Eating more/less/the same Sánchez-Sánchez et al.,2020(33)Spain14.March/9.May2020 (56)May2020Cross-sectional/retrospective web-based study on convenience sample Daily/weekly frequency before and during coredownMEDAS (14s). Cohort study; longitudinal Telephone-based survey Daily/weekly frequency before and during lockdown; DQI DiRenzoetal., 2020 (4) Italy March 9/May 5-24 April 2020 Cross-sectional/retrospective web-based study on convenience testing. Eat more/less/the same28,029≥18 Vandevijvereetal., 2020(54)Belgium18.March/4.May2020 (47)March–May2020Cross-sectional/retrospective web-based study on convenience trial Eat more/less/less. 2020(38)Poland March 13/April April-May 2020 Cross-sectional/ retrospective web-based study on convenience testing.
Changes by frequency of intake Ingrametal.,2020 (64)Scotland23 March/June March–May 2020Cross-sectional/retrospective web-based convenience sample survey among fertile academic users eating more/less/same BinZarahetal.–72020Mpri 72020M (72020M) – June 2020 Cross - cross-sectional/retrospective web-based survey on convenience sampling. Eat more/less/same1874≥18 Malta etal.,2020(82)Brazil17March/May20,2020 (21to47)24April–24May,2020Cross-sectional/retrospective Web-based survey on weekly-convenience-lock-in sample daily-and-lock-in consumption 4 daily conditions of consumption and regular consumption; 161≥18 Tebaretal.,2021(84)Brazil17 March/20 May 2020 (21 to 47) May 5–17,2020Cross-sectional/ retrospective Web-based survey on convenience sampling. Eat more/less/same1725≥18 Huancahuire-Vega etal.,2020(90)Peru16March/June16July–31August,2020Cross-sectional/retrospective Web-based survey on convenience sample Daily/weekly closing time ≥11h ≥ 11h ≥ 11h ≥ 6h and 11h. 2020 (87 )ChilePartial collapsesMay–June 2020Cross-sectional/retrospective web-based survey on convenience sample.
Daily/weekly frequency before and during lockdown Alfawazetal., 2021 (73) Saudi Arabia March 9/June 21, 2020 (84 to 104) May 11–6 June, 2020 Cross-sectional/retrospective sample web-based survey. Eating more/less/the same2137NA Matsungoetal.,2020 (91)ZimbabweMarch30/May2,2020 (33)11-25,2020 May11-25,2020Cross-sectional/web-based retrospective survey on convenience sample23130/2010/20202020202020202020202020 202020202020202020202020000000 020 Study Kohorst/ longitudinal-based Web-surveyDietaryQuestionnaire for Epidemiological Studies. Drywie´netal., 2020(41) Poland Whole grain products, lean meat and/or eggs, legumes, dairy products, cakes, homemade pastries, ice cream and pudding, alcohol, water.
A general interpretation provided Górnickaetal.,2020(42) Poland Whole grain products, lean meat and/or eggs, legumes, dairy and milk products, sweets, homemade pastries, alcohol, water. TABLE2(Continued) Key Findings First author,year(ref)CountryHighLowAuthors interpretation Shresthaetal.,2020(98)Nepal—Drinking alcohol(53.6%)An overall interpretation given 22 pulses,and given pulsation20F0.92. astfood, fried foods, junk foods (snacks, sugar sweetened drinks), alcohol. TABLE 2(Continued) Main findings First author, year(ref) Country increased reduced Author interpretation Ammaretal.,2020(102)Europe, North Africa, West Asia and the Americas unhealthy unhealthy food Alcohol misuse. 2021(107) Spain and 11 Latin American countries2.
WaterFast food Unhealthy lifestyle changes Janssenetal.,2021(110)Denmark(DK), Germany(DE) and Slovenia(SI) Sweets, alcoholic drinks(DE,DK)canned food(DE)Fruit,vegetables,meat(all countries) Fish bread(DE, SI) Dairy products (DE,DK). Fruits(GB),vegetables(IOI,GB,NZ),saturated fat(IOI,GB,NZ)—No overarching interpretation provided Pišotetal.,2020(106)Bosnia and Herzegovina, Croatia, Greece, Kosovo, Italy, Serbia, Slovakia , Slovenia, and Spain.
Change in overall diet quality in adults
Dietary changes in children/adolescents
TABLE3 Main results of included observational studies from general adult populations assessing changes in behavior during the lockdown due to the first wave of the COVID-19 outbreak1 Main results First author, year(ref)Country Increase Decrease Authors' interpretation of 20-20 years, 20-20 year. 3.5%), daily meals (23%), more efficient food preparation (64.2%). TABLE3(Continued) Main findings First author, year(ref) CountryIncreasedDecreasedAuthors’ interpretation Kolokotroniet.,2021(65)CyprusNumber of daily meals, pleasantness –Although participants reported that they had changed more, their quality of dietary supplements appears to change-to -4) 2. ing(40.4%),snacking(21.1%) —The solution created an opportunity to improve nutritional behaviors, such as cooking home-cooked meals, increasing consumption of fresh produce and buying food from local stores and /or farmers Martyetal., 2020(45) France Cooking (83.2%), energy intake – decrease in the quality of food where part of the food changed, ice motifs Constantetal.,2020(46)FranceSnacking(24%) — Less than 4 out of 10 respondents reported healthy changes during the same period, mainly in relation to better eating habits Drieskensetal., 2021(55) Belgium - Food prepared outside the home(39.7%) No overall interpretation Błaszczyk-Bębeneketal. 7.9%) Eat outside or order take-away food(51.6%) Nutritional behavior does not change during lockdown, nor does it increase the share of healthy products in the diet Dobrowolskietal., 2021(40) Poland Amount of food eaten(48) .4%) Home delivery and take-away (37.8%) Increase in the consumption of 20 foods and 20% of all 2000 products. countryEat more(35.7%)Home-cooked mealsTakeaway mealsNo overall interpretation provided Górnickaetal.,2020(42)PolandEating more(34.3%),home-cooked meals—positive and negative about diet-lifestyle changes Kowalczuketal.,2021(43)PolandEating more regular Diet diversityNooverarching203,203,203.9%) snacks (51.8%), cooking (62.3%) – A significant percentage of individuals may experience change in dietary habits, manifested by eating and snacking more Giacaloneetal., 2020(59)Denmark Cooking (29.9 %), eating (42.8 %) snack (41.7 %) – by eating (41.7 %) s (Continued. TABLE 3 (Continued) Main findings First author, year (ref) CountryIncreasedDecreased Authors’ interpretation Kriaucionieneetal .,2020(63)LithuaniaEating more(49.4%),snacking(45.1%),home cooking(62.1%)-without.TheNetherlandsEatingmore(8.9%),meal delivery(29.5%)—persistenceofdietingroutines Buckland et al.,2020(49)United KingdomFood intake(48%),snacking(53%),number of meals(31%)—eating behavior characteristics that increase susceptibility to hard, andobserved0 hard. 21(52)United KingdomHome-cooked food—no overall interpretation given Herle etal.,2021(53)United KingdomAmount of food eaten(17.3%)—One third of sample report changes quantitatively eaten during the first UK lockdown period Robinson etal., 2020(50)United KingdomUnited Kingdom Larcksgemshopping,drinking food,drinking food/ tation delivered Robinson et al.,2020(51)United KingdomBingedonfood (49%)—No overall interpretation given NorthAmericanstudies Lamarche et al.,2021(81)Canada—Meals taken outside,lunch taken outside,snackingImproved overall diet quality Chenaridesetal.,2020(78)USAEat more(21%),snacked.9%)(49%)(49%) shift away from consumptionfrom home (e.g. fast food)Tosnack food consumption SouthAmericanStudies Martínez-Vázquezetal., 2021 (85 ) Mexicohomemadefoods (28.4%)-Posivivechangesinthequalityofdiet pertuz-cruzetal., 2021 (86) colombiasnacking (48%) 48%) 48%) 48%) 48%) 48) %), easily digestible (50.2%), expenditure on food (71%), home-cooked food (59.3%).
Shifting to an unhealthy diet Reyes-Olavarríaetal.,2020(87)Chile Cooking at home(59.6%), eating out more (51.3%)—Irrelevant interpretation provided Aresetal.,2021(89)UruguayEating more food made at home-Creating amount of food at home (8.0) foods were observed Ramos-Padillaetal.,2021(88)EcuadorIntakeofanyushqim (44%), supplement (41.4%), or drink (31.6%)— First interpretation given Asianstudies Yangetal.,2021(94)China—Breakfast frequency(23.6%), midnight meal (15.8%) No overall interpretation provided (C). TABLE 3(Continued) Key Findings First Author,Year(ref)Place of AdultReduced Authors Interpretation Shresthaetal.,2020(98)NepalDiet Quality(67.6%)Drinking alcohol(53.6%)Experiencing alcohol. nackorme flour, freshly made staple flour, home cooking, skipping breakfast. Significant negative changes in healthy eating behavior Alhusseinietal.,2020(70)Saudi Arabia Home cooked meals Take away or deliver food provided No overall interpretation given Aljohani,2020(72)Saudi Arabia-No more than 39% ). interpretation provided Radwanetal.,2020(69) United Arab EmiratesFoodintake(31.8%), cooked food (84.4%)—unhealthy lifestyle changes including diet CheikhIsmailetal.,2020(68) United Emirates Arabic Home-made meals, daily meals, frozen ready-to-eat meals, skipping meals, eating out11 unbalanced food from Kurd20 unbalanced food odproductsAn improvement in eating behaviors was observed Oceanianstudies Curtisetal.,2021(101) AustraliaEnergjiangaalkooliEnerggiangaproteina Little variation in diet observed in the Philippines., 2020(100)Australia Binge eating (34.6%), food restriction (27.6%)—Potential negative health consequences due to increased overeating and restrictive behaviors Gerritsenetal. ,2020(99)New Zealand Hot food cooking, delicious food for all meals. , 2020(102) Europe, North Africa, West Asia and the Americas.
Snacking, number of meals Alcoholic beverages An unhealthy pattern of food consumption was exhibited CheikhIsmail et al., 2020(104) Middle East North Africa (MENA) region Daily meals, home-cooked meals (97.2%), breakfast (71.2%), frozen meals (71.2% ), frozen meals (1.5%), 5%). TABLE3(continued) Main results First author, year(ref)CountryIncreasedDecreasedAuthor's interpretation Molina-Montesetal European countries2Frequency of cooking and snacking, home-made pastry - An increase in overall diet quality and more engagement in home-made cooking Murphy number (1020, GB, 1020, USA and Murphy number) (1020,000, US and US). slandof Ireland (IOI). FreshIngredientsIndoor(IOIandGB),BakingPre-preparedDinner(Not US), TakeawayNo overall interpretation provided Pišotetal.,2020(106)Bosnia and Herzegovina, Croatia, Greece, Kosovo, Italy, Serbia, Slovakia, Slovenia and Spain.
Regular meals(44%), larger meals (29%)—No major explanation provided Papandreouetal.,2020(112)Spain, GreeceSnacks(34.1%Spain;40.8%Greece)Amount of food eaten(74.3%Spain ; 63.1%Greece)No major explanation provided 1COVID-19, coronavirus disease 2019 ;HED,high energy density;ref,reference;UPF,ultra processed food.
Discussion
397 Greek children with an average age of 7.8 years deteriorated their eating habits towards less healthy patterns, which was also related to their socio-economic position, comparable to 303 Spanish adolescents from the DESK cohort study, who increased the consumption of sweets and snacks increased (37). In contrast to this unhealthy dietary behavior, there was an improvement in the consumption of fresh and dried fruit and nuts. A retrospective analysis of a sample of 10,082 Chinese adolescents (93) found that adolescents' dietary patterns had changed significantly during the COVID-19 lockdown, with both negative and positive changes making it difficult to reach an overall conclusion.
Meanwhile, 447 Jordanian children and adolescents (74) increased consumption of key food groups (i.e. fruits, vegetables, grains and milk) compared to the previous period. A study conducted in Saudi Arabia, Great Britain and Turkey (108) among 330 children between 4 and 7 years old found a consistent increase in the consumption of sweets and unhealthy foods, along with an improvement in fruit intake, and showed that Turkish and British children followed a better diet during the lockdown than those from Saudi Arabia. Specifically, a qualitative analysis of dietary habits in each country underlined that adolescents from all countries increased the consumption of unhealthy foods, that adolescents from Europe increased the intake of fruits and sweet foods, and that in South America the consumption of legumes increased significantly during the lockdown.
Diet quality improved slightly during early COVID-19-related lockdown, Pertuz-Cruz et al Colombia Shift to a Western-like diet. A significantly higher adherence to the Mediterranean diet during the lockdown was observed in all countries. AHEI-2010, Alternative Healthy Eating Index–2010 score; COVID-19, 2019 coronavirus disease; DQI, Dietary Quality Index; HEI-2015, Healthy Food Index–2015; MEDAS, PREDIMED (PRevención con DIeta MEDiterránea) Screener of adherence to the Mediterranean diet; ref, reference; sPNNS-GS2, Simplified National Santé Nutrition Program—outcome guideline 2; UPF, ultra-processed food.
Studies analyzing changes in food and beverage intake The majority of studies assessed variations in consumption.
Studies analyzing changes in food and beverage intake The majority of studies assessed variations in the consump-
The period of lockdown in France was associated with a decrease in the nutritional quality of the diet, on average. TABLE 5 Key to include observational studies from general populations of children and adolescents assessing changes in diet during the lockdown resulting from the first wave of the COVID-191 outbreak Key findings First author, year(ref)Country grown 30 earlier . inKIDMED increased from 5.9±1.8 to 6.4±1.5—the KIDMED score increased, although the prevalence of children with high adherence to the Mediterranean diet and was not significantly improved Aguilar-Martínezetal.,20,20pa . cereals, dairy products, eggs, fresh food, number of meals (28.4%), snack food between meals (56.4%), amount of legumes eaten, meat, fish, sweets and pastries (39, 3%), convenience foods (49.2%), soft foods (49.2%). regularity of mealtimes. Changes in income without health were also related to students' socio-economic position. snacks; desserts—Significant change in dietary habits Mastorcietal.,2021(28)ItalyKIDMIncreased from 6.1±2.6 to 6.5±2.5—Increase in adherence to the Mediterranean diet and importance. products, pasta, cakes, total snacks.
FastfoodUnfavorablechangesinchildren'sandadolescents'lifestylebehaviorsduringthefirstCOVID-19lockdown Philippeetal.,2021(48)FranceMidafternoonsnackincreased(15%),fruit juiceandsoda,chips,saltybiscuits, candy,chocolate,icecream,pastries, cake,sweetcookies,creamdessert, milks,yogurt,cheese,quark , fresh dried fruit, nut compote, fruit syrup No overarching interpretation Jiaetal., 2020 (93) China Wheat products, other staple foods, preserved vegetables, tea Rice, meat, poultry, fresh vegetables, fresh fruit, soy products, dairy products, sugar-sweetened drinks. The nutritional system of the Turkish and British children was better than that of Saudi children during the lockdown Ruiz-Rosoetal., 2020(105) Italy, Spain, Brazil, Chile, Colombia Legumes, vegetables, fruits, fried foods, sweet foods Fast food The total quality of the diet has not increased 1 Values in the columns of the findings are means ± SDs. 019;KIDMED, Mediterranean Diet Quality Index for Children and Teenagers;ref,reference. of fruits and vegetables, legumes, grains, olive oil; lower intake of red and processed meat), indicating a moderate but consistent improvement in dietary habits worldwide. On the other hand, consumption of foods that should be consumed in small to moderate amounts, such as dairy products (115), increased, while fish consumption decreased significantly in most studies.
Analyzes of changes in alcohol consumption yielded mixed results, but a trend toward increased intake was observed. Analyzes by geographic area suggest a healthier trend in dietary patterns in European populations, showing increased consumption of fruit and vegetables, legumes and whole grains, as well as in Asian and South American countries. An unhealthy shift in dietary patterns was observed differently in North America, where alcoholic beverage consumption increased concurrently with a decrease in fruit and vegetable intake reported by half of the surveys (Supplementary Figures 1–4).
Studies analyzing changes in overall diet quality. In addition to studies analyzing changes in the major food groups.
Studies analyzing changes in overall diet quality In addition to studies analyzing changes in major food group
Studies analyzing changes in eating behaviors
Strengths and limitations of this study
In addition, most relied on retrospective recall, resulting in 2 major limitations—that is, recall bias and reliance on self-reported measures. It should be noted that although a small proportion of studies used validated questionnaires/indices (eg, MEDAS, AHEI-2010, etc.), the majority of studies (>60% analyzed) examined dietary differences by asking participants. to indicate whether they ate more/less/the same during constipation compared to before. Others, including cross-sectional studies using validated tools, have relied on the simultaneous administration of dietary questionnaires aimed at assessing food intake (or eating behavior) before and during confinement.
Conclusions
Acknowledgments
Changes in lifestyle behaviors during the COVID-19 confinement in Spanish children: a longitudinal analysis of the MUGI project. Body mass, physical activity and eating habits change during the first COVID-19 pandemic lockdown in Poland. Food choice motives and the nutritional quality of diet during the COVID-19 lockdown in France.
Reported changes in dietary habits during the COVID-19 lockdown in the Danish population: The Danish COVIDiet study. Lifestyle habits of adults during the COVID-19 pandemic lockdown in Cyprus: evidence from a cross-sectional study. Eating habits and lifestyle during the COVID-19 lockdown in the United Arab Emirates: a cross-sectional study.
Dietary and lifestyle changes during COVID-19 lockdown in the United Arab Emirates: results of a cross-sectional study. Increased screen time is associated with alcohol craving and sweetened food consumption during the COVID-19 pandemic. Changes in eating habits and lifestyle in the Peruvian population during social isolation due to the COVID-19 pandemic.
Eating habits and lifestyle during the initial phase of covid-19 lockdown in China: a cross-sectional study.
