Social Inequalities in Changes in Diet in Adolescents during Confinement Due to COVID-19 in Spain: The DESKcohort Project

Abstract

Adolescence is a critical period in the consolidation of healthy lifestyles that can last into adulthood. To analyze changes in food consumption and eating behaviors in high-school adolescents during the first confinement, a cross-sectional study was conducted at the end of confinement in Spain. Changes in the frequency or quantity of consumption of different types of food and food-related behaviors were analyzed. Socioeconomic and health-related variables were also considered. To determine whether dietary changes were related to socioeconomic position (SEP), Poisson regression models with robust variance were estimated. Overall, there were some changes towards a healthier diet such as an increase in fruit consumption (38.9%) and a decrease in the consumption of soft drinks (49.8%), sweets and pastries (39.3%), and convenience foods (49.2%). Some changes, however, were related to less healthy behaviors, such as a more irregular pattern of meal distribution (39.9%) or an increase in snacking between meals (56.4%). Changes towards less healthy eating were also related to students' SEP. The risk of worsening the diet was found to be 21% higher in adolescents from a more disadvantaged SEP. Future public policies could be adapted to avoid increasing nutritional and health inequalities.

Keywords: COVID-19; adolescent; food habits; social inequalities; socioeconomic position.

Figure 1

Changes in food consumption and eating behavior among high-school students in Central Catalonia during the confinement due to the COVID-19 pandemic. (a) Changes in girls; (b) Changes in boys.

Figure 2

Relationship between less healthy eating variables during the COVID-19 confinement and a more disadvantaged socioeconomic position of the high-school students from Central Catalonia. Perceived socioeconomic position has been considered as a dichotomous variable: the most disadvantaged tertile versus the medium and more advantaged tertiles. Prevalence ratio has been adjusted by sex, age, and self-perceived health status. Abbreviations: PR: Prevalence Ratio; SEP: Socioeconomic Position; IV: Independent Variable; I²: I-squared (proportion of total variation in effect estimate due to between-study heterogeneity).