How COVID-19 Has Affected Diet and Mental Health

It’s already well established that excessive or long-term stress may negatively affect mental health (1).

Thus, it’s not surprising that as stress levels rose during the pandemic, mental health simultaneously worsened.

Over the past year, people worldwide have reported increased anxiety, depression, and mood changes (2, 3).

A study including 600 adults found that nearly half of the participants interviewed reported feeling anxious about their food habits, specifically during the pandemic (4).

Another study including over 100,000 men and women found that moderate and severe depression symptoms increased from 6.4% to 8.8% during the pandemic in people under the age of 60 — particularly in young women (5).

Other studies also found that mothers and women, in general, appeared to be particularly susceptible to depression and anxiety during the pandemic (6).

However, research suggests there are also links between mental health and diet and exercise (3, 7, 8, 9).

Some of the changes people noticed in their mental health during quarantine may have been related to changes to their dietary and physical activity habits.

One survey noted that people who reported negative changes to their exercise habits during the pandemic simultaneously reported poorer mental health, while those who had improved exercise habits experienced better mental health (10).

Another survey in adolescents found similar results, observing that those who had better nutrition and moderate exercise during the pandemic reported fewer symptoms of depression and anxiety (11).

SUMMARY

People have reported increased stress, anxiety, depression, and mood disorders since the pandemic began. As mental health is closely related to physical health, diet and physical activity likely had some influence.

Soon after the pandemic began, people began reporting changes in their diet.

Studies have also documented a notable change in eating habits over the past year, though the changes weren’t the same for everyone.

More snacking and pastries

In a study including nearly 8,000 people, 30% of adults reported eating more unhealthy foods than usual during the pandemic (12).

Another study in around 2,500 people found that 45% snacked more than usual during the pandemic, and 50% ate more overall (13).

Although people reported eating out less and cooking at home more than usual, they also ate more pastries and fried foods.

Multiple other studies found similar results — with people eating out less but still consuming more food and snacks overall (14, 15, 16, 17).

That said, not everyone experienced the same changes to their food intake.

Some people noted healthy changes like consuming more servings of fruits and vegetables while eating at home (12, 18, 19, 20).

Food insecurity

In some instances, food choices and eating habits have been influenced by food insecurity during the pandemic (21, 22).

Food insecurity causes negative changes in food intake and dietary patterns due to a lack of financial resources.

A couple of studies noted that people who lost their job, had less work than usual, or experienced sudden changes to their living situation were more likely to report being food insecure during the pandemic (23, 24).

To cope with these changes, some people ate less and purchased cheaper foods than usual (24).

Others reported cutting back on certain food groups that were more expensive, such as meat and animal proteins, while replacing those with more affordable foods (21).

Effects on people with eating disorders

The pandemic also appears to have affected people with eating disorders.

Social distancing guidelines and lockdown restrictions have made it harder for some to access treatment and support (25).

One study surveyed 5,469 people, 180 of whom had a self-reported eating disorder or eating disorder history. It found that those with eating disorders experienced increased restricting, binging, purging, and exercising behaviors during the pandemic.

Interestingly, it found that even people without a history of disordered eating habits experienced higher levels of binging and restrictive eating during the pandemic (26).

While there are many reasons why some people might develop an eating disorder, mental health may have been one predictor that had a large effect during the pandemic (27).

The COVID-19 EAT study surveyed more than 700 young people during the height of the pandemic in 2020 (28).

The results revealed that elevated stress levels and symptoms of depression were significantly associated with a greater chance of experiencing binge eating behavior.

SUMMARY

COVID-19 had numerous effects on our eating habits. People reported eating different foods, eating more or less than usual, and increased struggles with food insecurity and disordered eating.

Surveys from the past year found that people are also reporting changes in their physical activity levels and weight.

Though yet again, the changes experienced haven’t been the same across the board.

Physical activity

Although results vary between groups of people, studies have shown a considerable decrease in physical activity and an increase in sedentary behavior since the start of the pandemic.

While women and university students reported an increase in exercise activities during the coronavirus pandemic, men and young people reported decreased physical activity alongside an increase in sedentary time during lockdown (20, 29, 30, 31, 32).

One survey including over 1,000 people from various countries worldwide found that daily sitting time increased by an average of 5–8 hours each day during lockdown (33).

Another study in adults in Spain reported that the amount of time spent walking each day during the pandemic decreased by 58%, while the amount of time spent sitting increased by 24% (34).

Weight status

Some people also experienced changes in weight over the past year, some of which may have resulted from changes in their usual food choices and physical activity routines.

A few studies found that 30–50% of people surveyed reported gaining weight during the pandemic (13, 35, 36, 37).

One study showed that people who already had excess weight before the pandemic were more likely to report gaining more weight (13).

That said, not everyone gained weight during this time.

In a survey of U.S. citizens, 19% of people reported losing weight, while 43% observed no change to their weight (35).

Furthermore, some studies found that weight gain was linked to specific factors, such as inadequate sleep, snacking after dinner, stress eating, reduced physical activity, and changes in work routines (37, 38).

SUMMARY

Many people noticed changes in their weight during the pandemic. Some people gained weight, while others lost weight. Interruptions to normal physical activity and eating habits likely contributed to the changes.

Though scientists are still uncovering all of the details, recent research studies provide evidence to support a link between diet and mental health (39, 40).

For example, changes in diet might cause subsequent changes in mood (39, 41).

The gut microbiome

The gut microbiome, which is highly influenced by what we eat, influences mood and behavior (39, 41).

Foods that are nutrient-rich and high in fiber, such as fruits and vegetables, increase the number of healthy microbes and improve gut health overall. They may also help protect against depression (40, 42).

On the other hand, highly processed foods tend to have negative effects on brain function and mental health. They’ve also been linked to increased stress and depression (43, 44, 45, 46).

Effects of nutrition counseling

One of the most notable studies on diet and mental health is the 2017 SMILES trial. It was one of the first randomized controlled trials to evaluate how effective dietary counseling by dietitians is as an intervention for depression.

The study measured the effects of nutrition counseling on symptoms of depression, mood, and anxiety levels. The group receiving dietary counseling experienced significantly improved symptoms at the end of the study (47).

A 2020 study compared individual versus group-based nutritional counseling on a number of factors, including some measures of mental health.

The researchers found participants in both groups reported lower levels of anxiety and body dissatisfaction after counseling (48).

The Mediterranean diet

Participants in the SMILES trial were counseled to follow a modified Mediterranean diet (47).

The Mediterranean diet is an eating pattern based on the traditional diets of people in countries like Italy, Greece, and Spain. It’s high in vegetables, fruits, whole grains, seafood, and olive oil and low in red meat, dairy products, and processed foods.

Multiple other studies have also examined how the Mediterranean diet may help reduce the risk of depression (49, 50, 51).

A recent study investigated how a Mediterranean diet with fish oil supplements influenced the mental health of 152 adults with depression. At 3 and 6 months, they noted reduced depression and improved mental health (52).

Healthy unsaturated fats, such as omega-3 fatty acids, are being investigated as one of the specific nutrients in the Mediterranean diet that may help reduce symptoms of depression (53, 54).

Still, research on specific diets and how they affect mental health is new and emerging.

While we know there’s a connection between diet and mental health, more studies are needed to understand the specifics (55).

SUMMARY

Early research on diet and depression has revealed some promising results. Nutrient-rich diets like the Mediterranean diet may help lower the risk of depression in some people.

As lockdown comes to an end and we enter a new phase of the pandemic, you may be looking for ways to get back to some of your previous routines.

Here are 5 tips on how to do so.

1. Envision your new normal

A lot has changed over the past year.

Understandably, things might not ever look the same as they did before the coronavirus pandemic took hold.

Instead of working toward how things used to be, think about how you want your new normal to look.

To envision your new normal, start with a clean slate. Forget about how things used to be, and reset your expectations based on how things are today.

You can do this by focusing on the things in your life that you have control over and can change, rather than those you can’t.

For example, you may not be able to attend your favorite group workout class, but you decide to ask a friend to take a weekly walk with you instead.

2. Set a goal

Once you have a vision of your new normal in mind, consider setting a goal to keep you motivated.

Identifying a specific goal — or even a few small goals — provides something concrete you can work toward.

First, reflect on the specific things you want to change.

Next, be sure to set a goal that is:

• realistic
• actionable
• measurable
• motivating

Finally, try writing your goal down or speaking it aloud to a friend or family member.

This might help your goal feel like something concrete that you’re accountable for.

3. Make a plan

Setting a plan for how you’re going to reach your goals and step into your new normal may be one of the quickest ways to get there.

A plan doesn’t have to be overwhelming or anxiety-provoking.

Rather, it can be a simple set of steps you plan to take to help keep your goals and your new normal in the forefront of your mind.

To make your plan, think about all of the individual steps you’ll need to take to reach your goal.

This might include things like:

• how much time you’ll need each day
• the supplies you’ll need
• any barriers you’ll need to overcome
• how you’ll document your progress

4. Focus on nutrients

If losing weight is part of the new normal you have in mind, resist the urge to focus on numbers like your calorie intake or the number on the scale.

Instead, focus on consuming nutrient-dense foods that have been associated with improved mental health and overall wellness (40).

This includes foods high in nutrients like iron, omega-3 fatty acids, vitamin B12, folate, and zinc (56, 57).

Multiple studies have demonstrated that consuming certain foods while avoiding others can improve the balance of healthy bacteria in the gut, supporting gut and brain health (58, 59, 60, 61).

To get the most of these nutrients, consume a diet high in (62):

• Fruits: apples, bananas, berries, pears, oranges, etc.
• Vegetables: tomatoes, cucumbers, broccoli, leafy greens, peppers, etc.
• Dairy: unsweetened milk and yogurt varieties, cheese, sour cream, etc.
• Whole grains: oats, millet, barley, brown rice, quinoa, etc.
• Healthy fats: fatty fish, avocados, olives, olive oil, etc.

You may want to limit or avoid (63):

• Sweets: hard candy, gummies, pastries, sweetened beverages, etc.
• Refined grains: refined bread, cakes, cookies, etc.
• Processed meats: bacon, cured meat, hot dogs, etc.

If you’re concerned that you’re not getting adequate intakes of certain nutrients, supplementation may be necessary.

For example, many people, including older adults and those on restrictive diets, are more likely to have low levels of vitamin D and B12, which can negatively affect overall health, including mental health (64, 65, 66).

Your healthcare provider can run laboratory tests and suggest supplementation if needed.

5. Take it easy on yourself as you adopt a new routine

Remember, this situation is new for everyone.

Figuring out your new normal may take time and experimentation.

Trust yourself to know what’s best for you on any given day as you aspire to meet your health goals.

As you strive toward your new normal, try:

• being flexible
• having realistic expectations
• practicing self-acceptance
• using positive self-talk and affirmations
• leaning on a support system

SUMMARY

Discovering your new normal post-pandemic may take time and planning. Choosing specific goals to work toward, eating a nutrient-dense diet, and taking things slowly could help to alleviate stress in the process.

All around the world, the coronavirus pandemic took a toll on people’s physical and mental health.

There’s lots of variation in how people were affected, yet one thing remains the same for most — people are ready to regain control of their health habits.

Getting regular exercise and eating a diet that’s rich in healthy nutrients not only has the potential to help with things like weight loss but also might support your mental health in the process.

Ease into your new normal with a few small goals and a plan for how you’re going to achieve them.

Read this article in Spanish.