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ORIGINAL ARTICLE
Year : 2022  |  Volume : 12  |  Issue : 4  |  Page : 263-268

Effect of Lockdown in the COVID-19 Pandemic on Dietary Habits and Self-Medication Practice in People Living in Jordan


1 Department of Nutrition and Food Technology, Al-Huson University College, Al-Balqa Applied University, Al-Salt, Jordan
2 Pharmacy, Irbid University College, Al-Balqa Applied University, Irbid, Jordan

Date of Submission14-Jul-2022
Date of Decision05-Aug-2022
Date of Acceptance08-Aug-2022
Date of Web Publication30-Nov-2022

Correspondence Address:
Malak M Angor
Associate Professor, Department of Nutrition and Food Technology, Huson University College, Al-Balqa Applied University, P.O. Box 50, Huson, 21510, Irbid
Jordan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijnpnd.ijnpnd_50_22

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   Abstract 


Background: The pandemic of the coronavirus disease 2019 (COVID-19) has impacted Jordanian society, particularly on health. Aims: This study examined the effect of the COVID-19 pandemic lockdown on Jordanian society’s dietary habits and self-medication practices. Methods: We surveyed 1252 Jordanians of both genders between the ages of 18 and 65 years by questionnaire. Three questions were asked to evaluate the frequency of foods/drinks consumption, general eating habits, and self-medication practice of individuals of both genders during the lockdown. Results: Dietary habits and food quality affected weight (increase or decrease) by 69.5% during the lockdown. The highest percentages of “very high” consumption per week for fruits, processed juices, and fried foods were 37.6 %, 36.7%, and 29.4%, respectively. The highest percentage of “very little” consumption per week for drinking water, milk, and soft drinks were 12.5%, 8.5%, and 7.4%, respectively. The percentage of respondents who had taken medicine without a doctor’s prescription was 84.7%. The highest percentage (74%) was in using self-medication as a preventive measure against the coronavirus, followed by treating a cold/flu (61.4%), in both genders and age groups. The largest percentage (78.5%) was for using paracetamol, followed by ibuprofen and azithromycin (78.1% and 77.1%), respectively. Conclusion: Dietary habits and the quality of the foods consumed during lockdown affected participants’ weight (increase or decrease) by 69.5%. The percentage of participants who self-medicated was 84.7%.

Keywords: COVID-19, dietary habits, jordan, pandemic, self-medication, weight


How to cite this article:
Angor MM, Nawasreh AO. Effect of Lockdown in the COVID-19 Pandemic on Dietary Habits and Self-Medication Practice in People Living in Jordan. Int J Nutr Pharmacol Neurol Dis 2022;12:263-8

How to cite this URL:
Angor MM, Nawasreh AO. Effect of Lockdown in the COVID-19 Pandemic on Dietary Habits and Self-Medication Practice in People Living in Jordan. Int J Nutr Pharmacol Neurol Dis [serial online] 2022 [cited 2023 Feb 6];12:263-8. Available from: https://www.ijnpnd.com/text.asp?2022/12/4/263/362417




   Introduction Top


Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It originated in Wuhan, China, spread globally, and was declared a pandemic by the World Health Organization.[1],[2]

The number of COVID-19-affected individuals exceeded 75 million resulting in >1.6 million COVID-19-related deaths recorded worldwide.[3] In Jordan, the number of COVID-19-affected individuals had reached >1.5 million, with >14,000 deaths recorded by May 2022.[4] Due to the pandemic, numerous restrictions on human movement and physical interactions have been imposed by various countries, and formal social lockdown measures have been implemented.[2],[5]

People have also faced changes in rules regarding access to medical services and products. Scientific literature suggested that the pandemic was influencing self-medication behaviors.[6],[7] However, such behaviors may have dangerous consequences in the form of side effects, fatalities, or insufficiency of drugs for needy patients.[7]

According to the World Health Organization,[8] self-medication is an important element of self-care, defined as taking medications to treat self-diagnosed problems or the self-administration of medicines prescribed by a doctor for chronic diseases, recurring diseases, or symptoms. Self-medication is also defined as taking medication on one’s initiative or on the initiative of someone who is not medically qualified.[9],[10]

In Jordan, during the COVID-19 pandemic, various lockdown measures were put into operation. Social distancing was implemented to slow down the spread of COVID-19.[11] The middle schools and universities in all regions of the Kingdom were closed until the end of 2019 to 2020 academic year. Individuals could no longer engage in physical activities and fitness exercises. Youth activity classes were canceled. Public parks and gyms were all closed. All government and private institutions were also closed. These sudden and stressful conditions and prolonged stays at home induced radical changes in lifestyle behavior, such as physical activity, eating habits, mental health, and sleep quality. General concerns were raised about the negative health implications of inactivity and sedentary behavior.[12],[13]

An increase in depression, difficulty sleeping, and worsening chronic conditions has been reported during lockdown[14],[15]; 37.1% of participants reported increased anxiety. However, the sale of prescription medications without proper authorization is continuing. In addition, the recent rise in adverse sleep changes may increase the sale of unprescribed sleep medicines.[16]

To the best of our knowledge, this is the first study investigating the effect of lockdown during the COVID-19 pandemic on dietary habits and self-medication practices in the Jordan population.


   Methods Top


Study design

This retrospective cohort survey study assessed the effect of lockdown in the COVID-19 pandemic on dietary habits and self-medication practices in people living in Jordan by using online-reported surveys completed between November 14 and November 28, 2020 (https://docs.google.com/forms/d/e/1FAIpQLSfZlpYEZgmJkQgdWNZ5cA4t3reUclmFCgR5KnDcQe56xbvxMw/viewform). Informed consent was obtained from all participants in this study.

Study population and sampling procedure

The sampling strategy used in this survey focused on including young and older individuals living in Jordan. Potential respondents were invited electronically through various social media platforms and e-mail lists of students, faculty, and staff in some universities. Inclusion criteria were as follows: aged between 18 and 65 years, ability to read and speak Arabic, and residing in Jordan. We tested the pilot study data of 10 subjects to assess the content validity of the survey form. Specifically, evaluating the extent to which the information required within the survey form was relevant and representative of the COVID-19 pandemic lockdown on dietary habits and self-medication practice in people living in Jordan.

Measures

After providing consent, participants answered questions, including self-reported weight and height. Questions included an assessment of the participants’ frequency of food/drink consumption, general eating habits, and self-medication practice during the lockdown period. Questions were presented in a randomized order.

Perceived changes during the COVID-19 lockdown

Questions started with “Compared to before the COVID-19 lockdown in Jordan, I have ....” Using a five-point Likert scale (very little, little, moderate, high, and very high), participants had to respond to 13 items on behaviors related to foods/drinks consumption (e.g., “snacks” and “fresh juice”). The perception of weight changes since the beginning of lockdown was included. This was followed by six items on the extent to which participants had self-medicated (e.g., “Have you taken self-medication to treat a cold?”) as compared to before lockdown, using a unipolar Likert scale (yes/no). Participants also completed six items on self-medication practice in using some particular medications as compared to before lockdown (e.g., “paracetamol” and “azithromycin”), using a unipolar Likert scale (yes/no).

Statistical analysis

Participants’ basic characteristics before the COVID-19 lockdown and activity patterns before and during the COVID-19 lockdown were described using mean and standard deviation for continuous variables and percentages for categorical variables. We used t tests and analysis of variance (or χ2 tests for categorical variables) to evaluate the significance of differences in dietary habits and self-medication practice before and during the COVID-19 lockdown. All statistical analyses were performed using SPSS version 23.[17]


   Results Top


Overall, 1252 individuals of both genders from the Jordanian society completed the questionnaire. The sociodemographic and clinical characteristics of the sample are shown in [Table 1]. The total number of male participants was 574 (45.8%), while the total number of females was 678 (54.2%). The highest percentage of participation was in the 18 to 35 years age group (n = 938; 74.9%). The percentage of participants reporting weight changes (increase or decrease) was 69.5%, and that with chronic diseases was 8.6%.
Table 1 Sociodemographic and clinical characteristics

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[Table 2] shows the effect of lockdown due to the COVID-19 pandemic on dietary habits. The highest percentage of “very high” consumption per week for fruits, processed juices, and fried foods was 37.6%, 36.7%, and 29.4%, respectively. Conversely, the highest percentage of “very little” consumption per week for drinking water, milk, and soft drinks was 12.5%, 8.5%, and 7.4%, respectively.
Table 2 The effect of lockdown due to the COVID-19 pandemic on dietary habits

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[Table 3] shows the lockdown effect of the COVID-19 pandemic on self-medication practice for both genders and age groups. There were 1060 respondents (84.7%) reporting that they had taken medicine without any doctor’s prescription. Based on different sociodemographic characteristics, the 15 to 35 years age group showed a greater tendency to self-medicate (63.5%), and female respondents (48.6%) were more frequent than males (36%) to self-medicate.
Table 3 The effect of the COVID-19 lockdown on self-medication practice for both genders and age groups

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The highest percentage (74%) was in using self-medication as a preventive measure against the coronavirus infection, followed by self-medication to treat a cold/flu (61.4%), in both genders and age groups.

[Figure 1] shows the responses to taking medications (self-treatment) in both genders and all age groups during the COVID-19 pandemic. Many respondents were taking medications (analgesics, antibiotics, and vitamins) as a self-treatment during the pandemic. In both genders and age groups, the greatest percentage (78.5%) was for using paracetamol, followed by ibuprofen and azithromycin (78.1% and 77.1%), respectively.
Figure 1 Percentage of responses that reported variations (yes or no) in the intake of some medications (self-treatment) in both genders and all age groups during the COVID-19 lockdown.

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   Discussion Top


This study examined the effect of the COVID-19 pandemic lockdown on dietary habits and self-medication practices in people living in Jordan. During the lockdown, daily activity was reduced, resulting in people spending time eating both healthy and unhealthy foods and consuming more starch and sugar-rich foods containing high amounts of calories to relieve the feelings of anxiety and tension that lead to depression. In addition, due to the lockdown, there was typically not enough space to engage in physical activity. Hence, the excess calories consumed could not be burned, and many individuals gained body mass.

In line with other studies,[18],[19] we noted that social lockdown had wide-ranging effects, making it more difficult to engage in behavior that protects against weight gain. We found that the percentage of participants who had fluctuations in their weight (increase or decrease) was 69.5% in both genders and age groups. Also, there was a difference in dietary habits due to the COVID-19 lockdown. The highest percentage of “very high” consumption per week for fruits, processed juices, and fried foods (37.6 %, 36.7%, and 29.4%), respectively, in our data obtained from participants parallels data from studies[20],[21] conducted in the general population in Spain. According to these studies, the reported consumption of fruit and vegetables increased by 25% of the population during the pandemic period. The highest percentage of “very little” consumption per week for drinking water, milk, and soft drinks was 12.5%, 8.5%, and 7.4%, respectively. This result agreed with a study[22] conducted in Denmark, Germany, and Slovenia, concluding that the lower rates of change occurred in bread and dairy products consumption during the pandemic.

We found that using medicines without any doctor’s prescription was reported by 84.7% of the participants. The highest percentage (74%) of participants reported using self-medication as a preventive measure against coronavirus, followed by treating a cold/flu (61.4%), in both genders and age groups. The most used medications were paracetamol (78.5%), ibuprofen (78.1%), and azithromycin (77.1%), respectively. This result agreed with other studies,[23],[24],[25] reporting that the most utilized medications were paracetamol (65.2%); the reasons reported for using these medications included respiratory symptoms, cold/flu, and preventive measures for COVID-19.

A study conducted in Ethiopia[26] revealed that self-medications were significantly associated with the 18 to 34 age group. Similarly, our result showed that the young age group (18–35 years) was more likely to self-medicate with analgesics, antibiotics, and multivitamins to cope with pandemic-related problems compared with the 36 to 65 years age group with percentages of 74.9% versus 25.1%, respectively. These results differ from those reported by a study among the residents of Umuahia, Abia State,[27] noting that those >40 years of age were 80% more likely to practice self-medication compared to those <40 years old. Female respondents showed a higher tendency to self-medicate compared to males (54.2% versus 45.8%). These results are similar to those reported by a study conducted in Pakistan,[23] noting that females were more likely to practice self-medication.

Obesity affects the health of individuals, making them more vulnerable to chronic diseases, such as diabetes, high blood pressure, and heart diseases, increasing further vulnerability to infection with SARS-CoV-2. Previous studies[5],[28] also found that the COVID-19 pandemic may have a disproportionately large and negative influence on weight-related behaviors among adults. For example, weight-gain risk factors during self-quarantine were inadequate sleep, snacking after dinner, lack of dietary restraint, eating in response to stress, and reduced physical activity.


   Conclusions Top


The results of this study in Jordanian society found that the participants (69.5%) had weight changes (increase or decrease) during the lockdown. The highest percentage changes were in the “very high” weekly consumption of fruits, processed juices, and fried foods. The highest change percentages in the “very little” weekly consumption were in drinking water, milk, and soft drinks. Dietary habits and the quality of the foods consumed while staying at home must be considered to avoid obesity and the accompanying diseases. Respondents (84.7%) reported taking medicine without any doctor’s prescription. The highest percentage was in using self-medication as a preventive measure against the coronavirus, followed by treating a cold/flu in both genders and age groups. Paracetamol was used most frequently (78.5%). There is a need for policies and strategies to address factors related to the awareness of and sensitization to the risks of self-medication affecting the individual’s health during this long-term pandemic.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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