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Impact of social isolation by Coronavirus disease 2019 in food: a narrative review

Impacto do isolamento social pela Coronavirus disease 2019 na alimentação: uma revisão narrativa

ABSTRACT

The objective of this narrative review, with a systematic survey, was to investigate the impact of social isolation on food (eating habits) during the 2019 Coronavirus disease pandemic. A retrieval of studies published from January 1st, 2019 to June 18th, 2020 was carried out in the PubMed, Web of Science and Embase databases. The screening was structured using the terms corresponding to Coronavirus disease 2019, social isolation and food. All steps were carried out independently by three reviewers. Twelve studies were included, totaling 20,789 people assessed, with a predominance of cross-sectional studies of adult population. The studies reviewed had been carried out in Italy (n=4), Spain (n=2), Poland (n=1), China (n=1), India (n=1), United States of America (n=1), South Africa (n=1) and in a continental multicenter (n=1). The analysis of the studies included showed that most people reported that they did not change their usual diet; in addition, an increase in cooking habits, consumption of fruits and vegetables and a decrease in the consumption of alcoholic beverages was observed. A decrease in fish consumption and an increase in comfort foods were also reported. It was found that food habits changed in times of social isolation. We suggest that new investigations be carried out in different socioeconomic and demographic frameworks. We propose to continue the study on this theme, with a systematic review with or without meta-analysis.

Keywords
Coronavirus infections; Diet; food and nutrition; Review; Social isolation

RESUMO

Trata-se de revisão narrativa com busca sistemática, tendo por objetivo investigar o impacto do isolamento social na alimentação (hábitos alimentares) durante a pandemia da Coronavirus Disease 2019. Foi realizado rastreio de estudos publicados no período de 1º de janeiro de 2019 a 18 de junho de 2020 nas bases PubMed, Web of Science e Embase. A busca foi estruturada utilizando os unitermos correspondentes a Coronavirus Disease 2019, isolamento social e alimentação. Todas as etapas foram executadas de forma independente por três revisores. Foram incluídos 12 estudos, totalizando 20.789 pessoas pesquisadas, com a predominância de estudos de corte transversal na população adulta. Os estudos analisados foram desenvolvidos na Itália (n=4), Espanha (n=2), Polônia (n=1), China (n=1), Índia (n=1), Estados Unidos da América (n=1), África do Sul (n=1) e multicêntrico continental (n=1). A análise dos estudos incluídos evidenciou que a maioria das pessoas relatou não mudar a dieta habitual, observando-se também o aumento do hábito de cozinhar, consumir frutas, legumes e verduras e a diminuição do consumo de bebidas alcoólicas. Constatou-se diminuição do consumo de peixes e aumento das chamadas comfort foods. Verificou-se que a alimentação sofreu alterações em tempos de isolamento social. Sugerimos que novas pesquisas sejam realizadas em diferentes contextos socioeconômicos e demográficos. Propomos a continuidade do estudo desta temática, com realização de revisão sistemática com ou sem metanálise.

Palavras-chave
Infecções por coronavírus; Alimentos; dieta e nutrição; Revisão; Isolamento social

INTRODUCTION

In March 2020, Coronavirus disease 2019 (Covid-19), an infectious disease caused by the Acute Severe Respiratory Syndrome 2 (SARS-CoV-2) virus, was characterized by the World Health Organization (WHO) as a pandemic [11 World Health Organization. WHO announces COVID-19 outbreak a pandemic 2020. Geneva: Organization; 2020 [cited 2020 Aug 2]. Available from: https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/3/who-announces-covid-19-outbreak-a-pandemic
https://www.euro.who.int/en/health-topic...
,22 Guo Y-R, Cao Q-D, Hong Z-S, Tan Y-Y, Chen S-D, Jin H-J, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak: an update on the status. Mil Med Res. 2020;7:11. https://doi.org/10.1186/s40779-020-00240-0
https://doi.org/10.1186/s40779-020-00240...
]. According to WHO data, until August 2, 2020, 17,660,523 million cases of the disease had been confirmed worldwide, and in Brazil, these numbers represented on that date 2,662,485 million cases, with 92,475 thousand deaths [33 World Health Organization. Coronavirus Disease (COVID-19) Dashboard 2020. Geneva: Organization; 2020 [cited 2020 Aug 2]. Available from: https://covid19.who.int/
https://covid19.who.int/...
].

Due to the exponential increase of cases and the absence of measures to immunize the population, non-pharmacological interventions, such as Social Isolation (SI), are indicated to mitigate the transmission of the disease virus. The main objective of social isolation is to contain the virus spread among populations, countries and continents and, to postpone the peak of the epidemic curve, thus reducing the demand for health care and the overload of these services [44 Ministério da Saúde (Brasil). Medidas não farmacológicas 2020. Brasília: Ministério; 2020 [citado 2 Ago 2020]. Disponível em: https://coronavirus.saude.gov.br/medidas-nao-farmacologicas
https://coronavirus.saude.gov.br/medidas...
]. However, the SI can have an impact on the physical and mental health of individuals and promote changes in life habits related to the practice of physical activity and eating [55 Garcia LP, Duarte E. Intervenções não farmacológicas para o enfrentamento à epidemia da COVID-19 no Brasil. Epidemiol Serv Saúde. 2020;29:e2020222. https://doi.org/10.5123/S1679-49742020000200009
https://doi.org/10.5123/S1679-4974202000...
]. Food choices may be compromised, mainly due to limited access to food shopping places, which can lead to reduced consumption of fresh food, especially fruits, vegetables and fish, to the detriment of ready-to-eat and ultra-processed foods [66 Kanter R, Boza S. Strengthening local food systems in times of concomitant global crises: reflections from Chile. Am J Public Health. 2020;110:971-3. https://doi.org/10.2105/AJPH.2020.305711
https://doi.org/10.2105/AJPH.2020.305711...
]. In addition, emotional factors in response to routine changes and due to the disease itself, can increase the demand for foods rich in sugars or increase the desire for food [77 Muscogiuri G, Barrea L, Savastano S, Colao A. Nutritional recommendations for CoVID-19 quarantine. Eur J Clin Nutr. 2020;74:850-1. https://doi.org/10.1038/s41430-020-0635-2
https://doi.org/10.1038/s41430-020-0635-...
]. Thus, the objective of this narrative review was to investigate the impact of SI on people’s eating habits during the Covid-19 pandemic.

METHODS

Narrative review with systematic survey for studies published from January 1, 2019 to June 18, 2020 in the PubMed, Web of Science and Embase databases using uniterms and with the help of Boolean operators, according to Chart 1, without using filters.

Chart 1
Systematic search strategy used in the narrative review. Florianópolis (SC), Brazil, 2020.

The studies captured were transferred to the reference manager Mendeley® to remove duplicates and selected in the Rayyan® program in two stages: reading titles and abstracts and reading the full text. In the selection, the eligibility criteria were used: data collection performed during the isolation period by Covid-19 and that evaluated food and/or eating habits. Review and recommendation studies were excluded.

Data extraction was performed in the Microsoft Excel® 2010 program using a standardized and tested form considering the following variables: authors, year and place of study; methodological design; sample characteristics (gender and age); method used for recruiting the sample; methodology used for data collection (such as online platform, telephone interview); instrument to assess diet; data collection period; type of measure adopted by the country to contain Covid-19 (such as SI); and main results related to food. For the collection, analysis and synthesis of the results related to food in the framework of social isolation, the following aspects were considered: quantity consumed, quality (referring to types of food and/or nutrients consumed), number of meals, cooking habits, forms of preparation, forms of acquisition and food availability.

All steps were carried out independently by three of the authors and compared to verify agreement between them. In the case of any divergence, a fourth reviewer was consulted for final decision.

RESULTS

A total of 439 studies were identified. Out of these, 85 studies were excluded because they were duplicates. A total of 354 were reviewed by title and summary and 21 studies were read in full for eligibility. Twelve studies were included in the narrative review. The selection process is shown in Figure 1.

Figure 1
Flowchart for selecting the 12 studies included in the narrative review.

The Table 1 presents the main characteristics of the studies assessed. Seven studies were carried out on the European continent, four in Italy, two in Spain and one in Poland [88 Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18:229. https://doi.org/10.1186/s12967-020-02399-5
https://doi.org/10.1186/s12967-020-02399...

9 Gallè F, Sabella EA, Da Molin G, De Giglio O, Caggiano G, Di Onofrio V, et al. Understanding knowledge and behaviors related to CoViD-19 epidemic in Italian undergraduate students: the EPICO study. Int J Environ Res Public Health. 2020;17(10)3481. https://doi.org/10.3390/ijerph17103481
https://doi.org/10.3390/ijerph17103481...

10 Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of covid-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study. Obesity. 2020;28:1382-5. https://doi.org/10.1002/oby.22861
https://doi.org/10.1002/oby.22861...

11 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...

12 Rodríguez-Pérez C, Molina-Montes E, Verardo V, Artacho R, García-Villanova B, Guerra-Hernández EJ, et al. Changes in dietary behaviours during the COVID-19 outbreak confinement in the Spanish COVIDiet study. Nutrients. 2020;12(6)1730. https://doi.org/10.3390/nu12061730
https://doi.org/10.3390/nu12061730...

13 Romeo-Arroyo E, Mora M, Vázquez-Araújo L. Consumer behavior in confinement times: food choice and cooking attitudes in Spain. Int J Gastron Food Sci. 2020;21:100-226. https://doi.org/10.1016/j.ijgfs.2020.100226
https://doi.org/10.1016/j.ijgfs.2020.100...
-1414 Sidor A, Rzymski P. Dietary choices and habits during COVID-19 lockdown: experience from Poland. Nutrients. 2020;12(6)1657. https://doi.org/10.3390/nu12061657
https://doi.org/10.3390/nu12061657...
]. Two studies were carried out on the Asian continent, one in China and one in India [1515 Zhao A, Li Z, Ke Y, Huo S, Ma Y, Zhang Y, et al. Dietary diversity among Chinese residents during the COVID-19 outbreak and its associated factors. Nutrients. 2020;12(6)1699. https://doi.org/10.3390/nu12061699
https://doi.org/10.3390/nu12061699...
,1616 Nachimuthu S, Vijayalakshmi R, Sudha M, Viswanathan V. Coping with diabetes during the COVID-19 lockdown in India: results of an online pilot survey. Diabetes Metab Syndr Clin Res Rev. 2020;14:579-82. https://doi.org/10.1016/j.dsx.2020.04.053
https://doi.org/10.1016/j.dsx.2020.04.05...
]. One study was carried out in the American continent, in the United States of America and another in the African continent (South Africa) [1717 Zachary Z, Brianna F, Brianna L, Garrett P, Jade W, Alyssa D, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obes Res Clin Pract. 2020;14(3)210-6. https://doi.org/10.1016/j.orcp.2020.05.004
https://doi.org/10.1016/j.orcp.2020.05.0...
,1818 Pillay L, Janse van Rensburg DCC, Jansen van Rensburg A, Ramagole DA, Holtzhausen L, Dijkstra HP, et al. Nowhere to hide: the significant impact of coronavirus disease 2019 (COVID-19) measures on elite and semi-elite South African athletes. J Sci Med Sport. 2020;23:670-9. https://doi.org/10.1016/j.jsams.2020.05.016
https://doi.org/10.1016/j.jsams.2020.05....
]. And only one study corresponded to a multinational survey, involving Europe, North Africa, West Asia and the Americas [1919 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;12:1-13. https://doi.org/10.3390/nu12061583
https://doi.org/10.3390/nu12061583...
].

Table 1
General characteristics of the 12 studies included in the narrative review. Florianópolis (SC), Brazil, 2020.

Cross-sectional studies were predominant (n=11) and there was only one longitudinal survey [1010 Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of covid-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study. Obesity. 2020;28:1382-5. https://doi.org/10.1002/oby.22861
https://doi.org/10.1002/oby.22861...
]. All studies were carried out with populations of both genders; the majority included individuals over 18 years of age [1212 Rodríguez-Pérez C, Molina-Montes E, Verardo V, Artacho R, García-Villanova B, Guerra-Hernández EJ, et al. Changes in dietary behaviours during the COVID-19 outbreak confinement in the Spanish COVIDiet study. Nutrients. 2020;12(6)1730. https://doi.org/10.3390/nu12061730
https://doi.org/10.3390/nu12061730...

13 Romeo-Arroyo E, Mora M, Vázquez-Araújo L. Consumer behavior in confinement times: food choice and cooking attitudes in Spain. Int J Gastron Food Sci. 2020;21:100-226. https://doi.org/10.1016/j.ijgfs.2020.100226
https://doi.org/10.1016/j.ijgfs.2020.100...

14 Sidor A, Rzymski P. Dietary choices and habits during COVID-19 lockdown: experience from Poland. Nutrients. 2020;12(6)1657. https://doi.org/10.3390/nu12061657
https://doi.org/10.3390/nu12061657...
-1515 Zhao A, Li Z, Ke Y, Huo S, Ma Y, Zhang Y, et al. Dietary diversity among Chinese residents during the COVID-19 outbreak and its associated factors. Nutrients. 2020;12(6)1699. https://doi.org/10.3390/nu12061699
https://doi.org/10.3390/nu12061699...
,1717 Zachary Z, Brianna F, Brianna L, Garrett P, Jade W, Alyssa D, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obes Res Clin Pract. 2020;14(3)210-6. https://doi.org/10.1016/j.orcp.2020.05.004
https://doi.org/10.1016/j.orcp.2020.05.0...

18 Pillay L, Janse van Rensburg DCC, Jansen van Rensburg A, Ramagole DA, Holtzhausen L, Dijkstra HP, et al. Nowhere to hide: the significant impact of coronavirus disease 2019 (COVID-19) measures on elite and semi-elite South African athletes. J Sci Med Sport. 2020;23:670-9. https://doi.org/10.1016/j.jsams.2020.05.016
https://doi.org/10.1016/j.jsams.2020.05....
-1919 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;12:1-13. https://doi.org/10.3390/nu12061583
https://doi.org/10.3390/nu12061583...
], two assessed specific populations such as athletes and individuals with diabetes and the longitudinal research assessed obese children and adolescents [1010 Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of covid-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study. Obesity. 2020;28:1382-5. https://doi.org/10.1002/oby.22861
https://doi.org/10.1002/oby.22861...
,1616 Nachimuthu S, Vijayalakshmi R, Sudha M, Viswanathan V. Coping with diabetes during the COVID-19 lockdown in India: results of an online pilot survey. Diabetes Metab Syndr Clin Res Rev. 2020;14:579-82. https://doi.org/10.1016/j.dsx.2020.04.053
https://doi.org/10.1016/j.dsx.2020.04.05...
,1818 Pillay L, Janse van Rensburg DCC, Jansen van Rensburg A, Ramagole DA, Holtzhausen L, Dijkstra HP, et al. Nowhere to hide: the significant impact of coronavirus disease 2019 (COVID-19) measures on elite and semi-elite South African athletes. J Sci Med Sport. 2020;23:670-9. https://doi.org/10.1016/j.jsams.2020.05.016
https://doi.org/10.1016/j.jsams.2020.05....
]. The sample sizes ranged from 41 to 7,514, totaling 20,789 people assessed in the 12 studies. Nine studies presented the type of measure established in the country for the containment of Covid-19, all of which described SI as a condition in which leaving home would occur only for essential purposes.

Data collections were carried out using questionnaires administered on online platforms, with a predominance of Google forms®. To collect data on food, two studies used previously validated questionnaires on frequency and eating behavior and Adherence to the Mediterranean Diet [88 Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18:229. https://doi.org/10.1186/s12967-020-02399-5
https://doi.org/10.1186/s12967-020-02399...
,1212 Rodríguez-Pérez C, Molina-Montes E, Verardo V, Artacho R, García-Villanova B, Guerra-Hernández EJ, et al. Changes in dietary behaviours during the COVID-19 outbreak confinement in the Spanish COVIDiet study. Nutrients. 2020;12(6)1730. https://doi.org/10.3390/nu12061730
https://doi.org/10.3390/nu12061730...
,1313 Romeo-Arroyo E, Mora M, Vázquez-Araújo L. Consumer behavior in confinement times: food choice and cooking attitudes in Spain. Int J Gastron Food Sci. 2020;21:100-226. https://doi.org/10.1016/j.ijgfs.2020.100226
https://doi.org/10.1016/j.ijgfs.2020.100...
]. The others used adapted instruments or not validated.

In the results related to food, the studies reviewed were grouped into three categories: (a) those that evaluated only eating changes during the SI period compared to the previous period [99 Gallè F, Sabella EA, Da Molin G, De Giglio O, Caggiano G, Di Onofrio V, et al. Understanding knowledge and behaviors related to CoViD-19 epidemic in Italian undergraduate students: the EPICO study. Int J Environ Res Public Health. 2020;17(10)3481. https://doi.org/10.3390/ijerph17103481
https://doi.org/10.3390/ijerph17103481...
,1010 Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of covid-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study. Obesity. 2020;28:1382-5. https://doi.org/10.1002/oby.22861
https://doi.org/10.1002/oby.22861...
,1212 Rodríguez-Pérez C, Molina-Montes E, Verardo V, Artacho R, García-Villanova B, Guerra-Hernández EJ, et al. Changes in dietary behaviours during the COVID-19 outbreak confinement in the Spanish COVIDiet study. Nutrients. 2020;12(6)1730. https://doi.org/10.3390/nu12061730
https://doi.org/10.3390/nu12061730...
,1717 Zachary Z, Brianna F, Brianna L, Garrett P, Jade W, Alyssa D, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obes Res Clin Pract. 2020;14(3)210-6. https://doi.org/10.1016/j.orcp.2020.05.004
https://doi.org/10.1016/j.orcp.2020.05.0...

18 Pillay L, Janse van Rensburg DCC, Jansen van Rensburg A, Ramagole DA, Holtzhausen L, Dijkstra HP, et al. Nowhere to hide: the significant impact of coronavirus disease 2019 (COVID-19) measures on elite and semi-elite South African athletes. J Sci Med Sport. 2020;23:670-9. https://doi.org/10.1016/j.jsams.2020.05.016
https://doi.org/10.1016/j.jsams.2020.05....
-1919 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;12:1-13. https://doi.org/10.3390/nu12061583
https://doi.org/10.3390/nu12061583...
]; (b) those which evaluated food intake only in the SI period [1616 Nachimuthu S, Vijayalakshmi R, Sudha M, Viswanathan V. Coping with diabetes during the COVID-19 lockdown in India: results of an online pilot survey. Diabetes Metab Syndr Clin Res Rev. 2020;14:579-82. https://doi.org/10.1016/j.dsx.2020.04.053
https://doi.org/10.1016/j.dsx.2020.04.05...
]; and (c) those which assessed both [88 Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18:229. https://doi.org/10.1186/s12967-020-02399-5
https://doi.org/10.1186/s12967-020-02399...
,1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
,1313 Romeo-Arroyo E, Mora M, Vázquez-Araújo L. Consumer behavior in confinement times: food choice and cooking attitudes in Spain. Int J Gastron Food Sci. 2020;21:100-226. https://doi.org/10.1016/j.ijgfs.2020.100226
https://doi.org/10.1016/j.ijgfs.2020.100...

14 Sidor A, Rzymski P. Dietary choices and habits during COVID-19 lockdown: experience from Poland. Nutrients. 2020;12(6)1657. https://doi.org/10.3390/nu12061657
https://doi.org/10.3390/nu12061657...
-1515 Zhao A, Li Z, Ke Y, Huo S, Ma Y, Zhang Y, et al. Dietary diversity among Chinese residents during the COVID-19 outbreak and its associated factors. Nutrients. 2020;12(6)1699. https://doi.org/10.3390/nu12061699
https://doi.org/10.3390/nu12061699...
].

Regarding changes in food eating during the SI shown in Table 2, the following changes were observed in the aspects: amount of food eaten [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
,1212 Rodríguez-Pérez C, Molina-Montes E, Verardo V, Artacho R, García-Villanova B, Guerra-Hernández EJ, et al. Changes in dietary behaviours during the COVID-19 outbreak confinement in the Spanish COVIDiet study. Nutrients. 2020;12(6)1730. https://doi.org/10.3390/nu12061730
https://doi.org/10.3390/nu12061730...
,1414 Sidor A, Rzymski P. Dietary choices and habits during COVID-19 lockdown: experience from Poland. Nutrients. 2020;12(6)1657. https://doi.org/10.3390/nu12061657
https://doi.org/10.3390/nu12061657...
,1717 Zachary Z, Brianna F, Brianna L, Garrett P, Jade W, Alyssa D, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obes Res Clin Pract. 2020;14(3)210-6. https://doi.org/10.1016/j.orcp.2020.05.004
https://doi.org/10.1016/j.orcp.2020.05.0...
,1919 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;12:1-13. https://doi.org/10.3390/nu12061583
https://doi.org/10.3390/nu12061583...
]; number of meals [88 Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18:229. https://doi.org/10.1186/s12967-020-02399-5
https://doi.org/10.1186/s12967-020-02399...
,1010 Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of covid-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study. Obesity. 2020;28:1382-5. https://doi.org/10.1002/oby.22861
https://doi.org/10.1002/oby.22861...
,1717 Zachary Z, Brianna F, Brianna L, Garrett P, Jade W, Alyssa D, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obes Res Clin Pract. 2020;14(3)210-6. https://doi.org/10.1016/j.orcp.2020.05.004
https://doi.org/10.1016/j.orcp.2020.05.0...
,1919 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;12:1-13. https://doi.org/10.3390/nu12061583
https://doi.org/10.3390/nu12061583...
]; cooking habits [88 Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18:229. https://doi.org/10.1186/s12967-020-02399-5
https://doi.org/10.1186/s12967-020-02399...
,1212 Rodríguez-Pérez C, Molina-Montes E, Verardo V, Artacho R, García-Villanova B, Guerra-Hernández EJ, et al. Changes in dietary behaviours during the COVID-19 outbreak confinement in the Spanish COVIDiet study. Nutrients. 2020;12(6)1730. https://doi.org/10.3390/nu12061730
https://doi.org/10.3390/nu12061730...
,1414 Sidor A, Rzymski P. Dietary choices and habits during COVID-19 lockdown: experience from Poland. Nutrients. 2020;12(6)1657. https://doi.org/10.3390/nu12061657
https://doi.org/10.3390/nu12061657...
]; preparation methods [1212 Rodríguez-Pérez C, Molina-Montes E, Verardo V, Artacho R, García-Villanova B, Guerra-Hernández EJ, et al. Changes in dietary behaviours during the COVID-19 outbreak confinement in the Spanish COVIDiet study. Nutrients. 2020;12(6)1730. https://doi.org/10.3390/nu12061730
https://doi.org/10.3390/nu12061730...
]; acquisition [88 Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18:229. https://doi.org/10.1186/s12967-020-02399-5
https://doi.org/10.1186/s12967-020-02399...
]; food availability [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
,1212 Rodríguez-Pérez C, Molina-Montes E, Verardo V, Artacho R, García-Villanova B, Guerra-Hernández EJ, et al. Changes in dietary behaviours during the COVID-19 outbreak confinement in the Spanish COVIDiet study. Nutrients. 2020;12(6)1730. https://doi.org/10.3390/nu12061730
https://doi.org/10.3390/nu12061730...
]; general quality of food [99 Gallè F, Sabella EA, Da Molin G, De Giglio O, Caggiano G, Di Onofrio V, et al. Understanding knowledge and behaviors related to CoViD-19 epidemic in Italian undergraduate students: the EPICO study. Int J Environ Res Public Health. 2020;17(10)3481. https://doi.org/10.3390/ijerph17103481
https://doi.org/10.3390/ijerph17103481...
,1818 Pillay L, Janse van Rensburg DCC, Jansen van Rensburg A, Ramagole DA, Holtzhausen L, Dijkstra HP, et al. Nowhere to hide: the significant impact of coronavirus disease 2019 (COVID-19) measures on elite and semi-elite South African athletes. J Sci Med Sport. 2020;23:670-9. https://doi.org/10.1016/j.jsams.2020.05.016
https://doi.org/10.1016/j.jsams.2020.05....
]; and eating-related behaviors [1717 Zachary Z, Brianna F, Brianna L, Garrett P, Jade W, Alyssa D, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obes Res Clin Pract. 2020;14(3)210-6. https://doi.org/10.1016/j.orcp.2020.05.004
https://doi.org/10.1016/j.orcp.2020.05.0...
]. With the exception of Gallè et al. [99 Gallè F, Sabella EA, Da Molin G, De Giglio O, Caggiano G, Di Onofrio V, et al. Understanding knowledge and behaviors related to CoViD-19 epidemic in Italian undergraduate students: the EPICO study. Int J Environ Res Public Health. 2020;17(10)3481. https://doi.org/10.3390/ijerph17103481
https://doi.org/10.3390/ijerph17103481...
], Nachimuthu et al. [1616 Nachimuthu S, Vijayalakshmi R, Sudha M, Viswanathan V. Coping with diabetes during the COVID-19 lockdown in India: results of an online pilot survey. Diabetes Metab Syndr Clin Res Rev. 2020;14:579-82. https://doi.org/10.1016/j.dsx.2020.04.053
https://doi.org/10.1016/j.dsx.2020.04.05...
], and Zachary et al. [1717 Zachary Z, Brianna F, Brianna L, Garrett P, Jade W, Alyssa D, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obes Res Clin Pract. 2020;14(3)210-6. https://doi.org/10.1016/j.orcp.2020.05.004
https://doi.org/10.1016/j.orcp.2020.05.0...
], all other studies analyzed the change in the consumption of specific drinks and foods, such as sugary drinks, vegetables, fruits, fish and sweets

Table 2
Changes in eating habits due to social isolation observed in the 12 studies included in the narrative review. Florianópolis (SC), Brazil, 2020.

The proportion of people who reported an increase in the amount of food eaten during SI ranged between 36.3% and 52.9% [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
,1212 Rodríguez-Pérez C, Molina-Montes E, Verardo V, Artacho R, García-Villanova B, Guerra-Hernández EJ, et al. Changes in dietary behaviours during the COVID-19 outbreak confinement in the Spanish COVIDiet study. Nutrients. 2020;12(6)1730. https://doi.org/10.3390/nu12061730
https://doi.org/10.3390/nu12061730...
,1414 Sidor A, Rzymski P. Dietary choices and habits during COVID-19 lockdown: experience from Poland. Nutrients. 2020;12(6)1657. https://doi.org/10.3390/nu12061657
https://doi.org/10.3390/nu12061657...
,1717 Zachary Z, Brianna F, Brianna L, Garrett P, Jade W, Alyssa D, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obes Res Clin Pract. 2020;14(3)210-6. https://doi.org/10.1016/j.orcp.2020.05.004
https://doi.org/10.1016/j.orcp.2020.05.0...
]. One study identified an increase in the mean score of eating out of control (1.80±0.02 to 2.04±0.03) [1919 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;12:1-13. https://doi.org/10.3390/nu12061583
https://doi.org/10.3390/nu12061583...
].

In the analysis of the number of meals, it is observed that during quarantine, three and four main meals per day (30.3% and 39.3%, respectively) and one and two daily snacks (28.3% and 36,1% respectively) were more prevalent [1414 Sidor A, Rzymski P. Dietary choices and habits during COVID-19 lockdown: experience from Poland. Nutrients. 2020;12(6)1657. https://doi.org/10.3390/nu12061657
https://doi.org/10.3390/nu12061657...
]. In addition, 65.0% reported having breakfast daily during the pandemic [1414 Sidor A, Rzymski P. Dietary choices and habits during COVID-19 lockdown: experience from Poland. Nutrients. 2020;12(6)1657. https://doi.org/10.3390/nu12061657
https://doi.org/10.3390/nu12061657...
]. In the Ammar et al. [1919 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;12:1-13. https://doi.org/10.3390/nu12061583
https://doi.org/10.3390/nu12061583...
] multicentric study and in the study with obese children and adolescents by Pietrobelli et al. [1010 Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of covid-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study. Obesity. 2020;28:1382-5. https://doi.org/10.1002/oby.22861
https://doi.org/10.1002/oby.22861...
] there was an increase in the number of meals and snacks throughout the day. Zachary et al. [1717 Zachary Z, Brianna F, Brianna L, Garrett P, Jade W, Alyssa D, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obes Res Clin Pract. 2020;14(3)210-6. https://doi.org/10.1016/j.orcp.2020.05.004
https://doi.org/10.1016/j.orcp.2020.05.0...
] observed that in 11.5%, 22.0% and 38.7% of the participants there was an increase in food intake at breakfast, lunch and dinner meals, respectively.

In two studies, significant increases in cooking habits were observed, reported by 45.7% and 62.3% of those investigated [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
,1212 Rodríguez-Pérez C, Molina-Montes E, Verardo V, Artacho R, García-Villanova B, Guerra-Hernández EJ, et al. Changes in dietary behaviours during the COVID-19 outbreak confinement in the Spanish COVIDiet study. Nutrients. 2020;12(6)1730. https://doi.org/10.3390/nu12061730
https://doi.org/10.3390/nu12061730...
]. The preparation of homemade recipes was more present in the food routine during isolation, just as there was a decrease in the proportion of participants who reported the consumption of fried foods and a decrease in the proportion of food delivery services use [88 Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18:229. https://doi.org/10.1186/s12967-020-02399-5
https://doi.org/10.1186/s12967-020-02399...
]. The most frequently used form of food purchase was supermarket shopping [88 Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18:229. https://doi.org/10.1186/s12967-020-02399-5
https://doi.org/10.1186/s12967-020-02399...
,1717 Zachary Z, Brianna F, Brianna L, Garrett P, Jade W, Alyssa D, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obes Res Clin Pract. 2020;14(3)210-6. https://doi.org/10.1016/j.orcp.2020.05.004
https://doi.org/10.1016/j.orcp.2020.05.0...
].

The difficulty in finding food was reported by 27.0% of the sample in the Rodríguez-Pérez et al. study [1212 Rodríguez-Pérez C, Molina-Montes E, Verardo V, Artacho R, García-Villanova B, Guerra-Hernández EJ, et al. Changes in dietary behaviours during the COVID-19 outbreak confinement in the Spanish COVIDiet study. Nutrients. 2020;12(6)1730. https://doi.org/10.3390/nu12061730
https://doi.org/10.3390/nu12061730...
]. This aspect negatively influenced consumption of fruits and vegetables, as, according to the study by Scarmozzino and Visioli [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
], 33.5% of people reported reducing their consumption due to the difficulty in finding them. This aspect has also been reported as a reason for dietary changes [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
].

In assessing the general quality of the diet, Gallè et al. [99 Gallè F, Sabella EA, Da Molin G, De Giglio O, Caggiano G, Di Onofrio V, et al. Understanding knowledge and behaviors related to CoViD-19 epidemic in Italian undergraduate students: the EPICO study. Int J Environ Res Public Health. 2020;17(10)3481. https://doi.org/10.3390/ijerph17103481
https://doi.org/10.3390/ijerph17103481...
] and Pillay et al. [1818 Pillay L, Janse van Rensburg DCC, Jansen van Rensburg A, Ramagole DA, Holtzhausen L, Dijkstra HP, et al. Nowhere to hide: the significant impact of coronavirus disease 2019 (COVID-19) measures on elite and semi-elite South African athletes. J Sci Med Sport. 2020;23:670-9. https://doi.org/10.1016/j.jsams.2020.05.016
https://doi.org/10.1016/j.jsams.2020.05....
] found improvement in 41.0% and 53.0% of the population, respectively. The quality deterioration was reported by 17.1% and 47.0%, respectively [99 Gallè F, Sabella EA, Da Molin G, De Giglio O, Caggiano G, Di Onofrio V, et al. Understanding knowledge and behaviors related to CoViD-19 epidemic in Italian undergraduate students: the EPICO study. Int J Environ Res Public Health. 2020;17(10)3481. https://doi.org/10.3390/ijerph17103481
https://doi.org/10.3390/ijerph17103481...
,1818 Pillay L, Janse van Rensburg DCC, Jansen van Rensburg A, Ramagole DA, Holtzhausen L, Dijkstra HP, et al. Nowhere to hide: the significant impact of coronavirus disease 2019 (COVID-19) measures on elite and semi-elite South African athletes. J Sci Med Sport. 2020;23:670-9. https://doi.org/10.1016/j.jsams.2020.05.016
https://doi.org/10.1016/j.jsams.2020.05....
]. In the study by Nachimuthu et al. [1616 Nachimuthu S, Vijayalakshmi R, Sudha M, Viswanathan V. Coping with diabetes during the COVID-19 lockdown in India: results of an online pilot survey. Diabetes Metab Syndr Clin Res Rev. 2020;14:579-82. https://doi.org/10.1016/j.dsx.2020.04.053
https://doi.org/10.1016/j.dsx.2020.04.05...
], which included people with diabetes mellitus, 80% reported being regularly following a diet and workout routine during SI and 19.0% reported difficulty due to lack of resources [1616 Nachimuthu S, Vijayalakshmi R, Sudha M, Viswanathan V. Coping with diabetes during the COVID-19 lockdown in India: results of an online pilot survey. Diabetes Metab Syndr Clin Res Rev. 2020;14:579-82. https://doi.org/10.1016/j.dsx.2020.04.053
https://doi.org/10.1016/j.dsx.2020.04.05...
].

Zachary et al. [1717 Zachary Z, Brianna F, Brianna L, Garrett P, Jade W, Alyssa D, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obes Res Clin Pract. 2020;14(3)210-6. https://doi.org/10.1016/j.orcp.2020.05.004
https://doi.org/10.1016/j.orcp.2020.05.0...
] evaluated behaviors related to the stimulus for food. The authors identified that the behaviors reported in the greatest proportion were the desire to eat certain foods (73%) and boredom (73%), followed by stimulation in response to sight and smell (65%), after dinner (65%), eating with friends and family (59%) and in response to stress (52.0%.

The use of food supplements as a behavior related to Covid-19 was mentioned in two studies [1515 Zhao A, Li Z, Ke Y, Huo S, Ma Y, Zhang Y, et al. Dietary diversity among Chinese residents during the COVID-19 outbreak and its associated factors. Nutrients. 2020;12(6)1699. https://doi.org/10.3390/nu12061699
https://doi.org/10.3390/nu12061699...
,1818 Pillay L, Janse van Rensburg DCC, Jansen van Rensburg A, Ramagole DA, Holtzhausen L, Dijkstra HP, et al. Nowhere to hide: the significant impact of coronavirus disease 2019 (COVID-19) measures on elite and semi-elite South African athletes. J Sci Med Sport. 2020;23:670-9. https://doi.org/10.1016/j.jsams.2020.05.016
https://doi.org/10.1016/j.jsams.2020.05....
]. Pillay et al. [1818 Pillay L, Janse van Rensburg DCC, Jansen van Rensburg A, Ramagole DA, Holtzhausen L, Dijkstra HP, et al. Nowhere to hide: the significant impact of coronavirus disease 2019 (COVID-19) measures on elite and semi-elite South African athletes. J Sci Med Sport. 2020;23:670-9. https://doi.org/10.1016/j.jsams.2020.05.016
https://doi.org/10.1016/j.jsams.2020.05....
] found that 32.0% of the athletes evaluated reported using supplements during this period to improve immunity. Among these individuals, 36.0% reported the use of multivitamins, 36.0% vitamin C, 15.0% protein, 4.0% zinc, 23.0% reported other supplements and 5% provided no information [1818 Pillay L, Janse van Rensburg DCC, Jansen van Rensburg A, Ramagole DA, Holtzhausen L, Dijkstra HP, et al. Nowhere to hide: the significant impact of coronavirus disease 2019 (COVID-19) measures on elite and semi-elite South African athletes. J Sci Med Sport. 2020;23:670-9. https://doi.org/10.1016/j.jsams.2020.05.016
https://doi.org/10.1016/j.jsams.2020.05....
]. In the study by Zhao et al. [1515 Zhao A, Li Z, Ke Y, Huo S, Ma Y, Zhang Y, et al. Dietary diversity among Chinese residents during the COVID-19 outbreak and its associated factors. Nutrients. 2020;12(6)1699. https://doi.org/10.3390/nu12061699
https://doi.org/10.3390/nu12061699...
], 37.7% of the interviewees reported making intentional use of dietary supplements, Chinese herbs or specific foods due to Covid-19, including vitamin C (18.2%), probiotics (11.7%), other food supplements (8.0%) and Chinese herbs (9.6%). A few studies have also assessed the change in intake of specific food and beverage groups [88 Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18:229. https://doi.org/10.1186/s12967-020-02399-5
https://doi.org/10.1186/s12967-020-02399...
,1010 Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of covid-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study. Obesity. 2020;28:1382-5. https://doi.org/10.1002/oby.22861
https://doi.org/10.1002/oby.22861...

11 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...

12 Rodríguez-Pérez C, Molina-Montes E, Verardo V, Artacho R, García-Villanova B, Guerra-Hernández EJ, et al. Changes in dietary behaviours during the COVID-19 outbreak confinement in the Spanish COVIDiet study. Nutrients. 2020;12(6)1730. https://doi.org/10.3390/nu12061730
https://doi.org/10.3390/nu12061730...

13 Romeo-Arroyo E, Mora M, Vázquez-Araújo L. Consumer behavior in confinement times: food choice and cooking attitudes in Spain. Int J Gastron Food Sci. 2020;21:100-226. https://doi.org/10.1016/j.ijgfs.2020.100226
https://doi.org/10.1016/j.ijgfs.2020.100...

14 Sidor A, Rzymski P. Dietary choices and habits during COVID-19 lockdown: experience from Poland. Nutrients. 2020;12(6)1657. https://doi.org/10.3390/nu12061657
https://doi.org/10.3390/nu12061657...
-1515 Zhao A, Li Z, Ke Y, Huo S, Ma Y, Zhang Y, et al. Dietary diversity among Chinese residents during the COVID-19 outbreak and its associated factors. Nutrients. 2020;12(6)1699. https://doi.org/10.3390/nu12061699
https://doi.org/10.3390/nu12061699...
,1818 Pillay L, Janse van Rensburg DCC, Jansen van Rensburg A, Ramagole DA, Holtzhausen L, Dijkstra HP, et al. Nowhere to hide: the significant impact of coronavirus disease 2019 (COVID-19) measures on elite and semi-elite South African athletes. J Sci Med Sport. 2020;23:670-9. https://doi.org/10.1016/j.jsams.2020.05.016
https://doi.org/10.1016/j.jsams.2020.05....
,1919 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;12:1-13. https://doi.org/10.3390/nu12061583
https://doi.org/10.3390/nu12061583...
], presented in Table 3.

Table 3
Changes in eating habits due to social isolation observed in the 12 studies included in the narrative review. Florianópolis (SC), Brazil, 2020.

The consumption of alcoholic beverages was assessed in eight studies [88 Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18:229. https://doi.org/10.1186/s12967-020-02399-5
https://doi.org/10.1186/s12967-020-02399...
,1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...

12 Rodríguez-Pérez C, Molina-Montes E, Verardo V, Artacho R, García-Villanova B, Guerra-Hernández EJ, et al. Changes in dietary behaviours during the COVID-19 outbreak confinement in the Spanish COVIDiet study. Nutrients. 2020;12(6)1730. https://doi.org/10.3390/nu12061730
https://doi.org/10.3390/nu12061730...

13 Romeo-Arroyo E, Mora M, Vázquez-Araújo L. Consumer behavior in confinement times: food choice and cooking attitudes in Spain. Int J Gastron Food Sci. 2020;21:100-226. https://doi.org/10.1016/j.ijgfs.2020.100226
https://doi.org/10.1016/j.ijgfs.2020.100...

14 Sidor A, Rzymski P. Dietary choices and habits during COVID-19 lockdown: experience from Poland. Nutrients. 2020;12(6)1657. https://doi.org/10.3390/nu12061657
https://doi.org/10.3390/nu12061657...
-1515 Zhao A, Li Z, Ke Y, Huo S, Ma Y, Zhang Y, et al. Dietary diversity among Chinese residents during the COVID-19 outbreak and its associated factors. Nutrients. 2020;12(6)1699. https://doi.org/10.3390/nu12061699
https://doi.org/10.3390/nu12061699...
,1818 Pillay L, Janse van Rensburg DCC, Jansen van Rensburg A, Ramagole DA, Holtzhausen L, Dijkstra HP, et al. Nowhere to hide: the significant impact of coronavirus disease 2019 (COVID-19) measures on elite and semi-elite South African athletes. J Sci Med Sport. 2020;23:670-9. https://doi.org/10.1016/j.jsams.2020.05.016
https://doi.org/10.1016/j.jsams.2020.05....
,1919 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;12:1-13. https://doi.org/10.3390/nu12061583
https://doi.org/10.3390/nu12061583...
]. Rodriguez-Pérez et al. [1212 Rodríguez-Pérez C, Molina-Montes E, Verardo V, Artacho R, García-Villanova B, Guerra-Hernández EJ, et al. Changes in dietary behaviours during the COVID-19 outbreak confinement in the Spanish COVIDiet study. Nutrients. 2020;12(6)1730. https://doi.org/10.3390/nu12061730
https://doi.org/10.3390/nu12061730...
] found a predominance in the decrease and maintenance of alcohol consumption, reported by 57.3% and 32.3% of the sample, respectively. Ammar et al. [1919 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;12:1-13. https://doi.org/10.3390/nu12061583
https://doi.org/10.3390/nu12061583...
] also observed a reduction in the mean alcohol binge score (1.15±0.01 to 1.08±0.01) [1919 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;12:1-13. https://doi.org/10.3390/nu12061583
https://doi.org/10.3390/nu12061583...
]. On the other hand, in the studies by Scarmozzino and Visioli [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
] and Sidor and Rzymski [1414 Sidor A, Rzymski P. Dietary choices and habits during COVID-19 lockdown: experience from Poland. Nutrients. 2020;12(6)1657. https://doi.org/10.3390/nu12061657
https://doi.org/10.3390/nu12061657...
], there was a higher proportion of reports indicating maintenance of the usual consumption of alcoholic beverages during the isolation period, representing 53.1% and 77.0% of the samples evaluated, respectively.

The study by Scarmozzino and Visioli [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
] found that the majority of the population maintained the usual consumption of sugary drinks (juices, soft drinks, tonic, etc.) (72.7%), with 79.8% of people consuming less than once a week [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
]. In contrast, in Pietrobelli et al. [1010 Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of covid-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study. Obesity. 2020;28:1382-5. https://doi.org/10.1002/oby.22861
https://doi.org/10.1002/oby.22861...
], the longitudinal analysis with children and adolescents identified an increase in the average daily frequency of consumption during the SI (0.90±1.16) when compared to the previous period (0.40±0.90) [1010 Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of covid-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study. Obesity. 2020;28:1382-5. https://doi.org/10.1002/oby.22861
https://doi.org/10.1002/oby.22861...
]. Pillay et al. [1818 Pillay L, Janse van Rensburg DCC, Jansen van Rensburg A, Ramagole DA, Holtzhausen L, Dijkstra HP, et al. Nowhere to hide: the significant impact of coronavirus disease 2019 (COVID-19) measures on elite and semi-elite South African athletes. J Sci Med Sport. 2020;23:670-9. https://doi.org/10.1016/j.jsams.2020.05.016
https://doi.org/10.1016/j.jsams.2020.05....
] mentioned that among the athletes who reported worsening of the diet during the SI (53% of the total sample), 30.0% reported to be due to the consumption of carbonated drinks. The increase in the consumption of hot drinks (coffee, tea and infusions) was reported by more than 20% of the individuals studied by Di Renzo et al. [88 Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18:229. https://doi.org/10.1186/s12967-020-02399-5
https://doi.org/10.1186/s12967-020-02399...
] and was also mentioned by 29.8% of the population in the study by Scarmozzino and Visioli [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
].

Maintaining the consumption of pasta, rice, bread and cereals was mentioned by more than 50% of the individuals in the studies by Romeo-Arroyo et al. [1313 Romeo-Arroyo E, Mora M, Vázquez-Araújo L. Consumer behavior in confinement times: food choice and cooking attitudes in Spain. Int J Gastron Food Sci. 2020;21:100-226. https://doi.org/10.1016/j.ijgfs.2020.100226
https://doi.org/10.1016/j.ijgfs.2020.100...
]. In contrast, Di Renzo et al. [88 Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18:229. https://doi.org/10.1186/s12967-020-02399-5
https://doi.org/10.1186/s12967-020-02399...
] observed that 20% of the study population increased cereal consumption.

Most individuals maintained their consumption of legumes according to the study by Romeo-Arroyo et al. [1313 Romeo-Arroyo E, Mora M, Vázquez-Araújo L. Consumer behavior in confinement times: food choice and cooking attitudes in Spain. Int J Gastron Food Sci. 2020;21:100-226. https://doi.org/10.1016/j.ijgfs.2020.100226
https://doi.org/10.1016/j.ijgfs.2020.100...
], but there was an increase in legumes consumption by more than 10% of the study individuals, according to Di Renzo et al. [88 Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18:229. https://doi.org/10.1186/s12967-020-02399-5
https://doi.org/10.1186/s12967-020-02399...
]. The prevalence of daily consumption of legumes was 70.1% according to Zhao et al. [1515 Zhao A, Li Z, Ke Y, Huo S, Ma Y, Zhang Y, et al. Dietary diversity among Chinese residents during the COVID-19 outbreak and its associated factors. Nutrients. 2020;12(6)1699. https://doi.org/10.3390/nu12061699
https://doi.org/10.3390/nu12061699...
]. Although it was found that the majority of individuals maintained their consumption of fruits and/or vegetables during SI, it is highlighted that 21.2% and more than 30% of the population reported a consumption increase of these foods [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
,1313 Romeo-Arroyo E, Mora M, Vázquez-Araújo L. Consumer behavior in confinement times: food choice and cooking attitudes in Spain. Int J Gastron Food Sci. 2020;21:100-226. https://doi.org/10.1016/j.ijgfs.2020.100226
https://doi.org/10.1016/j.ijgfs.2020.100...
].

Romeo-Arroyo, et al. [1313 Romeo-Arroyo E, Mora M, Vázquez-Araújo L. Consumer behavior in confinement times: food choice and cooking attitudes in Spain. Int J Gastron Food Sci. 2020;21:100-226. https://doi.org/10.1016/j.ijgfs.2020.100226
https://doi.org/10.1016/j.ijgfs.2020.100...
] highlighted that the majority of individuals maintained the consumption of meat and eggs. However, Pietrobelli et al. [1010 Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of covid-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study. Obesity. 2020;28:1382-5. https://doi.org/10.1002/oby.22861
https://doi.org/10.1002/oby.22861...
] observed a significant increase (p<0.05) in the average consumption of red meat in children and adolescents as compared to the previous period (1.80±1.53 servings/day) and during the SI (3.46±2.45 servings/day) [1010 Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of covid-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study. Obesity. 2020;28:1382-5. https://doi.org/10.1002/oby.22861
https://doi.org/10.1002/oby.22861...
]. Still, among those who mentioned worsening of the diet in the study by Pillay et al. [1818 Pillay L, Janse van Rensburg DCC, Jansen van Rensburg A, Ramagole DA, Holtzhausen L, Dijkstra HP, et al. Nowhere to hide: the significant impact of coronavirus disease 2019 (COVID-19) measures on elite and semi-elite South African athletes. J Sci Med Sport. 2020;23:670-9. https://doi.org/10.1016/j.jsams.2020.05.016
https://doi.org/10.1016/j.jsams.2020.05....
], 15% of the athletes reported that their response was on account of the excess consumption of red meat.

Di Renzo et al. [88 Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18:229. https://doi.org/10.1186/s12967-020-02399-5
https://doi.org/10.1186/s12967-020-02399...
] highlighted an increase in the consumption of white meat (not including fish) in more than 10% of people. A decrease in fish consumption was found in several studies: Di Renzo et al. [88 Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18:229. https://doi.org/10.1186/s12967-020-02399-5
https://doi.org/10.1186/s12967-020-02399...
] (reduction in more than 20% of individuals), Romeo-Arroyo et al. [1313 Romeo-Arroyo E, Mora M, Vázquez-Araújo L. Consumer behavior in confinement times: food choice and cooking attitudes in Spain. Int J Gastron Food Sci. 2020;21:100-226. https://doi.org/10.1016/j.ijgfs.2020.100226
https://doi.org/10.1016/j.ijgfs.2020.100...
] (reduction in more than 33.0% of the population) and Scarmozzino and Visioli [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
]. In the latter, the authors found that 64.8% of individuals consumed fresh and canned fish as usual, 8.5% increased and 13.7% reduced consumption. In addition, 13.0% of people were consuming less fresh fish and more canned fish [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
].

The change in the consumption of milk and dairy products and cheese was evaluated only by Scarmozzino and Visioli [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
]. The population studied by them reported usual consumption for these food groups, representing 76.3% for reports of consumption of milk and dairy products and 19.1% for cheese consumption. [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
].

Snacks and fast foods showed consumption similar to the period before social isolation, representing 46.7% and 57,6% for snacks, and 60% for fast-foods [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
,1212 Rodríguez-Pérez C, Molina-Montes E, Verardo V, Artacho R, García-Villanova B, Guerra-Hernández EJ, et al. Changes in dietary behaviours during the COVID-19 outbreak confinement in the Spanish COVIDiet study. Nutrients. 2020;12(6)1730. https://doi.org/10.3390/nu12061730
https://doi.org/10.3390/nu12061730...
]. Additionally, Scarmozzino and Visioli [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
] evaluated the change in the consumption of ready meals and found a higher proportion of reports of maintenance or decrease in consumption, with values of 47.4% and 49.5%, respectively.

In the longitudinal study by Pietrobelli et al. [1010 Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of covid-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study. Obesity. 2020;28:1382-5. https://doi.org/10.1002/oby.22861
https://doi.org/10.1002/oby.22861...
], children and adolescents reported a significant increase in the consumption of daily servings of potato chips with an average of 0.07±0.24 to 0.61±0.83. In the study by Ammar et al. [1919 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;12:1-13. https://doi.org/10.3390/nu12061583
https://doi.org/10.3390/nu12061583...
] the average score of frequency of junk food consumption increased significantly during the SI, from 2.18±0.02 to 2.27±0.03. However, in the study by Di Renzo et al. [88 Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18:229. https://doi.org/10.1186/s12967-020-02399-5
https://doi.org/10.1186/s12967-020-02399...
] the proportion of increase and decrease reports on the consumption of these foods was similar in the evaluated population, representing 25.6% and 29.8%, respectively.

Scarmozzino and Visioli [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
] observed in the studied population a greater predominance of usual consumption of cookies (66.1%). Usual consumption of sweets was reported in 44.0% and the authors observed an increase in 42.5% of the population for this food [1111 Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods (Basel, Switzerland). 2020;9(5)675. https://doi.org/10.3390/foods9050675
https://doi.org/10.3390/foods9050675...
]. Romeo-Arroyo et al. [1313 Romeo-Arroyo E, Mora M, Vázquez-Araújo L. Consumer behavior in confinement times: food choice and cooking attitudes in Spain. Int J Gastron Food Sci. 2020;21:100-226. https://doi.org/10.1016/j.ijgfs.2020.100226
https://doi.org/10.1016/j.ijgfs.2020.100...
] found similar values regarding the increase in the consumption of sweets in more than 50% of the individuals assessed.

DISCUSSION

This review included studies that investigated changes in consumption and/or eating habits in times of SI due to Covid-19. We found that in general people maintained the usual diet, although some studies have also found favorable and/or unfavorable changes in the diet.

As favorable changes in eating habits, we can highlight the increase in the habit of cooking and the decrease in the preparation of fried foods. Changes in these aspects may be related to the greater time availability for preparing meals. In a survey of university students (n=350), 51% reported that time is an important factor to have a healthy diet, and having time to cook was referred to as being very (47%) and extremely (29%) important for this practice [2020 Maia RP, Recine E. Valores e práticas sobre alimentação de estudantes da universidade de Brasília. Demetra Aliment Nutr Saúde. 2015;10:3-25. https://doi.org/10.12957/demetra.2014.14215
https://doi.org/10.12957/demetra.2014.14...
].

The increase in the consumption of fruits and vegetables, as well as the greater adherence to the Mediterranean diet, can be acknowledged as a positive change. This observation is in line with the publication of the WHO guidelines on food and nutrition for the isolation period. In this guide, WHO refers to fruits and vegetables as the best food to be consumed in the isolation period [2121 World Health Organization. Food and nutrition tips during self-quarantine 2020. Genebra: Organization; 2020 [cited 2020 July 30]. Available from: https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/technical-guidance/food-and-nutrition-tips-during-self-quarantine
https://www.euro.who.int/en/health-topic...
]. In addition, fruits and vegetables are sources of essential micronutrients for the immune system, mainly vitamins A, C, D, E, B2, B6 and B12, folic acid, iron, selenium and zinc [2222 Maggini S, Pierre A, Calder PC. Immune function and micronutrient requirements change over the life course. Nutrients. 2018;10(10):1531. https://doi.org/10.3390/nu10101531
https://doi.org/10.3390/nu10101531...
]. Another nutrient that favors the immune function and has an anti-inflammatory characteristic is omega-3 fatty acid, found in fish [2323 Saini RK, Keum Y-S. Omega-3 and omega-6 polyunsaturated fatty acids: dietary sources, metabolism, and significance: a review. Life Sci. 2018;203:255-67. https://doi.org/10.1016/j.lfs.2018.04.049
https://doi.org/10.1016/j.lfs.2018.04.04...
]. However, in our study, we identified a decrease in the consumption of this food, which may suggest a difficulty in the ability to prepare this type of food or in the reduction of the purchase at specific places where fish is sold [2424 Lopes IG, Oliveira RG, Ramos FM. Perfil do consumo de peixes pela população brasileira. Biota Amaz. 2016;6:62-5. https://doi.org/10.18561/2179-5746/biotaamazonia.v6n2p62-65
https://doi.org/10.18561/2179-5746/biota...
].

Among the diet changes considered negative for health, we can mention increase in the consumption of foods with high energy density, high concentration of sugar and fat (sweets, sugary drinks, snacks and sauces), also called comfort foods. The increase in consumption of these foods may be due to the increase in the levels of anxiety and stress and is related with negative health outcomes [2525 Leng G, Adan RAH, Belot M, Brunstrom JM, Graaf K, Dickson SL, et al. The determinants of food choice. Proc Nutr Soc. 2017;76:316-27. https://doi.org/10.1017/S002966511600286X
https://doi.org/10.1017/S002966511600286...
,2626 Payab M, Kelishadi R, Qorbani M, Motlagh ME, Ranjbar SH, Ardalan G, et al. Association of junk food consumption with high blood pressure and obesity in Iranian children and adolescents: the CASPIAN-IV study. J Pediatr (Rio J). 2015;91:196-205. https://doi.org/10.1016/j.jped.2014.07.006
https://doi.org/10.1016/j.jped.2014.07.0...
].

The results observed in only one study with obese children and adolescents indicate unfavorable changes in the diet, such as an increase in the intake of sugary drinks and potato chips. The habitual consumption of these foods is associated with an increased risk of overweight and obesity [2727 Costa CS, Del-Ponte B, Assunção MCF, Santos IS. Consumption of ultra-processed foods and body fat during childhood and adolescence: a systematic review. Public Health Nutr. 2018;21:148-59. https://doi.org/10.1017/S1368980017001331
https://doi.org/10.1017/S136898001700133...
]. It is noteworthy that the behaviors and habits acquired in this phase of life tend to be perpetuated in adult life, an aspect of great concern in a scenario of continuity of measures of social isolation for an indefinite period [2828 Llewellyn A, Simmonds M, Owen CG, Woolacott N. Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta-analysis. Obes Rev. 2016;17:56-67. https://doi.org/10.1111/obr.12316
https://doi.org/10.1111/obr.12316...
]. Thus, there is a need for further studies in this population to target interventions during this period.

Although the aim of this review was not the search for articles that exclusively evaluated alcohol consumption during the pandemic, the studies included indicated greater proportions of reduction and maintenance of alcohol consumption. However, it is known that alcohol consumption during the pandemic can represent an important public health problem [2929 Clay JM, Parker MO. Alcohol use and misuse during the COVID-19 pandemic: a potential public health crisis? Lancet Public Health. 2020;5(5):e259. https://doi.org/10.1016/S2468-2667(20)30088-8
https://doi.org/10.1016/S2468-2667(20)30...
]. During social isolation related to Covid-19, individuals may experience greater anxiety and depressive symptoms and evidence suggests that psychological suffering related to Covid-19 is associated with increased alcohol consumption [3030 Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;395:912-20. https://doi.org/10.1016/S0140-6736(20)30460-8
https://doi.org/10.1016/S0140-6736(20)30...
,3131 Rodriguez LM, Litt DM, Stewart SH. Drinking to cope with the pandemic: the unique associations of COVID-19-related perceived threat and psychological distress to drinking behaviors in American men and women. Addict Behav. 2020;110:106532. https://doi.org/10.1016/j.addbeh.2020.106532
https://doi.org/10.1016/j.addbeh.2020.10...
]. A study in Poland found that 17.4% of the sample reported a decrease in the consumption of alcoholic beverages due to the pandemic, 13.8% an increased consumption and about 41.1% did not report changes [3232 Chodkiewicz J, Talarowska M, Miniszewska J, Nawrocka N, Bilinski P. Alcohol consumption reported during the COVID-19 pandemic: the initial stage. Int J Environ Res Public Health. 2020;17:4677. https://doi.org/10.3390/ijerph17134677
https://doi.org/10.3390/ijerph17134677...
].

The decrease in alcohol consumption was observed concomitantly with the increase in the use of coffee/tea/infusions. One hypothesis is that staying at home without contact with other people has influenced the pattern of drink consumed, since alcoholic beverages are related to the socialization process, as a set of strategies that facilitate the coexistence between people, especially young people [3333 Rosa LFA, Nascimento ARA. Representações sociais de bebida alcoólica para homens universitários. Arq Bras Psicol. 2015;67:3-19.].

We observed that the use of dietary supplements was a strategy used during SI. Some authors and even social media professionals have recommended the use of supplements to enhance immunity [3434 Richards G, Mer M, Schleicher G, Stacey S. COVID-19 and the rationale for pharmacotherapy: a South African perspective. Wits J Clin Med. 2020;2:11-8. https://doi.org/10.18772/26180197.2020.v2nSIa2
https://doi.org/10.18772/26180197.2020.v...
,3535 Jukic I, Calleja-Gonzalez J, Cos F, Cuzzolin F, Olmo J, Terrados N, et al. Strategies and solutions for team sports athletes in isolation due to COVID-19. Sports. 2020;8(4):56. https://doi.org/10.3390/sports8040056
https://doi.org/10.3390/sports8040056...
]. Easy access to information may have favored the adoption of this behavior; however supplementation without the guidance of a trained professional is not advisable.

There was an increase in the number of meals among children and adolescents [1010 Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of covid-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study. Obesity. 2020;28:1382-5. https://doi.org/10.1002/oby.22861
https://doi.org/10.1002/oby.22861...
]. A study, carried out not in connection with the pandemic, with a population in the same age group, found that a greater number of meals at home may be associated with better quality of the diet and lower intake of saturated fat [3636 Prado BG, Hinnig PF, Tanaka LF, Latorre MRDO. Qualidade da dieta de escolares de 7 a 10 anos do município de São Paulo: associação com o número e os locais de refeições. Rev Nutr. 2015;28(6):607-18. https://doi.org/10.1590/1415-52732015000600004
https://doi.org/10.1590/1415-52732015000...
]. This behavior was also observed in studies with a predominantly adult sample [88 Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18:229. https://doi.org/10.1186/s12967-020-02399-5
https://doi.org/10.1186/s12967-020-02399...
,1717 Zachary Z, Brianna F, Brianna L, Garrett P, Jade W, Alyssa D, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obes Res Clin Pract. 2020;14(3)210-6. https://doi.org/10.1016/j.orcp.2020.05.004
https://doi.org/10.1016/j.orcp.2020.05.0...
,1919 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;12:1-13. https://doi.org/10.3390/nu12061583
https://doi.org/10.3390/nu12061583...
]. However, in the SI situation, it is not possible to infer that the increase in the number of meals can be beneficial for the diet, since it can be associated with the consumption of foods considered comfort food [2525 Leng G, Adan RAH, Belot M, Brunstrom JM, Graaf K, Dickson SL, et al. The determinants of food choice. Proc Nutr Soc. 2017;76:316-27. https://doi.org/10.1017/S002966511600286X
https://doi.org/10.1017/S002966511600286...
].

Finally, we highlight that according to the studies included in this review, it is not possible to infer whether food changes differ between countries, since the studies present different recruitment methodologies and data collection on food consumption, as well as the variability of the groups and types of foods assessed. Still, the method of data collection (online questionnaire), necessary due to social isolation, can be an important factor of sample selection bias, including populations with higher education and income, as well as younger populations, depending on the availability and familiarity with digital technologies. Most of the studies found so far have occurred in countries with a high Human Development Index (HDI) (n=8), with limited results in developing countries and no studies in low HDI countries. [3737 United Nations Development Programme. Human development report 2019. New York; 2019 [cited 2020 July 30]:352. Available from: http://hdr.undp.org/sites/default/files/hdr2019.pdf
http://hdr.undp.org/sites/default/files/...
]. We emphasize that Low and Middle-Income (LMIC) countries can suffer an even greater (or different) impact in the isolation process.

The potentialities of this study include: the current and relevant subject when covering this pandemic period and the methodological rigor in the stages of search, selection and data extraction, according to the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). As limitations, there is the time limit considering the continuity of the pandemic.

We suggest that new studies be carried out in different countries, age groups and economic levels. The studies should also focus on the impact of diet changes in times of isolation on future outcomes, with follow-up studies. We emphasize the importance of developing and validating self-applicable online tools that can reach different population groups, thus providing valid data for assessing food consumption in similar periods in the future. Finally, we propose to continue the study of this topic, with a systematic review with or without meta-analysis.

CONCLUSION

Social isolation can impact changes in the eating habits of different countries’ populations. There was an increase in the report of the cooking habits and consumption of fruits and vegetables. On the other hand, a decrease of fish consumption and an increase in comfort foods was reported. The decrease in the consumption of alcoholic beverages should be viewed with caution, since the present review was not limited to articles that exclusively evaluated their consumption. It is suggested that further studies be carried out in different socioeconomic and demographic contexts.

ACKNOWLEDGMENTS

We are grateful to the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, Coordination of Superior Level Stass Improvement) for their support.

  • Support: Conselho Nacional Brasileiro de Desenvolvimento Científico e Tecnológico (CNPq, National Council for Scientific and Technological Development) (Process n. 303233/2019-2).

How to cite this article

  • Matsuo LH, Tureck C, Lima LP, Hinnig PF, Trindade EBSM, Vasconcelos FAG. Impact of social isolation by Coronavirus disease 2019 in food: a narrative review. Rev Nutr. 2021;34:e200211. https://doi.org/10.1590/1678-9865202134e200211

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Publication Dates

  • Publication in this collection
    15 Mar 2021
  • Date of issue
    2021

History

  • Received
    10 Aug 2020
  • Reviewed
    10 Oct 2020
  • Accepted
    27 Nov 2020
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