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

MATSUO, Luísa Harumi; TURECK, Camila; LIMA, Luana Pucci de; HINNIG, Patrícia de Fragas; TRINDADE, Erasmo Benicio Santos de Moraes; VASCONCELOS, Francisco de Assis Guedes de

doi:10.1590/1678-9865202134e200211

person Luísa Harumi MATSUO

schoolUniversidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Nutrição. Campus Universitário Reitor João David Ferreira Lima, R. Eng. Agronômico Andrei Cristian Ferreira, s/n., Trindade, 88040-900, Florianópolis, SC, Brasil

0000-0003-4825-6729

person Camila TURECK

schoolUniversidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Nutrição. Campus Universitário Reitor João David Ferreira Lima, R. Eng. Agronômico Andrei Cristian Ferreira, s/n., Trindade, 88040-900, Florianópolis, SC, Brasil

0000-0002-5672-1400

person Luana Pucci de LIMA

schoolUniversidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Nutrição. Campus Universitário Reitor João David Ferreira Lima, R. Eng. Agronômico Andrei Cristian Ferreira, s/n., Trindade, 88040-900, Florianópolis, SC, Brasil

0000-0002-3914-2554

person Patrícia de Fragas HINNIG

schoolUniversidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Nutrição. Campus Universitário Reitor João David Ferreira Lima, R. Eng. Agronômico Andrei Cristian Ferreira, s/n., Trindade, 88040-900, Florianópolis, SC, Brasil

0000-0002-9348-8513

person Erasmo Benicio Santos de Moraes TRINDADE

schoolUniversidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Nutrição. Campus Universitário Reitor João David Ferreira Lima, R. Eng. Agronômico Andrei Cristian Ferreira, s/n., Trindade, 88040-900, Florianópolis, SC, Brasil

0000-0003-1736-4049

person Francisco de Assis Guedes de VASCONCELOS

schoolUniversidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Nutrição. Campus Universitário Reitor João David Ferreira Lima, R. Eng. Agronômico Andrei Cristian Ferreira, s/n., Trindade, 88040-900, Florianópolis, SC, Brasil

0000-0002-6162-8067

Correspondence to: F.A.G. VASCONCELOS. E-mail:
f.vasconcelos@ufsc.br.

groupsCONTRIBUTORS

LH MATSUO, C TURECK, and LP LIMA contributed to the conception and design of the study, search, collection, analysis and interpretation of data, writing of the manuscript and final version approval. PF HINNIG, EBSM TRINDADE, and FAG VASCONCELOS contributed to the conception and design of the study, analysis and interpretation of data, review and approval of the final version of the article.

PubMed
Covid-19
#1	“Coronavirus” [Mesh]
#2	“Coronavirus Infections” [Mesh]
#3	“Pandemics” [Mesh]
#4	“spike protein, SARS-CoV-2” [Supplementary Concept]
#5	“COVID-19” [Supplementary Concept]
#6	“Disease Outbreaks” [Mesh]
#7	“COVID-19” OR “SARS-CoV-2” OR “covid-19 pandemic” OR “2019-nCoV” OR “COVID-19 virus”
#8	#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7
Social Isolation
#9	“Social Isolation”[Mesh]
#10	“Quarantine” [Mesh]
#11	“Social Isolation” OR “Social Distancing” OR Lockdowns OR Lockdown OR Quarantine OR Quarantines OR “Physical Distance” OR “home confinement” OR home OR confinement*
#12	Distance” OR “home confinement” OR home OR confinement*
#13	#9 OR #10 OR #11 OR #12
Food and eating habits
#15	“Food” [Mesh]
#16	“Diet, Food, and Nutrition” [Mesh]
#17	“Diet” [Mesh]
#18	“Feeding Behavior” [Mesh]
#19	“Diet, Healthy” [Mesh]
#20	“Nutrients” [Mesh]
#21	“Nutritional Status” [Mesh]
#22	“Life Style” [Mesh]
#23	“Quality of Life” [Mesh]
#24	“food habit” OR “food habits” OR “Healthy eating” OR “eating habits” OR nutrition OR nutrient* OR “Food consumption” OR “dietary behavior” OR “Nutrition Status” OR “eating behavior” OR Lifestyle OR Lifestyles OR “Healthy Lifestyles” OR “Healthy Life Style”
#25	#15 OR #16 OR #17 OR #18 OR #20 OR #21 OR #22 OR #23 OR #24
#26	#8 AND #13 AND #25
Embase
Covid-19
1	‘spike protein sarscov 2’/exp OR ‘Coronavirus infection’/de OR ‘coronavirus disease 2019’/exp OR ‘pandemic’/exp
Social Isolation
2	‘social isolation’/exp OR ‘quarantine’/exp OR ‘social distancing’/exp OR ‘lockdown’/exp OR ‘home’/exp
Food and eating habits
3	‘food’/exp/mj OR ‘healthy eating’/exp OR ‘feeding behavior’/exp OR ‘food intake’/exp OR ‘nutrition’/exp OR ‘nutrient’/exp OR ‘diet’/exp/mj OR ‘feeding behavior’/exp OR ‘nutritional status’/exp OR ‘lifestyle’/exp OR ‘healthy diet’/exp/mj OR ‘healthy lifestyle’/exp/mj OR ‘quality of life’/exp
4	1 AND 2 AND 3
Web of Science
Covid-19
#1	Coronavirus OR “Coronavirus Infections” OR Pandemic* OR “COVID-19” OR “Disease Outbreaks” OR “SARS-CoV-2” OR “covid-19 pandemic” OR “2019-nCoV” OR “COVID-19 virus”
Social Isolation
#2	“Social Isolation” OR Quarantine* OR “Social Distancing” OR Lockdown* OR “Physical Distance” OR “home confinement” OR home OR confinement*
Food and eating habits
#3	Food OR “Diet, Food, and Nutrition” OR Diet OR “Feeding Behavior” OR “Diet, Healthy” OR Nutrients OR “Life Style” OR “Quality of Life” OR “food habit” OR “food habits” OR “Healthy eating” OR “eating habits” OR nutrition OR nutrient* OR “Food consumption” OR “dietary behavior” OR “Nutrition Status” OR “eating behavior” OR Lifestyle* OR “Healthy Lifestyles” OR “Healthy Life Style”
#4	#1 AND #2 AND #3

Variables
Author	Country	Design	Population	Gender	Age	Data collection method	Period
Di Renzo et al. [⁸].	Italy	Cross-sectional	n=3,533 (≥12 years of age)	M: 23.9% F: 76.1%	18-65 years of age: 91.5%	Google Forms	April 5-24, 2020
Food evaluation
(a) PREDIMED Mediterranean Diet Adherence Screener; (b) Questions about changes in the consumption of specific foods and/or drinks; (c) Questions about the frequency of consumption of specific foods and/or drinks; (d) Questions about meals (number and/or frequency); (e) Questions about food purchase; (f) Perception of diet change.
Conclusion
Greater adherence to the MD in the population between 18 and 30 years of age when compared to the younger and older population. Perception of weight gain was observed in 48.6% of the population, while a slight increase in physical activity has been reported in 38.3% of respondents. In addition, 15.0% of respondents turned to farmers or organic purchasing groups for fruits and vegetables, especially in Northern and Central Italy, where BMI values were lower.

Author	Country	Design	Population	Gender	Age	Data collection method	Period
Gallè et al. [⁹]	Italy	Cross-sectional	n=2,125 (undergraduates)	M: 37.2% F: 62.8%	Middle age: 22.5	Online questionnaire	Last 2 weeks of March 2020
Food evaluation
(a) Perception of diet change
Conclusion
Social isolation did not change the diet and smoking habits, but it did cause a decrease in the level of physical activity. Preventive interventions should also turn restrictive measures into an opportunity to improve lifestyle

Author	Country	Design	Population	Gender	Age	Data collection method	Period
Pietrobelli et al. [¹⁰]	Italy	Longitudinal	n=41 (obese children and adolescents)	M: 53.7% F: 46.3%	6-18 years of age	Baseline: Personal interview	Baseline: May 13 to July 30, 2019
Pietrobelli et al. [¹⁰]	Italy	Longitudinal	n=41 (obese children and adolescents)	M: 53.7% F: 46.3%	6-18 years of age	Lockdown: Telephone interview	Lockdown: March 10 to April 2020
Food evaluation
(a) Questions about changes in the consumption of specific foods and/or drinks; (b) Questions about meals (number and/or frequency).
Conclusion
In children and adolescents, social isolation seems to create an unfavorable environment for the maintenance of healthy lifestyle behaviors. Depending on the duration, the undesirable effects of social isolation can have a lasting impact on the level of adiposity.

Author	Country	Design	Population	Gender	Age	Data collection method and	Period
Scarmozzino e Visioli [¹¹]	Italy	Cross-sectional	n=1,929	M: 67.0% F: 32.9%	21-65 years of age 84.1%	Google Forms	April 3-15, 2020
Food evaluation
(a) Questions about frequency of consumption of specific foods and beverages; (b) Questions about changes in the consumption of specific foods and/or drinks.
Conclusion
Almost half (49.6%) of the respondents did not change their diet; however, 46.1% of them reported that they were eating more. There was an increase in the consumption of “comfort foods”, mainly chocolate, ice cream and desserts (42.5%) and snacks (23.5%). 21.2% of respondents increased their consumption of fresh fruits and vegetables. Purchases of ready meals reduced by almost 50%.

Author	Country	Design	Population	Gender	Age	Data collection method	Period
Rodríguez-Pérez et al. [¹²]	Spain	Cross-sectional	n=7,514 (>18 years of age)	M: 29.3% F: 70.6%	21-65 years of age: 91.3%	Google Forms	March 2020 (during 3 weeks)
Food evaluation
(a) PREDIMED Mediterranean diet Adherence Screener (validated); (b) Questions about changes in eating and/or cooking habits; (c) Questions about changes in consumption of specific foods and beverages.
Conclusion
Improvement in eating behaviors was observed during social isolation, reflected by greater adherence to MedDiet. Health-related food choices included greater intake of fruits, vegetables or legumes, and less consumption of red meat, alcohol, fried foods or sweets compared to usual habits.

Author	Country	Design	Population	Gender	Age	Data collection method	Period
Romeo-Arroyo et al. [¹³]	Spain	Cross-sectional	n=600 (NI)	F: 50.1%	18-68 years of age	Online survey;	Last week of April
Food evaluation
(a) Food Groups Consumption Frequency Questionnaire (QFCGA) (validated); (b) Dutch Eating Behavior Questionnaire, Spanish version (validated); (c) Questions about eating and cooking habits; (d) Questions about changes in the consumption of specific foods and/or drinks; (e) List of new habits acquired.
Conclusion
Different attitudes were present in Spanish homes, some of them related to low emotional status and possible less healthy eating habits, and others focused on trying to maintain healthier habits.

Author	Country	Design	Population	Gender	Age	Data collection method	Period
Sidor and Rzymski [¹⁴]	Poland	Cross-sectional	n=1,097 (≥18 years of age)	M: 4.9% F: 95.1%	18-25 years of age: 53.6%	Online survey	April 17/May 1, 2020
Food evaluation
(a) Questions about changes in eating and/or cooking habits; (b) Questions about the frequency of consumption of specific foods and/or drinks; (c) Questions about meals (number and/or frequency); (d) Level of concern of contracting SARS-CoV-2 during shopping or contact with food.
Conclusion
Social isolation can affect eating habits and behaviors (eating more, more snacks, increased alcohol consumption (Poland) and weight change). Overweight and obese individuals were more prone to these changes (frequency of consumption: <vegetables, fruits and legumes and >salty foods, meat and dairy products).

Author	Country	Design	Population	Gender	Age	Data collection method	Period
Zhao et al. [¹⁵]	China	Cross-sectional	n=1,938 (18-80 years of age)	M: 34.3%; F: 65.7%	18-45 years of age: 83.6%	Wenjuanxing	March 2020
Food evaluation
(a) Family Diet Diversity Index; (b) Questions about food purchase; (c) Questions about consumption of specific foods in the last 24 hours; (d) Questions about specific eating behaviors to deal with Covid-19.
Conclusion
Good general food diversity. Less food diversity in areas with a high number of Covid-19 confirmed cases. Eating behaviors to deal with Covid-19 (consumption of vitamin C, probiotics, other dietary supplements, alcohol and vinegar) were associated with greater diversity. The main ways of obtaining food were internal storage and personal purchases.

Author	Country	Design	Population	Gender	Age	Data collection method	Period
Nachimithu et al. [¹⁶]	India	Cross-sectional	n=100 individuals with diabetes	M: 54 F: 46	≥18-64: 57.0%	Survey Monkey	April 1-15, 2020
Food evaluation
(a) Question about diet and exercise during lockdown
Conclusion
Most people investigated reported that they were able to maintain food care as well as being more physically active at home during social isolation.

Author	Country	Design	Population	Gender	Age	Data collection method	Period
Zachary et al. [¹⁷]	United States	Cross-sectional	n=173 (>18 years of age)	M: 44.5% F: 55.5%	Average age: 28.1	Survey Monkey	NI
Food evaluation
Weight and Lifestyle Inventory
Conclusion
Approximately 22% of the sample reported weight gain during social isolation. The risk factors were inadequate sleep, snacks after dinner, lack of food restriction, food in response to stress and reduced physical activity.

Author	Country	Design	Population	Gender	Age	Data collection method	Period
Pillay et al. [¹⁸]	South Africa	Cross-sectional	n=692 (athletes)	M: 67.0% F: 33.0%	NI	Google Forms	April 28-30, 2020
Food evaluation
(a) Perception of diet change; (b) Questions about specific eating behaviors to deal with Covid-19.
Conclusion
Covid-19 has significant physical and mental effects on athletes, including worsening of nutrition. Medical, nutritional and psychological support is recommended during and after social isolation.

Author	Country	Design	Population	Gender	Age	Data collection method	Period
Ammar et al. [¹⁹]	Europe, Africa, Asia and the Americas	Cross-sectional	n=1,047 (≥18 years of age)	M: 46.2% F: 53.8%	18-35 years of age: 55.1%	Google Forms	April 6-11, 2020
Food evaluation
Short Diet Behaviors Questionnaire for Lockdowns
Conclusion
Interim results of the investigation indicate a negative effect of home confinement on physical activity and diet behavior with a significant increase in sitting time and an unhealthy diet, indicative of a more sedentary lifestyle.

Aspects assessed		Variables
Aspects assessed		⇋ %	↑ %	↓ %	Score
Quantity of food intake
	Scarmozzino and Visioli et al. [¹¹]	47.1	52.9	-	-
	Rodríguez-Pérez et al. [¹²]	63.7	36.3	-	-
	Sidor and Rzymski et al. [¹⁴]	-	43.5	-	-
	Zachary et al. [¹⁷]	61.3	38.7	-	-
	Ammar et al. [¹⁹]	-	-	-	↑
Number of daily meals
	Di Renzo et al. [⁸]	57.8	23.5	17.5	-
	Pietrobelli et al. [¹⁰]	-	-	-	↑
	Zachary et al. [¹⁷]	34.7	65.3	-	-
	Ammar et al. [¹⁹]	-	-	-	↑
Cooking
	Di Renzo et al. [⁸]	-	↑	-	-
	Rodríguez-Pérez et al. [¹²]	50.7	45.7	03.6	-
	Sidor and Rzymski et al. [¹⁴]	-	62.3	-	-
Preparation (frying)
	Rodríguez-Pérez et al. ">14	-	62.3	-	-
Preparation (frying)
	Rodríguez-Pérez et al. [¹²]	73.4	06.3	20.3	-
Acquisition (food delivery)
	Di Renzo et al. [⁸]	-	-	↓	-
Food availability
	Scarmozzino and Visioli et al. [¹¹]	-	-	33.5	-
	Rodríguez-Pérez et al. [¹²]	-	-	27.0	-
Food quality
	Gallè et al. [⁹]	41.9	41.0	17.1	-
	Pillay et al. [¹⁸]	-	53.0	47.0	-

Aspects assessed		Variables
Aspects assessed		⇋ %	↑ %	↓ %
Fruits and vegetables
	Di Renzo et al. [⁸]	-	37.4	35.8
	Scarmozzino and Visioli et al. [¹¹]	69.2	21.2	08.7
	Romeo-Arroyo et al. [¹³]	-	>30.0	-
Fruits and vegetables (canned)
	Scarmozzino and Visioli et al. [¹¹]	-	00.9	-
Fish1
	Di Renzo et al. [⁸]	-	-	-
	Scarmozzino and Visioli et al. [¹¹]	64.8	08.5	13.7
	Romeo-Arroyo et al. [¹³]	-	-	>33.0
Meat
	Pietrobelli et al. [¹⁰]	-	-	↑
	Scarmozzino and Visioli et al. [¹¹]	75.1	04.0	14.92
	Romeo-Arroyo et al. [¹³]	-	>20.0	-
Processed Meat
	Scarmozzino and Visioli et al. [¹¹]	-	06.0	-
Milk/yogurt
	Scarmozzino and Visioli et al. [¹¹]	76.3	14.3	09.4
Cheese
	Scarmozzino and Visioli et al. [¹¹]	79.1	13.3	07.6
Pasta
	Romeo-Arroyo et al. [¹³]	-	~40.0	-
Olive oil
	Scarmozzino and Visioli et al. [¹¹]	93.2	05.0	01.8
Snacks
	Scarmozzino and Visioli et al. [¹¹]	57.6	23.5	18.9
	Rodríguez-Pérez et al. [¹²]	46.7	37.6	15.7
Fast-food
	Rodríguez-Pérez et al. [¹²]	60.0	05.1	34.9
Ready meals
	Scarmozzino and Visioli et al. [¹¹]	47.4	03.1	49.5
Junk food
	Di Renzo et al. [⁸]	-	25.6	29.8
	Ammar et al. [¹⁹]	-	↑	-
Potato chips
	Pietrobelli et al. [¹⁰]		↑
Crackers
	Scarmozzino and Visioli et al. [¹¹]	66.1	19.1	14.8
Sweets
	Di Renzo et al. [⁸]	-	-	↓
	Scarmozzino and Visioli et al. [¹¹]	44.0	42.5	13.5
	Romeo-Arroyo et al. [¹³]	-	>50.0	-
Sugary Drinks
	Pietrobelli et al. [¹⁰]	-	↑	-
	Scarmozzino and Visioli et al. [¹¹]	72.7	5.0	22.3
Coffee/tea/infusions
	Di Renzo et al. [⁸]	-	↑	-
	Scarmozzino and Visioli et al. [¹¹]	58.7	29.8	11.5
Alcohol
	Di Renzo et al. [⁸]	-	-	↓
	Scarmozzino and Visioli et al. [¹¹]	53.1	10.1	36.8
	Rodríguez-Pérez et al. [¹²]	32.3	10.4	57.3
	Romeo-Arroyo et al. [¹³]	-	>20.0	-
	Sidor and Rzymski et al. [¹⁴]	77.0	14.6	-
	Zhao et al. [¹⁵]	-	10.6	-
	Pillay et al. [¹⁸]	-	10.0	-
	Ammar et al. [¹⁹]	-	-	↓

[1] Note: 2019-nCoV: Novel Coronavirus 2019; Covid-19: Corona Virus Disease 2019; Exp: Exploded; MeSH: Medical Subject Headings; Mj: Major Focus; SARS-Cov-2: Severe Acute Respiratory Syndrome Coronavirus 2.