Virtual Conference

Start Date

27-6-2022 11:00 AM

End Date

27-6-2022 12:10 PM


washington; spokane; covid-19



Diet quality is an important social determinant of health; having a poor diet quality over time increases odds of all-cause mortality. Although healthcare providers receive formal education on health-promoting behaviors such as having a healthy diet quality, evidence suggests that nurses on average do not follow national recommendations for diet. Registered Nurses working in the acute care setting during the SARS-CoV-2 pandemic have reported increased stress and poor emotional well-being, and strong evidence supports that stress is related to unhealthy diet quality. Increased stress is also linked to poor occupational outcomes, including higher risk for more missed days from work and poorer nursing care delivery. Nurses may need support to prevent worsening diet quality due to the stress of working during the pandemic, yet it is unclear what factors relate to self-reported changes in diet quality within this population.

Purpose/ Aims 

To determine relationships between nursing demographics, mood, exercise habits, and reported diet quality changes during the SARS-CoV-2 pandemic among acute care Registered Nurses working full-time, 12-hour shifts.

Methods / Approach

Guided by Orem’s Self Care Theory, nurses working full-time, 12-hour day or night shifts from the Western United States were recruited to measure diet, exercise, and sleep for seven days between October 2020-2021. This secondary analysis describes cross-sectional, nurse-reported measures (demographics, exercise stress, and COVID-related diet quality changes) collected during the pandemic.


Fifty-seven nurses provided data. Of these, 24 (42.1%) reported worse, 19 (33.3%) reported same, and 14 (24.6%) reported improved diet quality in the context of COVID-19. In our sample, significantly more nurses with an improved diet quality worked day shift (n = 12, 85.7%) and exercised more since the pandemic (n = 7, 50%) compared to those with the same (n = 11, 57.9%; n = 3, 15.8%, respectively) or worse diet (n = 11, 45.8%; n = 2, 8.3%, respectively). Nurses with a better diet quality had a significantly lower BMI (m = 24.1) and waist circumference (m = 31.3 in.) compared to those reporting a worse diet (m = 29.6; 36.7; respectively). Nurses with a self-reported worse diet were significantly more likely to walk less than 10,000 steps per day on average (RR=1.66, p<0.001). Nurses with an improved diet quality reported clinically less stress (m = 4.9) compared to those with the same (m = 6.1) or worse diet (n = 6.6).


This study aligned with prior evidence that nurses working night shift were more likely to report a poorer diet quality due to the pandemic than those working day shift. Also, nurses in our sample who reported an improved diet quality perceived better emotional health and were more likely to report exercising more since the pandemic compared to those whose diet quality stayed the same or worsened.

Implications and Further Research 

Future research is needed to uncover the best strategies to support diet quality and overall wellbeing for working nurses, especially when employed during times of high stress.


Asghari, G., Mirmiran, P., Yuzbashian, E., & Azizi, F. (2017). A systematic review of diet quality indices in relation to obesity. British Journal of Nutrition, 117(8), 1055–1065. https://doi.org/10.1017/s0007114517000915

Cho, H., & Steege, L. M. (2021). Nurse Fatigue and Nurse, Patient Safety, and Organizational Outcomes: A Systematic Review. Western Journal of Nursing Research, 0193945921990892.

Fryar, C. D., Kruszan-Moran, D., Du, Q., & Ogden, C. L. (2018). Mean body weight, height, waist circumference, and body mass index among adults: United states, 1999-2000 through 2015-2016 - pubmed. PubMed. https://pubmed.ncbi.nlm.nih.gov/30707668/

Khaled, K., Tsofliou, F., Hundley, V., Helmreich, R., & Almilaji, O. (2020). Perceived stress and diet quality in women of reproductive age: A systematic review and meta-analysis. Nutrition Journal, 19(1), 1-15.

Khubchandani, J., Kandiah, J., & Saiki, D. (2020). The COVID-19 pandemic, stress, and eating practices in the United States. European Journal of Investigation in Health, Psychology and Education, 10(4), 950-956.

Sagherian, K., Steege, L. M., Cobb, S. J., & Cho, H. (2020). Insomnia, fatigue and psychosocial well‐being during COVID‐19 pandemic: A cross‐sectional survey of hospital nursing staff in the United States. Journal of Clinical Nursing. https://doi.org/10.1111/jocn.15566

Sotos-Prieto, M., Bhupathiraju, S. N., Mattei, J., Fung, T. T., Li, Y., Pan, A., ... & Hu, F. B. (2017). Association of changes in diet quality with total and cause-specific mortality. New England Journal of Medicine, 377(2), 143-153.


Jun 27th, 11:00 AM Jun 27th, 12:10 PM

Podium Presentation: Registered Nurses' Diet Quality and Overall Health during the SARS-CoV-2 Pandemic

Virtual Conference