O0001: An Investigation of the Associations Between COVID-19, Adolescent Obesity, and Ultra-processed Food Intake

Background: A 10% increase in ultra-processed food in the diet is associated with an increased risk of visceral obesity (OR 1.07, 95% CI 1.02 to 1.13) and abdominal obesity (OR 1.07, 95% CI 1.01 to 1.13) (Neri, 2022). Processed foods now make up 67% of adolescents' diets (Wang et al., 2021), making it critical to understand how COVID-19 is impacting dietary choices and consumption of ultra-processed foods among adolescents and young adults.

Methods: This study reports findings from the Processed Intake Evaluation (PIE) study enrolling 1800 participants aged 13-19 years in the U.S. We present the interim analysis for the first 452 participants in the PIE study. Dietary intake of ultra-processed food was examined (1) before COVID-19 restrictions, (2) during COVID-19 restrictions, and (3) after easing COVID-19 restrictions in 2022. Additionally, we collected data on personality domains using the Big-5 Inventory (Rammstedt, 2007).

Results: The participants' mean age was 16.6±1.1 years, with 53% females. The processed food intake evaluation (PIE) decreased from 56.2 (before COVID-19) to 52.6 (during COVID-19 restrictions) to 48.1 (after COVID-19 restrictions eased). COVID-19 impact on reducing processed food intake did not significantly differ between genders. A larger impact of COVID-19 on reducing processed food intake was observed for participants whose parents worked remotely at home during COVID (-7.1 vs. -2.5, p< 0.01), if the participant did not drive independently (-6.9 vs. -1.9, p< 0.01), and if the participant was not affected by obesity at baseline (-7.4 vs. -1.6, p< 0.01). Next, we collected data on family factors. Participants with either no sibling or one sibling experienced a greater reduction in processed foods intake (-11.5 vs. -2.9, p< 0.01). The impact was also greater for participants who were proficient in cooking and able to prepare full meals without a recipe (-10.4 vs. -3.4, p< 0.01). Next, we collected data on personality domains. There was no significant difference in the impact of COVID-19 on reducing processed food intake for participants with high extraversion, agreeableness, conscientiousness, and neuroticism personalities; however, the impact in reducing processed food intake was significantly higher for participants with a high openness personality (-9.9 vs. -2.5, p< 0.01).

Conclusion: A significant reduction in food consumption of ultra-processed food was seen in this study among adolescents during the COVID-19 pandemic. Further, the decrease has been sustainable and continuing its downward slope even after easing pandemic restrictions. The final analysis of 1800 participants will confirm this decreasing trend; however, these interim results suggest that further research into COVID's impact on reducing ultra-processed foods may be warranted and presents an opportunity window to strengthen nutrition interventions targeting adolescents and young adults that reduce obesity-related risk factors.