O6 Depressive Symptoms, not Food Insecurity, Increased During COVID-19 Pandemic in At-Risk Group with Metabolic Syndrome

BACKGROUND: Metabolic syndrome (MetS) is a risk factor for COVID-19 morbidity and mortality, thus pandemic-driven policies may more strongly influence the emotional responses of those with MetS. OBJECTIVE: Examine emotional, mental health, and food security impact of COVID-19 pandemic on persons with metabolic syndrome STUDY DESIGN, SETTING, PARTICIPANTS: Baseline, pre-pandemic biomedical measures and online survey of persons enrolled, with minimal or no participation in a 2-year lifestyle intervention trial to reverse metabolic syndrome; repeated online survey during COVID-19 pandemic. MEASURABLE OUTCOME/ANALYSIS: Change in depressive symptoms (Patient Health Questionnaire-8 score), perceived stress (Cohen Stress Scale), food security (USDA 10-item Food Security Screener); baseline eating competence (EC; Satter Eating Competence Inventory), health (SF-36), socioeconomic and demographic items. Change in normal and transformed variables was analyzed with paired t-tests, multiple regression, repeated measures ANOVA. RESULTS: Participants (n = 132; MetS diagnosis) were mostly female (67%), White (70%), middle-aged (mean 57.0 ± 11.0 y) well-educated (62% college/post-graduate), with a median income of $86,000. Perceived stress was significantly higher at baseline than follow-up (18.5 ± 6.4 vs 14.9 ± 7.2; P < 0.001) even when controlling for confounders (eg, EC, vitality). Food security increased from 83% at baseline to 90% at follow-up (P < 0.001). Migration to or continued food insecurity (n = 13) tended to be associated with being non-White (P = 0.05). Depressive symptoms increased from baseline (2.1 ± 2.3 vs 3.5 ± 3.4; P < 0.001) even when controlling for EC or gender. Depression, which was a study exclusion criterion, was noted at follow-up (n = 10). Movement to depression was not associated with socioeconomic demographics, but was related to lower baseline vitality (44.4 ± 20.7 vs 60.3 ± 18.9; P = 0.012), mental health (71.0 ± 14.3 vs 82 ± 10.4; P = 0.002) and higher follow-up perceived stress (22.6 ± 7.7 vs 14.2 ± 6.8; P < 0.001). CONCLUSION: A high-risk sample for COVID-19, which was highly educated, did not experience increased stress or food insecurity, but demonstrated increased depressive symptoms after the onset of COVID-19 pandemic, with some baseline susceptibility noted.