Diet and physical activity during the coronavirus disease 2019 (COVID-19) lockdown (March–May 2020): results from the French NutriNet-Santé cohort study

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ABSTRACT

Background

Since December 2019, coronavirus disease 2019 (COVID-19) has been spreading steadily, resulting in overwhelmed health-care systems and numerous deaths worldwide. To counter these outcomes, many countries, including France, put in place strict lockdown measures, requiring the temporary closure of all but essential places and causing an unprecedented disruption of daily life.

Objectives

Our objective was to explore potential changes in dietary intake, physical activity, body weight, and food supply during the COVID-19 lockdown and how these differed according to individual characteristics.

Methods

The analyses included 37,252 adults from the French web-based NutriNet-Santé cohort who completed lockdown-specific questionnaires in April–May 2020. Nutrition-related changes and their sociodemographic, lifestyle, and health-status correlates were investigated using multivariable logistic regression models. Clusters of participants were defined using an ascending hierarchical classification of change profiles derived from multiple correspondence analyses.

Results

During the lockdown, trends of unfavorable changes were observed: decreased physical activity (reported by 53% of the participants), increased sedentary time (reported by 63%), increased snacking, decreased consumption of fresh food (especially fruit and fish), and increased consumption of sweets, cookies, and cakes. Yet, the opposite trends were also observed: increased home cooking (reported by 40%) and increased physical activity (reported by 19%). Additionally, 35% of the participants gained weight (mean weight gain in these individuals, 1.8 kg ± SD 1.3 kg) and 23% lost weight (2 kg ± SD 1.4 kg weight loss). All of these trends displayed associations with various individual characteristics.

Conclusions

These results suggest that nutrition-related changes occurred during the lockdown in both unfavorable and favorable directions. The observed unfavorable changes should be considered in the event of a future lockdown, and should also be monitored to prevent an increase in the nutrition-related burden of disease, should these diet/physical activity changes be maintained in the long run. Understanding the favorable changes may help extend them on a broader scale. This trial was registered at clinicaltrials.gov as NCT03335644.

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Most cited references 64

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A brief measure for assessing generalized anxiety disorder: the GAD-7.

Robert L Spitzer, Kurt Kroenke, Janet B W Williams … (2006)

Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.

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The PHQ-9: validity of a brief depression severity measure.

K Kroenke, R L Spitzer, J. Williams (2001)

While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.

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International physical activity questionnaire: 12-country reliability and validity.

CORA L. CRAIG, ALISON L. MARSHALL, MICHAEL SJ??STR??M … (2003)

Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity. Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity. Overall, the IPAQ questionnaires produced repeatable data (Spearman's rho clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median rho of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode. The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment.

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Author and article information

Contributors

Mélanie Deschasaux-Tanguy

Nathalie Druesne-Pecollo:

ORCID: http://orcid.org/0000-0002-2019-0775

Younes Esseddik

Fabien Szabo de Edelenyi

Benjamin Allès:

ORCID: http://orcid.org/0000-0002-7970-171X

Valentina A Andreeva

Julia Baudry

Hélène Charreire

Valérie Deschamps

Manon Egnell

Leopold K Fezeu

Pilar Galan:

ORCID: http://orcid.org/0000-0003-1706-3107

Chantal Julia:

ORCID: http://orcid.org/0000-0003-2006-5269

Emmanuelle Kesse-Guyot:

ORCID: http://orcid.org/0000-0002-9715-3534

Paule Latino-Martel

Jean-Michel Oppert

Sandrine Péneau

Charlotte Verdot

Serge Hercberg:

ORCID: http://orcid.org/0000-0002-3168-1350

Mathilde Touvier:

ORCID: http://orcid.org/0000-0002-8322-8857

Journal

Journal ID (nlm-ta): Am J Clin Nutr

Journal ID (iso-abbrev): Am J Clin Nutr

Journal ID (publisher-id): ajcn

Title: The American Journal of Clinical Nutrition

Publisher: Oxford University Press

ISSN (Print): 0002-9165

ISSN (Electronic): 1938-3207

Publication date (Electronic): 01 March 2021

Electronic Location Identifier: nqaa336

Affiliations

Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS) , Bobigny, France

Paris-Est University, Lab'Urba, Université Paris-Est Créteil (UPEC) , Créteil, France

Nutritional Surveillance and Epidemiology Team (ESEN), French Public Health Agency, Sorbonne Paris Nord University, Epidemiology and Statistics Research Center–University of Paris (CRESS) , Bobigny, France

Department of Public Health, Paris Seine-Saint-Denis University Hospital System, Assistance Publique - Hôpitaux de Paris (AP-HP) , Bobigny, France

Department of Nutrition, Institute of Cardiometabolism and Nutrition, Sorbonne University, Pitié-Salpêtrière Hospital , Paris, France

Department of Public Health, Paris Seine-Saint-Denis University Hospital System, Assistance Publique - Hôpitaux de Paris (AP-HP) , Bobigny, France

Author notes

Address correspondence to MD-T (e-mail: m.deschasaux@ 123456eren.smbh.univ-paris13.fr )

Author information

Nathalie Druesne-Pecollo http://orcid.org/0000-0002-2019-0775

Benjamin Allès http://orcid.org/0000-0002-7970-171X

Pilar Galan http://orcid.org/0000-0003-1706-3107

Chantal Julia http://orcid.org/0000-0003-2006-5269

Emmanuelle Kesse-Guyot http://orcid.org/0000-0002-9715-3534

Serge Hercberg http://orcid.org/0000-0002-3168-1350

Mathilde Touvier http://orcid.org/0000-0002-8322-8857

Article

Publisher ID: nqaa336

DOI: 10.1093/ajcn/nqaa336

PMC ID: 7989637

PubMed ID: 33675635

SO-VID: 6513261e-1dab-4055-8dd7-058cf4436c28

License:

This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model ( https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

History

Date received : 09 June 2020

Date accepted : 22 October 2020

Page count

Pages: 15

Funding

Funded by: Institut National de Prévention et d'Éducation pour la Santé, DOI 10.13039/100010102;

Funded by: NAM, DOI 10.13039/100009645;

Funded by: National Research Centre, DOI 10.13039/100007787;

Award ID: 0009/SAPRIS/997/NB

Funded by: Fondation pour la Recherche en Santé, DOI 10.13039/100009007;

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article-lifecycle PAP

ScienceOpen disciplines: Nutrition & Dietetics

Keywords: nutrition,covid-19 lockdown,diet,physical activity,sedentariness,body weight,cohort study

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ScienceOpen disciplines: Nutrition & Dietetics

Keywords: nutrition, covid-19 lockdown, diet, physical activity, sedentariness, body weight, cohort study

Diet and physical activity during the coronavirus disease 2019 (COVID-19) lockdown (March–May 2020): results from the French NutriNet-Santé cohort study

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ABSTRACT

Background

Objectives

Methods

Results

Conclusions

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Novel Coronavirus Disease COVID-19

Most cited references 64

A brief measure for assessing generalized anxiety disorder: the GAD-7.

The PHQ-9: validity of a brief depression severity measure.

International physical activity questionnaire: 12-country reliability and validity.

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