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

OBJECTIVES: To examine the associations between perceived changes in stress, eating, and weight during the COVID-19 pandemic among adults in Puerto Rico. METHODS: This cross-sectional analysis used data from the Puerto Rico Community Alliance Against COVID-19 Disparities (CEAL) study. A total of 551 adults (18 years) completed an online survey from December 30, 2021 to January 28, 2022. Three individual items assessed perceived changes in stress, eating, and weight throughout the pandemic (from March 2020 to survey completion). Response options were ‘increased’, ‘decreased’, and ‘no change’. Participants reporting decreases in stress (n = 9) were excluded from the analysis. Adjusted Poisson models with robust error variance estimated prevalence ratios (PR) and 95% confidence intervals (CI), using those reporting no change in stress as the reference group. All models were adjusted for age, gender, number of children in the household, education, income, employment, marital status, COVID-19 diagnosis, and pre-pandemic obesity. RESULTS: Eligible respondents with complete data on study variables (n = 495) were on average 38 + 14 years, the majority were women (73.9%), and had at least some college education (52.9%). The majority reported perceived increases in stress during the pandemic (74.7%). In adjusted regression models, a perceived increase in stress (vs. no change) was associated with perceived increases in eating (PR = 1.88, 95% CI = 1.38, 2.56) and weight (PR = 1.68, 95% CI = 1.11, 2.54) as well as decreases in eating (PR = 1.87, 95% CI = 1.06, 3.30) and weight (PR = 1.51, 95% CI = 1.21, 1.88). CONCLUSIONS: A large proportion of adults in Puerto Rico reported an increase in stress during the COVID-19 pandemic, which were significantly associated with changes (both increases and decreases) in eating and weight. Interventions and clinical programs targeting stress management during public health emergencies are needed to maintain healthy weight and eating habits. FUNDING SOURCES: Puerto Rico-CEAL was funded by NIH-NHLBI.