Changes in Lifestyle and Culinary Habits in the Context of the Covid-19 Pandemic in Romania

GRIGORE Nicoleta Diana1, MITITELU Magdalena1*, CHIȚU Florentina Roxana1, UDEANU Denisa Ioana1, HÎNCU Lucian2, NEACȘU Sorinel Marius1

1Clinical Laboratory and Food Safety Department, Faculty of Pharmacy, ”Carol Davila” University of Medicine and Pharmacy, 6, Traian Vuia Street, 020956, Bucharest (ROMANIA)

2Pharmaceutical Industry, Faculty of Pharmacy, ”Carol Davila” University of Medicine and Pharmacy, 6, Traian Vuia Street, 020956, Bucharest (ROMANIA)

*corresponding author: magdamititelu@yahoo.com 

Abstract

     Covid-19 is a severe acute respiratory condition caused by a newly discovered coronavirus, SARS CoV-2. This coronavirus was identified in Wuhan, Hubei Province in China, after people in this region developed a type of pneumonia without a clear cause and for which existing vaccines or treatments were not effective. The first cases were reported in early December 2019 and are believed to have been transmitted from animals to humans, the main site of contamination being the Wuhan Seafood Market where a variety of types of meat and wildlife organs were traded such as: fish, chickens, pheasants, bats, marmots, venomous snakes, deer, etc. [1,2].

     SARS-CoV-2 is a virus that is spread primarily by contact with an infected person, by inhalation of particles from coughing, sneezing, saliva droplets, nasal secretions and the risk of transmission is increased if the distance between two people is less than 1.5 m, and the time spent together in an unventilated space exceeds 15 minutes. The incubation period for SARS-CoV-2 is a minimum of 5 and a maximum of 10 days, but generally 6-7 days [2,3].

     Eating habits and changing lifestyle can threaten people’s health, so maintaining a proper nutritional status is crucial, especially at a time when the immune system may need to be activated and combat the effects of SARS-CoV-2 infection.

Keywards: SARS-CoV-2, Covid-19, culinary habits, lifestyle

Introduction

     The virus that causes COVID-19 is transmitted mainly by respiratory droplets, which are spread when an infected person coughs, sneezes or exhales. These drops are too heavy to remain in the air and are deposited on objects or surfaces that become sources of subsequent contamination of the population. COVID-19 affects people in different ways, most infected people can develop a mild to moderate form of the disease and recover without hospitalization. The incubation period of the new coronavirus is about two weeks and among the most common symptoms reported are: fever, dry cough, fatigue and difficulty breathing. Other symptoms reported are: headache and muscle aches, sore throat, diarrhea, conjunctivitis, headache, loss of taste or smell, skin irritation or discoloration of the fingers or toes [2,3,4].

     The main diseases with risk factors for the development of complications are diabetes, cardiovascular diseases, hypertension, respiratory diseases and diseases for which immunosuppressive treatments are followed. In general, the elderly and people with comorbidities are more affected and at risk than the rest of the population. The virus showed evidence of human-to-human transmission, and the rate of infection transmission has increased significantly since the first half of January 2020, both as a result of the growing number of infections reported by China and the number of cases reported worldwide [3,4].

    On January 30, 2020, the World Health Organization declared the new coronavirus reported in Wuhan as a global health hazard and on March 11, 2020, the outbreak triggered by the new coronavirus was declared a pandemic. The World Health Organization has developed a set of general recommendations to prevent the spread of the new coronavirus: avoid contact with people suffering from respiratory infections, rigorous hand hygiene before touching the face, wearing protective masks, distance from people with symptoms specific to respiratory infections [3,4].

     The first case of coronavirus in Romania was confirmed on February 26, 2020, and on March 16, 2020, a state of emergency was declared in Romania to prevent the mass spread of the new coronavirus [5].

      In Romania, the declaration of the pandemic situation and the preventive measures imposed by the authorities were slightly delayed compared to other European countries in which there was an exacerbated and advanced evolution of cases of infection with the new coronavirus.

Food of the Romanian population during the COVID-19 pandemic

     Although the state of emergency was declared in Romania later than in other states affected by the new coronavirus, the necessary measures were taken shortly after the identification of the first case of SARS-CoV-2 infection. These measures, by drastically reducing any form of socialization, have led to a radical change in the habits and lifestyle of the population [5].

      Physical distance and isolation have severely affected the lives of citizens, changing eating habits and daily behaviour. At first there was a state of panic that caused the population to storm the food stores to stock up on food and products needed for daily living, thus causing an artificial increase in consumption by achieving larger stocks than the usual need for a normal family. Products with higher validity were purchased with predilection, from the category of basic foods such as oil, corn, flour, beans, sugar in large quantities that far exceeded the usual requirements. Unfortunately, they were purchased in large quantities and products from food groups with low nutritional value and high caloric intake such as preserves, pastries, sweets, chips, snacks, etc. Overstocking of food has led to an increased consumption of food in general, especially products at risk of spoilage, which has generated a caloric imbalance in the consumer body due to reduced physical activity during the state of emergency. Many inactive people complained that during the state of emergency they took weight [6].

     According to a study conducted in April (April 3-9, 2020) by Unlock Research for Adama Agricultural Solutions, whose main purpose was to measure the eating behaviour of Romanians in the context of the COVID-19 pandemic, it turned out that Romanians bought more than before the onset of the emergency food in the category of fresh fruit and vegetables [7]. During this period, the Romanians also bought frozen products, preserves, but also basic products (flour, oil, corn), bottled water and soft drinks. On the other hand, ready-made food, alcohol or snacks, as well as bakery products and sausages were purchased during this period in smaller quantities than before the pandemic.

     The study also highlighted other changes in the behaviour of the population during this period, a large part of consumers paid more attention to hygiene rules and washed fruits and vegetables more carefully than before and disinfected product packaging after purchase.

     The population has changed the way it has shopped and the place where it has purchased various food products. Due to the limitations imposed by the pandemic situation, the population turned to modern trade channels, namely hypermarkets, discount stores and supermarkets, online trade to the detriment of agri-food markets, which, although offering the possibility to purchase fresh products, inspired a relatively low level. reliable due to poor hygiene and congestion / contact with many people.

    At the same time, it was observed that there were changes in the frequency of food purchases, which decreased significantly due to the restrictions imposed by the authorities. Before the pandemic, food purchases were often made several times a week, and in the pandemic, in order to limit contact and the possibility of infection, respectively transmission and spread of the virus, the population reduced the frequency of food purchases once a week. or less often. Instead, young people (18-24 years old) are the social category in which the volume of shopping has increased the most due to the fact that they have focused mainly on online shopping. The study was conducted on a sample of 600 people, mostly from urban areas, with a margin of error of +/- 4% [7].

     Changes in people’s behaviour related to social and work habits as well as those related to food and acquisitions made during the COVID-19 pandemic have been reported in various European and global countries.

     POLITICO EU sales data show that in the first weeks of March, people living in Italy, France and the United Kingdom dramatically increased their food spending and stopped buying certain foods considered specialties. The population spent more in supermarkets than before the crisis, after the closure of restaurants, and began to make stocks. In the first week of March, sales of hygiene, health care and packaged foods increased in all three countries. While general sales are rising, sales of certain products are declining, with sales of cosmetics falling in France and Italy, while less spending is being spent on products classified as general purpose goods in the United Kingdom and Italy [8].

     In the first week of March 2020 compared to the same week in 2019, Italians spent the most on alcohol, napkins, pharmaceuticals, protective gloves and fruit. In France, the population stocked itself primarily with pharmaceutical accessories (eg. thermometers), followed by soap, household gloves, poultry sausages, pasta and rice. In the United Kingdom, the best-selling products were cleaning products, followed by personal care products, facial wipes, toilet paper, canned meat and vitamin supplements [8,9]. Sales of alcoholic beverages fell by about 4% in France where in the first week of March compared to the same period in 2019. Italians bought less champagne (about 53%), but bought more beer, in Romania sales of beverages alcohol consumption increased a lot during the Easter holidays and especially for beer and wine to the detriment of hygiene products [8,9,10]. Also due to panic and the fact that measures were announced that restricted free movement, pharmacies were assaulted in order to ensure a stock of medicines for chronic diseases as well as protection products (masks, gloves, disinfectant solutions), but also with drugs that could be used in the treatment of specific symptoms in the infection with the new coronavirus (vitamin C, D supplements, products for the treatment of cold symptoms in the category of antipyretics, analgesics, anti-inflammatory, tablets for sore throat and cough) [8,9].

     There were two major influences on the one hand the restriction of free movement imposed the state at home of a large part of the population (children, households, unemployed, elderly), distance education, working from home, limiting physical activities in the open air and in the gym. sports and on the other hand the provision of large stocks of food products due to the psychological effects generated by the pandemic. These two influences have led to major lifestyle changes for the vast majority of the population of the affected states, as well as nutritional and energy imbalances.

     For the social categories whose incomes were not significantly affected by the economic crisis generated by the COVID-19 pandemic and with a high educational level, food consumption in the pandemic and post-pandemic period focused mainly on foods with high nutritional value (fruits and vegetables fresh, natural juices). Unfortunately, a large part of the population in Romania and especially in the social categories with affected incomes and a low educational level has undergone a series of negative changes in terms of eating habits.

     Thus, about 85% of Romanians bought only products that cover their basic needs, related to survival, safety and health, since the decree of the state of emergency, according to a study conducted by Aegon Romania in the first half of April [11].

     The interruption of the daily routine caused by quarantine determined that a large part of the population achieves a higher caloric consumption due to the tendency to “nibble” something, due to the lack of diversified activities. In addition to the lack of intense physical activity and the restriction of freedom of movement, the multitude of information in the media about COVID-19 as well as the fear of the unknown have exerted an additional erasure on the population, which has led to overeating through the consumption of comfortable foods rich in sugars. Consumption of foods rich in simple carbohydrates can reduce stress by stimulating the secretion of serotonin, which helps to improve mood [12,13,14].

     Moreover, people’s psychological and emotional response to the Covid-19 pandemic can cause dysfunctional eating disorders, as shown by many health professionals. It is well known that negative emotions can lead to exacerbated reactions such as “emotional eating”. To counteract the negative effects of self-isolation, many people have been more likely to be rewarded and satisfied with food consumption, not paying attention to other signs of satiety and hunger [15,16].

     In addition, the state of boredom that occurs during isolation is associated with the tendency to overeat as a means of getting rid of monotony. On the other hand, negative experiences can lead to dietary restrictions due to physiological stress reactions that mimic the internal sensations associated with induced satiety [17]. Lifestyle can be substantially altered due to the isolation measures imposed determine a sedentary behaviour of the population and the change of certain habits such as smoking, alcohol consumption and prolonged sleep. The quarantine imposed by the COVID-19 pandemic, the fact that people are forced to spend more time together with the tendency to increase alcohol consumption has shown, in most countries, an increase in cases of domestic violence. Various clinical studies have reported an association between sleep disorders and obesity due to increased secretion of pro-inflammatory cytokines by visceral adipose tissue that could contribute to altered sleep-wake rhythm [18].

     In addition, the diet seems to influence the quality of sleep, a fact recently revealed in a cross-sectional study that included 172 older adults where it was reported that people who did not have a sleep quality alert had a greater adherence to the Mediterranean diet (MD) and a lower body mass index compared to people with sleep disorders [19,20,21]. During the state of emergency when travel outside the home was limited and the possibility of various physical activities was reduced, to compensate for these limitations people tended to satisfy a number of culinary attractions (cravings for sweets, chips, chocolate, etc.) which led to energy imbalances, which led to weight gain. Low levels of physical activity promote both body fat gain and appetite disorder. People with severe obesity (BMI ≥ 40 kg / m 2) are one of the groups most at risk of developing complications from SARS-CoV-2 infection [22,23,24,25].

    A positive aspect of the crisis caused by the COVID-19 pandemic is the fact that during the pandemic and post-pandemic period, the Romanian population consumed more food cooked at home.

    Eating habits and changing lifestyle can threaten people’s health, so maintaining a proper nutritional status is crucial, especially at a time when the immune system may need to be activated and combat the effects of SARS-CoV-2 infection. Limited access to fresh food can influence maintaining a healthy lifestyle and can lead to increased consumption of processed foods, rich in fats, sugars and salt that can have a negative impact on health.

     Specialists from the World Health Organization have developed a guide with a set of recommendations on feeding the population to maintain adequate nutrition during the period of isolation and quarantine in which the population is recommended to buy especially foods suitable for a healthy diet, foods rich in valuable nutrients (eg various fresh vegetables and fruits), avoid as much as possible refined foods (hydrogenated fats, sugar, alcohol), hydrate properly and the size of food portions should be appropriate to the body’s energy needs [26].

Conclusions

    Therefore, during the pandemic, a balanced diet and a proper state of hydration are vital and contribute to maintaining a stronger immune system and a lower risk of developing chronic and infectious diseases.

     According to the WHO recommendations, a balanced diet can be achieved through a daily consumption of various fresh, unprocessed foods that bring an intake of vitamins, minerals, fiber and antioxidants that help strengthen the immune system. Water consumption is also important, and sugar, fat and salt should be avoided to significantly reduce the risk of obesity, cardiovascular disease, stroke, diabetes and certain cancers.

      Regarding the eating behaviour of the Romanian population during the pandemic, there are two important aspects: especially the social group with high level of culture and sufficient income for a decent living that was aware of the need to purchase and consume especially healthy foods and nutritionists and the predominant social group unfortunately, especially with low financial incomes or affected by the pandemic and possibly with a lower level of culture that during the pandemic period consumed mainly foods with low nutritional value which often led to a deterioration in the quality of health.

REFERENCES

  1. Lau, S.K., Luk, H.K., Wong, A.C., Li, K.S., Zhu, L., He, Z., et al. (April 2020). Possible Bat Origin of Severe Acute Respiratory Syndrome Coronavirus 2. Emerging Infectious Diseases. U.S. Centers for Disease Control and Prevention (CDC). 26 (7): 1542–1547
  2. Lau, H., Khosrawipour, V., Kocbach, P., Mikolajczyk, A., Ichii, H., Schubert, J., et al. (March 2020). Internationally lost COVID-19 cases. Journal of Microbiology, Immunology, and Infection [Wei Mian Yu Gan Ran Za Zhi]. 53 (3): 454–458
  3. Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., et al. (February 2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 395 (10223): 497–506
  4. Velavan, T.P., Meyer, C.G. (March 2020). The COVID-19 epidemic. Tropical Medicine & International Health. 25 (3): 278–280
  5. Decret al Președintelui României nr. 195/16 Martie 2020 privind instituirea stării de urgență pe teritoriul României, intrare în vigoare la data de 16 martie 2020 data publicării în MO nr. 212, partea I, 17 Mar 2020
  6. Yuen, K. F., Wang, X., Ma, F., Li, Kevin, X. (2020). The psychological causes of panic buying following a health crisis. International Journal of Environmental Research and Public Health. 17 (10): 3513
  7. https://www.retail-fmcg.ro/servicii/studii-de-piata-servicii/studiu-unlock-research.html
  8. https://www.politico.eu/article/coronavirus-what-europe-is-and-isnt-eating-during-quarantine
  9. https://www.politico.eu/wp-content/uploads/2020/03/IRI-Consumer-Spending-Tracker-in-Italy-France-UK-USA-11.pdf
  10. https://www.economica.net/magazinele-renunta-la-promotii_185102.html
  11. https://www.bursa.ro/studiu-aegon-romania
  12. Moynihan, A.B., van Tilburg, W.A.P., Igou, E.R., Wisman, A., Donnelly, A.E., Mulcaire, J.B. (2015). Eaten up by boredom: consuming food to escape awareness of the bored self. Front Psychol;6:369
  13. Yılmaz, C., Gökmen, V. (2020). Neuroactive compounds in foods: occurrence,mechanism and potential health effects. Food Res.;128:108744
  14. Ma, Y., Ratnasabapathy, R., Gardiner, J. (2017). Carbohydrate craving: not everything is sweet. Curr Opin Clin Nutr Metab Care.;20:261–5
  15. Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C.S., et al. (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health.;17:1729
  16. Montemurro, N. (2020). The emotional impact of COVID-19: from medical staffto common people. Brain Behav Immun.. https ://doi.org/10.1016/j.bbi.2020.03.032
  17. Crockett, A.C., Myhre, S.K., Rokke, P.D. (2015). Boredom proneness and emotion regulation predict emotional eating. J Health Psychol.;20:670–80
  18. Muscogiuri, G., Barrea, L., Annunziata, G., Di Somma, C., Laudisio, D., Colao, A.,et al. (2019). Obesity and sleep disturbance: the chicken or the egg? Crit Rev Food Sci Nutr.;59:2158–65
  19. Ioniță, A. C., Mititelu, M., Nicolescu, T. O., Nicolescu, F., Moroșan, E., Ozon, E. A., Ioniță, E. I., (2020). Research on the Hypolipidemic Action of Almond Oil and Almond Seeds, Proceedings of 6 th International Conference on Interdisciplinary Management of Diabetes Mellitus and its Complications INTERDIAB (Bucharest, Romania, 5-7 March 2020), Filodiritto Editore – Proceedings, pp. 326-331
  20. Mititelu, M., Nicolescu, T. O., Moroșan, E., Pop, A. L., Nicolescu, F. (2020). Study of Hypolipemiant Activity of Some Mussel Extracts. Proceedings of 6 th International Conference on Interdisciplinary Management of Diabetes Mellitus and its Complications INTERDIAB (Bucharest, Romania, 5-7 March 2020), Filodiritto Editore – Proceedings, pp. 338-343
  21. Mititelu, M., Nicolescu, T. O., Udeanu, D. I., Nicolescu, F. (2020). Research on the Influence of Some Sweeteners on Body Weight and Blood Glucose in Laboratory Mice. Proceedings of 6 th International Conference on Interdisciplinary Management of Diabetes Mellitus and its Complications INTERDIAB (Bucharest, Romania, 5-7 March 2020), Filodiritto Editore – Proceedings, pp. 332-337
  22. Ioniță, A. C., Nicolescu, T. O., Ioniţă, E. I., Nicolescu, F., Mititelu, M. (2020). Chemical-Toxicological Research on the Evaluation of Serum Malondialdehyde Levels in Patients with Diabetic Arteriopathy. Proceedings of 6 th International Conference on Interdisciplinary Management of Diabetes Mellitus and its Complications INTERDIAB (Bucharest, Romania, 5-7 March 2020), Filodiritto Editore – Proceedings, pp. 320-325
  23. Ghica, M., Băncescu, I., Udeanu, D. I., Tăerel, A., Arsene, A. L., Anuța, V., Velescu, B. Șt., Gerghiceanu, F., Mititelu, M., Ioniță, A. C. (2020). Computational Approach for Small Data in Animal Models with Induced Metabolic Disorders, Proceedings of 6 th International Conference on Interdisciplinary Management of Diabetes Mellitus and its Complications INTERDIAB (Bucharest, Romania, 5-7 March 2020), Filodiritto Editore – Proceedings, pp. 98-106, ISBN 978-88-85813-79-3.
  24. Pugliese, G., Barrea, L., Laudisio, D., Salzano, C., Aprano, S., Colao, A., et al. (2020). Sleep apnea, obesity, and disturbed glucose homeostasis: epidemiologic evidence, biologic insights, and therapeutic strategies. Curr Obes Rep.;9:30–8
  25. Muscogiuri, G., Barrea, L., Aprano, S., Framondi, L., Di Matteo, R., Laudisio, D., et al. (2020). Sleep quality in obesity: does adherence to the mediterranean diet matter? Nutrients.;12:1364
  26. https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/technical-guidance/food-and-nutrition-tips-during-self-quarantine