Dietary changes and anxiety during the coronavirus pandemic: a multinational survey

Eur J Clin Nutr. 2022 Jan;76(1):84-92. doi: 10.1038/s41430-021-00897-3. Epub 2021 Mar 19.

Abstract

Background/objectives: The 2020 global coronavirus pandemic is characterized by increased anxiety. Anxiety has been associated with poor diet quality and weight gain, which may lead to obesity, a risk factor for adverse COVID-19 outcomes. The present study was designed to examine associations between diet quality and anxiety levels during the COVID-19 pandemic.

Subjects/methods: This cross-sectional, international online study was conducted between March 30 and April 25, 2020 and available in seven languages: Arabic (7.6%), English (43.7%), French (0.8%), Hebrew (42.1%), Italian (3%), Russian (1.1%), and Spanish (1.6%). Diet quality was assessed using the Mediterranean Diet Score (possible range: 0-17 points) and anxiety scored using the General Anxiety Disorder 7-point scale (GAD-7). The Google Survey platform was used to conduct the survey.

Results: A total of 3797 persons were included in the present analysis. More than 75% of respondents were female; most completed the survey in English or Hebrew. Median age was 31 (IQ = 18) years. Almost 60% indicated that their pre-pandemic diet was healthier than their current diet. The median Mediterranean diet score was 9 (IQ = 3). The majority (54%) of participants reported at least mild anxiety, while 25% reported moderate anxiety or more severe. In a logistic regression model of at least moderate anxiety, Mediterranean diet score (OR 0.92, 95% CI 0.89-0.95, p < 0.0001) reduced odds of elevated anxiety, even after controlling for age, sex and other variables.

Conclusions: Though causality cannot be inferred, associations between diet quality and anxiety might suggest public health interventions including diet and stress control during future mass lockdowns.

MeSH terms

  • Adult
  • Anxiety / epidemiology
  • Anxiety Disorders / epidemiology
  • COVID-19*
  • Communicable Disease Control
  • Cross-Sectional Studies
  • Depression
  • Female
  • Humans
  • Pandemics*
  • SARS-CoV-2
  • Surveys and Questionnaires