Evaluation of the relationship between anxiety and nutritional habits in Turkish patients with multiple sclerosis during the Covid-19 outbreak
Palabras clave:
Anxiety, Covid-19 outbreak, Multiple sclerosis, Nutritional habits, Nutritional statusResumen
Objective
The Coronavirus disease 2019 is a global public health problem that has led to psychological disorders (depression, anxiety, etc.), especially in fragile individuals such as those affected by multiple sclerosis. This study investigated the relationship between anxiety and nutritional habits during the Coronavirus disease 2019 outbreak in multiple sclerosis patients.
Methods
This cross-sectional study was an online survey of multiple sclerosis patients living in Turkey. The total sample consisted of 294 multiple sclerosis patients. A questionnaire containing general demographic data, the Beck Anxiety Inventory, and nutritional attitudes and habits was applied to multiple sclerosis patients.
Results
Moderate or severe anxiety scores were found in 42.2% of multiple sclerosis patients. Weight gain was reported in 40.5% of them during the outbreak. A statistically significant difference was found in the distribution of individuals’ Beck Anxiety Inventory scores for consumption of nuts/seeds, rice/pasta, cake/cookies, and water. A 1-unit increase in Beck Anxiety Inventory scores led to a 1.04 times increased consumption of bread and rice/pasta and a 1.05 times increased consumption of cake/cookies either before or after controlling for potential confounders. A 1-unit increase in Beck Anxiety Inventory scores led to a 1.06 times decreased consumption of water and a 1.04 times decreased consumption of meat and poultry, fruit (fresh), and rice/pasta, either before or after controlling for potential confounders.
Conclusion
During the Coronavirus disease 2019 outbreak, anxiety led to changes in multiple sclerosis patients’ nutritional habits and food preferences. The continuous surveillance of psychological consequences and nutritional counseling during outbreaks should become routine as part of preparedness efforts worldwide.
Citas
Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. Int J Environ Res Public Health. 2020;17(5).
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-33.
Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet. 2020;395(10223):470-3.
World Health Organization. Coronavirus Disease (COVID-19) dashboard. Geneve: Organization; 2020 [cited 2021 Sep 22]. Available from: https://covid19.who.int/.
Republic of Turkey Ministry. COVID-19 Information Page. Turkey: Ministry; 2021 [cited 2021 Sep 22]. Available from: https://covid19.saglik.gov.tr/TR-66935/genel-koronavirus-tablosu.html
Brownlee W, Bourdette D, Broadley S, Killestein J, Ciccarelli O. Treating multiple sclerosis and neuromyelitis optica spectrum disorder during the COVID-19 pandemic. Neurology. 2020;24(92):949-52.
Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19): Underlying medical conditions associated with higher risk for severe COVID-19: information for healthcare professionals. DeKalb County: CDC; 2019 [cited 2022 June 15]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/ underlyingconditions.html
Willis MD, Robertson NP. Multiple sclerosis and the risk of infection: considerations in the threat of the novel coronavirus, COVID-19/SARS-CoV-2. J Neurol. 2020;267(5):1567-9.
Parmet WE, Sinha MS. Covid-19: the Law and Limits of Quarantine. N Engl J Med. 2020;382(15):e28.
Wilski M, Gabryelski J, Brola W, Tomasz T. Health-related quality of life in multiple sclerosis: Links to acceptance, coping strategies and disease severity. Disabil Health J. 2019;12(4):608-14.
Meyer J, McDowell C, Lansing J, Brower C, Smith L, Tully M, et al. Changes in physical activity and sedentary behavior in response to COVID-19 and their associations with mental health in 3052 US adults. Int J Environ Res Public Health. 2020;17(18):6469.
Stanton R, To QG, Khalesi S, Williams SL, Alley SJ, Thwaite TL, et al. Depression, Anxiety and Stress during COVID-19: associations with changes in physical activity, sleep, tobacco and alcohol use in Australian adults. Int J Environ Res Public Health. 2020;17(11):4065.
Talevi D, Socci V, Carai M, Carnaghi G, Faleri S, Trebbi E, et al. Mental health outcomes of the CoViD-19 pandemic. Riv Psichiatr. 2020;55(3):137-44.
Vindegaard N, Benros ME. COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain Behav Immun. 2020;89:531-42.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
Patel VP, Walker LA, Feinstein A. Revisiting cognitive reserve and cognition in multiple sclerosis: a closer look at depression. Mult Scler. 2018;24(2):186-95.
Butler E, Matcham F, Chalder T. A systematic review of anxiety amongst people with Multiple Sclerosis. Mult Scler Relat Disord. 2016;10:145-68.
Feinstein A, Magalhaes S, Richard J-F, Audet B, Moore C. The link between multiple sclerosis and depression. Nature Reviews Neurology. 2014;10(9):507.
Naser Moghadasi A. One aspect of Coronavirus disease (COVID-19) outbreak in Iran: high anxiety among MS patients. Mult Scler Relat Disord. 2020;41:e102138.
Stojanov A, Malobabic M, Milosevic V, Stojanov J, Vojinovic S, Stanojevic G, et al. Psychological status of patients with relapsing-remitting multiple sclerosis during coronavirus disease-2019 outbreak. Mult Scler Relat Disord. 2020;45:e102407.
Chiaravalloti ND, Amato MP, Brichetto G, Chataway J, Dalgas U, DeLuca J, et al. The emotional impact of the COVID-19 pandemic on individuals with progressive multiple sclerosis. J Neurol. 2021;268(5):598-607.
Firth J, Gangwisch JE, Borisini A, Wootton RE, Mayer EA. Food and mood: how do diet and nutrition affect mental wellbeing? Bmj. 2020;369:m2382.
Hosker DK, Elkins RM, Potter MP. Promoting mental health and wellness in youth through physical activity, nutrition, and sleep. Child Adolesc Psychiatr Clin N Am. 2019;28(2):171-93.
Lambrinakou S, Katsa ME, Zyga S, Ioannidis A, Sachlas A, Panoutsopoulos G, et al. Correlations between nutrition habits, anxiety and metabolic parameters in Greek healthy adults. Adv Exp Med Biol. 2017;987:23-34.
World Health Organization. Global Database on Body Mass Index: BMI classification. Geneve: Organization; 2004.
Beck AT, Ward C, Mendelson M, Mock J, Erbaugh J. Beck depression inventory (BDI). Arch Gen Psychiatry. 1961;4(6):561-71.
Ulusoy M, Sahin NH, Erkmen H. The Beck anxiety inventory: psychometric properties. J Cogn Psychother. 1998;12(2):163-72.
Çokluk Ö, Şekercioğlu G, Büyüköztürk Ş. Sosyal bilimler için çok değişkenli istatistik: SPSS ve LISREL uygulamaları. Ankara: Pegem Akademi; 2012.
Korostil M, Feinstein A. Anxiety disorders and their clinical correlates in multiple sclerosis patients. Mult Scler. 2007;13(1):67-72.
Talaat F, Ramadan I, Aly S, Hamdy E. Are multiple sclerosis patients and their caregivers more anxious and more committed to following the basic preventive measures during the COVID-19 pandemic? Mult Scler Relat Disord. 2020;46:102580.
Hosseinzadeh M, Vafa M, Esmaillzadeh A, Feizi A, Majdzadeh R, Afshar H, et al. Empirically derived dietary patterns in relation to psychological disorders. Public Health Nutr. 2016;19(2):204-17.
Kaya S, Uzdil Z, Cakiroğlu FP. Evaluation of the effects of fear and anxiety on nutrition during the COVID-19 pandemic in Turkey. Public Health Nutr. 2021;24(2):282-9.
Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods. 2020;9(5):675.
Kalron A, Dolev M, Greenberg-Abrahami M, Menascu S, Frid L, Avrech-Shezifi S, et al. Physical activity behavior in people with multiple sclerosis during the COVID-19 pandemic in Israel: results of an online survey. Mult Scler Relat Disord. 2020;47:e102603.
Błaszczyk-Bębenek E, Jagielski P, Bolesławska I, Jagielska A, Nitsch-Osuch A, Kawalec P. Nutrition behaviors in polish adults before and during COVID-19 lockdown. Nutrients. 2020;12(10):3084.
Ammar A, Brach M, Trabelsi K, Chtourou H, Boukhris O, Masmoudi L, et al. Effects of COVID-19 home confinement on eating behaviour and physical activity: results of the ECLB-COVID19 international online survey. Nutrients. 2020;12(6):1583.
Adams KK, Baker WL, Sobieraj DM. Myth Busters: Dietary Supplements and COVID-19. Ann Pharmacother. 2020;54(8):820-6.
Saghafian F, Malmir H, Saneei P, Keshteli AH, Hosseinzadeh-Attar MJ, Afshar H, et al. Consumption of fruit and vegetables in relation with psychological disorders in Iranian adults. Eur J Nutr. 2018;57(6):2295-306.
Yannakoulia M, Panagiotakos DB, Pitsavos C, Tsetsekou E, Fappa E, Papageorgiou C, et al. Eating habits in relations to anxiety symptoms among apparently healthy adults: a pattern analysis from the ATTICA Study. Appetite. 2008;51(3):519-25.
