March29, 2023

Abstract Volume: 2 Issue: 3 ISSN:

Food Production Chain, Changes of Consumers’ Behaviors and Lifestyles: COVID-19 Impact

Attapon Cheepsattayakorn*,Ruangrong Cheepsattayakorn1, Porntep Siriwanarangsun2

1.Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

2.Faculty of Medicine, Western University, Pathumtani Province, Thailand.

*Corresponding Author: Attapon Cheepsattayakorn, Faculty of Medicine, Western University, Pathumtani Province, Thailand.

10th Zonal Tuberculosis and Chest Disease Center, 143 Sridornchai Road Changklan Muang Chiang Mai 50100 Thailand.

Received Date: February 18, 2021

Publication Date: March 01, 2021


The  Objective  of the  Study  is to  review  and analyze  the impact of  COVID-19  or coronavirus  pandemic on  issue-related  to food  or  agri-food production, food  supply  chain, government’s  policies, employees  and  employers assistance  programs, individuals’  or consumers’  behavioural  changes.

Method  of the  Study : The  data were  collected  and analyzed  from  articles that  published  in journals, websites, news  papers, and  other  social media  between  2004 and  2020

Results of  the  Study: The consumers’  food  demand varies  depending  on income  level  of consumers, consumption, the price  of  foodstuffs, sociodemographic  situation, time constraints, and  shopping preferences, in  addition  to spending  money  on food  in  per visit  changed  and number  of  visits to  food  store. Interruption of the daily-routine life by COVID-19 pandemic  resulted in  boredom  with high  consumption  of carbohydrate, fat, and  protein, in  addition  to quarantine-caused  stress  that pushed  the  people to  sugary  food consumption  for  feeling positive.  Due to ability of  carbohydrate-rich  foods to  encourage  serotonin production, they  can be  used as  self-medicating  components. These unhealthy eating habits may lead to obesity-associated-COVID-19 serious  complications  and chronic  inflammation.  The Logistic  Sub-Group  of the  United  Kingdom developed  crisis  management, shore  base logistics  and  freight management, accommodation  and  transportation, and  safe passage  programs  to provide  safe  passage (health  issue) and  assurance  to health  personnel  and their  families, including  guidelines and  raising  awareness to  logistic  sector. The “green  lanes ”  for  vehicles carrying  agri-food  products for  ensuring  the fast  and  free movement  on  the borders  was  implemented by  the  Commission of  the  European Union (EU), in  addition  to highlighting  the  free movement  of  seasonal workers  and  agri-foods for  easy  reaching their  workplaces.

In conclusion, movement restrictions both national and international contributed  to challenges, including consumers’  changes  in demand.  These restrictions caused consumers to prepare cooking  at  their homes, in  addition  to preventing  them  from getting  COVID-19  infection at  the  stores, restaurants, markets, and  supermarket.            

Keywords: COVID-19, SARS-CoV-2, Impact, Food  Production, Food  Supply Chain.

Food Production Chain, Changes of Consumers’ Behaviors and Lifestyles: COVID-19 Impact


CAP: Common Agricultural Policy

CPS: Cyber Physical System

CREA: The Council for Agricultural Research and Economics of Italy

EU: European Union

SCM: Supply Chain Management

US CDC: United States Centers for Disease Control and Prevention

US FDA: United States Food and Drug Administration

WHO: World Health Organization

Objective of the Study

To review and analyze the impact of COVID-19 or coronavirus pandemic on issue-related to food or agri-food production, food supply chain, government’s policies, employees and employers assistance programs, individuals’ or consumers’ behavioural changes.

Method of the Study

The data were collected and analyzed from articles that published in journals, websites, news papers, and other social media between 2004 and 2020.

Results of the Study

The results of the study were analyzed and demonstrated below. Food Supply Chain Impacted By COVID-19 Pandemic Five stages of food supply chain include agricultural production, postharvest handling, processing, distribution/retail/service, and consumption (1). The two used-food-supply-chain systems include system-based on regulations and laws that use mandatory standards which are under the state agency inspection and voluntary standards which are under the market laws or international associations (2). The World Health Organization (WHO) the strategic preparedness and response plan that includes the health measures with eight priority steps and actions:

1) Coordination, planning, and monitoring at the country level,

2) Risk communication and community participation,

3) Surveillance, rapid response teams, and case investigation,

4) Entry points,

5) National laboratories,

6) Prevention and control of infection,

7) Situation management, and

8) Operational support and logistics (3).

Due to rapidly spread globally of the COVID-19, it eventually forced countries to apply lockdowns and strict social (physical) distancing measures. Currently, online meeting and flexible work from home have become standard practices (4-5). The United States Centers for Disease Control and Prevention (US CDC) developed response plans to provide guidance for continuity of operations in the food processing facilities and manage COVID-19 in the food industry, particularly, meat and poultry processing industries (6). COVID-19 pandemic might contribute to a US $ 80 billion loss in tourism sector and US $ 113 billion loss in aviation (7, 8). The European Food Safety Authority stated that there is no evidence of association between risk of COVID-19 and food consumption (9), whereas the Norwegian officials stated that there is no association between the transmission of SARS-CoV-2 (COVID-19) via imported food and the origin of the salmon outbreak is still unclear (10, 11). Nevertheless, some eating and cooking habits may contribute to the emergence of the coronavirus from animals to humans (9). During the COVID-19 pandemic era, four major issues involving the food supply chain and the food industry have been raised,

1) People tend to have follow a healthy diet for protecting their immune system (12), therefore , the demand in bioactive-ingredient-containing functional food is increased,

2) Producers, retailers, and consumers has payed more attention on food safety,

3) Due to people on lockdown restrictions, food security concerns have been arisen, and

4) During the COVID-19 pandemic era, the food sustainability problems have emerged (13). In Germany and France, some of the markets limited the number of items, such as pork and beef products that a customer can buy and some restaurants stopped serving beef hamburgers. Close-down of the food plants contributed to the ripple effect in the food supply chain (14-17).

Governments are facing financial pressures because of the economic shrinkage and reallocating their resources focusing on financial incentives and social assistance programs (18, 19). Seasonal or temporary employment, particularly for planting, sorting, harvesting, processing, or transporting crops to markets is common in the developing and developed countries that significantly affects the food supply chain as a result of the shortage of local or migrant workers because of travel restrictions imposed by city lockdown or sickness (20). The objective of “Pick for Britain” campaign in Britain was to identify 70,000 British to work during the harvest and in the field, whereas a call has been performed to the unemployed individuals to work in fields in France (21). In India, tea plants were being lost due to logistical challenges, whereas the British chair of dairy farmers demonstrated that around 5 million liters of milk are at risk in one week (22)


Impact of COVID-19 Pandemic on Consumer Behavior

The consumers’ food demand varies depending on income level of consumers, consumption, the price of foodstuffs, sociodemographic situation, time constraints, and shopping preferences, in addition to spending money on food in per visit changed and number of visits to food store (23, 24). Interruption of the daily-routine life by COVID-19 pandemic resulted in boredom with high consumption of carbohydrate, fat, and protein, in addition to quarantine-caused stress that pushed the people to sugary food consumption for feeling positive (25). Due to ability of carbohydrate-rich foods to encourage serotonin production, they can be used as self-medicating components (25). These unhealthy eating habits may lead to obesity-associated-COVID-19 serious complications and chronic inflammation (25). An unusual demand shift from food service to retail due to the closure of restaurants and limited service eating places that affected the eating or purchasing habits (23, 26). Using food service and purchasing food from supermarkets had the same ratio as 50 % before the COVID-19 outbreak, nevertheless, it is almost 100 % for supermarkets (23, 26). During the COVID-19 lockdown, consumers experienced decreased availability of certain types of foods (23, 26). The spending money on food was raised per visit, whereas the number of visits to food store was decreased (23, 26). Flour, a staple product was not found on food store shelves because of the more interest in home-baking, as a family activity in European countries (23, 26). Individuals have focused on the products with long shelf life, such as canned or dried foods, milk, milk substitutes, pasta, and frozen foods because of convenience and daily cooking at home (23, 26). Interestingly, the shortage of eggs was not only due to lack of packing for retail but also increased demand (27, 28).

In the United States, sales for eggs rose by 44 % compared to last year (2019), whereas household egg consumption increased 40 % since march 20, 2020 in Argentina (4, 27, 28). During COVID-19 pandemic, the flexibility associated with the packing and labelling of eggs because of the insufficient availability of suitably labelled retail packages to facilitate the egg distribution and fulfill the demand was provided by the United States Food and Drug Administration (US FDA) (4, 27, 28). In the European countries, the demand for frozen vegetables increased by 52 % and fresh bread by 76 % in the week when the COVID-19 pandemic was announced, whereas the demand for alcoholic beverages increased twice, one month after pandemic announcement (29). A study on 18 countries revealed that food buying behavior has changed due to willingness of healthy food consumption without exceeding normal budget. Most customers adopted a basic approach of returning to ingredient-containing beverage products, such as olive oil, whole grains, legumes, fruit, and vegetables and natural food. They are also looking for food products that improve their COVID-19-related mood (25, 30). The behavior of the Italian population on food choices and behavior was assessed under COVID-19 quarantine in a recent poll performed by the Italy’s the Council of Agricultural Research and Economics (CREA) among approximately responded 2,900 individuals from all regions of Italy demonstrated that healthy food and beverage consumption increased for 33 % of vegetables, 29 % of fruit, 26.5 % of legumes, and 21.5 % of extra-virgin olive oil. Nevertheless, 44.5 % and 16 % of them consumed more sweet food and drank more wine, respectively, whereas 44 % and 37 % of them reported body weight gain because of low-level physical activity and intake of higher calories and needed weight loss by adjusting their diet, respectively (31).

During COVID-19 pandemic in the United States, a survey of 630 consumers in May 2020 revealed that 70 % of consumers decreased the frequency of food shopping and preferred online shopping, 56 % of them were worried about not finding particular foods they would like to buy in the store orforgetting to buy something, 70 % of them consumed more food while staying at home, 43 % of them consumed more fruits, 42 % of them consumed more vegetables, 30 % of them consumed more protein-containing foods (fish, chicken, or meat), 39 % of them made their breakfast more balanced, 47 % of them consumed more sweet foods, 24 % of them consumed less vegetables, 21 % of them consumed less fruits, and 19 % of them consumed less protein-containing foods (32).

A survey on 1,005 over-18-year-old-male and -female French people demonstrated that during the 8-week quarantine, they changed their views on the ecological, economic, and social value of food production (33). They would only buy “essential” foods, spend more time cooking, and pay more attention to food spending when they return to “normal” after COVID-19 pandemic measures have been relieved (33). Approximately, one-third of them wasted less food, 29 % of them bought more local food, and 20 % of them went online shopping (33). Another survey in France conducted on April 6th and 7th, 2020 among 1,000 above-18-year-old adults revealed that 82 % of them believed in safety of foods they bought, 7 % of them believed in unsafety of foods they bought, 42 % of them preferred the packaged foods more than normal, 42 % of them stated that the COVID-19 pandemic did not change their attitudes towards packaged foods, 77 % of them believed in enough food production to meet the consumers’ needs, and 16 % of them did not believed in enough food production (34).


Impact of COVID-19 Pandemic on Global Food Trade

Before COVID-19 crisis, the vulnerability of food systems to problems-associated with diseases and climate has been confronted long, including the SARS and Ebola outbreaks, the oil crisis in the 1970s, and the food crisis in 2006-2008 (35). Due to current COVID-19 crisis, some governments changed the food trade policies by moving towards facilitating imports and restricting exports for ensuring the maintenance of the number of products in the domestic markets. The export restriction has some negative effects as the following : 1) Countries will lose their competitive advantage by losing their place

in international markets, 2) Dropping domestic prices that will decrease crop production and incentives in the industry, and 3) Undermining exporters’ reputation and decreasing importers’ confidence in the international markets that contribute to destroying future business opportunities and trust for exporters (36, 37). Due to COVID-19 pandemic, a total of 19 countries have taken to export restrictions for27 food products. Currently, a total of 8 countries are going on their measures on 11 food products. For considering the assessment of the effects of the import restrictions in term of kilocalorie unit, Tajikistan, Uzbekistan, Afghanistan, and Azerbaijan were negatively affected by 79 %, 70 %, 61 %, and 54 %, respectively (38). The world prices of stable food commodities, such as rice, wheat, and maize were pushed up by export-restricted policies and contributed to decreasing the quantity and quality of food products (39). Due to export restrictive policies and negatively effects of the capacity utilization of food-manufacturing plants to respond demand, foods that are not locally grown but needed for processing were not available, including inability of local sellers to find buyers that resulted in excess supply and waste accompanying economic losses and transportation challenges for air and sea cargo (40-43).

Minimizing The Impact of COVID-19 Pandemic

COVID-19 disruptions may contribute to hunger, malnutrition, and increasing number of individuals facing extreme hunger to 265 million in 2020 (44, 45). Among children who are younger than 5 years old, COVID-19 pandemic contributed to 14.3 % increase in prevalence of malnutrition wasting or health and social-protection interruption in low- and middle-income countries (46).


Food Supply Chain Strategies

At the household  level, COVID-19  pandemic  resulted  in  12 %  of  increase  in  food  waste (47).  Approximately, one-third  of  all  food  productions  was  wasted  across  the  food  supply  chain  stages (production, postharvest  handling, processing, distribution, and  consumption).  Some  bioactive  compounds  can  be  gained  from  food  wastes  to  re-utilize  them  in  food  chain, such  as  carotenoids, essential  oils, flavonoids, glucosinolates, isothiocyanates, phenols, and  whey  protein  by  conventional  or  innovative  techniques (extraction, fractionation, and  isolation  stages) (13, 48, 49).  Robot  systems  assist  individuals  to  serve  the  foods  to  consumers  in  food-serving  industry, in  addition  to  monitoring  the  unsafe  or  low-quality  food  products  in  food  supply  chain  by  the  Cyber  Physical  System (CPS) (50, 51).  Approximately, 25 %  increase  of  productivity  by  automation  to  complete  the  work  more  efficiently  than  humans, indicating  an  important  role  by  making  data-driven  autonomous  decision  in  production  in  the  fourth  industrial  revolution (50, 51).  The  COVID-19  pandemic  resulted  in  challenges  that  include  adopting  new  workplace  policies, actions  to  decrease  human  contact, and  change  of  working  conditions (52)

To  respond  to  these  challenges, organizations  should  establish  some  measures  as  the following:

1) Monitoring COVID-19 symptoms  of  the  workers, suppliers, contractors, and  visitors  before  entering  the  facilities, monitoring  all  staff  to  wear  face  protection  equipment  and  gloves, and  performing  body  temperature  screening  of  all staff  at  the  entrance  of  the  facilities;

2) Should  consider  employees’  work  rotation, working  hour  reduction, dividing  number  of  workers  in  each  work  shift  into  3  or  4  groups, and  adjusting  their  break  time  to  avoid  overcrowding; and 

3) Should  redesign  warehouses  and  processing  to  allow  social (physical)  distancing, build  barriers  or  dividers  that  cover  the  upper  part  of  the  body  of  the  workers  to  maintain  social  distance, and  use  diagonal  arrangement  in case  of  using  two  side  engagement  in  food  processing (53).  All  countries  should  maintain  the  balance  between  workers’  safety  and  food  product  quantity (54).  Decentralization  of  the  food  manufacture  provides  reduction  of  the  transportation  and  storage  costs, minimizing  the  environmental  impacts, shortening  the  food  supply  chain, reduction  of  the  emission  and  energy  consumption  during  storage  and  transportation, flexibility  in  food  supply  chain, and  simplifying  the  administrative  procedures (55-57).  During  COVID-19  pandemic, changes  in  food  demands  should  be  determined  by  using  simulations, statistical  models  and  forecasts, particularly, the  daily-life  products, such  as  food  items  and  sanitizers  to  propose  optimal  decision  for  demand  disruptions  and  tackling  supply  by  the  manufacturers (58)

Storage  centers  should  be  invested  by  the  government  or  private  centers.  Web-based-food-distribution  system  should  be  established  to  strengthen  the  relationship  between  buyer  and  seller (20, 54, 59-60).  Digital  commerce  services, an  important  role  in  interaction  and  trading  activities  among  the  actors  of  the  food  supply  chain  allow  small  farmers  to  reach  more  consumers  in  a  direct  effective  way  and  collaboration  between  the  largest  e-commerce  companies  and  government  to  encourage  rural  markets  to  be  part  of  e-commerce  economy  and  offer  mostly  organic  fertilizers  at  a  reasonable  cost (61), in  addition  to  “ Supply  Chain  Management (SCM)  Data  Science ” (62).

Agricultural  production  collection  centers  with  high  capacity  storage  at  the  location  comfortably  reached  by  small-scale  farmers  should  be  built  by  countries (63).  Maintaining  the  activities  of  small-  and  medium-size  agricultural  enterprises  requiring  additional  capital  injection  by  using  the capital  injections  from  donor  or  government  through  improved technologies  or  modern  facilities  that  entail  higher  production  costs (64).  Contractual  agricultural  arrangement  can  be  made  by  the  horizontal  and  vertical  coordination  mechanisms  between  food  banks  and  farmer  associations  as  the  following : 1) Assist  farmers  to  create  new  markets (65), 2) Countries  can  deploy  warehouse  receipt  systems  that  allow  small-scale  food  producers  to  easily  access  to  financial  loans  and  receive  the  best  price  for  their  agricultural  products (66), 3) Countries  should  develop  e-commerce  for  small  shareholders  to  commercialize  agricultural  products  to  wider  scale  of  consumers (67), and  4) Small-scale  agricultural  producers  should  have  easy  access  to  credit  for  involving  the  financial  problems (63).  Additionally, confidence  in  financial  organizations  can  be  promoted  by  the  temporary  liquidity  guarantee  program (TIGP)  that  allows  a  limited  term guarantee  for  newly  issued  debt  of  financial  companies  and  affiliates  and  non-interest  bearing  transaction  accounts (54, 68-70).       

Recommendations  for  Government

To  focus  on  the  impact  of  COVID-19  pandemic  on  agricultural  products  and  food  supply  cuts  by  observation  of  the  progress  and  recommended  actions  without  waiting  too  long  for  the  implementation  of  certain  interventional  strategies, a  COVID-19  crisis  committee  should  be  appointed  during  food  value  chain  in  collaboration  with  the  private  sectors (20).  An  Agriculture  Response  Program  was  designed  by  the  government  of  Canada  for  50-70 %  funding  assistance  without  paying  back  regarding  health  protocol, strategic  projects, product  distribution, product  movement, marketing, development, and  abattoir  efficiency (71).  The  government  of  Canada  also  implemented  a  US $ 50  million  financial  aid  program  for  small  farmers  who  hired  temporary  foreign  employees  through  the  COVID-19  outbreak  by  allowing  employers  to  get  US $  1,500  per  foreign  worker  with  14-day-self-isolation  upon  entry  into  Canada (72).  Additionally, The  government  of  Canada  and  Belgium  allowed  postponing  the  recruitment  or  offer  long-term  contracts  for  employers (73).  The  Logistic  Sub-Group  of  the  United  Kingdom  developed  crisis  management, shore  base  logistics  and  freight  management, accommodation  and  transportation, and  safe  passage  programs  to  provide  safe  passage (health  issue)  and  assurance  to  health  personnel  and  their  families, including  guidelines  and  raising  awareness  to  logistic  sector (74).  The  “green  lanes”  for  vehicles  carrying  agri-food  products  for  ensuring  the  fast  and  free  movement  on  the  borders  was  implemented  by  the  Commission  of  the  European  Union (EU), in  addition  to  highlighting  the  free  movement  of  seasonal  workers  and  agri-foods  for  easy  reaching  their  workplaces.  Common  Agricultural  Policy (CAP)  payments  and  temporary  framework  for  state  aid  measures  were  also  introduced  by  the  Commission  of  the  EU  to  extend  the  farmers’  application  deadline  to  get  income  support  and  supported  farmers  and  agri-food  business  for  ensuring  liquidity (75).  To  facilitate  connections  between  the  local  residents  and  agriculture  sectors, online  platforms  should  be  implemented (68).  The  best  way  to  solve  the  labor  shortage  over  the  medium  to  longer  term  during  COVID-19  pandemic  is  “ labor-replacing  mechanization  policy  ” (76).  Additionally, the  employed  agricultural-production  individuals  were  importantly  considered  as  “ critical  infrastructure  workers  ”  by  the  United  States  government (77, 78).  To  take  the  recommendations  and  measures  in  food  and  agriculture  during  the  COVID-19  pandemic, the  COVID-19  Commission  that  consisted  of  two  members  of  from  the  Ministry  of  Agriculture  and  Forestry  and  seven  academicians  in  Turkey  was  established (79)

Many  countries  like  Saudi  Arabia, United  Arab  Emirates, Bahrain, Egypt  and  Sudan  did  not  begin  easing  restrictions  until  the  end  of  June  2020, whereas  Yemen  declared  easing  lockdown  restrictions  in  Mid-July  2020 (80).  The  lockdown  restrictions  included  closure  of  the  borders, closure  of  non-essential  businesses, local  movement  and  travel  restrictions, nightly  travel  curfew, cancelling  prayers  to  avoid  mass gathering  events, and  facilitating  remote  working  and  online  learning (80).  Numerous  financial  plans  were  implemented  by  many  countries  to  cope  with  the  COVID-19  curfew.  The  Ministry  of  Finance  of  Saudi  Arabia  has  supported  the  private  sectors  and  individuals  who  lost  their  income  by  funding  during  COVID-19  crisis (81)   as  well  as  Canada  and  some  countries (82, 83).  A  recent  study  in  Saudi  Arabia  revealed  that  approximately  52 %  of  employed  study  participants  who  might  usually  not  have  adequate  free  time  to  cook  demonstrated  changes  in  their  eating  habits  due  to  having  more  time  to  cook (84).  Nevertheless, increased  prevalence  of  food  insecurity  due  to  COVID-19  pandemic  lockdown  among  negatively  affected  individuals  was  demonstrated  despite  this  efforts (85).    The  health  organizations  in  Saudi  Arabia  should  focus  on  the  importance  of  promoting  positive  eating  habits, avoiding  overconsumption  of  foods, and  increasing  physical  activity  during  curfew  for  maintaining  health  and  preventing  body  weight  gain (84)

 ALMughamis  et al  conducted  a  recent  study  in  Kuwait  and  demonstrated  that  41.6 %  of  the  valid  respondents  reported  that  their  body  weight  would  increase, 63.8 %  of  them  felt  anxious  sometimes  during  day, 25.5 %  of  them  always  felt  anxious, and  10.7 %  of  them  never  felt  anxious (86).  More  than  69 %  of  them  revealed  that  their  physical  activity  had  decreased  than  before  and  the  mean  number  of  hours  spent  being  sedentary  at  home  were  9.56 (86).  When  using  the  logistic  regression  model  for  predictors  of  body  weight  increase  among  the  Kuwaitis  in  this  study, the  study  revealed  that  those  respondents  who  reported  eating  unhealthy  diets  were  4.5  times (95 %  Confidential  Interval = 2.45  to  8.23)  more  likely  to  report  an  increase  in body  weight, compared  with  the  respondents  with  diet  changes (86).  Those  respondents  demonstrating  having  anxiety  throughout  the day  were  2.45  times  more  likely  to  have  an  increase  in  body  weight  than  those  who  never  confronting  it (86).  There  was  also  association  of  3.27  times  higher  odds  of  increase  in  body weight  among  respondents  who  consumed  snacks  excessively (> 3  times  per  day)  than  those  who  did  not consume  it, whereas  consuming  moderate  amounts  of  snacks (1-3  times  per  day)  did  not  differ  than    the  respondents  who  never  consumed  snacks  throughout  the  day (86).  Considering  Post-COVID-19  era  in  Kuwait, an  increase  in  body  weight  gain  and  unhealthy  eating  habits  will  be  a  challenge  that  the  Kuwait  government’s  policies  strengthen  health  systems  to  tackle  it (86).  Kuwait  National  Program  for  Healthy  Living (2013-2017)  had  previously  been  developed, therefore, the  authorities  can  develop  a  strategic  plan  to  fight  against  harmful  effects  of  this  pandemic  on  health  originated  from  unhealthy  eating  behaviors, psychological  issues, and  sedentary  lifestyle (86).   

A  recent  study  in  United  Arab  Emirates (UAE)  revealed  that  during  COVID-19  pandemic, the  participants  reported  lost  body  weight  20.9 %, gained  body weight  31.0 %, maintained  body  weight  40.1 %, and  they  did  not  know  their  body  weight  change  7.9 % (87).  The  study  participants  perceived  health  state  during  COVID-19  pandemic  as  the  following : 21.4 %  excellent, 39.7 %  very  good, 28.1 %  good, 10.1 %  fair, and  0.7 %  poor (87).  The  most  common  source  of  information  for  health  and  nutrition  updates  that  the  participants  relied  on  were  69.1 %  and  67.8 %, respectively (86).  The  second  source  of  information  for  health  information  and  nutrition  updates  were  65.4 %  and  48.7 %, respectively (87).  The  study  results  demonstrated  a  significant  increase  in  the  percentage  of  participants  consuming  mostly  homemade  meals  during  COVID-1  pandemic  and  a  significant  decrease  in  those consuming  fast-food (p < 0.001) (87).  Additionally, the  percentage  of  participants  consuming  five  or  more  meals  per  day  increased  from  2.1 %  before  the  COVID-19  pandemic  to  7 %  during  the  COVID-19  pandemic (p < 0.001), whereas  the  percentage  of  participants  consuming  breakfast  increased  from  66 %  to  74.2 % (p < 0.001) (87).  The  percentage  of  those  skipping  meals  reduced  from  64.5 % (mainly  due  to  lack  of  time  before  the  COVID-19  pandemic (62.3 %), 36 %  of  participants  was  lack  of  appetite)  to  46.2 %  during  the  COVID-19  pandemic (p < 0.001) (87).  The  percentage  of  participants  intaking  water  increased  from  24.1 % (consuming  eight  or  more  cups  per  day)  before  the  COVID-19  pandemic  to  27.8 %  during  the  COVID-19  pandemic (p = 0.003) (87).  More  than  half (51.2 %)  of  the  study  participants  did  not  consume  fruits  daily, 46.2 %  of  the  participants  did  not  consume  milk  and  dairy  products  daily, 37 %  of  the  participants  did  not  consume  vegetables  daily, 46.1 %  of  the  participants  consumed  sweets  and  desserts  at  least  once  daily, 37.1 %  of  the  participants  consumed  salty  snacks (nuts, crackers, and  chips)  daily, 86.5 %  of  the  participants  never  consumed  energy  drinks  during  COVID-19  pandemic, 69.2 %  of  the  participants  consumed  tea  or  coffee  at  least  once  daily, and  44.2 %  of  the  participants  never consumed  tea  or  coffee (87).  When  considering  the  physical  activity, 32.1 %  of  the  participants  did  not  engage  in  any  physical  activity  before  the  COVID-19  pandemic, the  percentage  increased  to  38.5 %  during  the  pandemic (p < 0.001) (87).  Interestingly, there  was  significant  association  between  the  reported  change  in body  weight  and  the  frequency  of  performing  physical  activity  among  the  participants  during  COVID-19  pandemic (p < 0.001) (87)

There  was  notification  of  a  significant  higher  percentage (47.6 %)  of  study  participants  spent  more  than  five  hours  per  day  on  the  computer for  work  or  study  compared  to  before  the  pandemic (32 %) (p < 0.001), and  spent  more  than  five  hours  on  screens  for  fun  increased  from  12.9 %  of  the  participants  before  the  city  lockdown  to  36.2 %  of  the  participants  during  the  lockdown (p < 0.001) (87).  The  study  results  also  demonstrated  a  significant  increase  in  the  percentage  of  the  participants  of  the  all  four  stress  parameters (physical  exhaustion, emotional  exhaustion, irritability, and  tension)  “ all  the  time  ”  during  the  COVID-19  pandemic  compared  to  before  the  pandemic : 13.3 %  versus  7.7 %  for  physical  exhaustion; 14.1 %  versus  6.3 %  for  emotional  exhaustion; 13.5 %  versus  6.9 %  for  irritability; and  17.8 %  versus  6.3 %  for  tension (all  p < 0.001) (87).  When  considering  the  poor  sleep  quality  during  the  COVID-19  pandemic  and  before  the  pandemic, the  results  demonstrated  a  significant  decrease  in  the  sleeping  hour  that  was  less  than  seven  hours  per  night  from  51.7 %  of  the  participants  to  39 %  of  the  participants  during  COVID-19  pandemic (p < 0.001), 28.1 %  of  the  participants  increase  in  poor  sleep  quality  compared  to  17.3 %  of  the  participants  before  the  pandemic, 60.8 %  of  the  participants  demonstrated  sleep  disturbance  compared  to  52.9 %  of  the  participants  before  the  pandemic, and  30.9 %  of  them  felt  lazy  and  less  energized  during  the  COVID-19  pandemic, compared  to  4.7 %  of  the  participants  before  the  pandemic (p < 0.001) (87).  More  male  reported  significantly  reduced  engagement  in  physical  activity (50 %  versus  39.3 %; p = 0.013)  and  increased  screen  time (54.5 %  versus  51 %; p =0.002) (87).  Female  participants  demonstrated  significantly  higher  sleep  disturbances (p = 0.011) (87).  Weight  gain  and  an  increase  in  the number  of  meals  consumed  daily  were  reported (p = 0.042  and  p = 0.024, respectively) (87).  Participants  aged  18-35  were  mostly  affected  in  sleep  duration  and  quality (p < 0.001) (87).  Association  between  lifestyle  changes  and  difference  of  the  education  levels  was  not  demonstrated (87).  The  realized  Mediterranean  diet  is  benefit  as  an anti-inflammatory  dietary  pattern  that  emphasizes  on   low  consumption  of  red  meat  and  dairy, moderate  consumption  of  monounsaturated  fat  source  such  as  olive  oil, and  high  consumption  of  plant  foods  that  associate  with  increased  immunity, and  lower  risk  of  inflammation  and  chronic  diseases (88-91), in  addition  to  having  a  lower  environmental  impact  than  the  characteristic  Western  diet  and  a  favorable  effect  on  chronically  inflammatory  diseases, such  as  type 2  diabetes  mellitus, metabolic  syndrome, and  visceral  obesity (92-97).  Several  previous  studies  indicated  a  transformation  of  the  diet  in  Eastern  Mediterranean  countries  from a  traditional  Mediterranean  diet  to  a  more  Westernized  diet  that  is  low  in  fruits, vegetables, fiber, and  polyunsaturated  fat  and  high  in  refined  carbohydrate, salt, cholesterol, saturated  fat, and  energy (98-101).  Thus, current  UAE  dietary  behaviors  may  be  ineffective  against  the  SARS-CoV-2 (COVID-19), whereas  it  was  questionable  that  these  dietary  patterns  were  due  to  city  lockdown  following  the  COVID-19  pandemic (102, 103).  By  considering  an  adequate  supply  of  macro-  and  micro-nutrients  are  necessary  for  optimal  immune  function  and  response  can  be  detrimental  implications (102, 103).  For  delivering  mental  health  service, the use  of  telehealth  has  been  demonstrated  to  be  useful  in  providing  support  to  the  patients (104).  An  increased  compliance  with  the  Mediterranean  diet  can  be  associated  with  better  sleep, higher  scoring  for  self-perceived  health  status, and  lesser  mental  distress (105-107), in  addition  to  having  a  protective  effect  on  the  risk  of  cardiovascular  diseases  and  some  types  of  malignancies (96, 108).

In  Zimbabwe, there  were  crucial  policy  implications  for  the  national  government  centred  around  the  need  to  stop  the  COVID-19  spread  using  city  lockdowns, in addition  to  the  glaring  need  to  deal  with  negative  impacts  of  such  policy  decisions  on  food  security  and  livelihood  that  were  greatly  affected  due  to  mobility  restrictions (109).  Naja  and  Hamadeh  provided  the  recommendations  the  government  of  Zimbabwe  on  how  to  provide  nutrition demands  during  COVID-19  pandemic  by  using  a  multilevel  framework  for  action  adapted  from  the  ecological  model  of  health  behavior (110).  The  government  of  Zimbabwe  was  also  encouraged  to  produce  evidence  and  informed  decisions  for  ensuring  responsible  lockdown  exit  strategies (109).  A  previous  study  in  Zimbabwe  demonstrated  that  there  was  decrease  in  immunizations  and  growth  monitoring (37.8 %), access  to  medical  doctors (58.6 %), and  access  to  drugs (59.9 %)  during  the  COVID-19-city-lockdown  period, (109), in  addition  to  disruptions  in  drug-  and  vaccine- supply  chains-associated  with  defaulters  on  immunization  schedules  among  children (111).

A recent study....


Movement  restrictions  both  national  and  international  contributed  to  challenges, including  consumers’  changes  in  demand.  These  restrictions  caused  consumers  prepared  cooking  at  their  home, in  addition  to  preventing  them  from  getting  COVID-19  infection  at  the  stores, restaurants, markets, and  supermarkets.   

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