Food delivery applications (FDAs) shined during COVID-19 global lockdown restrictions. As a consequence, this pandemic has changed the attitudes of individuals towards the greater use of these applications. This paper, therefore, aimed to examine the influence of using FDAs on knowledge and attitude lifestyle behaviours, including dietary habits and preferences among adult Saudi females. This cross-sectional study was conducted on 3667 adult Saudi females during the COVID-19 lockdown restrictions and found that the majorty of them (91.2%) were usually ordering food from FDAs while staying at home. One may possibly have to believe that this period can potentially alter their dietary habits when forcing the majority of individuals to remain at home for a prolonged period of time, with unlimited ease of access to palatable food. The study findings show that this belief is consistent with previous studies on ease-of-access, ease-of-use and speed-of-delivery of food delivery applications as important factors that impact prevalence, knowledge, attitude and dietary behaviour during the pandemic [17].
Prevalence and frequency of using food delivery applications and the sociodemographic patterns among adult Saudi female users during the Covid-19 lockdown period
To date, the prevalence and frequency of using food delivery applications and the sociodemographic patterns among adult Saudi female users during the Covid-19 lockdown period have not been investigated. Therefore, current understanding of the links between the prevalence and frequency of using FDAs among those users and their sociodemographic characteristics (age, education level, marital status, occupation, perceived obese status and income) and their habit patterns (i.e. do you use FDAs, how often FDAs are used, payment method used, spending rate, place of order, ways of order receiving, time of day to order, factors influencing an ordered meal from FDAs) will establish a baseline for comparison during and after the pandemic. Among the study participants, 44.6% of them asserts a continued usage of FDAs in the future. Similarly, [9]confirmed that food delivery services have been preferred, especially during dinner. Adopting and maintaining healthy lifestyle habits when using FDAs is recommended as a fundamental health principle. Thus, analysing their dietary habits, preferences and frequency using FDAs (72.7%) can express the future predominance of health risk behaviours such as high body mass index [18]. These health risks may become more prevalent and could persist after the pandemic among those students (82.2%) receiving a salary (80.5%) aged between 18–24 years (64.9%) with either high school and lower qualification (41.7%) or undergraduate and postgraduate degrees (58.3%), were not self-perceived obese (80%). For this reason, such a study allows future interventions to be targeted towards frequent users to serve as an indicator of potential public health issues and the need for further research on improving the content and services of FDAs.
Marital status
The majority of the participants were single (91.5%), and only 8.4% was married. Most of participants who were unmarried were more influenced to use FDAs and desired to increase their caloric intake than their counterparts. One possible reason for this could be the marital status that may shed light on how easy to use FDAs by the single females who show a weak moral obligation in meal planning and home-meal preparation compared to married ones who most likely reflect more interdependent self-orientation with their families for the meal's planning and preparation [19]. Another study referred the decrease in the online food industry during the COVID-19 pandemic to anxiety about food hygiene from outside [20]
Singles are easy to use apps while married women are mostly committed to preparing the meal for their family. For this reason, the percentage of obese single participants is higher than the married participants. The total percentage of Adult Saudi Female participant who were obese (n = 733, 20%). single subjects and married were 17.2% and 2.8% repectively.
One more finding of this study is that unhealthy eating patterns are well widespread among adult Saudi females by ordering from food delivery applications. Prevalence of such behavioural traits significantly counts towards overweight and obesity which provokes the need for improvements in FDAs and also obese management strategies by partners, healthcare providers and stakeholders.[21]
Time of day to order using FDAs
The results in the present study express the vital role of FDAs during the COVID-19 lockdown restrictions. 72.7% of the participants preferred to order meals using FDAs. Generally, the conventional time for dinner in Saudi Arabia is between 8:00–9:30pm [22]. However, findings showed that the preferred time to order is at dinner and midnight with 49.1% and 30.2%, respectively. The negative changes in the majority of late-night-dinner eating behaviour could be attributed to the COVID-19 pandemic, including prolonged home confinement, social distancing, isolation, being up late at night, psychological status, feeling a sense of boredom and stress [12, 23, 24, 25, 26, 27], supported by the increasing food availability, variety of meal choices and differential pricing offered by FDAs [28]. It is recommended to adhere to regular meal schedules to maintain a balanced diet and create a more stable energy source and continuous daily physical activity.
High-calorie food choices using FDAs
FDAs poses an inevitable challenge to the public health system by promoting unhealthy eating habits. It does this by enlarging the range of high-calorie food choices. Findings found roughly 32% of responses admitted that FDAs have greatly affected their eating habits by COVID-19 compared to those who did not change their eating pattern by ordering wisely and eating healthily when using FDAs (68.2%). During the confinement, the majority of participants were single (91.5%), students of distance learning from home (82.2%), receiving a salary from their institutions (80.5%) and using FDAs (72.7%), which made it difficult to cook and consume healthy homemade meals. Besides, these factors may also be the reasons for 53.6% of participants being highly motivated towards the consumption of high-calorie fast foods. Another study showed similar finding about the increased intake of carbohydrates, fat and fried food consumption [20, 29]. Therefore, unhealthy food consumption paired with low physical activity, especially for students with time constraints or busy schedules, may yield a positive energy balancen, increased body weight and related chronic diseases [18,30,31,32,33,34,35,36,37,38,39,]. Similar findings concerning the increased consumption of high calories due to COVID-19 confinement was also observed [21, 40, 41, 42]. In 2004, a brief review was published on the prevalence of physical inactivity in Saudi Arabia indicated that most Saudi females who are not physically active at a sufficient level (intensity, duration, frequency) [32]. In order to counteract poor dietary behaviours, meal planning and controlling food composition and meals' caloric content, adult females should be targeted for interventions aimed at maintaining and improving physical activity and dietary practices during this pandemic and beyond.
Fast-food advertising on social media platforms and FDAs
During the lockdown restrictions, fast food advertising posted on social media platforms targeting all age groups, especially adults, has grown exponentially [43]. In this study, the descriptive analysis results highlighted that almost half of the participants (58.8%) agreed that social media platforms encouraged fast-food consumption through the use of FDAs. Not only that, but 42.3% of participants agreed that their psychological state affected their meal type when using FDAs. While a total of 57.7% of the participants responded (28.9% stated not affect and 28.8% stated sometimes affect) about the impact of their psychological state on the type of meal chosen. This pattern has a close similarity to that found by [44] which is that social media platforms have a great effect on the mental (psychological) state of a customer when choosing food [44]. Presumably, the reason for this could be unhealthy food marketing through the leading social media platforms that have expanded to incorporate live streaming and augmented reality. In contrast, a total of 41.2% of the participants did not influence by social media. Affecting their usage can be related to their awareness of healthy and unhealthy food advertising and the reliability issues on social media [45, 46] This is an important indicator for both groups that cannot be ignored because this period would significantly impact an individual's nutritional status. However, there is no implemented ban, prohibition, or restriction on high-caloric food advertising either on social media platforms or the FDA's globally and Saudi Arabia. Therefore, globally fast-food services do not respond effectively to their health ministries' calling for reducing high-energy foods, especially in their digital menus[47, 48, 49]. Unless the government-led changing approach to effectively regulate social media advertising to protect public health by encouraging healthy food providers to participate in FDAs for a small fee, placing attractive pictures of healthy dishes and reviewing their prices because they are often expensive compared to unhealthy, especially high-calorie meals. The governmental supervisory approach as a third-party e-commerce platform should contribute to mitigating the negative and promoting the positive impacts of online food delivery on user's health, thus ensuring its sustainability.
Influence of food calorie information on using FDAs
As a part of Saudi Arabia's vision of 2030 to promote a healthier lifestyle, the Food and Drug Authority in Saudi Arabia obligated all food establishments to apply food calorie information on digital and non-digital menus by the end of 2018. The Ministry of Municipal Rural Affairs and Housing will be responsible for monitoring, and the Food and Drug Authority will be responsible for ensuring the correctness of calculating calories. A violation ticket for non-compliance will be issued to food businesses. Despite Saudi Arabia's keenness to offer health protection and care to citizens, 60% of participants in this study neglected the importance of calories displayed on the FDA's menu. In contrast, 26.7% of participants reported sometimes being influenced by the number of calories when ordering meals, and 13.1% of participants paid attention to such information. According to multiple previous studies, opposite opinions were observed that females were affected mainly by calorie labelling provided by restaurants than their counterparts [50, 51, 52]. Additionally, the findings of this study suggest that calorie information did not change the participant's habits even when the meal's ingredients were displayed on menus (61.5%). Other reviews emphasised a similar opinion that the effectiveness of calorie labelling on the menu has little impact on purchasing fast-food meals [53, 54, 55, 56]. However, there is a lack of information on the influence of food calorie labelling on the menu of FDAs. Whereas [57] found it is not promising that providing calorie labelling on the menu can prevent obesity. Thus, this emerging evidence shows that calorie information and meal ingredients (content) on the restaurant's digital and non-digital menus do not similarly influence all population groups' ordering decisions and may have unintended consequences for individuals who struggle with disordered eating or other weight-related concerns.