Changes of Exercise, Screen Time, Fast Food Consumption, Alcohol, and Cigarette Smoking during the COVID-19 Pandemic among Adults in the United States

Abstract

Objective: To investigate the impact of the COVID-19 pandemic on multiple lifestyle changes among adults in the United States (USA).

Methods: We conducted a survey, the Health, Ethnicity, and Pandemic (HEAP) Study, in October 2020 among USA adults. Participants were selected from the United States using 48 sampling strata, including age, race, ethnicity, education, and gender, and were asked to report five lifestyle behaviors (i.e., exercise time, screen time, fast-food meal consumption, alcohol drinking, and cigarette smoking) before and during the COVID-19 pandemic. The associations of sociodemographic factors with each lifestyle change were estimated using weighted multivariable logistic regression models.

Results: All 2709 HEAP participants were included in this study. Compared to pre-pandemic, the time spent on exercise decreased (32.06 vs. 38.65 min/day; p < 0.001) and screen time increased (6.79 vs. 5.06 h/day; p < 0.001) during the pandemic. The percentage of individuals who reported consuming fast-food meals ≥3 times/week decreased from 37.7% before the pandemic to 33.3% during the pandemic. The percentage of heavy drinkers (≥5 times/week) increased from 20.9% before the pandemic to 25.7% during the pandemic. Among smokers, heavy smoking (≥11 cigarettes/day) increased from 5.8% before the pandemic to 7.9% during the pandemic. We also identified subgroups who were more vulnerable to adverse influences from the pandemic, including racial/ethnic minority groups and young adults.

Conclusions: The COVID-19 pandemic had negative impacts on multiple lifestyle behaviors among Americans. Mitigating such negative impacts of COVID-19 requires effective interventions, particularly for some vulnerable subgroups.

Keywords: COVID-19; alcohol; exercise; fast food; lifestyles; screen time; smoking.

Figure 1

AmeriSpeak Panel Recruitment Methodology-Participants Selection Flowchart: The NORC national frame is an area probability sample of 3 million households based on the USA Postal Service Sequence File (covers approximately 97% of USA households) [16]. Abbreviations: NORC: National Opinion Research Center.

Figure 2

Bar chart for percentage (%) of undesired changes in 5 lifestyle behaviors during the COVID-19 pandemic. Changes in lifestyle behaviors were calculated (during pandemic–before pandemic) and categorized as “desired change” or “undesired change” for each behavior. The “undesired change” category refers to decreased exercise, increased screen time, increased numbers of fast-food meals, increased cigarettes smoking, or increased alcohol drinking during the pandemic as compared with before the pandemic, respectively, for each behavior.