Changes in ultra-processed food consumption during the first Italian lockdown following the COVID-19 pandemic and major correlates: Results from two population-based cohorts

Objective: To evaluate changes in ultra-processed food (UPF) intake and its major correlates during the first Italian lockdown (9 March-3 May 2020). Design: Retrospective observational study. Setting: Italy. Participants: We analysed 2992 subjects (mean age 57·9 ± 15·3 years, 40·4 % men). Individual participant data were pooled from two retrospective cohorts: (1) The Moli-LOCK cohort consists of 1501 adults, a portion of the larger Moli-sani study (n 24 325; 2005-2010) who were administered a phone-based questionnaire to assess lifestyles and psychological factors during confinement and (2) the Analysis of Long Term Risk of Covid-19 Emergency is a web-based survey of 1491 individuals distributed throughout Italy who self-responded to the same questionnaire by using Google forms. UPF was defined according to NOVA classification based on degree of food processing. An UPF score was created by assigning 1 point to increased consumption, -1 to decreased and 0 point for unchanged intakes of nineteen food items, with higher values indicating an increase in UPF during confinement. Results: Overall, 37·5 % of the population reported some increase in UPF (UPF score =1). Adults were more likely to decrease UPF (multivariable regression coefficient ß = -1·94; 95 % CI -2·72, -1·17 for individuals aged >75 years as compared with 18-39 years) as did individuals from southern Italian regions as compared with Northern inhabitants (ß = -1·32; 95 % CI -1·80, -0·84), while UPF lowering associated with increased exercise (ß = -0·90; 95 % CI -1·46, -0·35) and weight loss (ß = -1·05; 95 % CI -1·51, -0·59) during confinement. Conclusions: During the first Italian lockdown, about 40 % of our population switched to unfavourable eating as reflected by increased UPF intake and this may have long-term effects for health.