A cross-sectional web-based study was conducted on the Indian population to assess the impact of COVID -19 on mental health, and changes in daily lifestyle such as diet, physical activity, and sleep patterns using a validated questionnaire. Data were collected between August 15, 2020, and October 15, 2020, using the Google Form platform and a telephone survey.

A standardized study invitation message with a link to the online survey was distributed through personal and social networks via email, Facebook, Instagram, and WhatsApp. A total of 772 responses were collected anonymously.

An electronic survey was created on the Google platform. The form was used to collect demographic data, mental health, physical activity, dietary habits, sleep patterns, and changes in BMI before and during the covid lockdown. The differentiated questionnaire was used in this study. The questionnaire consists of four sections that capture socio-demographic information, and lifestyle changes (mental activity, physical activity, dietary habits, and behavioral changes). Participants’ consent was taken through the survey form. 

The data was analyzed using SPSS version 25.0 (IBM SPSS Statistics, Version 25.0, Armonk, NY: IBM Corp.). Qualitative data were expressed in percentages and compared using the chi-square test to examine the impact of COVID-19 on dietary behaviors, physical activity, sleep, sedentary behaviors, and mental health. Qualitative pre and during covid data were tested using McNemar-Bowker Test and Continuous pre and post data tested using a paired-t-test. Determinants of predictors of post covid obesity and stress status were analyzed by multivariate logistic regression analyses, by estimating odds ratios and their 95% confidence intervals. p-value <0.05 was considered statistically significant.

The survey recorded the weight of the subjects at specific time points, i.e., March 2020 and during the lockdown. BMI was calculated using the formula: BMI = weight/(height)². Mean BMI was almost similar in both pre (24.6 ± 5.2 SD) and during COVID (24.8 ± 5.1 SD) phase. 342 participants (44.3%) were obese before covid. There was a marginal increase in the number of participants with BMI > 25 kg/m² during the covid phase (1.73%).

There was a significant association seen between the age group and change in BMI pre and during covid phase (p < 0.001). There was an increase in the BMI of the following age group: 21–30 yrs (N= 320, 53.12%), <20 years (N=110, 56.36%), and 41–50 yrs (N= 176, 34.09%).

There was a significant association seen between the professions and change in BMI pre and during covid phase (p < 0.001). Almost 50 percent of students (N=168, 49.3%), shopkeepers (N=166, 48.2%), service classes (N=164, 46.3%), and homemakers' (N=104, 44.1%) BMI increased during the covid phase.

Predominantly, 59.2 % of participants were vegetarians, while 35.4% were non-vegetarians. A small proportion of participants were lacto-ovo vegetarians (4.9%), and vegans(0.5%).

Change in dietary intake was classified as an increase in intake, marginal increase in intake, no change in intake of food, or reduced drastically or reduced marginally. It was observed that out of 772 participants, 286 participants (37%) had no change in their dietary intake. And 384 participants (49.70%) increased their dietary intake, And 102 participants (13.20%) reduced their food intake during the lockdown period.

There was a significant association seen between dietary intake and change in BMI (p <0.001). Out of 384 participants whose intake increased during the lockdown, 246 participants (66.50%) had an increase in their BMI.

There was a significant change observed in the sleeping pattern when compared pre and during the covid phase (p <0.001). There was a decrease in the percentage of people who slept only at night for 8 hours during covid (82.9% vs 46.3%). The percentage of participants who slept both day and night was more during covid (7.2% vs 23.8%), as seen in (Figure 3)

The present cross-sectional web-based study with a sample size of 772 participants, (51.2% were males and 48.8% were females) was conducted on the Indian population to study the impact of COVID -19 on the dietary pattern, physical activity, mental health, and changes in daily lifestyle using a differentiated questionnaire created in the google form.

The age group of the majority of participants was between 21-30 years and 41-50 years. The majority of internet users in India belong to this age group (21-30) 11. By occupation, the majority of participants belong to the service classes, shopkeepers, students, and work from home. Most of the participants had no history of pre-existing as the majority of participants belong to the age group between en 21-30. Hypertension and diabetes were reported by only a few of the participants. Among all the age groups, maximum increase in BMI was observed in the age group 21-30. 11. By occupation, the majority of participants belong to the service classes, shopkeepers, students, and work from home. Most of the participants had no history of pre-existing as the majority of participants belong to the age group between 21-30. Hypertension and diabetes were reported by only a few of the participants.

In our study, it was found that a predominant number of participants (49.70%) reported an increase in their food intake during the lockdown. Similar reports were found in Renzo LD et al 9.

The lockdown led to changes in the eating habits and overall lifestyle of the population. It was found that there is an increase in consumption of fruits, vegetables, nutritional supplements, and immunity boosters. The spike in immunity boosters in food is primarily potentially tied up with overall wellness and immunity to fight Covid-19. Spices consumption such as garlic, cinnamon, turmeric, ginger, lemon was among the most prominent used out of all. Although on the other hand participants also increased their consumption of high-fat and sugar food items. Out of 254 participants (160, 48.78%) started consuming more fried items during lockdown. Similarly, out 224 participants (132, 41.77%) consumed more Cheese based food items. Out of 218 participants (146, 46.02%) increased consumption of refined flour. All the above food items correspond to increase in BMI as due lockdown physical activity is restricted. All these contribute to weight gain in an individual. In our study, it was found that there was a considerable decrease in physical activities during the lockdown. 82.6% were walking before covid, which dropped to 63% during covid19. Similarly, 33.9% of the participant’s jogged pre-covid which dropped to 21.8% during the lockdown.33% of the participants went to gym for workouts and during lockdown, it dropped to 31.9%. 34.7% of the participants performed Yoga which dropped marginally to 34.1% during the lockdown.

Lockdown measures and mobility restrictions were found to be effective to control the spread of COVID‑19, but from an individual’s perspective, it had some harmful consequences too, as the majority of the participants reported an increase in their BMI, which could be because of an increase in their food intake during the lockdown, exacerbated by a decrease in their physical activity. Increase in social media and overall screen time was observed, could be due to work from home, online schools and also boredom.

There was an increase in time spent on watching TV contributed by 85.7% increase in participants spending >1 hr. Using mobile phones, social media, playing games, and cooking also considerably increased. These all activities contribute to a lifestyle being more sedentary. This could also be the reason for a significant increase in activities during covid (t (771) - 6.97, p<0. 001) as compared to before covid.

According to the findings of the study, 216 participants reported a high impact of covid-19 on day to day life. 114 participants belong to the age group between 21-30 years. And, participants reported that they missed the feeling of meeting friends, going grocery shopping.

Due to lockdown, there is a steep decrease in the number of participants (n-640)s sleeping only at night dropped to (n- 358) participants. There was an exponential increase in the sleep pattern of people both day and night. Sleep only was reduced to sleeping at random times this could be due to stress and anxiety induced by lockdown, work from home, free time (no work, no employment), reduced physical activity.

These could explain that pandemics can make the public more sedentary and less active which could lead to increase in BMI and consequent weight gain.

Limitation of the study: As the design of survey questionnaires was limited to only in English language and to whom internet the outreach was confined to selected population.

In this study “Covid-19 Impact on dietary habit, mental health, and physical activity”, we conclude that there was few positive and negative impact of covid-19 on the dietary pattern, mental health, and physical activity. These observations have potential implications that could help to identify the possible factors for change in the dietary, mental and physical behavior and impede through proper counseling.

This paper and the research behind it would not have been possible without the exceptional support of our guide Mr. Shivshankar Timmanpayati, Chief Clinical Dietitian at Tata Memorial Hospital, and his insightful comments and expertise.