Effect of the COVID-19-induced lockdown on nutrition, health and lifestyle patterns among adults in Zimbabwe

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Abstract

The COVID-19 is a global public health emergency resulting in lockdowns, associated diet and lifestyle changes and constrained public health delivery.

Objective

To investigate the impacts of the COVID-19-induced lockdown in Zimbabwe on nutrition, physical activity, alcohol consumption and smoking among Zimbabwean population aged ≥18 years.

Methods

A cross-sectional online survey was conducted using a structured questionnaire to collect information on demographics (age, gender, place of residence, current employment), food system dimensions, diet and physical activity patterns, stress and anxiety, body image perceptions, lifestyle behaviours like smoking, alcohol intake, screen time and ease of access to health services.

Results

The participants (n=507) were mostly women (63.0%) between the ages of 31 and 40 years (48.1%) and had tertiary education (91.3%). The lockdown resulted in increase in food prices (94.8%) and decrease in availability of nutritious foods (64%). Most (62.5%) of the participants reported a reduction in their physical activity levels. The prevalence of generalised anxiety disorder (GAD) was 40.4% and mostly affecting woman (63.5%, p=0.909), 31–40 years age group (49.6%, p=0.886). Based on the Body Mass Index-based Silhouette Matching Test (BMI-SMT) 44.5% gained weight, 24.3% lost weight and 31.2% did not have weight change. The paired samples t-test showed that there was a significant increase in perceived body weight (p<0.001). More than half (59.6%) reported having difficulties accessing medicinal drugs and 37.8% growth monitoring services.

Conclusions

The lockdown period was associated with increase in food prices, decrease in dietary diversification, elevated GAD symptoms, disrupted diet and consumption patterns. There were low levels of physical activity and perceived weight gained during the lockdown period, thus increasing the risk of overweight and obesity. Further studies incorporating participants of different socioeconomic status are warranted to get more conclusive results.

Article activity feed

  1. SciScore for 10.1101/2020.06.16.20130278: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Electronic informed consent was obtained from all participants prior to completing the survey.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data analysis: Data collected was entered and analysed using SPSS v 20 (IBM Inc. Armonk, NY).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations: The main limitation of the present study is that we utilised an online and self-reported questionnaire with completion rate of 76%, thus missing values on some variables. Although our survey had respondents from all the 10 provinces of Zimbabwe, online surveys tend to be restricted to individuals with access to internet with potential under representation of people from lower socio-economic groups and rural settings. However, due to the lockdown travel restrictions the online survey was the only option to collect this critical dietary and physical activity data. Although the BMI-based Silhouette Matching Test (BMI-SMT) has its limitations with respect to collective objective anthropometry data, in the current lockdown context it remains useful alternative. It’s crucial that this rapid assessment went on at the most critical period of the COVID-19 pandemic, to inform program and policy decisions. Interestingly, evidence is gathering indicating that web based surveys are equivalent to conventional face to face interviews 34,35. There is growing concern that COVID-19 could deepen food insecurity, malnutrition in Africa. Unfortunately, in our current study we did not collect data to understand the different food groups and how they are affected by the hike in prices, this may have helped to clearly understand the impact of lockdown on food access and household food security issues.

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.