Impact of the COVID-19 Pandemic on Diet Behaviour Among UK Adults: A Longitudinal Analysis of the HEBECO Study

  1. Samuel J. Dicken
  2. John Joseph Mitchell
  3. Jessica Newberry Le Vay
  4. Emma Beard
  5. Dimitra Kale
  6. Aleksandra Herbec
  7. Lion Shahab

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Abstract

COVID-19 pandemic restrictions impacted dietary habits during the initial months of the pandemic, but long-term effects are unclear. In this longitudinal study, self-selected UK adults ( n = 1,733, 71.1% female, 95.7% white ethnicity) completed three online surveys (May–June, August–September, and November–December 2020, with a retrospective pre-pandemic component in the baseline survey), self-reporting sociodemographics, lifestyle, and behaviours, including high fat, salt, and sugar (HFSS) snacks, HFSS meals, and fruit and vegetable (FV) intake. Data were analysed using generalised estimating equations. Monthly HFSS snacks portion intake increased from pre-pandemic levels (48.3) in May–June (57.6, p < 0.001), decreased in August–September (43.7, p < 0.001), before increasing back to pre-pandemic levels in November–December (49.2, p < 0.001). A total of 48.5% self-reported increased [25.9 (95% confidence interval: 24.1, 27.8)] and 47.7% self-reported decreased [24.1 (22.4, 26.0)] monthly HFSS snacks portion intakes in November–December compared with pre-pandemic levels. Monthly HFSS meals portion intake decreased from pre-pandemic levels (7.1) in May–June (5.9, p < 0.001), was maintained in August–September (5.9, p = 0.897), and then increased again in November–December (6.6, p < 0.001) to intakes that remained lower than pre-pandemic levels ( p = 0.007). A total of 35.2% self-reported increased [4.8 (4.3, 5.3)] and 44.5% self-reported decreased [5.1 (4.6, 5.6)] monthly HFSS meals portion intakes in November–December compared with pre-pandemic levels. The proportion meeting FV intake recommendations was stable from pre-pandemic through to August–September (70%), but decreased in November–December 2020 (67%, p = 0.034). Increased monthly HFSS snacks intake was associated with female gender, lower quality of life, and – in a time - varying manner – older age and higher HFSS meals intake. Increased monthly HFSS meals intake was associated with female gender, living with adults only, and higher HFSS snacks intake. Reduced FV intake was associated with higher body mass index (BMI) and lower physical activity. These results suggest large interindividual variability in dietary change during the first year of the pandemic, with important public health implications in individuals experiencing persistent increases in unhealthy diet choices, associated with BMI, gender, quality of life, living conditions, physical activity, and other dietary behaviours.

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  1. Version published to 10.3389/fnut.2021.788043
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    SciScore for 10.1101/2021.10.01.21264008: (What is this?)

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

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data were captured and managed by the REDCap electronic data system at UCL [34,35].
    REDCap
    suggested: (REDCap, RRID:SCR_003445)
    Statistical Analysis: Statistical analysis was conducted in SPSS Statistics version 27 (IBM).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: Thank you for sharing your data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths and limitations: There are several strengths of this study. This is one of the first studies in UK adults examining changes in dietary behaviours and predictors of dietary change across the first year of the COVID-19 pandemic, from May to December 2020 compared with pre-pandemic. The longitudinal nature builds upon the largely cross-sectional current literature, providing a greater understanding of the long-term impacts of the pandemic on dietary behaviour. The analysis included a range of variables that reflect the wide-ranging impact of the pandemic, with time-varying measures to reflect the changing conditions of the pandemic over time. A range of health behaviours were also considered that are important for dietary behaviour. The use of GEE models for the longitudinal analysis provided several advantages over common analytical methods, including the ability to handle repeated measures, model different data distributions and use time-varying predictors. Complete case analyses and sensitivity analyses with binary cut-offs demonstrating largely similar associations indicates the robustness of the associations identified in this study. However, there are several limitations which may have introduced bias. Firstly, the study sample was self-selected and largely female, younger, and well-educated. Second, there were differences in various characteristics between included and excluded participants. This may limit the generalisability of results. Third, causality cannot...

    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.

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

    Results from scite Reference Check: We found no unreliable references.

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  3. Version published to 10.1101/2021.10.01.21264008v1 on medRxiv