Factors Associated with Dietary Change since the Outbreak of COVID-19 in Japan.

In Japan, dietary habits have greatly changed since the coronavirus disease (COVID-19) outbreak; we examined factors related to dietary changes. An online cross-sectional questionnaire survey was conducted in November 2020 among 6000 Japanese adults (aged 20-64 years) registered with a research company and gathered data on demographics, socioeconomic factors, medical history, COVID-19 status of the respondent's family and neighbors, fear of COVID-19, and changes in lifestyle and dietary habits since the COVID-19 outbreak. To the question "Have you made healthier changes to your dietary habits compared with the dietary habits before the spread of COVID-19 (1 year ago, November 2019)?", 1215 (20.3%), 491 (8.2%), and 4294 (71.6%) participants answered that their dietary habits were healthier, unhealthier, and unchanged, respectively. Healthier and unhealthier dietary habits were associated with greater fear of COVID-19, altered exercise and sleep times, and smoking. Unhealthy habits were positively associated with living alone, decreasing household income, colleagues with COVID-19, stress, and weight loss/gain. Annual household income, changing household income, COVID-19 in friends, health literacy, exercise frequency, weight loss, and starting smoking were positively associated with healthier dietary changes. The generalizability of these results and strategies to inculcate healthy diets in this "new normal" should be investigated.