key: cord-0771882-825phewn
authors: Robert, Margaux; Deschasaux-Tanguy, Mélanie; Shankland, Rebecca; Druesne-Pecollo, Nathalie; Esseddik, Younes; Szabo de Edelenyi, Fabien; Baudry, Julia; Galan, Pilar; Hercberg, Serge; Touvier, Mathilde
title: Association between positive psychological traits and changes in dietary behaviour related to first COVID-19 lockdown: A general population-based study
date: 2021-12-24
journal: Appetite
DOI: 10.1016/j.appet.2021.105885
sha: 57b5dea8c68d60675e75db7eef412fdf94c63d8d
doc_id: 771882
cord_uid: 825phewn

BACKGROUND: The spread of the coronavirus disease (COVID-19) led many countries to implement lockdown measures, which resulted in changes in dietary behaviours that could persist over the long term and have associated health consequences. Psychological traits may impact these changes given their known association with dietary behaviours. We aimed to investigate in a population-based study, whether positive psychological traits were associated with changes of snacking behaviour and food consumption observed during the first COVID-19 lockdown period. DESIGN: In 2016, levels of optimism, resilience, self-esteem, satisfaction with life, mindfulness and mastery were assessed in 33,766 adults of the French NutriNet-Santé cohort. Snacking and food group consumption were assessed in April–May 202. Association between psychological traits and changes (no change, increase, decrease) in snacking and food group consumption were assessed using logistic regressions. Multiple correspondence analysis followed by ascending hierarchical classification were used to derive clusters of dietary behaviours. Covariance analyses were used to compare mean scores of psychological traits between clusters. Analyses were adjusted for sociodemographic and lifestyle characteristics, anxiety and depressive symptomatology. RESULTS: Participants with higher levels of optimism, resilience, self-esteem, satisfaction with life, mindfulness or mastery were less likely to change their snacking behaviour and food group consumption of various food groups. Individuals with lower levels were more likely to make changes, with either unhealthy (e.g.,less fruits and vegetables, more processed meat) or healthy (e.g., more pasta/rice (whole-grain)) changes. Overall, individuals showed higher levels of positive psychological traits in the “no change” cluster, followed by the “healthy” and the “unhealthy” cluster (all P < 0.05). CONCLUSIONS: Individuals with higher levels of optimism, resilience, self-esteem, satisfaction with life, mindfulness or mastery were less impacted by the lockdown in terms of dietary behaviours.

In 2019, a novel corona virus disease leading to severe acute respiratory syndrome 76 emerged in China and quickly spread all over the globe. On March 12, 2020, the World Health 77 Organization (WHO) declared COVID-19 as a global pandemic (1) , which has led the national 78 authorities of many countries to implement a nationwide lockdown to constrain the transmission 79 of the virus. In France, the first lockdown entered into force on March 17, 2020 and was 80 loosened on May 11, 2020 . Under that situation, social distancing was advocated and French 81 people could leave their home only for grocery shopping, medical care, legal obligation and 82 physical activity within a 1 km radius (2) . Only workers from what was called "essential" 83 sectors (healthcare, medical research, food and drug manufactures and supplies, garbage 84 collection, city cleaning, vehicle and technology maintenance) maintained their usual activity 85 (2). All other non-essential public spaces including school and universities, workplaces, open 86 spaces, recreational spaces and non-food spaces were closed (2) . As a result, a vast majority of 87 the population either was asked to telework from home or became partially unemployed, and 88 parents had to relay school teachers at home (2) . 89 Studies conducted among the general population showed changes in the diet during the first 90 COVID-19 lockdown but with contrasted results. Both positive changes were observed, with 91 an increase in consumption of fruit and vegetables (3) (4) (5) (6) , whole grains (4), legumes and nuts 92 (3), and a reduced consumption of confectionery and salty snacks (4), ice cream (4) and alcohol 93 (5), and negative changes, characterised by an increase in snacking (3, 7, 8) , chocolate (3, 5) , ice 94 cream (4, 5) , salty snack (5, 9) , processed meat (6) , sugary food (6) and alcohol (6, 9) , and a 95 decrease in fruits and vegetables (3, 4, 9) , fish (4, 9) , whole grain products (4, 9) . Other behaviours 96 such as a decrease in physical activity (3, 8, (10) (11) (12) , an increase in sedentary time (3) , and an 97 increase in tobacco consumption (10) were also observed. 98 J o u r n a l P r e -p r o o f Given the impact of dietary behaviours on chronic diseases (13) and their potential impact on 99 the immune response (14) , it is important to understand their determinants. More specifically, 100 a better understanding of these determinants may help prevent unhealthy changes in dietary 101 behaviour in potential future similar crises such as the COVID-19 pandemic. This is particularly 102 important since negative dietary behaviour resulting from the lockdown may last thereafter, as 103 nutritional behaviours have been shown to be relatively stable over time (15) . 104 Individual psychological resources may have had an impact on the lockdown experience, and 105 in particular on changes in dietary behaviour, given the recognised influence of psychological 106 traits on dietary behaviours in general (16, 17) . For example, individuals in a cluster 107 characterised by higher neuroticism, insecurity, stress and 'type A' personality (i.e. more 108 competitive and ambitious) reported more negative impact of the lockdown on their lifestyle 109 behaviour, and in particular on their diet (18) . Positive psychological resources are of specific 110 interest since focusing on building competencies rather than correcting weakness could be a 111 step forward in health promotion (19) . Optimism (20) , satisfaction with life (21) , self-esteem 112 (22) , resilience (23) , mindfulness (24) and mastery (25) are all positive psychological resources 113 that have previously been associated with a healthier diet. Therefore, it is likely that these traits 114 may have played a role in the way individuals experienced the lockdown, and more specifically 115 their overall dietary behaviour during this period. 116 The aim of the present study was therefore to assess the association between several positive 117 psychological traits (optimism, satisfaction with life, self-esteem, resilience, mindfulness and 118 mastery), and changes in snacking behaviour, food group consumption and overall dietary 119 behaviours related to the first COVID-19 lockdown period in a large population-based sample. 123 This study was conducted within the NutriNet-Santé Study, an ongoing web-based prospective 124 cohort launched in 2009, the aims of which being to explore the relations between nutrition and 125 health, as well as the determinants of eating behaviours and nutritional status. The rational, 126 design and methods have been described (26) . Participants are volunteers aged ≥ 18 years 127 from the general French population. At inclusion, they are asked to complete a set of self-128 reported web-based questionnaires to assess their diet, health status, physical activity, 129 anthropometric data, socio-economic conditions and lifestyle characteristics. In addition, 130 optional questionnaires related to eating behaviour determinants and specific health-related 131 outcomes are sent each month. Dispositional optimism is defined as the general expectation that good things, rather than bad 141 things, will occur in one's future (27) . It was assessed with the French version (28) of the Life 142 Orientation Test -Revised (LOT-R) (29) , which was administered between October and 143 December 2016. This validated questionnaire consists of 6 items: 3 positively worded (e.g., 144 "I'm always optimistic about my future") and 3 negatively worded (e.g., "I hardly ever expect 145 things to go my way"), rated on a 5-point Likert scale ranging from 0 (strongly disagree) to 4 146 J o u r n a l P r e -p r o o f (strongly agree). The scoring for the negatively worded items was reversed. Item scores were 147 summed up and divided by the number of items, leading to a final score ranging from 0 (low 148 optimism) to 4 (high optimism). The scale showed good internal consistency (Cronbach's α = 149 0.84). Self-esteem Self-esteem refers to an individual's evaluation of their own worth (33). It was assessed with 161 the French version (34) of the Rosenberg Self-Esteem Scale (R-SES) (33) which was completed 162 by participants between October and December 2016. This validated questionnaire is composed 163 of 10 items: 5 positively worded (e.g., "I feel I have a number of good qualities") and 5 164 negatively worded (e.g., "At times I think I am no good at all"). All items are rated on a 4-point 165 Likert scale ranging from 1 (strongly disagree) to 4 (strongly agree). The scoring for the 166 negatively worded items was reversed. The scores were summed and then divided by the 167 number of items. The final score of self-esteem was ranging from 1 (low self-esteem) to 4 (high Resilience, the ability to bounce back or recover from stress (35), was assessed with the French 172 version of the Brief Resilience Scale (BRS) (35) between January and July 2017. This validated 173 questionnaire consists of 3 items positively worded (e.g., "I tend to bounce back quickly after 174 hard times") and 3 items negatively worded (e.g., "I have a hard time making it through stressful 175 events"), each rated on a 5-points Likert scale, ranging from 1 (strongly disagree) to 5 (strongly 176 agree). The scoring for the negatively worded items was reversed. Item scores were summed 177 and divided by the number of items, leading to a final score ranging from 1 (low resilience) to worded (e.g., "I am easily distracted") rated on a 5-points Likert scale ranging from 1 (never or 186 very rarely true) to 5 (very often or always true). The score of the negative worded items were 187 reversed before summing all items. This score was divided by the number of items, leading to 188 a final overall score ranging from 1 (low degree of mindfulness) to 5 (high degree of 189 mindfulness). The scale displayed good internal consistency (Cronbach's α = 0.89). questionnaire: 3 positively worded (e.g., "What happens to me in the future mostly depends on 196 me") and 5 negatively worded (e.g., "There is really no way I can solve some of the problems 197 I have") rated on a 7-point Likert scale ranging from 1 (strongly agree) to 7 (strongly disagree).

The items scored were summed and then divided by the number of items. The score was ranging 199 from 1 (low mastery) to 7 (high mastery). The scale displayed good internal consistency participants were asked to choose an answer between the following statements: "Compared to 211 the situation before lockdown: I snack more, I snack less, I snack neither more nor less". To 212 assess potential changes in dietary habits, participants were also asked to choose an answer 213 between the following statements: "Check the answer that best describe your situation for each 268 We use used chi-square test and student t test to compare included with excluded participants, 269 as appropriate. Individual characteristics, changes in snacking behaviour and food group 270 consumption were described with frequencies or mean ± standard deviation. Relationship 

Missing data with regard to confounders were handled with multiple imputations by fully 307 conditional specification (20 imputed data sets). All tests of statistical significance were 2-308 sided, and significance was set at 5%. The MCA and the ACH were performed using the Table 2 . shows the distribution of participants who declared increasing, decreasing or not 343 having changed their snacking behaviour and food group consumption. The proportion of 344 participants who did not change their consumption was greater than 50% for every food group 345 considered, except for sugary drinks and sodas (20.4%).

A large proportion of participants increased their intake, and in particular more than 10% France. Our results showed that participants with higher optimism, satisfaction with life, self-421 esteem, resilience, mindfulness or mastery scores were less likely to change their snacking 422 behaviour, food group consumption and overall dietary behaviour during the lockdown.

Individuals who scored lower in terms of these positive psychological traits were more likely 424 to display unhealthy changes and, to a lower extent, healthy changes. psychological traits are associated with greater stress and anxiety (72, 73, 76, 78, 81, 95) . In 4 For each food group, participants who did not consume the food group of interest were excluded from the analyses. 

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