Dietary changes in the NutriNet Brasil cohort during the covid-19 pandemic

Steele, Eurídice Martínez; Rauber, Fernanda; Costa, Caroline dos Santos; Leite, Maria Alvim; Gabe, Kamila Tiemann; Louzada, Maria Laura da Costa; Levy, Renata Bertazzi; Monteiro, Carlos Augusto

doi:10.11606/s1518-8787.2020054002950

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Original Article • Rev. Saúde Pública 54 • 2020 • https://doi.org/10.11606/s1518-8787.2020054002950 linkcopy

Dietary changes in the NutriNet Brasil cohort during the covid-19 pandemic

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE To describe the dietary characteristics of participants in the NutriNet Brasil cohort immediately before and during the covid-19 pandemic.

METHODS Our data stem from an adult cohort created to prospectively investigate the relationship between diet and morbidity and mortality from chronic non-communicable diseases in Brazil. For this study, we selected the first participants (n = 10,116) who answered twice to a simplified questionnaire on their diet the day before, the first time when entering the study, between January 26 and February 15, 2020, and the second between May 10 and 19, 2020. The questionnaire inquiries about the consumption of healthy (vegetables, fruits and legumes) and unhealthy (ultra-processed foods) eating markers. Comparisons of indicators based on the consumption of these markers before and during the pandemic are presented for the study population and according to gender, age group, macro-region of residence and schooling. Chi-square tests and t-tests were used to compare proportions and means, respectively, adopting p < 0.05 to identify significant differences.

RESULTS For all participants, we found a modest but statistically significant increase in the consumption of healthy eating markers and stability in the consumption of unhealthy food markers. This favorable pattern of dietary changes during the pandemic occurred in most sociodemographic strata. We observed a less favorable changing pattern, with a tendency to increasing consumption of healthy and unhealthy food markers, in the Northeast and North macro-regions and among people with less schooling, suggesting social inequalities in the response to the pandemic.

CONCLUSIONS If confirmed, the trend of increased consumption of ultra-processed foods in underdeveloped regions and by people with less schooling is concerning, as eating these foods increases the risk of obesity, hypertension and diabetes, whose presence increases the severity and lethality of covid-19.

Coronavirus infections; Food Consumption; Whole Foods; Industrialized Foods

Variables	N	%
Gender
Male	2,221	22.0
Female	7,895	78.0
Age group (years)
18–39	5,174	51.1
40–59	4,034	39.9
> 60	908	9.0
Macro-region of residence
North	290	2.9
Northeast	1,122	11.1
Midwest	732	7.2
Southeast	6,188	61.2
South	1,784	17.6
Schooling level (years)
< 11	227	2.2
11	1,283	12.7
> 12	8,606	85.1
Total	10,116	100

Variables	Consumption the day before of:
	Vegetables (%)		Fruit (%)		Beans or other legumes (%)		Vegetables + fruit + legumes (%)
	Before	During	Before	During	Before	During	Before	During
Gender
Male	85.5	88.7 ^c	76.7	81.3 ^c	60.6	63.0	43.9	50.5 ^c
Female	87.8	89.2 ^c	78.8	81.9 ^c	51.4	53.1 ^c	39.1	43.0 ^c
Age group (years)
18–39	85.2	86.3	72.1	75.7 ^c	56.1	56.3	38.8	42.3 ^c
40–59	88.9	91.4 ^c	83.2	86.9 ^c	50.9	54.3 ^c	41.1	46.5 ^c
> 60	92.5	94.5	92.2	93.5	49.8	54.6 ^c	44.4	49.9 ^c
Macro-region of residence
North	84.5	86.9	71.4	76.9	53.4	56.2	36.5	42.8
Northeast	81.2	85.6 ^c	76.6	80.4 ^c	63.1	63.6	43.5	47.6
Midwest	89.7	88.9	81.0	79.8	59.4	58.3	46.7	45.8
Southeast	87.8	89.5 ^c	77.8	82.2 ^c	53.6	56.0 ^c	40.2	45.9 ^c
South	89.2	90.2	81.2	82.8	44.6	46.2	36.3	38.1
Schooling level (years)
< 11	81.5	85.5	75.8	81.9	64.3	62.9	42.3	49.8
11	83.4	86.9 ^c	73.0	79.9 ^c	57.3	61.2 ^c	38.4	48.2 ^c
> 12	88.1	89.5 ^c	79.2	82.0 ^c	52.6	54.2 ^c	40.4	43.9 ^c
Total	87.3	89.1 ^c	78.3	81.8 ^c	53.5	55.3 ^c	40.2	44.6 ^c

Variables	Consumption the day before of ultra-processed foods
	Consumption of at least one group (%)		Consumption of five or more groups (%)		Number of groups consumed (average)
	Before	During	Before	During	Before	During
Gender
Male	82.3	83.9	14.3	14.0	2.4	2.4
Female	79.3	79.3	10.0	9.4	2.1	2.1
Age group (years)
18–39	82.8	83.6	12.9	12.6	2.3	2.3
40–59	78.0	77.8	9.3	8.7	2.0	2.0
> 60	72.8	73.2	6.7	5.6	1.7	1.8
Macro-region of residence
North	77.6	81.7	14.1	14.1	2.2	2.4
Northeast	77.9	79.6	8.8	10.9	2.0	2.2 ^c
Midwest	77.5	76.2	7.8	7.4	1.9	1.9
Southeast	80.4	80.7	11.5	10.5	2.2	2.2
South	81.3	80.9	11.3	10.2	2.2	2.2
Schooling level (years)
< 11	86.3	87.2	14.5	15.4	2.5	2.7
11	82.4	83.9	14.1	13.5	2.4	2.4
> 12	79.5	79.6	10.4	9.8	2.1	2.1
Total	80.0	80.3	11.0	10.4	2.1	2.1

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Faculdade de Saúde Pública da Universidade de São Paulo Avenida Dr. Arnaldo, 715, 01246-904 São Paulo SP Brazil, Tel./Fax: +55 11 3061-7985 - São Paulo - SP - Brazil
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[TFN1] ^a Between 26 January and 15 February 2020.

[TFN2] ^b Between 10 and 19 May 2020.