Coronavirus disease (COVID-19), which originated in the Wuhan province of China, was declared as a global pandemic by the World Health Organization (W.H.O) on March 11, 2020. 1 Since then it has spread beyond borders and affected the lifestyle behaviour of people.

The entire globe is undergoing an unprecedented challenge of unimaginable proportions due to COVID-19 which has affected the lifestyle behaviour of individuals. This pandemic not only adversely affected the physical health of individuals, but also brought forth significant changes in their lifestyle. India has a widely recognized health care delivery system but due to the lack of organized infrastructure, there is a growing sense of crisis, as the majority (66.53%) of its population reside in rural areas which are plagued with wide discrepancies related to the delivery of health care needs. 2 Needless to say, this pandemic has magnified this dearth by diverting its focus on specific medical conditions, neglecting other issues related to lifestyle behaviour. 3

The lockdown disrupted normal social, economic, occupational, leisure and religious activity. 4 A review published recently in Lancet, which studied the literature on the psychological impact of quarantine stated that the separation and curtailed the movement of people potentially exposed to a contagious disease during previous epidemics such as SARS, resulted in a range of psychological conditions, from posttraumatic stress symptoms to confusion, anger, depression, stress, insomnia and emotional exhaustion. 5

Due to this crisis (COVID-19) paralleled with the growing number of cases, there was an immediate spike in the need for several preventive and protective tools namely N-95 masks, personal protective equipment (PPE kits), ventilators, thermo-regulators, oximeters, etc., and as a result of which, the majority of the existing health care facilities/centres were either turned into dedicated COVID-19 centers or existing health resources were shifted to COVID-19 management. Health and wellbeing are the priorities of any nation, therefore India went through perhaps the strictest lockdown in 5 phases following partial-unlock down along with recommendations like restrictions on freedom of movement, social and physical distancing, self-isolation, and quarantine measures, etc., to curb down the disease spread. 2

Whilst the entire nation is gradually progressing through the process of gradual ‘unlocking’, along with the prevailing state of confinement side by side, there is a need of the hour to assess the impact of COVID-19 on changes in lifestyle behaviour among individuals. Arguably all these prevailing restrictions might have had bearing on the eating or dietary habits, sleep status, physical activity, and mental stress, culminating in worsening of both the physical and mental health among the rank and file.

This was a cross-sectional study using online survey by google forms with link sent using WhatsApp. The data was collected from the general population from December 2021 to January 2022. Daily reminder was sent. The survey invitation clearly stated that the participants will have the right not to participate in the survey and participation in the survey will imply providing informed consent. The survey questionnaire would take around 5 –7 min to complete. Total 705 responses were received by the stipulated time.

There were total 705 participants who enrolled for the study. Mean age was 43.8 years with with SD of 9.62 years ranged from 18 years to 62 years. 67.2% were males and 32.8% were females. 682 (96.8%) were Hindu by religion, majority (50.1%) of the participants were graduates and 367 (52.1%) were employers. [Table 1]

Majority of the respondents heard about COVID-19 pandemic (97.7%) and knew what COVID-19 exactly was (96.2%). Majority (93.1%) of the respondents recognized the symptoms of COVID-19, e.g., fever, cough, shortness of breath, and sneezing; however, none recognized myalgia or body aches and pains as one of the symptoms. Near about 46.3% of the respondents enumerated the options to stop COVID-19, e.g., social distancing, hand washing, cough etiquette, and wearing mask. Majority of the respondents were supportive of government's decision of lockdown (88.5%) and 84.4% were satisfied by the steps taken by the government to contain COVID-19 pandemic. [Table 2]

The Probability of skipping meals has decreased by 24.2%. However it has remained the same for 47.9% of the people. The habit of snacking between the main meals has increased by 54.1%. The quantity/portions of meals and snacks have increased by 45.9%. The daily intake of fruits and vegetables has increased by 52.5%. The consumption of fast food or junk food has decreased by 49.2%. The intake of sugar sweetened beverages has decreased by 42.4%. The participation in cooking new or traditional recipes has increased by 58%. The consumption of unhealthy food when bored has remained same as before by 38%. The intake of nutritional supplements to boost immunity has increased by 60.9%. The support of the family and friends in eating healthy has increased by 76%. The interest in learning healthy eating tips from media has increased by 55.8%. The time spent in exercise has increased by 48.9%. The participation in leisure activity has increased by 57%. The sitting and screening time has increased by 65.9%. The hours of sleep have increased by 54.1%. The quality of sleep has increased by 44.9%. At the same time the stress and anxiety levels has increased by 45.9%. [Table 3]

In our study we noticed mixed responses from participants, both in positive and negative modes. The socio-demographic profile suggests that majority of the respondents were male, well-educated, Hindus and were employers. This survey consciously made an attempt to keep the health-care professional out of the ambit, but still near about one-tenth (29.9%) were health-care providers.

Majority of the respondents were aware of the symptoms of COVID-19 and were also aware of the precautionary steps to follow to prevent the spread of the disease. This gave the impression that public health awareness measures were percolating down to the general population. Majority of the respondents supported government's decision of lockdown and were satisfied by the steps taken by the government to contain COVID-19 pandemic. This showed that general people were ready to sacrifice their personal agenda for greater good. These findings were similar to a study conducted by Kaustav Chakraborty et al in West Bengal. 5 In a study conducted by Gunchan Paul et al, 34.2% of general population knew that COVID-19 is a viral disease whereas 38% considered it as a biological weapon. 6

In a similar study conducted by Prasanth Sankar et al in South India, it was found that the most important dietary change during the lockdown, 80.9% reported increased consumption of vegetables, 42.7% reported increased consumption of fruits, whereas only 24.5% reported increased consumption of snacks, fried or processed foods. 63% reported decreased consumption of snacks, fried or processed foods, whereas only 11.8% had a change in meal timings. Less than 3% consumed health supplements or home remedies as a preventive strategy against COVID-19. Almost same findings were noted in our study. 7

In a study conducted by Amerta Ghosh et al 8 in North India, 56% of patients reported that they were taking same quantity of diet as before lockdown whereas 25% were eating less than before. Increase in consumption of fruits was recorded in 20%, and interestingly, 7% of patients started eating fruits during lockdown. In 23% of patients there was an increase in frequency of snacking (more than 4 times/day). Some form of exercise was followed by 62% of patients. These finding were similar to our study.

In our study we found that hours of sleep had increased among 54.1% participants. In a similar study conducted in Italy showed that sleep habits has increased by 54% which is very similar. 9

During the current pandemic there have been many lifestyle changes noted in our participants. COVID-19 had negative impact on their lifestyle. There is mixed response but most have indulged in eating unhealthy food like junk foods, but they have shown interest in learning about healthy lifestyle by involving in cooking and household works. A detailed understanding can help to develop interventions to mitigate the negative lifestyle behaviors manifested during COVID-19.