Fear of COVID-19, healthy eating behaviors, and health-related behavior changes as associated with anxiety and depression among medical students: An online survey

Minh H Nguyen; Tinh X Do; Tham T Nguyen; Minh D Pham; Thu T M Pham; Khue M Pham; Giang B Kim; Binh N Do; Hiep T Nguyen; Ngoc-Minh Nguyen; Hoa T B Dam; Yen H Nguyen; Kien T Nguyen; Thao T P Nguyen; Trung T Nguyen; Tuyen Van Duong

doi:10.3389/fnut.2022.938769

Fear of COVID-19, healthy eating behaviors, and health-related behavior changes as associated with anxiety and depression among medical students: An online survey

Front Nutr. 2022 Sep 23:9:938769. doi: 10.3389/fnut.2022.938769. eCollection 2022.

Authors

Minh H Nguyen¹, Tinh X Do², Tham T Nguyen³, Minh D Pham^{4

5}, Thu T M Pham^{3

6}, Khue M Pham^{3

7}, Giang B Kim^{8

9}, Binh N Do^{10

11}, Hiep T Nguyen^{12

13

14}, Ngoc-Minh Nguyen¹², Hoa T B Dam¹⁵, Yen H Nguyen^{16

17}, Kien T Nguyen^{18

19}, Thao T P Nguyen²⁰, Trung T Nguyen²¹, Tuyen Van Duong²²

Affiliations

¹ International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
² Department of Psychiatry, Military Hospital 103, Hanoi, Vietnam.
³ Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam.
⁴ Department of Clinical Nutrition, Military Hospital 103, Hanoi, Vietnam.
⁵ Department of Nutrition, Vietnam Military Medical University, Hanoi, Vietnam.
⁶ School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
⁷ President Office, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam.
⁸ Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
⁹ Center for Assessment and Quality Assurance, Hanoi Medical University, Hanoi, Vietnam.
¹⁰ Department of Infectious Diseases, Vietnam Military Medical University, Hanoi, Vietnam.
¹¹ Division of Military Science, Military Hospital 103, Hanoi, Vietnam.
¹² Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam.
¹³ Pham Ngoc Thach Clinic, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam.
¹⁴ President Office, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam.
¹⁵ Department of Psychiatry, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam.
¹⁶ Department of Pharmacology and Clinical Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.
¹⁷ Department of Pharmacy, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Vietnam.
¹⁸ President Office, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.
¹⁹ Department of Physiology, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.
²⁰ Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
²¹ School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam.
²² School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan.

Abstract

Background: Medical students' health and wellbeing are highly concerned during the COVID-19 pandemic. This study examined the impacts of fear of COVID-19 (FCoV-19S), healthy eating behavior, and health-related behavior changes on anxiety and depression.

Methods: We conducted an online survey at 8 medical universities in Vietnam from 7th April to 31st May 2020. Data of 5,765 medical students were collected regarding demographic characteristics, FCoV-19S, health-related behaviors, healthy eating score (HES), anxiety, and depression. Logistic regression analyses were used to explore associations.

Results: A lower likelihood of anxiety and depression were found in students with a higher HES score (OR = 0.98; 95%CI = 0.96, 0.99; p = 0.042; OR = 0.98; 95%CI = 0.96, 0.99; p = 0.021), and in those unchanged or more physical activities during the pandemic (OR = 0.54; 95%CI = 0.44, 0.66; p < 0.001; OR = 0.44; 95%CI = 0.37, 0.52; p < 0.001) as compared to those with none/less physical activity, respectively. A higher likelihood of anxiety and depression were reported in students with a higher FCoV-19S score (OR = 1.09; 95%CI = 1.07, 1.12; p < 0.001; OR = 1.06; 95%CI = 1.04, 1.08; p < 0.001), and those smoked unchanged/more during the pandemic (OR = 6.67; 95%CI = 4.71, 9.43; p < 0.001; OR = 6.77; 95%CI = 4.89, 9.38; p < 0.001) as compared to those stopped/less smoke, respectively. In addition, male students had a lower likelihood of anxiety (OR = 0.79; 95%CI = 0.65, 0.98; p = 0.029) compared to female ones.

Conclusions: During the pandemic, FCoV-19S and cigarette smoking had adverse impacts on medical students' psychological health. Conversely, staying physically active and having healthy eating behaviors could potentially prevent medical students from anxiety and depressive symptoms.

Keywords: COVID-19; anxiety; depression; fear; healthy eating behavior; medical students; physical activity; smoking.