necessary measure to protect public health, results indicate that it alters physical activity and eating behaviours in a health compromising direction. A more detailed analysis of survey data will allow for a segregation of these responses in different age groups, countries and other subgroups, which will help develop interventions to mitigate the negative lifestyle behaviours that have manifested during the COVID-19 confinement.
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              Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths

              The world is in the grip of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing the risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increasing concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced the risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D (25(OH)D) concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome; and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40–60 ng/mL (100–150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.
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                Author and article information

                Journal
                Food Qual Prefer
                Food Qual Prefer
                Food Quality and Preference
                Elsevier Ltd.
                0950-3293
                0950-3293
                23 March 2021
                October 2021
                23 March 2021
                : 93
                : 104231
                Affiliations
                [a ]Department of Nutrition and Food Science, University of Granada, Campus of Cartuja, 18071 Granada, Spain
                [b ]Institute of Nutrition and Food Technology (INYTA) ‘José Mataix’, Biomedical Research Centre, University of Granada, Avenida del Conocimiento s/n, E-18071 Granada, Spain
                [c ]Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
                [d ]Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública CIBERESP, Madrid, Spain
                [e ]Department of Health and Nutritional Sciences, Institute of Technology Sligo, Ash Ln, Bellanode, Sligo F91 YW50, Ireland
                [f ]Department of Food Science and Nutrition, Agricultural University of Athens, Iera Odos 75, Athens 11855, Greece
                [g ]Computer Systems Department, Jožef Stefan Institute, Jamova cesta 39, Ljubljana, Slovenia
                [h ]General Hospital Novo mesto, Šmihelska cesta 1, 8000 Novo mesto, Slovenia
                [i ]University of Zagreb, Faculty of Food Technology and Biotechnology, Pierottijeva ul. 6, 10000 Zagreb, Croatia
                [j ]University Hospital Centre Zagreb, Department of Internal Medicine, Division of Gastroenterology and Hepatology & Unit of Clinical Nutrition, Kišpatićeva ul. 12, 10000 Zagreb, Croatia
                [k ]Department of Technology and Innovation, University of Southern Denmark, Campusvej 55, DK5230 Odense, Denmark
                [l ]Department of Food Science, University of Copenhagen, Rolighedsvej 26, DK-1958 Frederiksberg, Denmark
                [m ]Institute for Medical Research, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, National Institute of Serbia, Beograd, Tadeuša Košćuška 1, PAK 104 201, 11158 Belgrade, Serbia
                [n ]Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland
                [o ]Poznan University of Life Sciences, Department of Human Nutrition and Dietetics, Wojska Polskiego 28, 60-637 Poznan, Poland
                [p ]Bezmialem Vakif University, Medical Faculty Hospital, Nutrition and Diet Department, Vatan Cad. 34093, Istanbul, Turkey
                [q ]Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, LT-47181 Kaunas, Lithuania
                [r ]Center for Health Ecology of Institute of Public Health of Montenegro, Dzona Dzeksona bb, 81 000 Podgorica, Montenegro
                [s ]Faculty of Agriculture and Food Sciences, University of Sarajevo, Sarajevo, Bosnia and Herzegovina, Zmaja od Bosne 8, 71000 Sarajevo, Bosnia and Herzegovina
                [t ]Institute of Public Health, 50. Divizija 6, 1000 Skopje, Macedonia
                [u ]Faculty of Medicine, Ss. Cyril and Methodius University, 50. Divizija 6, 1000 Skopje, Macedonia
                [v ]Centro Hospitalar e Universitário de Coimbra, Portugal
                [w ]Department of Nutrition and Food Science, University of Granada, Campus of Melilla, Calle Santander, 1. 52071, Melilla, Spain
                Author notes
                [* ]Corresponding author at: Department of Nutrition and Food Science, University of Granada, Campus of Melilla, Calle Santander, 1. 52071, Melilla, Spain.
                [1]

                Joint first authors.

                [2]

                Joint senior authors.

                Article
                S0950-3293(21)00058-6 104231
                10.1016/j.foodqual.2021.104231
                9759462
                36569642
                21ff5a87-a639-479b-814e-7583ab805140
                © 2021 Elsevier Ltd. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 6 October 2020
                : 8 February 2021
                : 4 March 2021
                Categories
                Article

                covid-19 confinement,eating behaviours,mediterranean diet,stringency index,nutritional survey,covid-19, sars-cov-2 coronavirus,meddiet, mediterranean diet,medas, validated 14-items mediterranean diet adherence screener,si, stringency index,oxcgrt, oxford covid-19 government response tracker,sd, standard deviations

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