Comparative Study of the Long-Term Impact of the COVID-19 Pandemic on Mental Health and Nutritional Practices Among International Elite and Sub-Elite Athletes: A Sample of 1420 Participants from 14 Countries

TLDR

COVID‑19 lockdowns have been linked to negative mental health and eating behaviors in the general population and athletes, yet long‑term effects on elite and sub‑elite athletes remain understudied. This study examined the long‑term impact of the COVID‑19 lockdown on mental health and eating behaviors in elite versus sub‑elite athletes two years into the pandemic. A cross‑sectional survey of 1,420 athletes from 14 countries, recruited via convenient snowball sampling in March–April 2022, collected sociodemographic data, pandemic experiences, DASS‑21 scores, and REAP‑S eating‑behavior assessments. Elite athletes scored significantly lower on DASS‑21 depression, anxiety, and stress subscales and on the REAP‑S diet‑quality index than sub‑elite athletes, indicating better mental health but poorer diet quality two years after the pandemic began.

Abstract

Although several studies have shown that the Coronavirus Disease 2019 (COVID-19) lockdown has had negative impacts on mental health and eating behaviors among the general population and athletes, few studies have examined the long-term effects on elite and sub-elite athletes. The present study aimed to investigate the long-term impact of COVID-19 lockdown on mental health and eating behaviors in elite versus sub-elite athletes two years into the pandemic. A cross-sectional comparative study was conducted between March and April 2022, involving athletes from 14 countries, using a convenient non-probabilistic and snowball sampling method. A total of 1420 athletes (24.5 ± 7.9 years old, 569 elites, 35% women, and 851 sub-elites, 45% women) completed an online survey-based questionnaire. The questionnaire included a sociodemographic survey, information about the COVID-19 pandemic, the Depression, Anxiety and Stress Scale-21 Items (DASS-21) for mental health assessment, and the Rapid Eating Assessment for Participants (REAP-S) for assessing eating behavior.The results showed that compared to sub-elite athletes, elite athletes had lower scores on the DASS-21 (p = .001) and its subscales of depression (p = .003), anxiety (p = .007), and stress (p < .001), as well as a lower REAP-S score indicating lower diet quality (p = .013).In conclusion, two years into the pandemic, elite athletes were likelier to have better mental health profiles than sub-elite athletes but surprisingly had lower diet quality.