In order to limit the spread of the coronavirus disease 2019 (COVID-19), countries around the world implemented public health measures, including physical distancing requirements to prevent close contact between people. These measures resulted in various home confinement directives comprising stay-at-home orders, isolation requirements, lockdowns that prohibit normal daily activities, such as going to school or work, visiting gyms or restaurants, or large social gatherings. During this time, many individuals transitioned rapidly to working from home where possible, but many others suffered job loss or worked fewer hours, while those on the front lines worked more and longer hours [1
]. Accordingly, in addition to coping with the immediate health threat of COVID-19, individuals also coped with abrupt lifestyle adjustments as a result of employment change, often leading to economic hardships, as well as home isolation [3
]. These sudden lifestyle changes frequently manifested as psychosocial stressors with negative consequences for mental health [4
], including increased reports of depression and anxiety during the first wave of COVID-19 transmission [6
]. Importantly, the combination of lifestyle and psychosocial stressors can be detrimental for body weight management, which can influence metabolic syndrome and overall physical health [12
Nearly one in four adults recruited through social media or paid advertisements reported gaining up to 10 pounds during the first wave of COVID-19 [13
], and weight gain was more prevalent in individuals with obesity [11
]. This is particularly significant as two in three adults in North America are overweight or have obesity [14
], thus, a sustained period of weight gain during the pandemic could further aggravate metabolic syndrome [6
]. This has implications for related health conditions like obesity [6
] and its comorbid diseases, including diabetes [18
], hypertension [18
], and cardiovascular disease [19
] that are significant risk factors for COVID-19 severity [20
]. Indeed, half of patients hospitalized for COVID-19 have obesity [21
], and patients with obesity are also more likely to require a ventilator [22
]. Even among younger patients, who are a lower risk group for complications related to COVID-19 infection, those who have obesity were twice as likely to require intensive care [23
], and the severity of COVID-19 infection increased with greater obesity [22
Healthy eating behaviors are essential features for body weight management [24
], which is relevant for resistance to severe COVID-19 outcomes [25
]. However, healthy eating can be disrupted when individuals are stressed. Conscious eaters who follow a restricted diet may report eating more when feeling stressed, and they are typically eating more highly palatable snack-type foods [26
], particularly those high in fat, sugar, or salt, whereas consumption of fruit or vegetables may be reduced [26
]. Furthermore, as comfort eating is a form of emotion-focused coping [28
], experiencing negative affect or mood is also strongly associated with unhealthy snacking or binge eating [30
]; conversely, positive affect or mood has been associated with healthy snack choices [33
]. In effect, comfort eating can help individuals cope with negative moods and stress, essentially serving as a form of self-therapy, which may be detrimental in the long-term.
Individuals experienced greater feelings of depression or anxiety during the lockdown phase of COVID-19 [6
], and the vast majority of research surveys completed during this time reported that individuals ate more and snacked on calorie-dense foods between meals [3
]. This said, one study reported healthier eating because of reduced access to fast foods and preparing meals at home [38
], and individuals consuming homemade meals were less vulnerable to unhealthy eating [36
]. Aside from increased eating being tied to loneliness or boredom [39
], comfort eating can help individuals cope with other ongoing stressors, such as those created by unemployment and financial hardships stemming from COVID-19 [3
]. Job insecurity and job loss are strongly associated with poor mental health outcomes [40
] and were widespread as a result of home confinement directives to contain the spread of COVID-19 [1
]. While emerging studies revealed poor mental state and unhealthy eating among individuals during the COVID-19 pandemic, it is uncertain whether a relationship exists between negative mood and food choice or how coping with employment change may impact mood and/or food choice.
It has been proposed that, in response to stressful situations, individuals make appraisals concerning the threat that these challenges represent followed by secondary appraisals concerning their ability to contend with these threats [45
]. These appraisals then promote the adoption of particular coping strategies that may vary across individuals depending upon previous experiences and dispositional characteristics [46
]. These coping processes may, in turn, be related to mood alterations. In the context of the distress related to the COVID-19 pandemic, it is conceivable that these coping changes might also contribute to the eating patterns individuals adopted, including their propensity to snack on comfort foods. While early findings during the first wave of COVID-19 indicated that home confinement led to unhealthy snacking, the mechanisms responsible for this relationship are not known.
In order to evaluate the relationships underlying coping mechanisms that impact mood and food choice, we conducted an online research survey during the COVID-19 pandemic to assess stressor appraisals, affective state, and snacking behavior in participants living in Canada or the United States. We hypothesized that:
Changes of employment status in the context of COVID-19 would be appraised as both stressful and uncontrollable.
Stressor appraisals would mediate the relations between change of employment status and greater use of particular coping strategies, including problem-focused, emotion-focused, and avoidant coping.
Changes of employment status, appraisals of the COVID-19 situation, and coping strategies would be predictive of positive and negative affect.
Negative affect, but not positive affect, would be associated with eating to cope, as well as unhealthy snacking behaviors, i.e., eating more salty and sweet processed snacks rather than wholesome/unprocessed foods.
Eating to cope would mediate the relations between negative mood and snacking behaviors.
We found that employment change increased appraisals of stress leading to worsened mood. This association is important because participants were eating to cope with stress and choosing unhealthy snacks like salty and/or sweet treats.
This study aimed to determine the variables underlying the affect associated with COVID-19 stress reactions and unhealthy eating during the pandemic. One of the most prominent consequences of the outbreak was home confinement, which resulted in drastic shifts of lifestyles and employment status. As seen in other studies, employment change involving job loss or reduced work hours during the COVID-19 outbreak was widespread [51
] disproportionately affecting younger and lower income participants [53
]. Such changes were appraised as stressful and uncontrollable; individuals tended to avoid the issue or use emotion-based strategies to cope with distress. Employment change also directly predicted negative affect, which was associated with unhealthy snacking. Eating is an emotion-based coping strategy [55
], and during the COVID-19 outbreak, individuals were found to cope by eating, and in particular, they tended to eat more salty or sweet processed snacks but not wholesome snacks, such as fruit or vegetables. In contrast, positive affect was inversely related to emotional eating, and was directly related to consumption of wholesome snacks.
Many individuals lost their jobs or worked fewer hours during the COVID-19 outbreak, as stay-at-home orders forced the closure of businesses and workplaces. The extended period of uncertainty and job insecurity, a known work stressor [56
], contributed to worsened mental health states and increased reports of anxiety and depression [5
]. As previously reported [53
] and in our study, females and younger workers, as well as those living in shared accommodations or lower income households were more likely to be laid off. While our survey did not identify worker occupations, findings from other research suggests that this demographic profile may be attributable to the prevalence of young people and women in the restaurant or service industry [57
], which was most adversely impacted by the COVID-19 outbreak [60
]. As expected, those reporting a reduction or loss of employment were more likely to appraise the COVID-19 situation as stressful and reported higher negative and lower positive affect. It has been suggested that financial pressure and fear of not working may drive the relationship between job insecurity and mental state [5
], and indeed, lower income individuals vulnerable to employment loss reported worsened mood in the present study.
In order to understand mood outcomes linked to COVID-19 stressors, we assessed subjective appraisals and coping strategies. Workers who experienced reduced work or loss of work were more likely to appraise their situation to be stressful and out of their control. As expected, elevated stress appraisals were, in turn, related to avoidant or emotion-focused coping strategies, whereas appraising the COVID-19 situation to be controllable was accompanied by greater use of problem-focused coping strategies. The uncertainty surrounding the COVID-19 situation may make it difficult to prepare or plan job searches, thus hindering the use of problem-focused coping strategies [44
Eating is a form of emotion-based coping to deal with stressors [55
]. Indeed, our data showed a strong correlation between coping by eating with appraisals of stress, together with emotion-focused and avoidant coping strategies. An individual may use food to cope with their internal emotions, as well as with external stressors, such as change of employment status [28
]. Our findings are consistent with numerous studies from Europe [7
] and North America [3
] indicating that during the COVID-19 outbreak increased feelings of depression, anxiety, and stress, and a worsened mental state was associated with emotional eating. Indeed, COVID-19 appeared to have a clear relationship to eating behaviors, particularly eating more snack-type foods [3
]. In this regard, individuals who appraised their situation to be stressful or who experienced greater negative mood were more likely to consume both salty and sweet snacks. We do not have retrospective reports of food intake prior to the COVID-19 outbreak and, hence, cannot ascertain whether these food habits were ascribed to COVID-19. However, given that self-reports typically lead to inaccurate reporting, particularly of unhealthy snacks [65
], the value of retrospective data is questionable. The fact is that in the present investigation, employment status and coping methods were tied to snacking and specific types of foods consumed. Moreover, greater perceived distress was associated with lower consumption of healthy foods like fruits or vegetables [27
]. This is in line with previous research indicating that negative mood is associated with hedonic food consumption, whereas positive mood is associated with eating fewer hedonic foods [32
]. It should be noted that although stress can shift eating behavior to favor snacks over meal-type foods, it does not necessarily mean that individuals are overeating [26
Change in the amount of food consumed is commonly linked to baseline dieting status. Individuals who ordinarily restrict their diet may be more likely to overeat when experiencing increased stress, particularly as they lose control over their eating [26
]. Females are more frequent dieters than are males, and more susceptible to emotional eating [66
]. In fact, females were shown to eat more high caloric foods during home confinement [34
]. We focused on the types of food rather than the amount of food consumed and found that female participants reported higher consumption of healthy, but not unhealthy, snacks. That said, females are more likely to under- and/or mis-report their food intake [68
], which may contribute to our findings. Furthermore, unhealthy food consumption associated with mood states varies with basal body weight. Specifically, underweight individuals eat less than normal or overweight individuals when in a negative mood state, but may eat more when in a positive mood state [55
]. In contrast, overweight individuals tend to overeat during negative mood states [29
]. Individuals with higher BMI may be more restrained eaters [69
] and, hence, may have exhibited less control over their eating during home confinement [7
]. We similarly found that high BMI was related to lower whole food snacking, but BMI did not mediate the relationships between stress and coping or mood and snacking behaviors.
There are several caveats that ought to be mentioned with respect to the findings of the present investigation. As alluded to earlier, it would have been ideal to have data available concerning changes of snack intake relative to the pre-COVID period. Nevertheless, the present findings speak to the links between snack choices and employment change, mood state, and coping methods. A second limitation of our investigation concerns the lack of a representative sample given that participants were largely recruited through various digital or social media platforms. For instance, the present sample were highly educated and also seemed to have a higher household income. Finally, although we have ascribed the altered eating profiles to employment related distress and coping factors, it is possible that several other factors (e.g., more time at home, boredom) contributed to unhealthy eating.
Although the pandemic gave rise to multiple stressors (e.g., fear of contamination, social isolation), financial challenges including employment change have been amongst the most distressing. We showed that distress from employment change was associated with altered mood and unhealthy eating, particularly for carbohydrate-rich foods. Indeed, greater perceived stress or more negative mood was associated with emotional eating and increased consumption of salty or sweet snacks. Poor food choices and increased snack consumption [70
], especially when combined with reduced physical activity [11
], can lead to weight gain, which was reported in a quarter of people sampled during the COVID-19 outbreak [13
]. The indirect impact of COVID-19 includes shifts in food choices, which can be detrimental to overall health. This is concerning given the prevalence of overweight and obesity within the population, and emerging evidence has indicated that obesity or obesity-related diseases increase the risk for more severe outcomes among those infected with COVID-19 [20
Government agencies have increasingly been advising individuals to adopt public health measures (e.g., wearing face masks, handwashing, physical distancing), and there has also been concern regarding potential mental health challenges. Much less attention seems to have been devoted to the indirect impact of the pandemic on unhealthy behaviors, such as those related to food intake. In considering factors important for emergency preparedness, a series of recommendations were made concerning those factors that favor resilience during such situations and the recovery period that follows [71
]. Essential to this is that individuals have social support available as a potent coping resource prior to the emergency or, failing this, that effective support networks can be readily established. The present findings are consistent with this view and point to the need to address health-related behaviors beyond those that focus only on psychological disturbances.