2021

UCLA-led research finds Americans drank more, smoked more, and exercised less during the COVID-19 pandemic


Analysis found a marked increase in sedentary behaviors, alcohol consumption, cigarette smoking, & a decline in exercise.

television, remote, and bowl of chips

Americans drank and smoked more, have spent less time exercising, and spent more time in front of a computer or television in comparison to before the pandemic, a UCLA-led research team has found.

“We found that regulations to restrict non-essential activities and stay-at-home orders during the pandemic have had profoundly negative impacts on multiple lifestyle behaviors in American adults,” said Dr. Liwei Chen, UCLA Fielding School associate professor of epidemiology and lead author of the study. “As bad as these changes have been for all Americans, they disproportionately impact racial and ethnic minorities in the U.S., who already bear a higher disease burden from COVID-19.”

The research – “Changes of Exercise, Screen Time, Fast Food Consumption, Alcohol, and Cigarette Smoking during the COVID-19 Pandemic among Adults in the United States" – is published in the current edition of the peer-reviewed journal Nutrientsbased in Basel, SwitzerlandThe study is led by UCLA researchers in collaboration with scholars from 10 other U.S. institutions, including the Center for Reducing Health Disparities at the University of Nebraska Medical Center.  

The novel coronavirus disease (COVID-19), induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a worldwide pandemic since March, 2020. About 5% of those infected had severe symptoms and needed intensive care, and as of September, 2021, more than 220 million people have been infected and 4.5 million have died worldwide. According to the U.S. Centers for Disease Control and Prevention, as of October, more than 702,000 Americans with COVID-19 have died since January, 2020.

“During the current pandemic, many countries, including the United States, implemented measures and recommendations to restrict non-essential activities and reduce the spread of the disease,” said Dr. Jian Li, Fielding School professor of environmental health sciences and a co-author. “While these restrictions are vital to reduce human-to-human infection of COVID-19, it is clear they result in a profound change in normal daily activities and behaviors, including exercise and eating patterns, as well as smoking and the consumption of alcohol.”

The research team surveyed representative samples of American adults from across the country in October, 2020, using 48 sampling criteria, including age, race, ethnicity, education, and gender, and were asked to report five lifestyle behaviors (i.e., exercise time, screen time, fast- food meal consumption, alcohol drinking, and cigarette smoking) before and during the COVID-19 pandemic.

Compared to before the COVID-19 outbreak, across those surveyed, the time spent on exercise decreased by 31.2%, while screen time increased by 60.4%. Alcohol consumption increased by 23.2% and smoking by 9%. The average consumption of fast food actually dropped, from 1.41 times/week before to 0.96 times/week during the pandemic.

“The observed decrease in fast food consumption is likely due to the stay-at-home order and the closure of fast-food restaurants during the pandemic,” Chen said. “Although the majority of our study’s participants, about 77 percent, reduced or did not see a change in their fast-food meal consumption, there were still almost 23 percent that increased how much fast food they ate in the same period.”

The researchers acknowledge their work has limitations; the survey was carried out at the peak of the pandemic in the U.S., so the changes in lifestyle behaviors may only reflect the peak of the pandemic. Nonetheless, there are lessons to be learned, researchers said.

“We found a marked increase in sedentary behaviors, alcohol consumption, and cigarette smoking, and a decline in exercise,” said Li, who is also affiliated with the Fielding School's Center for Occupational and Environmental Health. “Whether these persisted as the pandemic continued, and whether individual’s quality of life and health well-being are subsequently affected, has to be studied, but it is clear that resources and support that can help people maintain healthy lifestyles, during the pandemic and afterwards, are urgently needed.”

Methods: This analysis was conducted using data from the Health, Ethnicity, and Pandemic (HEAP) Study, designed by investigators from several universities, led by the Center for Reducing Health Disparities at the University of Nebraska. The HEAP survey was carried out by the National Opinion Research Center (NORC) at the University of Chicago. The HEAP is a cross-sectional study in design and the survey included questions related to mental health, lifestyle changes, racial discrimination, financial status, and healthcare use. Of those surveyed, 20.5% were from 18–29, 25.5% from 30–44, 24.2% from 45–59, and 29.8% were 60 or older. The study population reflected the racial/ethnic composition of the U.S., including Non-Hispanic Whites (61.3%), followed by Hispanics (16.7%), Non- Hispanic Blacks (11.9%), and Asian and Pacific Islanders (6.4%). Respondents’ answers were analyzed using SAS statistical software.

Funding: The “Health, Ethnicity, and Pandemic” (HEAP) study was funded by the Center for Reducing Health Disparities at University of Nebraska Medical Center, The Chinese Economists Society, and Calvin J. Li Memorial Foundation. Tong Xia was supported by a scholarship from Department of Epidemiology at the University of California Los Angeles (UCLA).

Data availability statement: The data presented in this study are available on request from the corresponding author and the Center for Reducing Health Disparities at University of Nebraska.

Citation: Liwei Chen, Jian Li, Tong Xia, Timothy A. Matthews, Tung-Sung Tseng, Lu Shi, Donglan Zhang, Zhuo Chen, Xuesong Han, Yan Li, Hongmei Li, Ming Wen, and Dejun Su. 2021. "Changes of Exercise, Screen Time, Fast Food Consumption, Alcohol, and Cigarette Smoking during the COVID-19 Pandemic among Adults in the United States" Nutrients 13, no. 10: 3359. https://doi.org/10.3390/nu13103359


The UCLA Fielding School of Public Health, founded in 1961, is dedicated to enhancing the public's health by conducting innovative research, training future leaders and health professionals from diverse backgrounds, translating research into policy and practice, and serving our local communities and the communities of the nation and the world. The school has 761 students from 26 nations engaged in carrying out the vision of building healthy futures in greater Los Angeles, California, the nation and the world.

Faculty Referenced by this Article

Dr. Liwei Chen
Liwei Chen

Professor in Epidemiology

Epidemiology
Read Faculty Profile
Jian Li
Jian Li
Environmental Health Sciences Epidemiology
Read Faculty Profile
Michael Jerrett
Michael Jerrett
Environmental Health Sciences
Read Faculty Profile
Faculty/staff profile placeholder image
Teresa Ellen Seeman
Epidemiology
Read Faculty Profile
Onyebuchi Arah headshot
Onyebuchi A. Arah
Epidemiology
Read Faculty Profile
Dr. Yifang Zhu
Yifang Zhu
Environmental Health Sciences
Read Faculty Profile
Dr. Marjan Javanbakht
Marjan Javanbakht
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Dallas Swendeman
Epidemiology
Read Faculty Profile
Pablo Cicero-Fernandez
Pablo Cicero-Fernandez
Environmental Health Sciences
Read Faculty Profile
Ximena Vergara
Ximena Vergara
Epidemiology
Read Faculty Profile
Jody Heymann
Jody Heymann
Epidemiology Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Lawrence Ash
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
N/A
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Annette Regan
Epidemiology
Read Faculty Profile
Tao Huai
Tao Huai
Environmental Health Sciences
Read Faculty Profile
Dr. Shira Shafir
Shira Shafir
Community Health Sciences Epidemiology
Read Faculty Profile
Naomi Greene
Naomi Greene
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Paul Dluzniewski
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Noel Weiss
Epidemiology
Read Faculty Profile
Tony Kuo
Tony Kuo
Epidemiology
Read Faculty Profile
Pamina Gorbach
Pamina Gorbach
Epidemiology
Read Faculty Profile
Richard Ambrose
Richard Ambrose
Environmental Health Sciences
Read Faculty Profile
Dr. Robert Schiestl
Robert Schiestl
Environmental Health Sciences
Read Faculty Profile
Haroutune Armenian
Haroutune Armenian
Epidemiology
Read Faculty Profile
Dr. Zuo-Feng Zhang
Zuo-Feng Zhang
Epidemiology
Read Faculty Profile
Hashibe, Mia
Mia Hashibe
Epidemiology
Read Faculty Profile
sheena sullivan photo
Sheena G. Sullivan
Epidemiology
Read Faculty Profile
Sung-Jae Lee
Sung-Jae Lee
Epidemiology
Read Faculty Profile
Bailley, Julia
Julia Bailey
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Kelika Konda
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Jian Yu Rao
Epidemiology
Read Faculty Profile
Dr. Oliver Hankinson
Oliver Hankinson

Dr. Hankinson is a Distinguished Professor of Pathology and Laboratory Medicine, and of EHS, and Chair of the Molecular Toxicology IDP

Environmental Health Sciences
Read Faculty Profile
Alexandra Binder Headshot
Alexandra Binder
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Roberta Malmgren
Epidemiology
Read Faculty Profile
Dr. Brian Bradbury
Brian Bradbury
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Nina Harawa
Epidemiology
Read Faculty Profile
Michael Collins
Michael Collins
Environmental Health Sciences
Read Faculty Profile
Sander Greenland
Sander Greenland
Epidemiology
Read Faculty Profile
Arabzadah, Hamid
Hamid Arabzadeh
Environmental Health Sciences
Read Faculty Profile
Su Yong Jung
Su Yon Jung
Epidemiology
Read Faculty Profile
Susan Cochran
Susan Cochran
Epidemiology
Read Faculty Profile
Robert Kim-Farley
Robert J. Kim-Farley

Robert J. Kim-Farley, MD, MPH, is a Professor-in-Residence with joint appointments in the Departments of Epidemiology and Community Health Sciences

Community Health Sciences Epidemiology
Read Faculty Profile
Marissa J. Seamans
Marissa Seamans
Epidemiology
Read Faculty Profile
Jared Diamond
Jared Diamond
Environmental Health Sciences
Read Faculty Profile
Angelo J Bellomo
Angelo Bellomo
Environmental Health Sciences
Read Faculty Profile
Dr. Dvora Joseph Davey
Dvora Joseph Davey

Dr. Joseph Davey is an infectious disease epidemiologist with over 20 years' experience leading research on HIV/STI services for women and children.

Epidemiology
Read Faculty Profile
Dr. Jane Valentine
Jane Valentine
Environmental Health Sciences
Read Faculty Profile
Faculty/staff profile placeholder image
Leeka I. Kheifets
Epidemiology
Read Faculty Profile
Dr. Daniel Uslan
Daniel Uslan
Environmental Health Sciences
Read Faculty Profile
Rosenstock
Linda Rosenstock
Environmental Health Sciences Health Policy and Management
Read Faculty Profile
Dr. Wendie Robbins
Wendie Robbins
Environmental Health Sciences
Read Faculty Profile
Paul Simon Headshot
Paul Simon
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Nicole Hoff
Epidemiology
Read Faculty Profile
Rachael Jones
Rachael Jones
Environmental Health Sciences
Read Faculty Profile
Matthew Mimiaga
Matthew J. Mimiaga
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Kirsten Schwarz
Environmental Health Sciences
Read Faculty Profile
Dr. Kevin Njabo
Kevin Njabo
Environmental Health Sciences
Read Faculty Profile
Roch Nianogo
Roch A. Nianogo
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Nicole Green
Environmental Health Sciences
Read Faculty Profile
DerSarkissian, Maral
Maral DerSarkissian
Epidemiology
Read Faculty Profile
Andre Nel
André Nel
Environmental Health Sciences
Read Faculty Profile
Brian Cole
Brian Cole
Environmental Health Sciences
Read Faculty Profile
Faculty/staff profile placeholder image
Frank J. Sorvillo
Epidemiology
Read Faculty Profile
Dr. Pouran D. Faghri
Pouran D. Faghri
Environmental Health Sciences
Read Faculty Profile
Arthur Cho
Arthur Cho
Environmental Health Sciences
Read Faculty Profile
Dr. Beate Ritz
Beate Ritz
Environmental Health Sciences Epidemiology
Read Faculty Profile
Jonathan Jacobs
Jonathan Jacobs
Epidemiology
Read Faculty Profile
Otoniel Martinez-Maza
Otoniel Martinez-Maza
Epidemiology
Read Faculty Profile
Dr. Timothy Brewer
Timothy Brewer
Epidemiology
Read Faculty Profile
Curtis Eckhert
Curtis Eckhert
Environmental Health Sciences
Read Faculty Profile
Dr. Shane Que Hee
Shane Que Hee

Industrial Hygiene & Analytical Chemistry

Environmental Health Sciences
Read Faculty Profile
Nathan Wong
Nathan D. Wong
Epidemiology
Read Faculty Profile
Julia Heck
Julia Heck
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Ondine S. von Ehrenstein
Community Health Sciences Epidemiology
Read Faculty Profile
Richard J. Jackson
Richard J. Jackson
Environmental Health Sciences
Read Faculty Profile
Faculty/staff profile placeholder image
Niklas Krause
Environmental Health Sciences Epidemiology
Read Faculty Profile
Mel Suffet
Irwin Suffet
Environmental Health Sciences
Read Faculty Profile
Faculty/staff profile placeholder image
Jesus Araujo
Environmental Health Sciences
Read Faculty Profile
Akihiro Nishi Headshot
Akihiro Nishi
Epidemiology
Read Faculty Profile
Anne Coleman
Anne Coleman
Epidemiology
Read Faculty Profile
Dr. Candace Tsai
Candace Tsai

Associate Professor for Industrial Hygiene and Environmental Health Sciences

Environmental Health Sciences
Read Faculty Profile
Ralph R. Frerichs, 12/25/21
Ralph R. Frerichs
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Peter R. Kerndt
Epidemiology
Read Faculty Profile
Feng Gao
Feng Gao
Environmental Health Sciences
Read Faculty Profile
Dr. Roger Detels
Roger Detels
Epidemiology
Read Faculty Profile
Kamyar Kalantar-Zadeh
Kamyar Kalantar-Zadeh
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Peter Katona
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Catherine Carpenter
Epidemiology
Read Faculty Profile
Karin Michels
Karin B. Michels
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Timothy Malloy
Environmental Health Sciences
Read Faculty Profile
Aziz, Najib headshot_2023
Najib Aziz
Epidemiology
Read Faculty Profile
Dr. Anne Rimoin
Anne Rimoin
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Jørn Olsen
Epidemiology
Read Faculty Profile
Woman dressed in blue and wearing pearls and eye glasses
Lisa V. Smith
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Amy Wohl
Epidemiology
Read Faculty Profile
Miriam Marlier
Miriam Marlier
Environmental Health Sciences
Read Faculty Profile
Faculty/staff profile placeholder image
Vonthanak Saphonn
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Arthur Winer
Environmental Health Sciences
Read Faculty Profile
Headshot
Christie Jeon
Epidemiology
Read Faculty Profile
Dr. Paul Hsu
Paul Hsu
Epidemiology
Read Faculty Profile
Dr. Lara Cushing
Lara Cushing
Environmental Health Sciences
Read Faculty Profile
Elizabeth Rose Mayeda photo
Elizabeth Rose Mayeda
Epidemiology
Read Faculty Profile

Related Content

2024_Alumni_Dinner
October 30, 2024
2024 Hall of Fame Induction and Alumni Dinner
Read Full Article
October 11, 2024
Dr. Michael Jerrett appointed inaugural holder of Jonathan Fielding Chair in Climate Change and Public Health
Read Full Article