Eating habits, food insecurity and perceived stress during the COVID-19 pandemic

Introduction: Restrictive measures during the COVID-19 pandemic directly impacted on the population's eating habits. Objective: To evaluate changes in eating habits, access to food and perceived stress during COVID-19 confinement, reported by patients returning to nutritional outpatient follow-up in a public reference unit in the treatment of infectious diseases in Rio de Janeiro. Methods: Cross-sectional study, with 75 patients over 18 years of age, from July to December 2020. We collected sociodemographic data, eating habits during confinement, and applied validated questionnaires to access healthy and unhealthy food intake markers (Sistema de Vigilância Alimentar e Nutricional form), food insecurity (short version of Brazilian Food Insecurity Scale), and Perceived Stress Scale. Statistical Package for Social Sciences (SPSS®) version 16.0 (IBM Corp, Armonk, NY) was used for data analysis. Variables were described as median and interquartile range (IQR), and absolute numbers and frequencies, and association between them was investigated by Pearson’s chi-square test. P values < 0.05 showed statistically significant tests. Institution's Ethics Committee approved the study and all participants signed an informed consent. Results: During confinement, most patients changed their eating habits (68%) and felt that they “used food to cope with stress and anxiety” (53.3%), despite this, healthy food had the highest frequency of consumption. Almost half of participants (46.7%) were in food insecurity situation. The majority (61.9%) were categorized as moderate stress. Food insecurity was more frequent among people with low household income (p=0.004), people living with HIV (p=0.024), people who changed food purchase routine (p=0.008), people with worsening eating habits (p=0.009), and people with moderate/high stress (p=0.004). Conclusions: COVID-19 confinement interfered negatively in patient’s eating habits and perceived stress. Although negative feelings were reported by most patients, and the majority presented moderate stress, healthy food intake markers had the highest frequency of consumption.