Associations Between Perceived Changes in Eating, Weight, and Perceived Health During the COVID-19 Pandemic Among Adults in Puerto Rico: Assessments of Puerto Rico-CEAL

OBJECTIVES: To examine the associations between changes in eating, weight, and perceived health during the COVID-19 pandemic among adults in Puerto Rico. METHODS: This analysis used cross-sectional data from the Puerto Rico-Community Alliance Against COVID-19 Disparities (CEAL) study. Individuals were adult men and women (n = 551; ≥18 y) who completed an online survey from December 30, 2021, to January 28, 2022. Two items assessed perceived changes in eating and weight throughout the pandemic (from March 2020 to survey completion). Response options were ‘increased’, ‘decreased’, and ‘no change’. Two other items assessed overall perceived health, one pre-pandemic (asked retrospectively) and one pandemic (current). Response options were on a five-point scale: excellent-poor. Changes in perceived health were calculated and categorized as decrease, increase, and no change. Adjusted Poisson models with robust error variance estimated prevalence ratios (PR) and 95% confidence intervals (CI), using those reporting no change as the reference group. RESULTS: Eligible respondents with complete data on study variables (n = 496) were on average 38 ± 14 y and 73.4% were women. Overall, 55.6% had no change in perceived health during the COVID-19 pandemic, whereas 36.7% experienced a decrease and 7.5% an increase. In adjusted models, individuals reporting an increase in eating (vs. no change) were more likely to experience a decrease in perceived health (PR = 1.59, 95% CI = 1.24, 2.05). Individuals reporting an increase in weight (vs. no change) and a decrease in weight (vs. no change) were more likely to experience a decrease in perceived health (PR = 1.75, 95% CI = 1.29, 2.28; and PR = 1.70, 95% CI = 1.17, 2.48; respectively). No significant associations were observed for changes in weight and eating and increases in perceived health. CONCLUSIONS: Over a third of adults in Puerto Rico reported decreases in perceived health during the COVID-19 pandemic. Increases in eating and changes in weight during the pandemic were associated with a decrease in perceived health. Interventions and public health campaigns on the island need to address negative eating behaviors and promote healthy weight maintenance during public health emergencies to preserve the population's health. FUNDING SOURCES: Puerto Rico-CEAL was funded by NIH-NHLBI.