Dietary changes and anxiety during the coronavirus pandemic: a multinational survey

Background/objectives The 2020 global coronavirus pandemic is characterized by increased anxiety. Anxiety has been associated with poor diet quality and weight gain, which may lead to obesity, a risk factor for adverse COVID-19 outcomes. The present study was designed to examine associations between diet quality and anxiety levels during the COVID-19 pandemic. Subjects/methods This cross-sectional, international online study was conducted between March 30 and April 25, 2020 and available in seven languages: Arabic (7.6%), English (43.7%), French (0.8%), Hebrew (42.1%), Italian (3%), Russian (1.1%), and Spanish (1.6%). Diet quality was assessed using the Mediterranean Diet Score (possible range: 0-17 points) and anxiety scored using the General Anxiety Disorder 7-point scale (GAD-7). The Google Survey platform was used to conduct the survey. Results A total of 3797 persons were included in the present analysis. More than 75% of respondents were female; most completed the survey in English or Hebrew. Median age was 31 (IQ = 18) years. Almost 60% indicated that their pre-pandemic diet was healthier than their current diet. The median Mediterranean diet score was 9 (IQ = 3). The majority (54%) of participants reported at least mild anxiety, while 25% reported moderate anxiety or more severe. In a logistic regression model of at least moderate anxiety, Mediterranean diet score (OR 0.92, 95% CI 0.89-0.95, p < 0.0001) reduced odds of elevated anxiety, even after controlling for age, sex and other variables. Conclusions Though causality cannot be inferred, associations between diet quality and anxiety might suggest public health interventions including diet and stress control during future mass lockdowns.

Automated summary

This study aims to examine the relationship between diet quality and anxiety levels during the COVID-19 pandemic. Findings showed that most participants reported having a healthier diet before the pandemic and over half of the respondents reported at least mild anxiety.