Influence of nutritional status on eating habits and food choice determinants among Brazilian women during the COVID-19 pandemic

We aimed to evaluate the influence of nutritional status on eating habits and food choice determinants among Brazilian women during the COVID-19 outbreak. This cross-sectional survey was conducted between June and September, 2020, period in which social distancing measures were in place. Participants (n=1,183) were classified as normal weight (60.4%), overweight (26.2%) and obese (13.4%). Eating habits changed during quarantine irrespective of nutritional status. The number of women participating in grocery shopping was reduced by 34% during quarantine (p<0.001, OR=0.55, 0.79), whereas participation in cooking and ordering delivery service increased by 28% (p=0.004, OR=1.08, 1.51) and 146% (p<0.001, OR=2.06, 2.95), respectively. The number of participants reporting the habit of snacking (p=0.005, OR=1.07, 1.43) and eating at the table increased by 24% and 40% (p<0.001, OR=1.20, 1.64). Interestingly, the number of participants reporting the habit of dieting decreased by 41% (p<0.001, OR=0.59 [0.50, 0.70]). During the quarantine, “liking”, “need and hunger”, and “habits” were the most commonly reported determinants of food choice overall. “Health”, “natural concerns” and “need and hunger” were less important determinants for participants with overweight/obesity compared to those with normal weight. Regression models showed that (i) “health”, “natural concerns” and “affect regulation”; (ii) “health”, “pleasure”, “convenience”, and “natural concerns”; and (iii) “visual appeal” and “pleasure” were the food choice determinants more associated with eating habits among women with normal weight, overweight and obesity, respectively. In conclusion, eating habits were influenced during the pandemic despite nutritional status, whereas food choice determinants differed between overweight/obesity and normal weight women. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement B.C.M., F.I.S., G.P.E., A.J.P., and B.G. were supported by Sao Paulo Research Foundation (FAPESP) (grants # 2019/14820-6, # 2019/14819 8, #2020/07860-9, #2015/26937 4, and #2017/13552-2). C.F.N. was supported by National Council for Scientific and Technological Development (CNPq) (grant #402123/2020-4). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study was approved by the Ethics Committee for Research Projects Analysis (CAPPesq) of the University of Sao Paulo, School of Medicine with Certificate of Presentation for Ethical Appreciation (CAAE) under the number 33561720.2.0000.0068 and was conducted in accordance with the Helsinki declaration. All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.