Background: The pandemic of novel coronavirus (COVID-19) that we are facing affects daily habits. On a global scale, restrictions in mobility, social distancing measures, and the persistent health alarm resulted in dramatic lifestyle changes and affected physical and even psychological wellbeing during the period of a pandemic. We assessed consumption and acquisition of food before and during the lockdown due to the COVID-19 outbreak to understand eating behavior during an unexpected situation.
Objectives: The study aims to develop new diagnostic, predictive, and prognostic systems in health promotion for a fuller picture of the real world. It examined complex causal models with both simultaneous and sequential mediation between media exposure, healthy diet, food literacy, and fear of anxiety. As a moderator, characteristics of socioeconomic status were considered to influence the level and presence of a relationship between food media use and healthy food consumption.
Theoretical Framework: Social cognitive theory predicts healthy eating based on media exposure to food. In addition, on the basis of the generalized arousal mechanism, fear of coronavirus anxiety predicts food media use and healthy eating habits. When food literacy levels are taken into account in the model, the association between food media exposure and healthy eating habits is strengthened. Hypothetically, the level of a relationship between these variables is influenced by four characteristics of socioeconomic status, including education, income, employment status, and subjective social status.
Method: An international research team was constituted to develop a study involving different countries about food media use, dietary habits, and behaviors related to food intake, acquisition,
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and preparation. This study presented the results of an online survey in the Greater China area (Mainland China, Taiwan, Hong Kong, and Macao), by carrying out during the first lockdown, in 2020. It assessed food-related behavior and how people perceived them to change, compared to the period preceding the COVID-19 outbreak. A cross-sectional survey was conducted online from November and December 2020. It was intended for Chinese residents 18 years of age or older. Two clusters were identified, based on the nutritional level of food type, which was classified as “healthier” and “unhealthier.” To examine the modeling effect, a multiple regression analysis for the data on food media and healthy diet with categorical status (employment, social status) demographic were operated jointly. Participants were asked to select whether the frequency was lower, higher, or equivalent compared to their usual behavior before the pandemic. After collecting data on each of these variables, SPSS statistics 24 was used for descriptive analysis and causal relationships.
Results: A total of 474 responses, collected from Mainland China (64.1%), Macau (23.6%), Hong Kong, and Taiwan (1.5%), were considered for analysis. Results suggested that the relationship between food media use and healthy food consumption showed full mediation, and its total effect was also significant. Considering food literacy was a mediating factor, a positive statistical relationship between food media exposure and healthy eating habits remained (B = .051, p < .001). Another finding showed that media use affected healthy eating mainly through the fear of coronavirus anxiety (B = .014, p < .001). In addition, regarding the contribution to the total product, the percentage of the mediation effect of food literacy was 3.7 times higher than that of fear. In this study, socioeconomic characteristics was found to be a preeminent factor of the learning process regarding sustainable and healthy diets. In particular, two moderators, subjective social status and employment status, helped judge the external validity of this study. Social status served as a moderator to identify the limitations of when the
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relationship between food media and eating holds. The other moderator showed that while food media use predicted the level of healthy food consumption, this relationship was stronger among those with higher employment status. In comparision, the moderating effect of subjective social status was more influential than employment status, which played a positive and important role in reinforcing each of the three pathways from food media exposure to food literacy, to fear feelings, and to healthy eating.
Conclusions: Including mediators and moderators in our research goes beyond studying a simple relationship between food and media. It also facilitates our understanding of the complex causal relationships, the main changes, and their underlying motivations in a time of unprecedented crisis. It is of major importance, as it provides the scientific support that allows one to anticipate the implications for the future of the global food and nutrition system and, consequently, to take the appropriate action.

研究背景与目的：新冠肺炎疫情 (COVID-19) 的大流行引发了人们对饮食选择和习惯的改变。在社会认知、习得性恐惧和普遍性唤醒的理论基础框架下，本研究意图通过食品素养和恐惧情绪，构建食品媒介曝光对健康饮食行为变化的中介效应模型。除此之外，社会经济特征的调节效应 本研究还探究了。

研究方法与结果：本研究采用了2020年11月至12月收集的474名中国成年人的横断面调查。研究结果显示了一个完全正向的互补性中介效应模型。针对于总效应的贡献度而言，食品素养的中介效应的占比是疫情恐惧情绪的3.7倍。与此同时，两个社会经济特征，即主观社会地位和雇佣状态，在塑造媒介曝光和健康饮食行为之间的关系中起到了积极的、间接性的调节作用。重要的是，主观社会地位较高的群体可以从接触食品媒介中习得更多的健康饮食相关的行为。

结论：媒介曝光可能通过培养食品素养促进更健康的行为。除此之外，媒介还有一个鲜为人知的功能，即在危机时期煽动理性的恐惧，例如呼吸道疾病的大流行。这可能会煽动一个没有受到即时和瞬间影响的领域的普遍的唤醒，例如对食品和健康饮食的关注，以促进更健康的行为。

关键词： 媒介曝光、健康饮食、食品素养、恐惧、主观社会地位、雇佣状态