AUTHOR=Nguyen Minh H. , Do Tinh X. , Nguyen Tham T. , Pham Minh D. , Pham Thu T. M. , Pham Khue M. , Kim Giang B. , Do Binh N. , Nguyen Hiep T. , Nguyen Ngoc-Minh , Dam Hoa T. B. , Nguyen Yen H. , Nguyen Kien T. , Nguyen Thao T. P. , Nguyen Trung T. , Duong Tuyen Van 

TITLE=Fear of COVID-19, healthy eating behaviors, and health-related behavior changes as associated with anxiety and depression among medical students: An online survey

JOURNAL=Frontiers in Nutrition

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.938769

DOI=10.3389/fnut.2022.938769

ISSN=2296-861X

ABSTRACT=Background
Medical students’ health and well-being are highly concerned during the COVID-19 pandemic. This study examined the impacts of fear of COVID-19 (FCoV-19S), healthy eating behavior, and health-related behavior changes on anxiety and depression.
Methods
We conducted an online survey at 8 medical universities in Vietnam from 7th April to 31st May 2020. Data of 5765 medical students were collected regarding demographic characteristics, FCoV-19S, health-related behaviors, healthy eating score (HES), anxiety, and depression. Logistic regression analyses were used to explore associations.
Results
A lower likelihood of anxiety and depression were found in students with a higher HES score (OR= 0.98; 95%CI= 0.96, 0.99; p= 0.042; OR= 0.98; 95%CI= 0.96, 0.99; p= 0.021),  and in those unchanged or more physical activities during the pandemic (OR= 0.54; 95%CI= 0.44, 0.66; p<0.001; OR= 0.44; 95%CI= 0.37, 0.52; p<0.001) as compared to those with none/less physical activity, respectively. A higher likelihood of anxiety and depression were reported in students with a higher FCoV-19S score (OR= 1.09; 95%CI= 1.07, 1.12; p<0.001; OR= 1.06; 95%CI= 1.04, 1.08; p<0.001),  and those smoked unchanged/more during the pandemic (OR= 6.67; 95%CI= 4.71, 9.43; p<0.001; OR= 6.77; 95%CI=  4.89, 9.38; p<0.001) as compared to those stopped/less smoke, respectively. In addition, male students had a lower likelihood of anxiety (OR= 0.79; 95%CI= 0.65, 0.98; p= 0.029) compared to female ones. 
Conclusions
During the pandemic, FCoV-19S and cigarette smoking had adverse impacts on medical students’ psychological health. Conversely, staying physically active and having healthy eating behaviors could potentially prevent medical students from anxiety and depressive symptoms.