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.
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