The protracted wars with Iran, Hamas, and Hezbollah have implanted in many Israelis of all ages the “What the Hell Effect,” and the authorities need to do something about it, such as “targeted health interventions during emergencies,” according to researchers.
With soldiers dying and being wounded, civilians murdered by missiles, and homes destroyed, people across the country have been caught in the What the Hell Effect: “Who cares if I eat junk food, smoke, stop exercising, and spend hours daily looking at electronic screens?”
Public health experts at the Hebrew University of Jerusalem (HUJI) who surveyed Israelis aged 20 to 70 about the changes in their health behaviors and those of their young children are worried about whether they will again adopt healthful habits if/when the violence and danger end.
The survey was conducted by a team from the “For a Change” Lab at HUJI’s School of Public Policy, led by lab co-founder Dr. Roni Lotan, together with co-founder Prof. Eyal Peer, and cognitive and social psychology researcher Dana Roll.
Two years ago. Peer and Lotan established the For A Change Lab to promote healthful behaviors and make the general public, nongovernmental organizations, and government offices aware of changes that have to be made.
“We believe that people can choose healthier and more sustainable lifestyles if given the right choice environment. Our vision is to help public and private organizations create personally optimal choice environments where individuals can make the healthiest and most sustainable decisions.”
They have now surveyed 485 Israeli Jews (mean age 42.9; 52.8% women), sampled via iPanel. The survey was distributed approximately two weeks after the outbreak of the current war, and respondents reported on their health habits during the war compared to the two months preceding it. Israelis don’t need a survey to learn that they have been severely sleep deprived since Iran and Hezbollah in Lebanon began raining ballistic missiles, rockets, and drones on them at all hours of the day and night. About 60% of respondents reported reduced sleep duration during the war, with an average decline of 13.4%.
In an interview with The Jerusalem Post, Peer – a social psychologist and behavioral researcher who focuses on how “choice architecture” (the design of environments in which people make decisions without restricting freedom of choice can be used to help people make better decisions) – said that when some normalcy returns, they will survey the same participants to see if they have returned to pre-war behavioral patterns.
But they will be interested in learning of the effects the war has had on all other aspects of their health behaviors, including nutrition, physical activity, smoking, sleep, and more – mostly bad news but also some good tidings.
Drop in physical activity since start of the war
The most salient finding was a major drop in exercise and other physical activity. Nearly two-thirds of respondents reported a decrease in their daily step count, averaging about 30% fewer steps compared to the pre-war period. A total of 57% reported reduced physical activity, including aerobic exercise, strength training, and flexibility workouts, with weekly exercise frequency declining from an average of 3.8 sessions to 2.6 (a 30% decrease).
Many increased their intake of ultra-processed junk food such as snacks, sweets, and pastries, products typically high in fat, sugar, and salt. About half of the respondents reported that they ate more of these foods, rising from an average of 1.2 servings per day before the war to 1.63 during the war (a 36% increase). At the same time, 44% reported decreased consumption of fruits and vegetables, with intake declining from 1.93 to 1.84 servings per day (a 6.2% decrease). Alcohol consumption also increased, with an average rise of 31%, although only 18.1% of respondents reported drinking more.
Surprisingly, no link was found between decreased fruit and vegetable intake and increased consumption of ultra-processed foods. This means that the rise in ultra-processed food consumption did not come at the expense of more healthful foods, but instead reflected an overall increase in food intake.
Gender differences were also observed: women reported a more pronounced decrease in fruit and vegetable consumption and a greater increase in ultra-processed food intake compared to men. Not big differences. Maybe by chance.
However, sleeping less was linked with both increased consumption of ultra-processed foods and decreased physical activity. Individuals who slept less during the war experienced greater deterioration in both dietary and physical activity habits.
Investigating the use of tobacco, they found that among smokers (18% of the sample), 31% reported increasing the number of cigarettes they lit up, with an average increase of 17%. However, this finding should be interpreted cautiously due to the relatively small number of smokers in the sample. People were not ashamed to tell the truth.
They didn’t poll children, but they did ask the 206 participants who were parents of children aged two to 10 years. The most striking finding was a substantial increase in screen time, reported by 85% of parents.
Dietary habits among children also worsened. Over half of parents (56.6%) reported increased consumption of snacks, sweets, and pastries; 48% reported increased intake of fast food (such as frozen schnitzels and hot dogs); and 45% reported drinking more sugary drinks. Additionally, 52% of parents reported reduced physical activity among their children, and 41% reported decreased sleep duration.
These behavioral changes tended to bunch together. Spending more time with screens (TV and smartphones was associated with higher consumption of junk foods, including fast-food, salty snacks, and sugary drinks – as well as foods with less physical activity. Sleeping less was also linked to reduced sleep. These findings suggest that the war did not affect isolated behaviors but led to a simultaneous deterioration across multiple health domains in children.
The frequency of Home Front alarms and sirens was also linked with children’s behaviors – less sleep and more screen time. Interestingly, having young children appeared to act as a protective factor for parental alcohol consumption –parents of children aged two to 10 years reported smaller increases in alcohol intake compared to those without young children.
“Our findings highlight the urgent need for targeted health interventions during emergencies,” said Lotan, an epidemiologist and clinical dietitian specializing in behavioral health. “It’s essential to design environments and solutions that support the maintenance of healthy routines under stress and uncertainty. These may include facilitating access to home-based physical activity, shaping healthier family food environments, and supporting parents in maintaining structured daily routines for their children.”
Among the lab’s projects are increasing colon cancer screening using personalized behavioral interventions; reducing single-use plastics especially among ultra-Orthodox (haredi) households (the Shas-controlled Health Ministry canceled a tax that would help achieve this); encouraging breast cancer patients to take medicines as prescribed; increasing participation in smoking-cessation courses; encouraging Ashkenazi women to undergo genetic screening for BRCA mutations that raise their risk of breast cancer; and reducing health gaps in Arab society, including identifying barriers that prevent parents from performing hearing screening tests for their newborn children.
Peer said that war doesn’t just hurt people only when it occurs, but also in the long term. “It’s unfortunate that young children from kindergarten age are not taught how to adopt health-promoting behaviors. The lab is working on such a program for youths in intermediate schools. I am worried, but I’m not despondent,” Peer concluded. “There is much to do in the battle for better health.”
