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 (March 9 -May 3 2020). DESIGN: Retrospective observational study. SETTING: Italy. PARTICIPANTS: We analysed 2,992 subjects (mean age 57.9±15.3 y, 40.4% men). Individual participant data were pooled from 2 retrospective cohorts: 1) The Moli-LOCK cohort consists of 1,501 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; 2) the ALT RISCOVID-19 is a web-based survey of 1,491 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 19 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 s=-1.94; 95%CI: -2.72,-1.17 for individuals aged >75 y as compared to 18-39 y) as did individuals from southern Italian regions as compared to Northern inhabitants (s=-1.32; -1.80,-0.84), while UPF lowering associated with increased exercise (s=-0.90; -1.46,-0.35) and weight loss (s=-1.05; -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.