Nguyen Tham T, Nguyen Minh H, Pham Thu T M, Le Vinh-Tuyen T, Nguyen Tan T, Luong Thuc C, Do Binh N, Dao Hung K, Nguyen Huu C, Ha Tung H, Pham Linh V, Nguyen Phuoc B, Nguyen Hoai T T, Do Thinh V, Nguyen Hung Q, Trinh Manh V, Le Thuy T, Tra Anh L, Nguyen Thao T P, Nguyen Kien T, Phan Dung T, Pham Khue M, Bai Chyi-Huey, Duong Tuyen Van
Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Haiphong, Vietnam.
International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Front Nutr. 2021 Nov 12;8:774328. doi: 10.3389/fnut.2021.774328. eCollection 2021.
The COVID-19-induced lockdown has been implemented in many countries, which may cause unfavorable changes in lifestyles and psychological health. People's health literacy, healthy diet, and lifestyles play important roles in mitigating the negative impacts of the pandemic. Therefore, we aimed to examine associations of COVID-19 lockdown with changes in eating behavior, physical activity, and mental health; and the modification effects by digital healthy diet literacy (DDL) and eHealth literacy (eHEALS) on the associations. We conducted an observational study on 4,348 outpatients from 7th April to 31st May 2020. Data from 11 hospitals in Vietnam included demographic characteristics, DDL, eHEALS, eating behavior, physical activity, and mental health changes. Multiple logistic regression and interaction models were performed to examine associations. Patients under lockdown had a lower likelihood of having "unchanged or healthier" eating behavior (odds ratio, OR, 0.38; 95% confidence interval, 95%CI, 0.29 to 0.51; < 0.001), "unchanged or more" physical activity (OR, 0.79; 95% CI, 0.69 to 0.90; < 0.001), and "stable or better" mental health (OR, 0.77; 95% CI, 0.67 to 0.89; < 0.001), as compared to those after lockdown. In interaction models, as compared to patients after lockdown and with the lowest DDL score, those under lockdown and with a one-score increment of DDL had a higher likelihood of having "unchanged or healthier" eating behavior (OR, 1.05; 95% CI, 1.02 to 1.07; < 0.001), and "stable or better" mental health (OR, 1.02; 95% CI, 1.01 to 1.04; < 0.001). Similarly, as compared to patients after lockdown and with the lowest eHEALS score, those under lockdown and with a one-score increment of eHEALS had a higher likelihood of having an "unchanged or more" physical activity (OR, 1.03; 95% CI, 1.01 to 1.05; < 0.001). The COVID-19 lockdown measure could negatively affect eating behavior, physical activity, and mental health among outpatients. Better DDL and eHEALS were found to mitigate the negative impacts of the lockdown, which may empower outpatients to maintain healthy lifestyles and protect mental health. However, this study holds several limitations that may undermine the certainty of reported findings.
许多国家都实施了因新冠疫情而导致的封锁措施，这可能会使人们的生活方式和心理健康出现不利变化。人们的健康素养、健康饮食和生活方式对于减轻疫情的负面影响起着重要作用。因此，我们旨在研究新冠疫情封锁措施与饮食行为、身体活动及心理健康变化之间的关联；以及数字健康饮食素养（DDL）和电子健康素养（eHEALS）对这些关联的调节作用。我们于2020年4月7日至5月31日对4348名门诊患者进行了一项观察性研究。来自越南11家医院的数据包括人口统计学特征、DDL、eHEALS、饮食行为、身体活动及心理健康变化。我们采用多元逻辑回归和交互模型来研究这些关联。与解封后的患者相比，处于封锁状态的患者出现“不变或更健康”饮食行为的可能性更低（优势比，OR，0.38；95%置信区间，95%CI，0.29至0.51；<0.001），出现“不变或更多”身体活动的可能性更低（OR，0.79；95%CI，0.69至0.90；<0.001），以及出现“稳定或更好”心理健康的可能性更低（OR，0.77；95%CI，0.67至0.89；<0.001）。在交互模型中，与解封后且DDL得分最低的患者相比，处于封锁状态且DDL得分增加一分的患者出现“不变或更健康”饮食行为的可能性更高（OR，1.05；95%CI，1.02至1.07；<0.001），以及出现“稳定或更好”心理健康的可能性更高（OR，1.02；95%CI，1.01至1.04；<0.001）。同样，与解封后且eHEALS得分最低的患者相比，处于封锁状态且eHEALS得分增加一分的患者出现“不变或更多”身体活动的可能性更高（OR，1.03；95%CI，1.01至1.05；<0.001）。新冠疫情封锁措施可能会对门诊患者的饮食行为、身体活动和心理健康产生负面影响。研究发现，更好的DDL和eHEALS能够减轻封锁措施的负面影响，这可能使门诊患者有能力维持健康的生活方式并保护心理健康。然而，本研究存在一些局限性，可能会削弱所报告结果的确定性。
