Towards an In-Depth Understanding of Physical Activity and Eating Behaviours during COVID-19 Social Confinement: A Combined Approach from a Portuguese National Survey
Abstract
:1. Introduction
1.1. Social Confinement and Eating Behaviours
1.2. Social Confinement and Physical Activity
1.3. The Need for Adequate, Local, and Integrated Monitoring—A Step for Effective Public Health Policies
2. Methods
2.1. Study Design and Participants
2.2. The Survey
2.2.1. Eating Behaviours
2.2.2. Physical Activity and Sedentary Behaviour
2.3. Statistical Analyses
3. Results
3.1. Participants’ Characteristics
3.2. Physical Activity and Sedentary Behaviour
3.3. Eating Habits
3.4. Combined Approach: Health and Risk Patterns
4. Discussion
Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Participants’ Characteristics | Total | Men | Women | p |
---|---|---|---|---|
% (95% CI) | % (95% CI) | % (95% CI) | ||
Age | 45.8 (45.4, 46.3) | 45.5 (44.9, 46.1) | 46.2 (45.6, 46.8) | |
Age-group | <0.001 | |||
16–34 years | 27.9 (26.8, 29.1) | 29.5 (27.8, 31.2) | 26.4 (24.8, 27.9) | |
35–54 years | 34.9 (33.7, 36.1) | 35.9 (34.2, 37.7) | 34.0 (32.3, 35.7) | |
≥55 years | 37.2 (35.9, 38.4) | 34.5 (32.7, 36.3) | 39.6 (37.9, 41.3) | |
Education | <0.001 | |||
Secondary school or below | 81.5 (80.5, 82.5) | 83.5 (82.1, 84.9) | 79.9 (78.5, 81.4) | |
Higher education | 18.5 (17.5, 19.5) | 16.5 (15.1, 17.9) | 20.1 (18.6, 21.5) | |
Professional situation | <0.001 | |||
Employee | 57.4 (56.1, 58.8) | 58.7 (56.8, 60.6) | 56.2 (54.4, 58.0) | |
Student | 15.1 (14.1, 16.0) | 14.9 (13.5, 16.3) | 15.2 (13.8, 16.5) | |
Retired | 17.4 (16.4, 18.4) | 19.3 (17.8, 20.9) | 15.7 (14.3, 17.0) | |
Housekeeper | 3.4 (2.9, 3.8) | 0.1 (0.0, 0.2) | 6.4 (5.5, 7.3) | |
Unemployed | 6.7 (6.1, 7.4) | 6.9 (6.0, 7.9) | 6.6 (5.7, 7.5) | |
Subjective financial well-being | 0.004 | |||
Comfortable or very comfortable | 30.1 (28.9, 31.3) | 30.3 (28.6, 32.1) | 29.9 (28.3, 31.6) | |
Reasonable | 51.3 (50.0, 52.6) | 52.8 (50.9, 54.7) | 49.8 (48.1, 51.6) | |
Difficult or very difficult | 18.6 (17.6, 19.7) | 16.8 (15.4, 18.3) | 20.2 (18.8, 21.7) | |
Children | 0.448 | |||
No | 67.8 (66.6, 69.0) | 67.3 (65.5, 69.1) | 68.2 (66.6, 69.9) | |
Yes | 32.2 (31.0, 33.4) | 32.7 (30.9, 34.5) | 31.8 (30.1, 33.4) | |
Social confinement (reasons) | ||||
Sickness (COVID-19) | 1.2 (1.0, 1.5) | 1.9 (1.4, 2.4) | 0.7 (0.4, 1.0) | <0.001 |
Sickness (other) | 2.2 (1.8, 2.6) | 1.3 (0.9, 1.8) | 3.0 (2.4, 3.6) | <0.001 |
Family support | 16.6 (15.6, 17.6) | 14.3 (12.9, 15.6) | 18.7 (17.3, 20.1) | 0.064 |
Telework | 30.3 (29.1, 31.5) | 31.5 (29.8, 33.2) | 29.3 (27.7, 30.9) | <0.001 |
Prophylactic isolation | 5.5 (4.9, 6.1) | 7.9 (6.9, 9.0) | 3.3 (2.7, 4.0) | |
Lockdown (time) | 0.246 | |||
Up to 3 weeks | 26.0 (24.9, 27.1) | 26.7 (25.0, 28.3) | 25.5 (23.9, 27.0) | |
Up to 4 weeks | 43.6 (42.3, 44.9) | 44.0 (42.1, 45.8) | 43.2 (41.5, 44.9) | |
Up to 5 weeks | 30.3 (29.2, 31.5) | 29.4 (27.7, 31.1) | 31.3 (29.7, 33.0) | |
Self-rated health | <0.001 | |||
Very good | 37.4 (36.2, 38.7) | 43.0 (41.2, 44.9) | 32.5 (30.8, 34.1) | |
Good | 37.2 (36.0, 38.4) | 35.6 (33.8, 37.4) | 38.7 (36.9, 40.4) | |
Reasonable | 25.4 (24.3, 26.5) | 21.4 (19.9, 22.9) | 28.9 (27.3, 30.5) |
Participants’ Characteristics | IPAQ Categories | p | Sitting Time (min/day) | p | ||||
---|---|---|---|---|---|---|---|---|
% (95% CI) | % (95% CI) | |||||||
Low Active | Active | HEPA | <180 | 181–419 | ≥420 | |||
Total | 33.5 (32.3, 34.7) | 20.5 (19.5, 21.5) | 46.0 (44.7, 47.2) | 34.4 (33.2, 35.7) | 28.4 (27.3, 29.6) | 37.1 (35.9, 38.4) | ||
Gender | <0.001 | <0.001 | ||||||
Men | 29.4 (27.7, 31.1) | 20.7 (19.2, 22.2) | 49.9 (48.0, 51.7) | 29.8 (28.1, 31.5) | 30.8 (29.1, 32.5) | 39.4 (37.5, 41.2) | ||
Women | 37.1 (35.4, 38.8) | 20.3 (18.9, 21.7) | 42.6 (40.9, 44.4) | 38.5 (36.7, 40.2) | 26.4 (24.8, 27.9) | 35.2 (33.5, 36.8) | ||
Age-group | <0.001 | <0.001 | ||||||
16–34 years | 27.5 (25.3, 29.6) | 18.6 (16.7, 20.5) | 53.9 (51.5, 56.3) | 24.4 (22.3, 26.4) | 26.1 (24.0, 28.3) | 49.6 (47.1, 52.0) | ||
35–54 years | 37.0 (34.9, 39.1) | 16.3 (14.7, 17.9) | 46.6 (44.4, 48.8) | 36.0 (33.9, 38.1) | 29.0 (27.0, 31.0) | 35.0 (32.9, 37.0) | ||
≥55 years | 34.8 (32.8, 36.8) | 25.8 (24.0, 27.7) | 39.4 (37.3, 41.4) | 40.6 (38.5, 42.6) | 29.6 (27.7, 31.5) | 29.8 (27.8, 31.7) | ||
Education | <0.001 | <0.001 | ||||||
Secondary school or below | 34.6 (33.3, 36.0) | 20.8 (19.7, 22.0) | 44.6 (43.1, 46.0) | 37.4 (36.0, 38.8) | 28.9 (27.6, 30.1) | 33.7 (32.4, 35.1) | ||
Higher education | 28.7 (26.0, 31.4) | 19.1 (16.8, 21.4) | 52.2 (49.2, 55.2) | 21.4 (19.0, 23.8) | 26.7 (24.0, 29.3) | 52.0 (49.1, 55.0) | ||
Family income perception | <0.001 | <0.001 | ||||||
Good | 25.6 (23.5, 27.6) | 21.7 (19.8, 23.7) | 52.7 (50.3, 55.1) | 33.7 (31.5, 36.0) | 26.4 (24.3, 28.5) | 39.9 (37.5, 42.2) | ||
Reasonable | 34.9 (33.2, 36.6) | 21.7 (20.2, 23.2) | 43.4 (41.6, 45.3) | 31.4 (29.7, 33.1) | 29.1 (27.5, 30.8) | 39.5 (37.7, 41.3) | ||
Poor | 40.8 (37.8, 43.7) | 16.9 (14.7, 19.2) | 42.3 (39.3, 45.3) | 39.7 (36.8, 42.7) | 29.8 (27.0, 32.5) | 30.5 (27.7, 33.3) | ||
PA recommendation knowledge | <0.001 | 0.234 | ||||||
Yes | 34.8 (33.0, 36.6) | 19.5 (18.0, 21.0) | 45.7 (43.8, 47.6) | 37.6 (35.7, 39.4) | 27.5 (25.8, 29.2) | 34.9 (33.1, 36.7) | ||
No | 32.5 (30.8, 34.1) | 21.3 (19.9, 22.7) | 46.3 (44.5, 48.0) | 31.8 (30.2, 33.4) | 29.2 (27.6, 30.8) | 38.9 (37.2, 40.6) | ||
PA usefulness of recommendations | <0.001 | <0.001 | ||||||
Not useful | 36.2 (30.9, 41.5) | 13.7 (9.9, 17.4) | 50.2 (44.6, 55.7) | 24.4 (19.7, 29.2) | 38.1 (32.7, 43.5 | 37.1 (31.8, 42.5) | ||
I am not sure | 41.7 (35.9, 47.5) | 23.0 (18.1, 28.0) | 35.3 (29.6, 40.9) | 36.3 (30.7, 42.0) | 19.1 (14.4, 23.7) | 45.0 (39.1, 50.8) | ||
Very useful | 33.7 (31.7, 35.7) | 19.9 (18.2, 21.6) | 46.4 (44.2, 48.5) | 39.7 (37.6, 41.8) | 27.0 (25.1, 28.9) | 33.3 (31.2, 35.3) | ||
Lockdown (time) | 0.005 | 0.015 | ||||||
Up to 3 weeks | 35.5 (33.1, 37.9) | 19.0 (17.0, 20.9) | 45.5 (43.0, 48.0) | 37.9 (35.4, 40.3) | 28.1 (25.9, 30.4) | 34.1 (31.7, 36.4) | ||
Up to 4 weeks | 31.0 (29.2, 32.8) | 21.7 (20.1, 23.3 | 47.3 (45.4, 49.3) | 33.1 (31.3, 34.9) | 28.5 (26.7, 30.2) | 38.4 (36.5, 40.3) | ||
Up to 5 weeks | 35.6 (33.3, 37.8) | 20.1 (18.2, 22.0) | 44.3 (42.0, 46.7) | 33.4 (31.2, 35.6) | 28.7 (26.6, 30.8) | 37.9 (35.7, 40.2) |
Physical Activities and Sedentary Behaviours | Men | Women | p |
---|---|---|---|
% (95% CI) | % (95% CI) | ||
Types of physical activities | |||
House cleaning | 51.1 (49.2, 52.9) | 86.7 (85.5, 87.9) | <0.001 |
Up and down stairs | 49.3 (47.4, 51.2) | 50.6 (48.9, 52.4) | 0.294 |
Walking | 31.5 (29.8, 33.3) | 32.9 (31.3, 34.6) | 0.253 |
Fitness activities | 21.5 (19.9, 23.0) | 28.9 (27.3, 30.5) | <0.001 |
Gardening | 21.8 (20.2, 23.3) | 23.3 (21.9, 24.8) | 0.147 |
Bricolage | 24.0 (22.4, 25.6) | 14.2 (13.0, 15.4) | <0.001 |
Strength training | 23.7 (22.1, 25.3) | 12.9 (11.7, 14.1) | <0.001 |
Jogging | 22.7 (21.1, 24.2) | 6.5 (5.6, 7.3) | <0.001 |
Static bicycle | 11.7 (10.5, 12.9) | 5.3 (4.5, 6.0) | <0.001 |
Dance | 2.2 (1.6, 2.7) | 10.1 (9.1, 11.2) | <0.001 |
Types of sedentary behaviours | |||
Watching television | 70.6 (68.9, 72.3) | 69.5 (67.8, 71.1) | 0.359 |
Computer, tablet, smartphone | 66.5 (64.7, 68.2) | 55.4 (53.7, 57.2) | <0.001 |
Telework | 39.0 (37.2, 40.8) | 34.4 (32.7, 36.1) | <0.001 |
Read | 28.6 (26.9, 30.3) | 33.8 (32.2, 35.5) | <0.001 |
Board games, puzzles, Legos | 8.2 (7.2, 9.2) | 9.2 (8.2, 10.2) | 0.191 |
Play musical instrument | 3.7 (3.0, 4.4) | 1.2 (0.8, 1.6) | <0.001 |
Self-Reported Changes of Food Behaviours | Total | Men | Women | p |
---|---|---|---|---|
% (95% CI) | % (95% CI) | % (95% CI) | ||
Changes in dietary habits | <0.001 | |||
Yes | 45.1 (43.9, 46.4) | 42.6 (40.8, 44.5) | 47.3 (45.5, 49.0) | |
No | 54.9 (53.6, 56.1) | 57.4 (55.5, 59.2) | 52.7 (50.9, 54.4) | |
Changes in diet quality | 0.037 | |||
No changes/do not know | 62.2 (60.4, 64.0) | 63.8 (61.3, 66.5) | 60.9 (48.5, 63.4) | |
Yes | 37.8 (36.5, 39.0) | 36.2 (34.4, 38.0) | 39.1 (37.4, 40.8) | |
Improved (from those who reported changes) | 58.1 (56.1, 60.2) | 59.7 (56.6, 62.7) | 56.9 (54.2, 59.7) | 0.193 |
Worsened (from those who reported changes) | 41.9 (39.8, 43.9) | 40.3 (37.3, 43.4) | 43.1 (40.3, 45.9) | |
Cook more often | <0.001 | |||
Yes | 56.9 (55.6, 58.1) | 51.8 (49.9, 53.6) | 61.4 (59.7, 63.1) | |
No | 43.1 (41.9, 44.4) | 48.2 (46.4, 50.1) | 38.6 (36.9, 40.3) | |
Change in the number of meals | 0.007 | |||
No | 69.8 (68.6, 71.0) | 71.6 (69.9, 73.3) | 68.4 (66.7, 70.0) | |
Yes | 30.2 (29.0,31.3) | 28.4 (26.7, 30.1) | 31.6 (30.0, 33.3) | |
Increased (from those who reported changes) | 67.8 (65.6, 69.9) | 66.5 (63.1, 69.7) | 68.8 (65.8, 71.6) | 0.328 |
Decreased (from those who reported changes) | 32.2 (30.1, 34.4) | 33.5 (30.1, 36.7) | 31.2 (28.4, 34.2) | |
Snacking more often * | 0.186 | |||
Yes | 31.4 (30.2, 32.6) | 32.2/30.5, 34.0) | 30.6 (29.0, 32.3) | |
No | 68.6 (67.4, 69.8) | 67.8 (66.0, 69.5) | 69.4 (67.7, 71.0) | |
Changes on shopping frequency | <0.001 | |||
Decreased | 87.3 (86.3, 88.3) | 82.5 (80.7, 84.2) | 91.1 (89.9, 92.3) | |
Increased | 12.7 (11.7, 13.7) | 17.5 (15.8, 19.3) | 8.9 (7.7, 10.1) | 0.317 |
Self-reported changes in body weight | ||||
No changes/do not know | 66.1 (63.8, 68.4) | 63.4 (60.2, 66.7) | 68.4 (65.2, 71.7) | |
Increased | 21.0 (20.0, 22.0) | 22.3 (20.8, 23.9) | 19.8 (18.5, 21.3) | |
Decreased | 12.9 (12.1, 13.8) | 14.3 (13.0, 15.6) | 11.7 (10.7, 12.9) | |
Knowledge about dietary recommendations for lockdown period | <0.001 | |||
Yes | 45.3 (44.0, 46.6) | 38.5 (36.7, 40.3) | 51.4 (49.6, 53.2) | |
No | 54.7 (53.4, 56.0) | 61.5 (59.7, 63.3) | 48.6 (46.8, 50.4) | |
Usefulness of dietary recommendations for lockdown period | <0.001 | |||
None | 11.9 (10.7, 13.2) | 14.7 (12.7, 17.0) | 10.0 (8.6, 11.5) | |
I am not sure | 10.5 (9.4, 11.7) | 9.2 (7.6, 11.0) | 11.3 (9.8, 12.9) | |
Very useful | 77.6 (76.0, 79.2) | 76.0 (73.4, 78.5) | 78.7 (76.6, 80.6) |
Food Category | Reduced Intake | p | Increased Intake | p | Maintained Intake | |||
---|---|---|---|---|---|---|---|---|
Men | Women | Men | Women | Men | Women | |||
% (95% CI) | % (95% CI) | % (95% CI) | % (95% CI) | % (95% CI) | % (95% CI) | |||
Take-away or delivered meals | 43.3 (41.5, 45.2) | 44.3 (42.6, 46.1) | 0.459 | 9.8 (8.8, 11.0) | 5.5 (4.7, 6.3) | <0.001 | 46.9 (45.0, 48.7) | 50.2 (48.4, 52.0) |
Ready meals | 40.5 (38.7, 42.4) | 40.8 (39.1, 42.6) | 0.831 | 6.7 (5.9, 7.7) | 3.3 (2.7, 3.9) | <0.001 | 52.7 (50.8, 54.6) | 55.9 (54.1, 57.6) |
Soft drinks | 33.5 (31.7, 35.2) | 32.2 (30.6, 33.9) | 0.328 | 4.6 (3.8, 5.4) | 3.0 (2.5, 3.7) | 0.003 | 62.0 (60.2, 63.8) | 64.8 (63.0, 66.4) |
Alcoholic beverages | 30.3 (28.6, 32.0) | 26.4 (24.9, 28.0) | 0.001 | 12.7 (11.6, 14.0) | 6.8 (6.0, 7.7) | <0.001 | 57.0 (55.2, 58.9) | 66.8 (65.1, 68.4) |
Savoury snacks | 28.2 (26.6, 29.9) | 30.7 (29.0, 32.3 | 0.044 | 9.3 (8.3, 10.4) | 8.5 (7.6, 9.5) | 0.311 | 62.5 (60.7, 64.3) | 60.8 (59.1, 62.5) |
Sweet snacks | 19.0 (17.6, 20.5) | 20.9 (19.5, 22.3) | 0.082 | 28.8 (27.2, 30.6) | 32.8 (31.1, 34.4) | 0.001 | 52.2 (50.3, 54.0) | 46.4 (44.6, 48.1) |
Fish and other seafood | 17.0 (15.7, 18.5) | 15.1 (13.8, 16.3) | 0.041 | 15.5 (14.2, 16.9) | 13.7 (12.5, 14.9) | 0.053 | 67.5 (65.7, 69.2) | 71.2 (69.6, 72.8) |
Fruit juices | 14.1 (12.8, 15.4) | 17.0 (15.7, 18.3) | 0.003 | 12.6 (11.4, 13.9) | 12.0 (10.9, 13.2) | 0.498 | 73.2 (71.6, 74.9) | 71.0 (69.4, 72.6) |
Other canned food (not seafood) | 13.8 (12.6, 15.1) | 16.4 (15.1, 17.7) | 0.006 | 9.5 (8.5, 10.7) | 9.9 (8.8, 10.9) | 0.69 | 76.7 (75.1, 78.3) | 73.8 (72.2, 75.3) |
Meat | 12.5 (11.3, 13.7) | 11.8 (10.7, 13.0) | 0.47 | 8.6 (7.6, 9.7) | 6.8 (5.9, 7.7) | 0.012 | 78.9 (77.4, 80.5) | 81.4 (80.0, 82.7) |
Canned seafood | 12.0 (10.8, 13.2) | 14.1 (12.9, 15.4) | 0.018 | 13.2 (11.9, 14.5) | 11.6 (10.5, 12.8) | 0.079 | 74.8 (73.2, 76.4) | 74.3 (72.7, 75.8) |
Vegetables | 10.8 (9.6, 12.0) | 9.9 (8.9, 11.0) | 0.301 | 19.9 (18.4, 21.4) | 22.1 (20.7, 23.6) | 0.04 | 69.4 (67.6, 71.1) | 68.0 (66.3, 69.6) |
Water | 10.2 (9.1, 11.4) | 14.2 (13.0, 15.5) | <0.001 | 31.4 (29.7, 33.1) | 30.8 (29.2, 32.4) | <0.001 | 58.4 (56.6, 60.3) | 55.0 (53.3, 56.8) |
Fruit | 8.2 (7.2, 9.3) | 8.0 (7.1, 9.0) | 0.773 | 32.2 (30.5, 34.0) | 27.4 (25.9, 29.0) | <0.001 | 59.6 (57.8, 61.4) | 64.6 (62.9, 66.2) |
Dietary patterns | Total; % (95% CI) | Men; % (95% CI) | Women; % (95% CI) | p | ||||
Improved dietary patterns | 18.2 (17.2, 19.2) | 18.1 (16.7, 19.6) | 18.3 (16.9, 19.7) | 0.193 | ||||
Worsened dietary patterns | 10.8 (10.1, 11.7) | 12.9 (11.7, 14.2) | 9.0 (8.0, 10.1) |
Reasons for Changes in Food Intake | Total | Men | Women | p |
---|---|---|---|---|
% (95% CI) | % (95% CI) | % (95% CI) | ||
Changes in shopping frequency | 34.3 (33.1, 35.5) | 34.8 (33.0, 36.6) | 33.9 (32.3, 35.6) | 0.469 |
Changes in appetite | 19.3 (18.3, 20.3) | 18.0 (16.6, 19.4) | 20.5 (19.1, 21.9) | 0.015 |
Changes in appetite caused by stress | 18.6 (17.6, 19.6) | 14.1 (12.9, 15.5) | 22.6 (21.1, 24.0) | <0.001 |
Different work schedule | 17.6 (16.6, 18.6) | 19.5 (18.0, 21.0) | 15.9 (14.7, 17.2) | <0.001 |
Changes in regular place for shopping | 10.6 (9.9, 11.4) | 10.5 (9.4, 11.7) | 10.6 (9.6, 11.7) | 0.91 |
Concerns with the economic context | 10.3 (9.5, 11.1) | 9.9 (8.8, 11.0) | 10.6 (9.5, 11.7) | 0.391 |
Different people at meals time | 9.7 (9.0, 10.5) | 9.8 (8.8, 11.0) | 9.7 (8.7, 10.8) | 0.873 |
Problems with access to usually bought food | 9.1 (8.4, 9.9) | 9.5 (8.5, 10.7) | 8.7 (7.8, 9.8) | 0.311 |
Because diet can protect against the novel coronavirus | 5.5 (5.0, 6.1) | 6.0 (5.2, 7.0) | 5.1 (4.3, 5.9) | 0.114 |
Changes on food prices | 4.8 (4.3, 5.4) | 5.3 (4.5, 6.2) | 4.3 (3.7, 5.1) | 0.087 |
Fear of getting infected with the novel coronavirus through food | 3.8 (3.3, 4.3) | 4.0 (3.4, 4.8) | 3.5 (2.9, 4.2) | 0.264 |
Concerns with possible stock rupture of food in supermarkets | 2.5 (2.1, 2.9) | 3.5 (2.9, 4.3) | 1.6 (1.2, 2.0) | <0.001 |
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Silva, M.N.; Gregório, M.J.; Santos, R.; Marques, A.; Rodrigues, B.; Godinho, C.; Silva, C.S.; Mendes, R.; Graça, P.; Arriaga, M.; et al. Towards an In-Depth Understanding of Physical Activity and Eating Behaviours during COVID-19 Social Confinement: A Combined Approach from a Portuguese National Survey. Nutrients 2021, 13, 2685. https://doi.org/10.3390/nu13082685
Silva MN, Gregório MJ, Santos R, Marques A, Rodrigues B, Godinho C, Silva CS, Mendes R, Graça P, Arriaga M, et al. Towards an In-Depth Understanding of Physical Activity and Eating Behaviours during COVID-19 Social Confinement: A Combined Approach from a Portuguese National Survey. Nutrients. 2021; 13(8):2685. https://doi.org/10.3390/nu13082685
Chicago/Turabian StyleSilva, Marlene Nunes, Maria João Gregório, Rute Santos, Adilson Marques, Bruno Rodrigues, Cristina Godinho, Catarina Santos Silva, Romeu Mendes, Pedro Graça, Miguel Arriaga, and et al. 2021. "Towards an In-Depth Understanding of Physical Activity and Eating Behaviours during COVID-19 Social Confinement: A Combined Approach from a Portuguese National Survey" Nutrients 13, no. 8: 2685. https://doi.org/10.3390/nu13082685