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

Esther Molina-Montes; Irina Uzhova; Vito Verardo; Reyes Artacho; Belén García-Villanova; Eduardo Jesús Guerra-Hernández; Maria Kapsokefalou; Olga Malisova; Antonis Vlassopoulos; Alexandra Katidi; Barbara Koroušić Seljak; Robert Modic; Tome Eftimov; Irena Hren; Eva Valenčič; Zvonimir Šatalić; Ines Panjkota Krbavčić; Darija Vranešić Bender; Davide Giacalone; Michael Bom Frøst; Aleksandra Konic Ristic; Jelena Milesevic; Marina Nikolic; Ezgi Kolay; Merve Güney; Vilma Kriaucioniene; Magdalena Czlapka-Matyasik; Aleksandra Bykowska-Derda; Enisa Kujundzic; Irzada Taljić; Muhamed Brka; Igor Spiroski; Sérgio Cunha Velho; Sofia Patrícia Sousa Pinto; Inês Nascimento Monteiro; Janice Adriana Pereira; María Dolores Ruíz-López; Celia Rodríguez-Pérez

doi:10.1016/j.foodqual.2021.104231

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

Food Qual Prefer. 2021 Oct:93:104231. doi: 10.1016/j.foodqual.2021.104231. Epub 2021 Mar 23.

Authors

Esther Molina-Montes^{1

2

3

4}, Irina Uzhova⁵, Vito Verardo^{1

2}, Reyes Artacho¹, Belén García-Villanova¹, Eduardo Jesús Guerra-Hernández¹, Maria Kapsokefalou⁶, Olga Malisova⁶, Antonis Vlassopoulos⁶, Alexandra Katidi⁶, Barbara Koroušić Seljak⁷, Robert Modic⁷, Tome Eftimov⁷, Irena Hren⁸, Eva Valenčič⁷, Zvonimir Šatalić⁹, Ines Panjkota Krbavčić⁹, Darija Vranešić Bender¹⁰, Davide Giacalone¹¹, Michael Bom Frøst¹², Aleksandra Konic Ristic^{13

14}, Jelena Milesevic¹³, Marina Nikolic¹³, Ezgi Kolay¹⁵, Merve Güney¹⁶, Vilma Kriaucioniene¹⁷, Magdalena Czlapka-Matyasik¹⁵, Aleksandra Bykowska-Derda¹⁵, Enisa Kujundzic¹⁸, Irzada Taljić¹⁹, Muhamed Brka¹⁹, Igor Spiroski^{20

21}, Sérgio Cunha Velho²², Sofia Patrícia Sousa Pinto²², Inês Nascimento Monteiro²², Janice Adriana Pereira²², María Dolores Ruíz-López^{1

2}, Celia Rodríguez-Pérez^{2

3

23}

Affiliations

¹ Department of Nutrition and Food Science, University of Granada, Campus of Cartuja, 18071 Granada, Spain.
² Institute of Nutrition and Food Technology (INYTA) 'José Mataix', Biomedical Research Centre, University of Granada, Avenida del Conocimiento s/n, E-18071 Granada, Spain.
³ Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
⁴ Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública CIBERESP, Madrid, Spain.
⁵ Department of Health and Nutritional Sciences, Institute of Technology Sligo, Ash Ln, Bellanode, Sligo F91 YW50, Ireland.
⁶ Department of Food Science and Nutrition, Agricultural University of Athens, Iera Odos 75, Athens 11855, Greece.
⁷ Computer Systems Department, Jožef Stefan Institute, Jamova cesta 39, Ljubljana, Slovenia.
⁸ General Hospital Novo mesto, Šmihelska cesta 1, 8000 Novo mesto, Slovenia.
⁹ University of Zagreb, Faculty of Food Technology and Biotechnology, Pierottijeva ul. 6, 10000 Zagreb, Croatia.
¹⁰ University Hospital Centre Zagreb, Department of Internal Medicine, Division of Gastroenterology and Hepatology & Unit of Clinical Nutrition, Kišpatićeva ul. 12, 10000 Zagreb, Croatia.
¹¹ Department of Technology and Innovation, University of Southern Denmark, Campusvej 55, DK5230 Odense, Denmark.
¹² Department of Food Science, University of Copenhagen, Rolighedsvej 26, DK-1958 Frederiksberg, Denmark.
¹³ 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.
¹⁴ Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland.
¹⁵ Poznan University of Life Sciences, Department of Human Nutrition and Dietetics, Wojska Polskiego 28, 60-637 Poznan, Poland.
¹⁶ Bezmialem Vakif University, Medical Faculty Hospital, Nutrition and Diet Department, Vatan Cad. 34093, Istanbul, Turkey.
¹⁷ Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, LT-47181 Kaunas, Lithuania.
¹⁸ Center for Health Ecology of Institute of Public Health of Montenegro, Dzona Dzeksona bb, 81 000 Podgorica, Montenegro.
¹⁹ Faculty of Agriculture and Food Sciences, University of Sarajevo, Sarajevo, Bosnia and Herzegovina, Zmaja od Bosne 8, 71000 Sarajevo, Bosnia and Herzegovina.
²⁰ Institute of Public Health, 50. Divizija 6, 1000 Skopje, Macedonia.
²¹ Faculty of Medicine, Ss. Cyril and Methodius University, 50. Divizija 6, 1000 Skopje, Macedonia.
²² Centro Hospitalar e Universitário de Coimbra, Portugal.
²³ Department of Nutrition and Food Science, University of Granada, Campus of Melilla, Calle Santander, 1. 52071, Melilla, Spain.

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.

Keywords: COVID-19 confinement; COVID-19, SARS-CoV-2 coronavirus; Eating behaviours; MEDAS, validated 14-items mediterranean diet adherence screener; MedDiet, mediterranean diet; Mediterranean diet; Nutritional survey; OxCGRT, Oxford COVID-19 government response tracker; SD, standard deviations; SI, stringency index; Stringency index.