Changes in food during Covid-19 pandemic: the different role of stress and depression in women and men.

Abstract

Dear Editor, we read with great interest the manuscript " Psychological distress and its association with intake of sugar-sweetened beverages, discretionary foods, and alcohol in women during the COVID-19 pandemic in Australia.” by Grieger JA and coworkers [1] and found it extremely important from the point of view of the impact of pandemic on food habits. The Authors explored psychological distress, lifestyle, and demographic factors, as well as their relationship to discretionary choices in women of reproductive age during the coronavirus disease 2019 pandemic in Australia. They found that in the group of 1005 women included in the study, the 40% had a high level of psychological distress. Furthermore, women with high psychological distress and those who gained weight during the pandemic were more likely to consume discretionary foods. Authors concluded that public health messaging to promote healthy eating should take into account the effect of psychological distress on health behavior. We would like to contribute to the discussion on this topic. The recent pandemic has changed various aspects of lifestyle, heavily affecting, above all, food-related choices. Various factors influence food choice and among these socio-economic conditions and stress were particularly active during the pandemic. [2,3,4] With this in mind, we believe that the article by Grieger JA and coworkers has a very important role in clinical practice. However, we think that the gender difference in the management of stressful situations should be emphasized. The impact of stress is different in the 2 sexes and, also, the methods used to cope with stress are different in the 2 sexes. [5,6] Women are more likely to cope with stress through food by increasing their intake of comfort foods, sugar- and fat-rich foods. [7,8] Psychological stress influences the development of diseases, specifically regarding cardiovascular disease it acts both with a direct action through endothelial dysfunction and the development of atherosclerosis and with an indirect action through a change in lifestyle and lifestyle habits concerning Diet, exercise physical, sedentary lifestyle and sleep quality. [2,3,6,7] During pandemic the stress was increased in all population leading to the development of unhealthy habits. It is known that simple changes to diet and lifestyle can significantly, and rapidly, reduce the risks associated with coronavirus disease 2019 (COVID-19) in terms of infection risk, severity of disease, and even disease-related mortality. [2]A wide range of interventions including regular exercise, adequate sleep, plant-based diets, maintenance of healthy weight, dietary supplementation, and time in nature have each been shown to have beneficial effects for supporting more positive health outcomes with COVID-19, in addition to promoting better overall health. [2] However, it is well known that the pandemic itself has led to lifestyle changes that have favored the development of unhealthy habits both relating to food and a sedentary lifestyle. The lockdown disrupted traditional food supply and access strategies and introduced new ones. In doing so, mitigation measures have changed food environments and the way consumers interact with them. [9] It could have a lasting impact on consumer behavior. COVID-19 has caused a shift in household consumption and spending habits in relation to food. [10] Specifically, the following were observed: hoarding of food, buying more food than usual, avoiding shop purchases and in parallel an increase in the online delivery and pick-up services. Thompson and Coworkers highlight how people have been forced to adapt the way they shop by varying shopping times, shopping for others, and reducing the frequency of shopping trips. [11] Stock up and buy more food than usual was often used to compensate for these changes. Online shopping was a popular and necessary alternative to in-store shopping, but this excluded groups without the necessary resources or skills. In addition, the quality of food purchased has changed with an increase in sugar-rich food, facilitating the development of food cravings [4] There is a different response between the sexes regarding diet. These different diets habits are influenced by psycho-social environmental factors, as reported during the recent pandemic, and change throughout the lifespan of women. [3, 12] Women are more likely to develop food craving. Food craving is influenced by hormones and also by the stress response. [13] Moreover, it is also generally known that absorption of nutrients, bioavailability and tolerance are different in women and men. Some studies found that genetic and environmental factors influence the absorption of nutrients. Phenolic compounds are known to have different effects in women than in men. [13] In foods and beverages, phenolic compounds are accumulated as glycone or, mainly, as glycosidic conjugates. In the body, they are metabolized by enzymes which are expressed differently in males and females. [14] Patients with cardiovascular disease need a careful management of the diet due to the influence it exerts on endothelial dysfunction and on the traditional cardiovascular risk factors (i.e. obesity and dyslipidemia) and also on sex-specific cardiovascular risk factors. It is necessary to investigate whether these changes in food habits and food acquisition will persist after the pandemic and may contribute to the development of obesity in the population and obesity seems to be a risk factor for long Covid syndrome in women. [15] Declaration of interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Reference 1 Grieger JA, Habibi N, O'Reilly SL, Harrison CL, Moran LJ, Vo H, Sabir S BSc(Hons, Statistics), MSc(Statistics), Enticott J, Teede H PhD, Lim S MND, PhD. Psychological distress and its association with intake of sugar-sweetened beverages, discretionary foods, and alcohol in women during the COVID-19 pandemic in Australia. Nutrition. 2022 Nov-Dec;103-104:111794. doi: 10.1016/j.nut.2022.111794. Epub 2022 Jul 17. PMID: 36055124; PMCID: PMC9427120. 2 Campbell JL. COVID-19: reducing the risk via diet and lifestyle. Journal of Integrative Medicine (2022), doi: https://doi.org/10.1016/j.joim.2022.10.001 1 Vogel B, Acevedo M, Appelman Y, et al. The Lancet women and cardiovascular disease Commission: reducing the global burden by 2030. Lancet. Jun 19;397(10292):2385-2438. (2021) doi: 10.1016/S0140-6736(21)00684-X 2 Bracale R, Vaccaro CM. Changes in food choice following restrictive measures due to Covid-19. Nutr Metab Cardiovasc Dis. 2020 Aug 28;30(9):1423-1426. doi: 10.1016/j.numecd.2020.05.027. Epub 2020 May 30. 3 Mattioli AV, Sciomer S, Cocchi C, Maffei S, Gallina S. Quarantine during COVID-19 outbreak: Changes in diet and physical activity increase the risk of cardiovascular disease. Nutr Metab Cardiovasc Dis. 2020 Aug 28;30(9):1409-1417. doi: 10.1016/j.numecd.2020.05.020. Epub 2020 May 30. 4 McLean CP, Asnaani A, Litz BT, Hofmann SG. Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness. J. Psychiatr. Res. 2011, 45, 1027–1035 5 Mattioli AV, Sciomer S, Maffei S, Gallina S. Lifestyle and Stress Management in Women During COVID-19 Pandemic: Impact on Cardiovascular Risk Burden. Am J Lifestyle Med. 2020 Dec 10;15(3):356-359. doi: 10.1177/1559827620981014 6 Torres SJ, Nowson CA. Relationship between stress, eating behavior, and obesity. Nutrition. 2007;23(11- 12):887-894. https://doi. org/10.1016/j.nut.2007.08.008 7 Leone, L.A., Fleischhacker, S., Anderson-Steeves, B., et al, 2020. Healthy food retail during the COVID-19 pandemic: challenges and future directions. In: Healthy Food Retail during the COVID-19 Pandemic: Challenges and Future Directions, vol. 17. 8 Criteo Coronavirus Survey, 2020. Coronavirus consumer trends: consumer electronics, pet supplies, and more [Online]. Available at https://www.criteo.com/insights/coronavirus-consumer-trends/ [Accessed]. 9 Thompson C, Hamilton L, Dickinson A, Fallaize R, Mathie E, Rogers S, Wills W. Changes to household food shopping practices during the COVID-19 restrictions: Evidence from the East of England. Health Place. 2022 Sep 6;78:102906. doi: 10.1016/j.healthplace.2022.102906 10 Bucciarelli V, Nasi M, Bianco F, et al. Depression pandemic and cardiovascular risk in the COVID-19 era and long COVID syndrome: Gender makes a difference. Trends Cardiovasc Med. 2022 Jan;32(1):12-17. doi: 10.1016/j.tcm.2021.09.009. 11 Gilhooly CH, Das SK, Golden JK, et al. Food cravings and energy regulation: The characteristics of craved foods and their relationship with eating behaviors and weight change during 6 months of dietary energy restriction. Int J Obes. 2007;31(12):1849–58. 12 Campesi I, Marino M, Cipolletti M, Romani A, Franconi F. Put "gender glasses" on the effects of phenolic compounds on cardiovascular function and diseases. Eur J Nutr 2018;57(8):2677-2691. doi: 10.1007/s00394-018-1695-0. Epub 2018 Apr 25 13 Mattioli AV, Coppi F, Nasi M, Pinti M, Gallina, S. Long COVID: A New Challenge for Prevention of Obesity in Women. Am J of Lifestyle Med 2022; doi: 10.1177/15598276221111054