Change in food consumption pattern during Covid-19 Pandemic in Indian Population – A web based descriptive study

Emergence of Corona virus Disease 2019, a global pandemic has hit India hard with reporting of 10 million cumulative cases as per WHO(1).The first case of COVID 19 was reported on January 30, 2020 and ever since the number kept increasing exponentially with phases of waxing and waning(2).

 

Measures such as social distancing, social isolation and wearing masks were being adopted to limit the spread of the disease, however a huge impact on lives was observed with implementation of “Lockdown”.Various restrictions and rules set in during Lockdown brought major changes in the lives of people, the most drastically affected ones being in the aspects of health, income and lifestyle(3,4).

 

Lifestyle changes especially changes in eating habits have been the prominent ones deteriorating both physical and mental health of the individuals adversely. Limited access to fresh foods due to trade restrictions, stress of increased chance of transmission of infection, overeating out of boredom due to home isolation, stockpiling of highly processed food, closure of food outlets and restaurants had huge impact on food consumption pattern(5,6). Very few studies have been carried out in India to assess the impact of COVID 19 on food consumption pattern. Thus this study was undertaken to determine the change in food culture during first wave of COVID 19 pandemic among Indian population

A web based cross sectional descriptive study was conducted during 15thJanuary to 31st July 2021. A pretested validated questionnaire developed by Kumari et al.(7) was administered using Google forms and disseminated through electronic media. The Google form consisted of brief introduction to the study for better understanding and participation of the study population followed by consent and the questionnaire section. Electronic media used for dissemination were Whats app, Telegram and Facebook.

The study details were sent either as an individual message or a group message in order to achieve better representation of the study population. The responses were recorded from all the individuals above 18 years who consented and gave response within the study period. Incomplete responses were excluded (Fig 1).

 

The questionnaire used consisted of sociodemographic details, self-reported anthropometric parameters and details of dietary practices during COVID 19 pandemic. Data was analyzed using SPSS v20 and summarized as proportions, mean and standard deviation.

SOCIODEMOGRAPHIC DETAILS:

Among 357 participants, mean age was found to be 30.5 ±7.9 years and 51.5% were in the age group of 18 to 29 years, 54.6% were females, 38.7% went to work as before, 29.4% were students, 17.1% worked from home, 50.1% were married. Majority (93.6%) had qualification of graduation and above, 77.3% were from nuclear family while 84% were from class I socioeconomic class(8).

 

Mean BMI was found to be 25±4.4 kg/m2. Perceived change in weight as per participants was that 40.3% reported gain while 16.5% reported weight loss. (Table 1)

 

Table 1: Socio-demographic characteristics of the study population (N=357)

 

CHANGE IN FOOD CONSUMPTION PATTERN:

Out of 357 participants, 265 (74.2 %) reported change in food consumption pattern during ongoing Covid infection in one or the other way (Fig 2).

 

 

Among participants reporting change in their food pattern (Table 2), snacking habit was increased in 157 (78.5%) individuals (n=200), meal quantity was increased in 155 (74.5%) individuals (n=208), intake of balanced diet increased in 146 (78.9%) individuals (n=185), intake of junk food decreased in 149 (63.1%) individuals (n=236), emotional eating of unhealthy food increased in 110 (60.1%) individuals (n=183), immunity boosting food consumption significantly increased in 224 (96.5%) individuals (n=232)

Among 357 participants, participation in cooking new/ traditional recipes were reported by 234 (65.5%) individuals, support by family members in eating healthy was reported by 231 (64.7%), preference of consuming cooked food over raw food was seen in 251 (70.3%), use of handwashing practices (correct technique) while dealing with food stuffs increased in 352 (98.6%) individuals, adopting healthy eating habits tips from media was increased in 197 (55.2%) individuals.

 

Table 2: Direction (increased/ decreased) of change in food habits among study participants:

Table 3: Other reasons under non-specified category for change in food pattern by study participants (N=56)

                                                    *Percentage calculated for 265 responses

Covid pandemic had major impact on the health of the individuals. Of all the aspects affected, life style changes had been the predominant ones. The eating habits of the individuals are highly influenced by the pandemic due to Lockdown. Studies revealed that lockdown affected health adversely (9)

 

In our study, out of 357 participants, 265 (74.2 %) reported change in food consumption pattern during ongoing Covid infection. However the change observed is not unidirectional. Change in eating habits and other practices related to food consumption had been observed to be both health promoting as well as health deteriorating type in certain aspects.

 

Health promoting habits:

As reported by the participants, some individuals took social isolation as an opportunity to improve their eating habits which were not being able to follow by them due to their hectic daily routines in pre-covid period.

 

The major positive health promoting habits adopted were increased intake of balanced diet and immunity boosting food items, strictly following hand washing practices while cooking and eating, avoiding junk food, preferring cooked homemade food. Majority preferred and opted for consuming Balanced diet i.e. 146 (78.9%) in our study. In a study by Martínez-Steele et al. (2020), the consumption of vegetables, fruits and legumes increased on daily diet which is a health promoting habit.(10) Munasinghe et al. (2020) in his study found the there were declines in fast food consumption following implementation of physical distancing but no substantial changes in fruit and vegetable consumption.(11) Jyothi S et al. in their study found that during COVID-19, there was a slight improvement in the consumption of foods and drinks that increase immunity, such as turmeric milk, lemon water, ginger, and garlic.(12) The emphasis and increased awareness through social media on consumption of food items which boosted the body immunity as an effective measure against Covid 19 infection was very much predominant during pandemic and was also reported in our study. A similar finding was reported in a study wherein about 71.8% of participants were consuming Kadha, a herbal concoction during COVID-19 as they considered it helpful in boosting immunity and effective in combating the viral infection specifically.(13)

 

Health deteriorating habits:

Snacking habits, emotional eating of unhealthy food, binge drinking and skipping meals were the health deteriorating habits observed in our study.

The rise in frequency of snacks and junk food intake may be due to stress as these products increase serotonin release, which reduces depression and anxiety. Pellegrini et al. (2020) revealed in their study that there was an increased consumption of snacks, cereals, and sweets which is similar to our study findings where snacking habit was increased in 78.5% of study participants. This can be because of stress which induces dietary alterations.(14) In contrast to this, the study by Kumar RR  et al. (15)  revealed that the individuals consumed fewer sugar-containing items in order to stay fit and also in the study conducted by Jyothi S et al.(12) adolescents' habits of consuming junk food and meat items were decreased during COVID 19 which can be due to health conscious study population. According to a study by Kumar RR(15) in India, the majority of participants lost weight during the pandemic. Cereal consumption has increased since it is easier to stock up on at home, whilst the consumption of bakery products like bread has fallen. However in present study, perceived weight gain (40.3%) was reported by study participants. 

 

Meal quantity was increased in 75 % of the individuals in our study whereas the consumption pattern of cereals such as wheat, rice, maize, oats remained same during COVID-19 in a study by Jyothi S et al.(12) Fear of infection being the most common reason for change in food consumption pattern during the pandemic followed by increased stress and unavailability of grocery. Similar findings were reported by other studies (5,6). The fear of getting exposed to infection did not let the people follow their routine like grocery shopping from a market or getting food from the restaurants or outlets etc which led to the deviation from their routine food habits.

 

The authenticity of the responses from the participants cannot be assured as it was an online survey and many answers reported by them may be subjective.

Change in food habits was reported during the Covid pandemic by the study participants and this change observed was both in positive and negative ways (bidirectional).

Positive changes included increased intake of balanced diet and immunity boosting food items, strictly following hand washing practices while cooking and eating, avoiding junk food, preferring cooked food. On the other hand, negative changes being increased snacking habit, increase in main meal quantity and stress induced over eating of junk food, majority gained weight due to sedentary life.

These changes observed were due to multiple factors and were mainly influenced by concerns related to personal hygiene and safety from transmission of infection in such crisis situation. Further studies revealing population at risk for developing unhealthy eating habits and having a targeted health interventions planned for such individuals will be effective in case of emergence of new waves of Covid infections in future.

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3.        Chiu NC, Chi H, Tai YL, Peng CC, Tseng CY, Chen CC, et al. Impact of Wearing Masks, Hand Hygiene, and Social Distancing on Influenza, Enterovirus, and All-Cause Pneumonia During the Coronavirus Pandemic: Retrospective National Epidemiological Surveillance Study. J Med Internet Res. 2020 Aug 20;22(8):e21257.

4.        Chopra S, Ranjan P, Singh V, Kumar S, Arora M, Hasan MS, et al. Impact of COVID-19 on lifestyle-related behaviours- a cross-sectional audit of responses from nine hundred and ninety-five participants from India. Diabetes & Metabolic Syndrome. 2020 Dec;14(6):2021.

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6.        Ammar A, Brach M, Trabelsi K, Chtourou H, Boukhris O, Masmoudi L, et al. Effects of COVID-19 Home Confinement on Eating Behaviour and Physical Activity: Results of the ECLB-COVID19 International Online Survey. Nutrients. 2020 Jun;12(6):1583.

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10.     Martínez Steele E., Rauber F., dos Santos Costa C., Leite M.A., Gabe K.T., da Costa Louzada M.L., Levy R.B., Monteiro C.A. Dietary changes in the NutriNet Brasil cohort during the COVID-19 pandemic. Rev. Saude Publica. 2020;54:91.

11.     Munasinghe S., Sperandei S., Freebairn L., Conroy E., Jani H., Marjanovic S., Page A. The Impact of Physical Distancing Policies During the COVID-19 Pandemic on Health and Well-Being Among Australian Adolescents. J. Adolesc. Health. 2020;67:653–661.

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