This cross-sectional survey was conducted from 2nd to 12th April 2020 among the general public in Kuwait. All data were collected through social media platform (WhatsApp groups), through convenience and snowball sampling methods. Inclusion criteria included participants being Kuwaiti nationals residing in Kuwait. There were no specific exclusion criteria pertaining to age, language, gender or occupation of the respondents. After signing a written informed consent, the respondents were briefed about the objectives of the survey, ensured anonymity and that the group findings will be reported. Respondents could leave the study at any time if they felt uncomfortable. Approval for this study was provided by the Ethical Review Board of Ministry of Health of Kuwait, Kuwait.
Minimum sample size required for this survey was calculated to answer out primary research objective of documenting prevalence of poor eating habits among Kuwaitis. Based on a statistical power of 80%, confidence level 95%, margin of error 5% and a population size of 1.3 million Kuwaitis, a minimum sample size of 385 was required. All data were collected using an electronic version of a bilingual questionnaire in Arabic and English language. Participants were encouraged to provide their responses in either of the languages. The questionnaire comprised of three sections: a) demographic characteristics of respondents, b) eating habits particularly binge eating, consumption of snacks and beverages c) subjective feelings of anxiety and d) weight before and during the pandemic. Demographic characteristics included gender, age, nationality, marital status, parity and housing of the respondents. Several questions were asked regarding binge eating habits documenting change in nutrition habits, time of increased food consumption, number and type of snack foods consumed during the day, water and coffee intake. Physical activity during the day was inquired using two questions: a) a trichotomous question documenting change in physical activity when compared with normal routine before the quarantine and number of hours spent in a sedentary manner per day in the last week. Symptoms of anxiety were measured subjectively using a three point Likert type question. Participants were asked the extent to which they experienced anxiety every day in last 7 days. Responses were given on a three point scale ranging from never to always.
All data were analyzed using the SPSS (v.25). Descriptive statistics were calculated for all variables where quantitative variables were presented as mean (SD) and categorical ones as frequency and percentage. Statistical significance for difference between weight of respondents during the COVID-19 pandemic and before it was assessed using t-test for dependent samples. To delineate predictors of weight gain, it was planned apriori to run multiple regression however due to non-normal nature of the data, preference was given to logistic regression analysis.
Thereafter, the respondents were categorized in to two groups: participants with weight gain and participants with negative or no change in weight. To identify the predictors of experience in weight gain among the Kuwaitis, binary logistic regression (stepwise method) was employed. Theoretically sound factors showing relationship with weight gain in previous literature were added as predictors in the logistic regression model. These predictors included demographic characteristics of respondents, eating habits c) subjective feelings of anxiety and d) questions pertaining to physical inactivity. The final model reported significant predictors of weight, with statistical significance set at ≤ 0.05.