Quarantine during COVID-19 outbreak: Changes in diet and physical activity increase the risk of cardiovascular disease

Psychological responses and dietary changes of residents during the local outbreak of COVID-19 in the post-epidemic era: A cross-sectional study

The coronavirus disease 2019 (COVID-19) pandemic has had a dramatic impact on the psychological state and dietary behavior of individuals. Many previous studies have discussed the psychological and dietary problems during the first COVID-19 pandemic. However, few papers have discussed them during the local COVID-19 outbreak in the post-epidemic era. To explore the psychological responses and the influencing factors, dietary changes and the relationship with psychological responses during the local COVID-19 outbreak in the post-epidemic era. Methods: A total 3790 residents were surveyed by online questionnaire to collect information about social demography, health status, local outbreak related information, lifestyle changes, anxiety and depression. Binary logistic regression was used to discuss the influencing factors of anxiety and depression. Kendall tau-b correlation coefficient was used to discuss the relationship between anxiety, depression and dietary changes. Self-perceived physical condition, chronic disease, lockdown or quarantine, fear of COVID-19, changes in smoking, drinking and physical activity were the influencing factors of anxiety and depression. The top 3 foods with increased intake were drinking water, fresh fruits and fresh vegetables, while the top 3 foods with reduced intake were puffed foods, fried foods and sugary foods. Dietary changes were correlated with generalized anxiety disorder-7 and patient health questionnaire-9 scores. These findings provide experience and clues for local governments to improve the psychological status and dietary habits of residents during the local COVID-19 outbreak in the post-pandemic era.

Cognitive decline among older adults with heart diseases before and during the COVID-19 pandemic: A longitudinal cohort study

Background

Little is known about the impact induced by the COVID-19 pandemic on the cognitive function of older adults with heart diseases. This study aimed to examine whether older adults with heart diseases suffered larger cognitive deterioration during the COVID-19 pandemic.

Methods

This study leveraged longitudinal data from the Health and Retirement Study (HRS), a nationally representative U.S. aging cohort with objective cognitive assessments measured before and during the pandemic. The interval from HRS waves 13 to 14 (April 2016 to June 2019) was defined as the pre-pandemic period to control the pre-existed cognitive difference between participants with and without heart diseases, and the interval from waves 14 to 15 (June 2019 to June 2021) was defined as the pandemic period. The HRS wave 14 survey was considered the baseline. The heart disease status was defined by a self-reported diagnosis. Linear mixed models were performed to evaluate and compare the cognitive differences during different periods.

Results

A total of 9,304 participants (women: 5,655, 60.8%; mean age: 65.8 ± 10.8 years) were included, and 2,119 (22.8%) had heart diseases. During the pre-pandemic period, there was no significant difference (-0.03, 95% CI: -0.22 to 0.15, P = 0.716) in the changes in global cognitive scores between participants with and without heart disease. During the pandemic period, a larger decreased change in the global cognitive score was observed in the heart disease group compared with the non-heart disease group (-0.37, 95% CI: -0.55 to -0.19, P < 0.001). An enlarged difference in global cognitive score was observed during the pandemic period (-0.33, 95% CI: -0.65 to -0.02, P = 0.036).

Conclusion

The findings demonstrated that the population with heart diseases suffered more cognitive decline related to the pandemic, underscoring the necessity to provide immediate cognitive monitoring and interventions for the population with heart diseases.

Change in eating habits during the Spanish COVID-19 pandemic lockdown: evidence for a sample of university community

Background

The stress and anxiety caused by COVID-19 lockdown may have changed the eating habits of the population. Our aim is to assess the eating changes that have taken place due to the pandemic.

Methods

Data were collected through an electronic survey created by the Health Economics Research Group of the University of Cantabria and IDIVAL and conducted between 14/01/2021 and 19/02/2021. A total of 1,417 responses were recorded, but only 507 complete observations were considered. We carried out a cross-sectional analysis through ordered probit regressions.

Results

The improvement in post-confinement eating habits is associated with higher income level, better self-assessed health status and more physical activity. The worsening of eating habits is associated with having a certain level of nomophobia or the fear of contagion.

Conclusions

Our analysis can be used for designing and implementing new strategies to overcome the negative spill overs of the COVID-19 pandemic and improve the dietary patterns.

Changes in diet quality and its association with students' mental state during two COVID-19 lockdowns in Croatia

Background: The COVID-19 pandemic has left substantial consequences on the mental health of the student population, primarily through an increase in the symptoms of acute stress and anxiety. Aim: This study evaluated diet quality and its association with mental state among Croatian students during the spring and winter COVID-19 lockdowns in 2020. Methods: Data were collected using an anonymous online self-reported questionnaire taken on two occasions. During the spring lockdown (from May 18 to June 7, 2020) and the winter lockdown (from December 14-22, 2020), 751 and 1188 students completed the questionnaire, respectively. Diet quality was determined using the pro-healthy diet index (pHDI) and non-healthy diet index (nHDI). Results: Although to the greatest extent associated with increased white meat, fish, and legumes intake, an increase in pHDI was also linked to increased consumption of water and sweets and decreased intake of processed meat products and nuts. Increased nHDI was mainly due to increased intake of processed meat products, alcohol, and sweets. Moreover, diet quality was higher during the lockdowns than in the periods before. However, diet quality increased to a lesser extent during the winter lockdown and was associated with a poorer mental state, shown as type D (Distressed) personality. Type D personality positively correlated with nHDI and sweets intake but negatively with pHDI, fruit, and vegetable consumption. Conclusion: These results indicate the need to alleviate further students' diet quality and mental state impairment. Also, further investigation of the association between diet quality and mental state should be provided.

Changes in Adults' Eating Behaviors During the Initial Months of the COVID-19 Pandemic: A Narrative Review

Factors such as regulations and health concerns shifted daily habits, including eating behaviors, during the early months of the coronavirus disease 2019 (COVID-19) pandemic. This comprehensive narrative review synthesizes research on eating behavior changes during the early months of the pandemic (February to June 2020), including changes in amount, rate, and timing of food consumption, types and healthfulness of foods consumed, the occurrence of other specified eating behaviors (eg, restrained eating or binging), and reasons for eating (eg, stress or cravings), among adults. A literature search using three EBSCOhost databases and Google Scholar was conducted to identify relevant articles made available in 2020. A total of 71 articles representing 250,715 individuals from more than 30 countries were reviewed. Findings show eating behaviors changed little during the early COVID-19 pandemic for most participants. Among those whose eating behaviors changed, increases in both intake and frequency of eating meals and snacks were more common than decreases. Findings on timing of eating and healthfulness of food consumed showed mixed results. However, when changes occurred in the type of food consumed, increases were more common for snacks, homemade pastries, white bread/pasta, legumes, and fruits/vegetables; decreases were more common for meats, seafood/fish, frozen foods, fast food, dark breads/grains, and dark leafy green vegetables. During the pandemic, binging, uncontrolled eating, and overeating increased, meal skipping decreased, and restrictive eating had mixed findings. Changes in factors such as emotions and mood (eg, depression), cravings, and environmental factors (eg, food insecurity) were related to changes in eating behaviors. Findings can inform clinical practitioners in efforts to mitigate disruptions to normal, healthy eating patterns among adults both in and outside of global health catastrophes.

Bone fragility during the COVID-19 pandemic: the role of macro- and micronutrients

Bone fragility is the susceptibility to fracture due to poor bone strength. This condition is usually associated with aging, comorbidities, disability, poor quality of life, and increased mortality. International guidelines for the management of patients with bone fragility include a nutritional approach, mainly aiming at optimal protein, calcium, and vitamin D intakes. Several biomechanical features of the skeleton, such as bone mineral density (BMD), trabecular and cortical microarchitecture, seem to be positively influenced by micro- and macronutrient intake. Patients with major fragility fractures are usually poor consumers of dairy products, fruit, and vegetables as well as of nutrients modulating gut microbiota. The COVID-19 pandemic has further aggravated the health status of patients with skeletal fragility, also in terms of unhealthy dietary patterns that might adversely affect bone health. In this narrative review, we discuss the role of macro- and micronutrients in patients with bone fragility during the COVID-19 pandemic.

A 'health message' on sustainable physical and mental health for the prolonged COVID-19 and other pandemics

The world has been living with another pandemic physical inactivity (PI) and sedentary behavior (SB) and of other nature for years. As social measures to prevent the spread of COVID-19 have been strengthened, the physical activity (PA) barrier has been hit and the PI/SB pandemic has been exacerbated, and in the current situation, triggered by its prolonged period, it is emerging as a problem to be considered in order to combat the PI/SB pandemic through PA and to maintain continuous physical and mental health. This review aims to summarize existing and recent studies on the effects of PA/SB on physical and mental health in preparation for the context of prolonged COVID-19 and provides an easy and fun way to motivate, access PA, and PA recommendations for maintaining physical and mental health. We performed search strategies on PubMed, Medline, Scopus, and Google Scholar databases, and used a literature review of the current available literature on the COVID-19 and the effects of PI, SB, and PA on physical and mental health. The clinical relevance of this review shows that integrating PA into daily life and reducing prolonged sitting time is an important strategy for continuing a healthy life physically and mentally. As a result, for those who have not yet incorporated exercise as part of their daily routine, fun and easy access to PA suggests that in the long run, may be an opportunity to implement newer habits. In addition, in an emergency such as the COVID-19 quarantine period or other pandemics, it is essential for one to maintain health through PA at home, and underscore the 'health message' of the current review that reducing SB, progressively increasing PA, and doing more PA regularly in the current context prolonged COVID-19 can bring significant benefits to long-term habits and physical and mental health.

Changes in Lifestyle Behaviors of Children and Adolescents during the COVID-19 Pandemic and the Impact on the Development of Non-Communicable Diseases: A Narrative Review

Background: Quarantine restrictions have changed the usual lifestyle habits of children and adolescents. In this review, we summarize how the COVID-19 outbreak changed lifestyle during childhood and discuss potential short- and long-term effects of NCD high-risk behaviors on health outcomes. Methods: literature search was conducted in Medline database (PubMed), Scopus, Embase, Web of Science, and Google Scholar. All studies that assessed the relationship between COVID-19 outbreak and lifestyle changes were included. Results: NCD risk factors such as unhealthy diet, physical inactivity, prolonged screen time and sedentary behavior, disrupted sleep schedules and sleep quality, as well as mental disorders during COVID19 in childhood, may increase the susceptibility to NCDs in adulthood. These changes in lifestyle behaviors have short and long-term cardio-metabolic and psychological health outcomes. Since it is not clear when COVID-19 is completely controlled, assessment of the interactions between COVID-19 and lifestyle activities in the pediatric age group is critical. Conclusion: The pandemic of coronavirus disease 2019 (COVID-19) has greatly influenced all levels of health systems. During the COVID-19 pandemic, prevention and management of non-communicable diseases (NCDs) will need to be prioritized even further.

Depression and Anxiety Are Associated With Cardiovascular Health in Young Adults

Background Cardiovascular health (CVH) declines in young adulthood, and mood disorders commonly emerge during this life stage. This study examined the association between depression, anxiety, and CVH metrics among young adults. Methods and Results We conducted a cross-sectional analysis of participants aged 18 to 34 years who completed the Emory Healthy Aging Study Health History Questionnaire (n=875). We classified participants as having poor, intermediate, or ideal levels of the 8 CVH metrics using definitions set forth by the American Heart Association with adaptions when necessary. We defined depression and anxiety as absent, mild, or moderate to severe using standard cutoffs for Patient Health Questionnaire and General Anxiety Disorder scales. We used multivariable regression to examine the association between depression and anxiety and CVH, adjusting for age, sex, race and ethnicity, income, and education. The mean participant age was 28.3 years, and the majority identified as women (724; 82.7%); 129 (14.7%) participants had moderate to severe anxiety, and 128 (14.6%) participants had moderate to severe depression. Compared with those without anxiety, participants with moderate to severe anxiety were less likely to meet ideal levels of physical activity (adjusted prevalence ratio [aPR], 0.60 [95% CI, 0.44-0.82]), smoking (aPR, 0.90 [95% CI, 0.82-0.99]), and body mass index (aPR, 0.79 [95% CI, 0.66-0.95]). Participants with moderate to severe depression were less likely than those without depression to meet ideal levels of physical activity (aPR, 0.48 [95% CI, 0.34-0.69]), body mass index (aPR, 0.75 [95% CI, 0.61-0.91]), sleep (aPR, 0.79 [95% CI, 0.66-0.94]), and blood pressure (aPR, 0.92 [95% CI, 0.86-0.99]). Conclusions Anxiety and depression are associated with less ideal CVH in young adults. Interventions targeting CVH behaviors such as physical activity, diet, and sleep may improve both mood and CVH.

Knowledge and behaviors of using vitamin D to boost immunity against COVID-19 pandemic: A cross-sectional study in Saudi Arabia

The coronavirus 2019 (COVID-19) pandemic has globally impacted all aspects of life since its emergence and spread. There is a strong biological assumption and progressing epidemiological data supporting the role of vitamin D (VD) in COVID-19 infection. This study aims to determine the knowledge about VD supplements to boost immunity against COVID-19 and if participation in specific behaviors has increased the consumption of VD supplements during social distance restriction in Saudi Arabia (SA) in May 2021. This cross-sectional study used a structured online questionnaire for 2369 SA people, including demographic characteristics and knowledge about VD supplements to boost immunity against COVID-19 showed that there was a significant association between sex and vitamin D deficiency (VDD) (P = .000), and having VDD was strongly associated with having another vitamin deficiency (P = .008). Additionally, there was a statistically significant difference between VDD and cardiovascular (P = .027) and respiratory diseases (P = .019). Almost half of the participants used VD supplements to reduce or heal their COVID-19 symptoms. The adverse association between having VDD and understanding of COVID-19 symptoms was statistically significant (P = .01). Ginger is commonly used as an alternative medicine for the treatment of VD. The administration of VD is now known to be of physiological significance for general health, and evidence suggesting the beneficial role of VD in the prevention and/or treatment of diseases, particularly infectious diseases, such as COVID-19, is increasing.

The impact of the COVID-19 pandemic on the diet, training habits and fitness of Masters cyclists

Background: The number of Masters-level athletes (≥ 35 years of age) taking part in cycling has increased in the past years which may have beneficial effects on their health. The restrictions brought on by the COVID-19 pandemic has the potential to negatively impact the diet, training and fitness of these individuals due to restrictions in place to slow the spread of the virus. Aim: To investigate how the COVID-19 pandemic impacted the diet, training and fitness of Masters-level cyclists. Methods: 32 Masters cyclists (12 males, 20 females; mean age 47 ± 10 years) completed two incremental exercise tests one month apart during the pandemic to assess sport-specific fitness. Participants also completed online questionnaires to report their sedentary behavior and dietary intake before and during the pandemic, and their training volume and intensity for a specified week in February (before the pandemic) and each of March, April and May (during the pandemic). Results: No differences were seen in fitness (p = 0.6), training volume (p = 0.24) or intensity (p = 0.79) and sedentary behavior (p = 0.14) during the pandemic. Energy intake was unchanged (p = 1.0) during the pandemic, but participants consumed lower amounts of key nutrients such as fiber, vitamin A, omega-3 fatty acids and potassium (p < 0.05) while consuming more alcohol (p = 0.008) and vitamin C (p = 0.03). Conclusions: Our data shows that the COVID-19 pandemic has undesirable effects on nutrient and alcohol intake of Masters cyclists without impacting their training regimes, which may have adverse effects on their overall health and fitness in the long term.

The effect of COVID-19 home quarantine on the psychological state of pharmacy students: a cross-sectional study

Background

Psychological morbidity has been documented in medical and pharmaceutical undergraduate students in different countries around the world. In this study, we examined the impact of coronavirus disease 2019 (COVID-19) home quarantine on the depressive psychological aspects of last-grade pharmacy students.

Methods

A cross-sectional study was conducted by the Department of Clinical Pharmacy, Faculty of Pharmacy, Deraya University, Egypt. Two hundred and sixty-eight last-grade pharmacy students were included in this study, and they completed a self-administered, pre-designed, anonymous questionnaire. The main outcome measures were the Hamilton Depression Rating Scale (HRS) and Patient Health Questionnaire-9 (PHQ-9), which were measured to screen for the symptoms of psychological depression and determine the degree of depression severity between the beginning and the end of the COVID-19 home quarantine period. Data entry and analysis were done using the Statistical Package for Social Science (SPSS) software version 26. Descriptive statistics were employed for analyses of the data, and categorical variables were described by frequencies and percentages. Bivariate and multivariable analyses were performed to examine relations between demographic data and psychological scales. The study protocol was approved by the Faculty of Pharmacy, Minia University Ethical Committee.

Results

A total of 268 students participated in this study (102 males and 166 females). The mean ± SD score of baseline HRS and HRS at the end of the study was 6.3 ± 4.45, 7.95 ± 5.36, respectively, with the presence of a statistically significant difference between the two scores (p < 0.001). The mean ± SD score of baseline PHQ-9 and PHQ-9 at the end of the study was 4.35 ± 3.45, 5.37 ± 4.14, respectively, with the presence of a statistically significant difference between the two scores (p < 0.001). The results showed that the COVID-19 home quarantine period led to a depressive psychological effect on the students in this study.

Conclusions

Students’ psychological depression causes morbidity and, in some cases, mortality. Psychological depressive problems were significantly associated with the COVID-19 home quarantine period, which calls for early intervention to solve it. Student counselling services must be more accessible and affordable to overcome this problem.

Social network analysis of tourism data: A case study of quarantine decisions in COVID-19 pandemic

Tourism is one of the most affected sector during the COVID-19 pandemic all over the world. Quarantine decisions are the leading measures taken in practice to reduce possible negative consequences of the COVID-19 pandemic. There is limited work in the literature on how to make the right quarantine decisions in a pandemic. Therefore, the aim of this study is to propose the use of social network analysis (SNA) based on tourism data to make the right quarantine decisions in the COVID-19 pandemic. A case study on quarantine decision is conducted based on data obtained from Turkish Statistical Institute to show how to perform SNA. Household domestic tourism survey is used as input data for SNA. The most critical region among 12 regions in Türkiye is Istanbul to decrease possible negative affect of COVID-19 pandemic on the tourism sector.

COVID-19's impact on interest in gastrointestinal topics

There has been a disparity in familiarity regarding the public interest in gastroenterology terminologies during the COVID-19 pandemic. This study aimed to understand the outcomes of the public's view on gastrointestinal topics and their potential social effects. This study is a comparative analysis of American Google Trends gastrointestinal terminology during the COVID-19 pandemic compared to a similar time frame (March 2018-February 2020) to determine how trends in the patient-seeking behavior of gastrointestinal terminology changed throughout the pandemic. The analysis discovered a substantial decrease in search volumes of gastrointestinal topics, more significantly in the first pandemic months. Later in the pandemic, search volumes trended toward pre-pandemic years in terms of public interest. In the case of gastrointestinal procedures, endoscopy and colonoscopies, they surpassed pre-pandemic interest levels statistically (p-values of 0.01 and 0.002). The public's decreased interest in gastrointestinal topics at the beginning of the COVID-19 pandemic may have adverse effects on the healthcare maintenance of patients who could have had a positive outcome in their gastrointestinal health with proper monitoring. Although gastrointestinal internet searches increased toward pre-pandemic levels as the seasons progressed, further research is needed to determine the social impact of decreased public interest.

The Social Distance Impacts from COVID-19 Pandemic on the Development of Two Orders of a Concurrent Training Programme for Morbidly Obese Patients

BACKGROUND

Although there is relevant information regarding the consequences of the coronavirus SARS-CoV-2 (COVID-19), little is known about the impact of the imposed social confinement (at home) on the development of exercise training programmes in populations with morbid obesity.

AIM

To describe the effects of the imposed COVID-19 confinement on the cardiometabolic health benefits acquired through a concurrent training programme that started before the pandemic in populations with morbid obesity.

METHODS

This was an experimental randomized clinical study, in which sedentary morbidly obese women were assigned 1:1 to a high-intensity interval training (HIIT) plus resistance training (RT) group (HIIT + RT; n = 11; BMI 42.1 ± 6.6) or to the same exercise dose, but in different order group of RT plus HIIT group (RT + HIIT; n = 7; BMI 47.5 ± 8.4). Both groups undertook two sessions/week. When COVID-19 confinement at home started, a post-test was applied in January 2020 (Post1) and after 20 months (Post2). The main outcomes were waist circumference (WC), systolic (SBP) and diastolic blood pressure (DBP), high-density lipids (HDL-c), triglycerides (Tg), and fasting plasma glucose (FPG).

RESULTS

In the HIIT + RT group, the WC showed significant increases from Post1 to Post2 (Δ + 3.1 cm, p = 0.035); in the RT + HIIT group, it decreased from Post1 to Post2 (Δ - 4.8 cm, p = 0.028). In the HIIT + RT group, SBP showed significant increases from Post1 to Post2 (Δ + 6.2 mmHg, p = 0.041); the RT + HIIT group decreased SBP from Pre0 to Post1 (Δ - 7.2 mmHg, p = 0.026) and increased DBP from Pre0 to Post1 (Δ + 8.1 mmHg, p = 0.015). Tg in the HIIT + RT group decreased from Pre0 to Post1 (Δ - 40.1 mg/dL, p = 0.023) but increased from Post1 to Post2 (Δ + 86.3 mg/dL, p < 0.0001).

CONCLUSIONS

The COVID-19 social confinement worsened metabolic syndrome (MetS) outcomes that had improved from 20 weeks' RT + HIIT during the training period, such as WC, SBP, and Tg from HIIT + RT, when, worryingly, SBP increased to another more serious clinical classification in both groups.

Surface Plasmon Effect Dominated High-Performance Triboelectric Nanogenerator for Traditional Chinese Medicine Acupuncture

Available, effectively converting low-frequency vibration into available electricity, triboelectric nanogenerator (TENG) is always research hot nowadays. However, the enhancing effect of the existing methods for the output have all sorts of drawbacks, i.e., low efficiency and unstable, and its practical applications still need to be further explored. Here, leveraging core-shell nanoparticles Ag@SiO2 doping into tribo-materials generates the surface plasmon effect to boost the output performance of the TENG. On one hand, the shell alleviated the seepage effect from conventional nanoparticles; on the other hand, the surface plasmon effect enabled the core-shell nanoparticles to further boost the output performance of TENG. We circumvent the limitations and present a TENG whose output power density can be up to 4.375 mW/cm2. Points is that this article novelty investigate the high-performance TENG applicating for traditional Chinese medicine and develop a pratical self-powered acupuncture system. This technology enables rapid, routine regulation of human health at any age, which has potential applications in nearly any setting across healthcare platforms alike.

Influence of Using Food Delivery Applications on Adult Saudi Female Dietary Habits and Preferences during COVID-19 Lockdown Restrictions: Attitude Survey

Food delivery applications (FDAs) shined during COVID-19 global lockdown restrictions. Consequently, lifestyle changes imposed a greater use of these applications over this period. These changes may strongly influence the nutritional health of individuals, particularly adult Saudi females. A cross-sectional study was performed to examine the influence of using FDAs during COVID-19 lockdown restrictions on attitude behaviours, including dietary habits and preferences among Saudi adult females. Participants voluntarily submitted their answers to a questionnaire administered via the Google Survey platform. Results illustrated that most Saudi female users of FDAs were aged between 18-24 years with 64.9%, 91.5% being single and 37% ordering food online within one to two days a month. There was a significant association between the influence of using FDAs during COVID-19 lockdown restrictions and age, education, and average days of ordering food online (p ˂ 0.05). Another important factor is that higher education was associated with more frequent use of the FDAs, there were direct relationships between education level and using FDAs, 58% of the participants were educated as undergraduate or postgraduate. Although lifestyle changes increased the use of FDAs during COVID-19 global lockdown restrictions, these changes may negatively affect individuals' dietary habits and preferences, particularly adult Saudi females. These findings can aid in promoting healthy diet management globally and in Saudi Arabia unless the governments lead to significant beneficial changes toward improving food delivery applications.

Gestational diabetes mellitus in the COVID-19 pandemic: A retrospective study from Hangzhou, China

AIMS

Our study aimed to investigate changes in the prevalence of gestational diabetes mellitus (GDM) in the COVID-19 pandemic and postpandemic era and the risk of adverse pregnancy outcomes in pregnant women diagnosed with GDM during the blockade period.

METHODS

First, we investigated changes in the prevalence of GDM and the population undergoing oral glucose tolerance tests (OGTT) after the COVID-19 pandemic. We then collected clinical information from pregnant women diagnosed with GDM to explore the risk of adverse pregnancy outcomes in pregnant women with GDM during the COVID-19 pandemic.

RESULTS

After the COVID-19 pandemic, the proportion of pregnant women in the total number of outpatient OGTT tests decreased yearly. The ratio was 81.30%, 79.71%, and 75.48% from 2019 to 2021, respectively, with the highest proportion of pregnant women in February 2020 (92.03%). The prevalence of GDM was higher in March 2020 compared to the same period in 2019. However, from 2019 to 2021, the prevalence decreased year by year with 21.46%, 19.81%, and 18.48%, respectively. The risk of adverse pregnancy outcomes for pregnant women diagnosed with GDM during the most severe period of the COVID-19 pandemic did not differ from before the COVID-19 pandemic.

CONCLUSIONS

After the COVID-19 pandemic, the prevalence of GDM increased during the most severe period of the epidemic, but the overall prevalence of GDM decreased year by year. In addition, the pandemic did not change the risk of adverse pregnancy outcomes in pregnant women with GDM.

Long-Term Impact of COVID-19 Pandemic in Sleep Quality and Lifestyle in Young Adults

Due to the evolution of COVID-19,restrictive measures were implemented. The quarantine resulted in significant changes in the social, economic, and psychological status of the population; however, its long-term effects have not yet been elucidated, especially in young adults. In the present study, people aged 18-25 years were studied, in relation to their sleeping, smoking, eating, and drinking habits and their physical activity before, during, and after the implementation of quarantine. We included 540 respondents (21.2 ± 2.3 years, 62.8% female). During quarantine, from 23 March to 4 May 2020, we observed an increase in sleep hours by 1.17 ± 1.98 h (p < 0.001), time of sleep arrival by 11.90 ± 30.41 min (p < 0.001), and number of daily meals by 0.66 ± 1.4 (p < 0.001). The subjects who consumed alcoholic beverages never or almost never had an upward change of 27.04%, and the time of daily exercise was reduced by 10.16 ± 48.68 min (p < 0.001). After quarantine, cigarettes per day increased by 1.14 ± 3.62 (p < 0.001) and the awakenings during night time increased by 0.37 ± 1.93 (p < 0.001). Our results suggest that the quarantine brought about significant changes in smoking, sleeping habits, physical activity, dietary habits, and the consumption of alcoholic beverages, some of which continue after its termination.

Study protocol of "From Science 2 School"-prevalence of sports and physical exercise linked to omnivorous, vegetarian and vegan, diets among Austrian secondary schools

The increasing prevalence of unhealthy lifestyle choices contribute to almost all chronic conditions negatively affecting individual and public health. As the most beneficial preventative solution, a healthy lifestyle focusing on the dual approach of physical activity (PA) and a healthful diet is highly recommended. Considering the growing number of people interested in sustainable, plant-based diets, it seems crucial to analyze lifestyle behaviors with a special focus on diet type to delve deeper into the unenthusiastic health status among young populations. Therefore, this multidisciplinary study aims to survey and scale health behaviors with a special focus on the prevalence of traditional and vegetarian diets in connection with PA levels among Austrian pupils (10-19 years), teachers and principals in secondary education levels I and II. Following a cross-sectional design, sociodemographic and school-related data along with a complete profile of lifestyle behaviors, including detailed information regarding diet, PA, sports & exercise, and other health-related behaviors, were collected using online-based questionnaires. A total number of 8,845 children/adolescents (~1.2% of the eligible 771,525 Austrian secondary school pupils) and 1,350 adults (~1.5% of total eligible 89,243 Austrian teachers/principals) participated in the study. As this is the first investigation to explore the prevalence of veganism/vegetarianism amongst a large group of pupils, the present study will add an important contribution to overcome the lack of knowledge on PA, sports & exercise linked to healthy alternative diets. With a sustainable healthy lifestyle, a healthy transition from childhood to adulthood occurs, which can result in growing healthier functioning generations at all social levels. As a study protocol, the present article is intended to present comprehensive details of the study design, objectives, and the associated analytical procedures of the "From Science 2 School" study.

Working from Home during the COVID-19 Pandemic and Its Effects on Diet, Sedentary Lifestyle, and Stress

Many companies switched to working from home (WFH) after the COVID-19 pandemic. This paper aimed to examine the changes in dietary behavior, body weight, sedentary lifestyle, and stress in individuals who practice WFH. A cross-sectional, web-based questionnaire was administered between March and May 2021 and included socio-demographic characteristics, anthropometric measurements, WFH arrangement, changes in diet, sedentary lifestyle, and stress status. A total of 328 individuals (260 women, 68 men), aged 31.3 ± 8.3 years with a BMI of 24.9 ± 4.6 kg/m2, participated in the study. The questionnaire revealed that the daily working time increased with WFH. The majority of the individuals (59.1%) gained weight. The average daily sedentary time and the Perceived Stress Scale score increased significantly. The daily sedentary time and Non-Healthy Diet Index scores were higher in individuals who gained weight (p < 0.05). A multinominal regression model revealed that increased body weight was less likely in individuals with underweight and normal BMI classifications. Normal BMI, stable work shifts, and no physical activity were positive predictors for gaining weight. These results suggest that WFH may have significant negative effects on physical and mental status of individuals.

Impact of COVID-19 Lockdown on Food Consumption and Behavior in France (COVISTRESS Study)

The COVID-19 pandemic and subsequent lockdowns modified work environments, lifestyles, and food consumption. Eating habits and mood changes in a French population during the first lockdown were examined using an online self-reported questionnaire with REDCap software through the COVISTRESS.ORG website. In 671 French participants, the main changes during lockdown were increased stress levels (64 [23; 86] vs. 3 [0; 18]) and sedentary behavior (7 [4; 9] vs. 5 [3; 8] hours per day), a deterioration in sleep quality (50 [27; 83] vs. 70 [48; 94]) and mood (50 [30; 76] vs. 78 [50; 92]), and less physical activity (2.0 [0.5; 5.0] vs. 3.5 [2.0; 6.0]). Mood was modified, with more anger (56 [39; 76] vs. 31 [16; 50]), more sadness (50 [34; 72] vs. 28 [16; 50]), more agitation (50 [25; 66] vs. 43 [20; 50]), and more boredom (32 [7; 60] vs. 14 [3; 29]). A total of 25% of the participants increased their consumption of alcoholic beverages, 29% their consumption of sugary foods, and 26% their consumption of cocktail snacks. A multiple-correspondence analysis highlights four different profiles according to changes in eating habits, food consumption, lifestyle, and mood. In conclusion, eating habits and lifestyle changes during lockdown periods should be carefully monitored to promote healthy behaviors.

Bibliometric analysis of the top-50 cited articles on COVID-19 and physical activity

Background

Since the 2019 novel coronavirus (COVID-19) pneumonia outbreak in late 2019, an endless stream of research has emerged surrounding physical activity. This study analyzes the 50 most influential articles on COVID-19 and physical activity over the past 2 years to describe the research landscape and hotspots from bibliometric citation analysis.

Methods

The top-50 cited articles were extracted from the Web of Science Core Collection database, and bibliometric citation analysis was performed by Excel 2019 and VOSviewer software.

Results

The top-50 articles were cited 160.48 ± 106.90 (range: 70-587). Most of the articles were from the United States (14), followed by Italy (11) and England (9). The International Journal of Environmental Research and Public Health (n = 10) is the journal with the top-50 cited articles. The collaboration between authors was mainly among three teams, including Smith L, Musumeci G, and Napoli C. The hotspot of research around COVID-19 and physical activity focused on lifestyle change (sedentary behavior, sitting time), mental health (depressive, anxiety, loneliness), the credibility of physical activity assessment tools (reliability, validity), and physical activity of different populations (gender, youth, children).

Conclusions

Based on a bibliometric analysis of high-impact articles on COVID-19 and physical activity highlights physical activity as an essential lifestyle change and developments and hotspots in this field. These data will provide insights for future researchers regarding the direction of physical activity research in the COVID-19 pandemic.

Physical activity and emotions in a period of social distancing due to the COVID-19 pandemic

Social distancing (SD) to prevent SARS-CoV-2 (COVID-19) transmission reduced practices of physical activities (PA) and changed emotional conditions, but the relationship between PA and the emotions has to be further studied. This study aimed to analyze PA and the intensity of basic emotions during a period of social distancing in the State of São Paulo, Brazil. Data collection was performed using the snowball system and an online survey with questions about the minimum weekly frequency of 30-min moderate and/or vigorous activities (MVPA), intensity of basic emotions, and sociodemographic profile. A total of 704 volunteers participated; mean age 38.1 ​± ​13.4 years, 67.9% female, 82.0% insufficiently practiced MVPA, and 37.9% of the group reported no weekly PA. Anxiety/fear was the emotion with the highest intensity in the study period. A significant association was observed between PA and intensity of happiness (rho ​= ​0.125; p ​< ​0.01) and a negative association between PA practice and intensity of anxiety/fear (rho ​= ​-0.090; p ​< ​0.05), sadness (rho ​= ​-0.134; p ​< ​0.01), and anger (rho ​= ​-0.109; p ​< ​0.01). Also, an association was observed between anxiety/fear and social isolation (rho ​= ​0.082; p ​< ​0.05). These results suggest that public policies offering PA programs and psychological care are required to improve the quality of life of the population.

COVID-19 and Gestational Diabetes: The Role of Nutrition and Pharmacological Intervention in Preventing Adverse Outcomes

Pregnant women with GDM affected by COVID-19 seem to be at higher risk of adverse maternal and neonatal outcomes, especially those with overweight or obesity. Good glycemic control seems to be the most effective measure in reducing the risk of GDM and severe COVID-19. For such purposes, the Mediterranean diet, micronutrient supplementation, and physical activity are considered the first line of treatment. Failure to achieve glycemic control leads to the use of insulin, and this clinical scenario has been shown to be associated with an increased risk of adverse maternal and neonatal outcomes. In this review, we explore the current evidence pertaining to the pathogenesis of SARS-CoV-2 leading to the main complications caused by COVID-19 in patients with GDM. We also discuss the incidence of complications caused by COVID-19 in pregnant women with GDM according to their treatment.

Sex Differences in Clinical Parameters, Pharmacological and Health-Resource Utilization in a Population With Hypertension Without a Diagnosis of COVID-19

Objectives: Determine the changes in clinical, pharmacological and healthcare resource use parameters, between the 6 months prior to the lockdown and the 6 months following its end, in a population with hypertension who did not have a diagnosis of COVID-19. Methods: Real world data observational study of 245,979 persons aged >16 years with hypertension in Aragon (Spain). Clinical (systolic-diastolic blood pressure, estimated glomerular filtration rate (eGFR), blood creatinine, cholesterol, triglycerides and anthropometric measures); pharmacological (diuretics, calcium channel antagonists, and ACE inhibitors); and utilization of healthcare resources were considered. We performed the Student's T-test for matched samples (quantitative) and the Chi-squared test (qualitative) to analyze differences between periods. Results: SBP, DBP, parameters of renal function and triglycerides displayed a significant, albeit clinically irrelevant, worsening in women. In men only DBP and eGFR showed a worsening, although to a lesser extent than in women. Certain antihypertensive drugs and health-resource utilization remained below pre-pandemic levels across the 6 months post-lockdown. Conclusion: Changes in lifestyles, along with difficulties in access to routine care has not substantially compromised the health and quality of life of patients with hypertension.

Emotional exhaustion and unhealthy eating among COVID-19 front-line healthcare workers during recuperation: A cross-sectional study

Objective

Thousands of healthcare workers on the frontlines who have been battling the COVID-19 pandemic could face emotional and mental health risks even after their critical pandemic work. This study examined the impact of affective rumination on emotional exhaustion and the spillover effect of affective rumination on unhealthy food consumption among healthcare workers during recuperation.

Methods

A total of 418 frontline healthcare workers from 10 Chinese medical institutions were recruited through random cluster sampling. A linear mixed model in SPSS25.0 was performed for hierarchical regression to analyze the effect of affective rumination on unhealthy food consumption via emotional exhaustion. A conditional process analysis was employed to investigate the moderating role of family support in the mediating effect of emotional exhaustion.

Results

Front-line healthcare workers scored at a medium level on an emotional exhaustion scale (2.45 ± 0.88). Affective rumination mediated by emotional exhaustion had a significant positive predictive effect on unhealthy food consumption. The indirect effect accounted for ~43.9% of the total effect. Family support amplified the effect of emotional exhaustion on unhealthy food consumption (β = 0.092, p < 0.05).

Conclusion

Affective rumination could be a cause of emotional exhaustion and unhealthy food consumption. First-line healthcare workers could be screened for possible emotional exhaustion through the evaluation of affective rumination in order to provide them with targeted interventions. Family support did not prove to be beneficial in all cases as it enhanced the positive effect of emotional exhaustion on unhealthy eating in the current study. Therefore, family support should be carefully integrated in future interventions.

Intrahepatic Fat Content and COVID-19 Lockdown in Adults with NAFLD and Metabolic Syndrome

Background: COVID-19 lockdowns had a significant impact on people’s health, triggering levels of anxiety, perceived stress, and changes in food and nutritional status. Objectives: To assess the changes in dietary habits, metabolic syndrome (MetS) and liver parameters before and after the COVID-19 lockdown according to changes in intrahepatic fat content in adults with non-alcoholic fatty liver disease (NAFLD) and MetS. Design: Pre- and post-lockdown observation of the COVID-19 lockdown on fifty-nine 40–60-year-old participants with MetS and NAFLD, in a parallel group, randomised experiment intended to treat NAFLD. Methods: Anthropometrics, liver and MetS biochemical parameters, intrahepatic fat content by abdominal magnetic resonance imaging, and dietary assessment using a validated 148-item Food Frequency Questionnaire were collected pre-COVID-19 lockdown and post-lockdown. Results: COVID-19 lockdown led to negative changes in the liver of patients with NAFLD and MetS, with weight gain and increases in glycemia, ALT and intrahepatic fat content post lockdown. Participants with worsened liver status had low consumption of fibre, cheese, nuts and coffee, and high consumption of sweets and pastries. Participants who improved liver status ameliorated ALT values, waist circumference, and intrahepatic fat content, assessed by magnetic resonance imaging post-lockdown. Conclusions: The maintenance of healthy lifestyle habits is vital, especially for populations with NAFLD and MetS, to reduce unhealthy lifestyle patterns displayed during lockdown.

Physical Activity Level and Perspectives of Participants Transitioning from Onsite to Virtual Cardiac Rehabilitation during the Early COVID-19 Pandemic: A Mixed-Method Study

This mixed-method study aimed to compare physical activity (PA) patterns of a cross-over cardiac rehabilitation (CR) cohort with a center-based CR cohort and to explore barriers and facilitators of participants transitioning and engaging in virtual CR. It included the retrospective self-reported PA of a cross-over CR cohort (n = 75) and a matched center-based CR cohort (n = 75). Some of the participants included in the cross-over cohort (n = 12) attended semi-structured focus group sessions and results were interpreted in the context of the PRECEDE-PROCEED model. Differences between groups were not observed (p > 0.05). The center-based CR cohort increased exercise frequency (p = 0.002), duration (p = 0.007), and MET/minutes (p = 0.007) over time. The cross-over cohort increased exercise duration (p = 0.04) with no significant change in any other parameters. Analysis from focus groups revealed six overarching themes classified under predisposing factors (knowledge), enabling factors (external support, COVID-19 restrictions, mental health, personal reasons/preferences), and reinforcing factors (recommendations). These findings suggest an improvement of the PA levels of center-based CR cohort participants pre-pandemic and mitigated improvement in those who transitioned to a virtual CR early in the pandemic. Improving patients’ exercise-related knowledge, provider endorsements, and the implementation of group videoconferencing sessions could help overcome barriers to participation in virtual CR.

The Correlation of Swedish Snus, Nicotine Pouches and Other Tobacco Products with Oral Mucosal Health and Salivary Biomarkers

In society, tobacco products, such as e-cigarettes, and smokeless tobacco products, such as snus and nicotine pouches, are becoming more attractive. There is still a lack of information regarding the effects of these products on the oral mucosa and oral saliva biomarkers. The aim of this study is to evaluate oral mucosa and the presence of inflammatory biomarkers IL-6, IL-1, IL-8, TNF alpha and LRG-1 in saliva. Respondents were divided in four groups based on their tobacco product usage. Oral examination was carried out, saliva samples were taken, and the detection of IL-6, IL-8, IL-1, TNF alpha and LRG-1 levels in saliva was carried out. Out of the tobacco users, 30.8% were snus users, 48.7% were cigarette users and 20.5% were e-cigarette users. The control group was composed of respondents who did not use any tobacco products. E-cigarettes were used more by women, but snus was used more by men. Mucosal changes were seen in the group of snus users, and mucosal changes were only seen in men who had used 5–10 tobacco units per day for 5–10 years. Increased IL-6 levels in saliva were detected in respondents who also experienced mucosal changes. Mucosal changes were white, leathery and localized at the site where snus sachets were placed. Saliva, as an easily available biofluid, could be used as a first tool to detect potentially precancerous signs, but the LRG1 marker cannot be used as a prognostic marker.

The Impact of the COVID-19 Pandemic on Dietary Patterns of Pregnant Women: A Comparison between Two Mother-Child Cohorts in Sicily, Italy

A maternal diet, before and during pregnancy, plays a key role in ensuring maternal and newborn health. The COVID-19 pandemic, however, may have compromised dietary habits in the general population and in specific subgroups of individuals. Here, we evaluated the impact of COVID-19 on the diet of pregnant women, using data from two mother-child cohorts in Sicily (Italy). Dietary data were collected using a food frequency questionnaire and analyzed through the Mediterranean diet (MD) score and principal component analysis (PCA). The comparison of maternal dietary consumption before and during the COVID-19 pandemic showed differences in terms of vegetables (p < 0.001), fruit (p < 0.001), dairy products (p < 0.001), fish (p < 0.001), and legumes (p = 0.001). Accordingly, after adjusting for covariates, mothers enrolled during the pandemic were more likely to report low adherence to MD than those enrolled before (OR = 1.65; 95%CI = 1.12−2.42; p = 0.011). A similar result was obtained by analyzing the adherence to a prudent dietary pattern, derived through PCA and characterized by high intake of cooked and row vegetables, legumes, fruit, fish, and soup. Overall, these findings suggested that the COVID-19 pandemic may have influenced maternal diet during pregnancy. However, further efforts are needed to investigate the main causes and consequences of this change.

The positive role of parental attachment and communication in Chinese adolescents' health behavior and mental health during COVID-19

INTRODUCTION

Given that coronavirus disease 2019 (COVID-19) has largely influenced adolescents' physical and mental health around the globe, it is important to identify protective factors that may promote adolescents' positive adjustment during the pandemic. This study aimed to examine the role of parental attachment and COVID-19 communication in adolescents' health behavior and mental health during COVID-19.

METHODS

A total of 442 Chinese parent-adolescent dyads (mean age of adolescents = 13.35 years; 50% girls) completed two-wave longitudinal surveys over the span of 2 months during the pandemic (Wave 1: July 2020; Wave 2: September 2020). At each wave, adolescents reported on their COVID-19-related health behavior, general health behavior, depressive symptoms, and anxiety symptoms. At Wave 1, parent-adolescent attachment security and COVID-19 communication were also assessed.

RESULTS

Adolescents' attachment security to parents was associated with their increased COVID-19-related and general health behavior as well as decreased depression and anxiety over 2 months during COVID-19. Moreover, more frequent parent-adolescent COVID-19 communication was associated with adolescents' increased COVID-19-related and general health behavior over time. Notably, attachment security's and COVID-19 communication's associations with health behavior largely remained the same after taking into account both factors simultaneously. In addition, results from exploratory analyses suggest that more frequent COVID-19 communication mediates the link between attachment security and increased health behavior.

CONCLUSIONS

These findings highlight the importance of promoting attachment security and COVID-19 communication between parents and adolescents during the pandemic, which may play a positive role in adolescents' health behavior and mental health.

COVID-19 triggered a physically active lifestyle of people with cardiovascular diseases: Results of a small Austrian qualitative study

Objective

This paper explores physical activity patterns and compensation strategies of people with cardiovascular diseases. The aim is to provide insights into the factors and their relationships that may affect physical activity levels positively or negatively during the pandemic.

Methods

We adopted a qualitative approach with 35 participants who were purposively sampled from different provinces in Austria, including rural and urban areas. Semi-structured interviews were conducted during the second COVID-19 wave in autumn/winter 2020 and the fourth wave in autumn/winter 2021. Content analysis was applied to explore physical activity patterns, the perceived impact of the pandemic on physical activity as well as strategies adopted by participants to maintain physically active during the pandemic waves.

Results

Results show encouraging signs of a recovery or even increase in physical activity during the pandemic waves. The main drivers for maintaining or even increasing physical activity were intrinsic motivation and self-determined motivation relating to the pursue of individual health goals. Furthermore, analysis suggests a reinforcing effect of exercising in green natural areas by decreasing perception of effort and increasing motivation. There was also one group who experienced difficulties in adapting physical activity behaviors. Study participants who were used to exercise indoors struggled to replace accustomed activity patterns with alternatives that were not impacted by lockdown restrictions.

Conclusions

This study provides novel qualitative evidence on the effect of COVID-19 lockdowns on physical activity patterns of people with cardiovascular diseases. Public health interventions to enhance a physically active lifestyle during and beyond the COVID-19 pandemic are recommended to target moderate outdoor exercising and enhance adaptive capacities of people with cardiovascular diseases.

The Impact of the COVID-19 Lockdown on Physical Therapy Undergraduates and Their Families. A Qualitative Study from the United Arab Emirates

Background

The COVID-19 pandemic closed most establishments in the United Arab Emirates except health care and other essential services from 8 March 2020 until 24 June. By 22 March, most citizens were working online, including physical therapy students, and a no-movement policy restricted exercise to homes. The lockdown ended partially in August 2021 and almost complete by January 2022.

Objective

We aimed (1) to explore the physical activities of advanced undergraduate physical therapy students and their families during the lockdown, (2) to discuss how participants helped promote and maintain their own and their family’s physical health, and (3) to identify what knowledge and skills gained in their physical therapy study students utilized during the lockdown.

Methods

We took a qualitative approach; a one-to-one semi-structured interviews were conducted by Year 4 physical students who at the time were registered for a module covering qualitative research methods. The students interviewed other physical therapy students from year 4 and 5 who were recruited using convenience sampling from a health sciences educational institution. Interviews were conducted and recorded on the Zoom platform and transcribed verbatim. Thematic analysis was utilised to analyse the data.

Findings

Forty-six students agreed to participate, and data saturation was achieved with interviews of 24 students. During the COVID-19 Stay Home—Stay Safe initiative, students of physical therapy were found to be physically active and to have designed home exercise programs for themselves and their families. Adherence to regular exercise was high among the students but low among family members. Three overarching themes, each with three subthemes, emerged through synthesis, coding, and categorizing.

Conclusion

Undergraduate students can effectively promote their own and their family’s health. Energy imbalance and increasing neck, shoulder, and back pain among youth and lack of exercise among adults, midlife, and older, raise health concerns.

Mental Health and Physical Activity of Female Higher Education Students during the COVID-19 Pandemic: A Comparative Cross-Sectional Study from Lithuania

During emerging adulthood (EA), higher education medical students undergo a higher risk of anxiety and depression compared to the general population. The aim of this comparative cross-sectional study was to compare the proportions of three mental disorders, namely anxiety, depression and somatisation in terms of their symptoms and self-reported physical activity (PA) levels across the cohorts of biomedical and non-biomedical female students as well as to assess the association between the mental health outcomes and PA use. Between September 2021 and January 2022, a total of 1231 female higher education students aged between 18 and 29 years old were recruited for the study. Severe symptoms of anxiety and depression, as well as unexplained somatic complaints, were suffered by 51.9%, 11% and 23% of female students, respectively. Non-biomedical female students, compared to medicine and health sciences students, were more vulnerable due to the increased prevalence of negative mental health outcomes. The relationship between increased sports activity as a potential trigger for mental well-being and decreased severity of depressive symptoms was identified in the cohorts of both biomedical (adjusted odd ratio (OR_adj) 0.4; 95% confidence interval (CI): 0.1-1.0) and non-biomedical (OR_adj 0.4; 95% CI: 0.2-0.9) female students. The current research highlights the importance of increasing sports activity by involving students in regular physical exercise of specific types for decreasing the severity of depressive symptoms in student-aged female populations.

Adapted Physical Activity Protocol for Lower Limb Functional and Strength Recovery in a Young Athlete with Cutaneous Melanoma: Feasibility and Efficacy during COVID-19 Pandemic

Adapted physical activity (APA) can improve psychophysical wellbeing and quality of life (QoL) in cancer survivors, a vulnerable population requiring a global management, especially during the recent pandemic. On this basis, we investigated for the first time the impact of a tailored APA intervention on a melanoma-affected 18-year-old female athlete to counteract treatment sequelae and promote lower limb functional and strength recovery. Patient was evaluated at baseline and post-protocol by a test battery focusing on mobility, muscle strength measured by dynamometry, and lower limb girths assessed at specific anatomical points. Moreover, health-related QoL, depression/anxiety, psychological distress and pain intensity were evaluated by Functional Assessment of Cancer Therapy-Melanoma (FACT-M), Hospital Anxiety and Depression Scale (HADS), distress thermometer, and numerical rating scale (NRS) questionnaires, respectively. An almost doubled up increase in lower limb strength, along with hip mobility improvement, and post-surgical edema and pain reduction were observed following the protocol. Concerning the QoL assessment, a moderate post-intervention improvement in physical and emotional wellbeing was detected, while depression state worsened though remaining within the normality range. Our findings show that a specialist-supervised structured APA protocol based on a patient-centered multidisciplinary approach may represent an effective strategy to recover functional and psychophysical efficiency, thus promoting a quick return to daily life activities and offering a concrete chance of resuming competitive sport practice.

Changes in dietary patterns among Bangladeshi adult population during the COVID-19 pandemic: A web-based cross-sectional study

Background

The home confinement induced by the COVID-19 pandemic affects individuals' mental wellbeing and increases unhealthy behaviors, such as minimum to no physical activity, overeating, and substance use.

Objective

This study aimed to assess the changes in dietary patterns among the Bangladeshi adult population during the COVID-19 pandemic and identify their determinants.

Methods

This web-based cross-sectional survey was carried out from 10-17 December 2020 using an e-questionnaire based on Google Forms. A semi-structured e-questionnaire was forwarded to the participants - Bangladesh citizens aged above 18 years - through social media platforms and email in order to collect information about socio-demographic issues and multidimensional dietary patterns. From the initial 817 responses gathered through snowball sampling, 748 responses were retained. Bivariate and multivariate analyses were executed.

Results

The findings suggest that 50% of the participants reported a reduction in weight and physical activities, while approximately 52% experienced increased sleep time. One in three participants (31.4%) experienced a decrease in food buying capacity. The findings further indicate that women were 1.65 times more likely to reduce food consumption than men. Meanwhile, employed people were about 34% less likely to increase food consumption than their unemployed counterparts. People who were getting more than 6 h of sleep per day were nearly 61% less likely to increase food consumption than people who slept for less than 6 h per day. People struggling to buy food items were 2.31 times more likely to reduce food intake than people with no such limitations.

Conclusions

The study shows that COVID-19 has substantially affected Bangladeshi people's common food consumption patterns. Being confined within the household, primarily due to countrywide lockdowns and 'general holidays', has affected both the dietary patterns and the financial wellbeing of people. Therefore, the concerned authorities should promote effective nutrition education and healthy dietary behaviors; meanwhile, financial support or incentives for people in need are also strongly advocated.

The Covid-19 pandemic and food consumption at home and away: An exploratory study of English households

The Covid-19 pandemic has changed attitudes of English households towards food consumption at home and when eating out. Little academic research has however examined the scope and the scale of these changes, especially in the context of foodservice provision. This mixed methods study explores the effect of Covid-19 on food consumption in English households at home and away. It reveals increased frequency and variety of cooking during lockdown as a driver of household food wastage. The study demonstrates public hesitance towards eating out post-Covid-19. Foodservice providers are expected to re-design their business settings and adopt protective and preventative measures, such as frequent cleaning and routine health checks, to encourage visitation. After the pandemic, increased preference towards consuming (more) sustainable food at home, but not when eating out, is established. These insights can aid grocery and foodservice providers in offering more tailored products and services in a post-pandemic future.

Perceived Stress, Resilience, and Wellbeing in Seasoned Isha Yoga Practitioners Compared to Matched Controls During the COVID-19 Pandemic

Background

Yoga practices, including breathing, meditation, and posture protocols (asanas), have been shown to facilitate physical and mental wellbeing.

Methods

Seasoned yoga practitioners were recruited from the Isha Foundation. Recruitment of the comparison group was achieved using snowball sampling and were not yoga practitioners. Participants in the non-yoga group were randomized to a 3-min Isha practice or a comparator group asked to perform 15-min of daily reading. Participants completed a series of web-based surveys (REDCap) at baseline, 6, and 12 weeks. These surveys include validated scales and objective questions on COVID-19 infection and medical history. The validated questionnaires assess for: perceived stress (PSS), mood states [anxiety and depression (PHQ-4), joy (DPES-Joy subscale)], mindfulness attention and awareness (MAAS), resilience (BRS), mental wellbeing (WEMWBS) and recovery from traumatic event (PTGI). Weekly activity diaries were employed as a tool for collecting compliance information from study participants. Perceived stress scale scores were identified as primary outcome for this study.

Findings

The median Perceived Stress Scale (PSS) score for the yoga practitioners compared to the active and placebo comparators was significantly lower at all time-points: baseline: 11 [IQR 7–15] vs. 16 [IQR 12–21] in both the active and placebo comparators (p &lt; 0.0001); 6 weeks: 9 [IQR 6–13] vs. 12 [IQR 8–17] in the active comparator and 14 [IQR 9–18] in the placebo comparator (p &lt; 0.0001); and 12 weeks: 9 [IQR 5–13] vs. 11.5 [IQR 8–16] in the active comparators and 13 [IQR 8–17] in the placebo comparator (p &lt; 0.0001). Among the randomized participants that were compliant for the full 12 weeks, the active comparators had significantly lower median PSS scores than the placebo comparators 12 weeks [10 (IQR 5–14) vs. 13 (IQR 8–17), p = 0.017]. Further, yoga practitioners had significantly lower anxiety at all three-time points (p &lt; 0.0001), lower depression at baseline and 6 weeks (p &lt; 0.0003), and significantly higher wellbeing (p &lt; 0.0001) and joy (p &lt; 0.0001) at all three-time points, compared to the active and placebo comparator groups.

Interpretation

The lower levels of stress, anxiety, depression, and higher level of wellbeing and joy seen in the yoga practitioners compared to the active and placebo comparators illustrate the impact of regular yoga practices on mental health even during the pandemic.

Trial Registration

ClinicalTrials.gov, identifier: NCT 04498442.

Food Intake Changes and Their Impact on Quality of Life in Spanish Citizens with and without COVID-19 during Lockdown

The pervasive impact of the COVID-19 pandemic is just beginning to be analyzed. To date, only a handful of these studies have investigated the relationship between an individual’s quality of life (QoL) and their changes in food intake due to the virus (from the associated symptomatology of diagnosis to the universal impact of lockdown on individual lives, regardless of a person’s health status). Therefore, the purpose of this study is to identify changes in food intake resulting from the pandemic and the corresponding impact on QoL in the Spanish population. This study focuses its investigation on the 3-month time period within which lockdown was its most restrictive, March−May 2020. Survey questions ask participants to compare their eating habits, general health status, and QoL during these 3 months to times prior to the pandemic. We conducted an online survey amongst the Spanish population over 18 years old. Three surveys were administered: (1) the adult eating behavior questionnaire (EABQ), (2) EuroQoL-5D-5L, and (3) The determinants lifestyle changes during lockdown period (March to May 2020). A total of 86 participants were included, with a mean age of 34 years. In the analysis of QoL, significant differences were found according to age, sex, and the presence of a COVID-19 diagnosis. Likewise, in the analysis of food intake, significant differences were found by age (greater changes in the 18−29-years-old population) (p< 0.01) and by sex (women p < 0.03), as well as greater changes in those with a diagnosis of COVID-19. Furthermore, both food intake and COVID-19 diagnosis were variables that predicted QoL outcomes. In sum, forced home lockdown can cause changes in food intake, which can predict a lower QoL. It follows that the lockdown situation caused by the worldwide COVID-19 pandemic has affected the food intake and overall QoL of the Spanish population.

Sedentary behavior and cardiovascular disease risk: An evolutionary perspective

A ubiquitous aspect of contemporary societies is sedentary behavior (SB), defined as low intensity activities in a seated, reclined, or supine posture. Leading public health agencies, including the World Health Organization, have recognized the strong association between SB and poor health outcomes, particularly cardiovascular disease. However, while public health agencies have begun to advocate for “reductions” in SB, the current US guidelines are typically vague and non-specific. There is good reasoning behind this non-committal advocacy—there is limited mechanistic and clinical evidence to support policy development. To guide SB policy development, it is important to first consider the origins and evolution of SB, including the following: 1) is SB really a novel/contemporary behavior? i.e., how has this behavior evolved? 2) how did our ancestors sit and in what contexts? 3) how does SB interact with 24-hour activity behaviors, including physical activity and sleep? 4) what other historical and contemporary facets of life interact with SB? and 5) in what context do these behaviors occur and how might they provide different evolutionarily novel stressors? This perspective article will synthesize the available evidence that addresses these questions and stimulate discussion pertaining to the lessons that we can learn from an historical and evolutionary perspective. Last, it will outline the gaps in current SB interruption literature that are hindering development of feasible SB reduction policy.

Exercise in Cold Weather for COVID-19-Recovered Individuals (CRI)

Background: The sedentary lifestyle caused by the COVID-19 quarantine has resulted in a devastating threat to human health due to stress and anxiety. Although infected individuals must stop exercising, exercise is not prohibited when without symptoms and complications. Whereas exercise can be effective in immune system reinforcement during the prevention, recovery, and post-recovery stages, COVID-19-recovered Individuals (CRI) must exercise under accurate considerations. Objectives: This study aimed to study exercise in cold weather for the CRI. Methods: This article overviews how different exercises affect the immune system. PubMed, Science Direct, and Google Scholar Databases and keywords including cold weather, COVID-19, immune system, and combined exercise were used to access scientific articles. Results: Recent reports show that different sports and exercises significantly improve COVID-19 symptoms, although there are many discrepancies among researchers in prescribing exercise programs (various training protocols, duration, and intensity). Also, CRI should avoid exercise in cold weather due to breathing complications Conclusions: Based on the present study, regular exercises (aerobic, resistance, and combined) with moderate intensity improve COVID-19 symptoms and the immune system.

Effect of emotional eating and social media on nutritional behavior and obesity in university students who were receiving distance education due to the COVID-19 pandemic

Aim

This study aimed to evaluate the effects of emotional eating and social media on nutritional behavior and obesity in university students receiving distance education during the pandemic.

Subject and methods

This cross-sectional study was performed with 1000 undergraduate students who were receiving distance education due to COVID-19 in Türkiye. Data were collected using an online questionnaire that included demographic information, height, body weight, eating habits, the Scale of Effects of Social Media on Eating Behavior (SESMEB), and the Emotional Eating Scale (EES). A p value less than 0.05 was considered as statistically significant for statistical tests.

Results

During the distance education period, more than half of both male and female students (61.7%; 58.2%) changed their meal pattern, 31.7% of them started to consume their main meals more regularly, and 31.2% of them began to skip their main meals. Of the participants, 52.6% spent more than 2 hours a day on social media. The female students who spend more than 2 hours a day on social media have higher SESMEB and EES scores than those who spend 2 hours or less a day (p < 0.01). The score SESMEB is positively weakly correlated with body mass index (BMI) (rho 0.132, p < 0.01) and positively moderately associated with the EES score (rho 0.334, p < 0.01). The interaction between the SESMEB and EES scores increases the risk of overweight/obesity (odds ratio (OR) 1.002, p = 0.009).

Conclusion

For the students who received distance education, social media affects eating behavior, BMI, and emotional eating. Additionally, these effects may increase the risk of overweight/obesity.

Counseling for Physical Activity in Adults during the COVID-19 Pandemic: A Scope Review

Objective: The aim of this scope review was to map the available scientific evidence on physical activity counseling for adults during the COVID-19 pandemic. Methods: The search was performed in PubMed, Web of Science, Scopus, SPORTDiscus, LILACS, SciELO, and CINAHL databases. Studies that described the population of adults over 18 years of age that used physical activity counseling during the COVID-19 pandemic context were selected. Data extracted were author, study location, sample, age group, sex, population characteristics, design, means used for intervention, time of intervention, professionals involved, and intervention or counseling strategy. Results: Physical activity counseling interventions were aimed at participants with insufficient levels of physical activity or with comorbidities; counseling was carried out in the online format; by health professionals, in the highest proportion of coaches, physicians, researchers, and nutritionists; through educational contents regarding the practice of physical activity; and using the transtheoretical model of behavior change as a reference method. Conclusions: The results of this review can provide tools for health professionals to assist in the process of coping with physical inactivity.

Early Pandemic Improvements in Diet Quality Are Associated with Increased Physical Activity and Weight Loss in US Adults

In March 2020, the COVID-19 pandemic led to restricted vocational (Voc-PA) and recreational physical activity (Rec-PA) outside of the home. We conducted a nation-wide survey in the United States (US) during the mitigation peak of the pandemic (June 2020) to assess health-related changes from the previous year. A diet quality (DQ) assessment tool weighted the relative healthfulness of eating occasions from foods prepared-at-home (Home) and away-from-home (Away). Previously-validated instruments assessed PA and demographic variables; height/weight were self-reported to calculate body mass index (BMI). T-tests explored longitudinal, between-sex, and obesity status differences in DQ, PA, and BMI; Pearson correlations explored associations. Of 1648 respondents, 814 valid responses (56.8% female, 81.7% white) were analyzed. Overall and Home DQ was higher for females than males in 2020 (p < 0.001 for both). Respondents increased DQ from 2019 to 2020, primarily from Away (p < 0.001 for both sexes). Total Rec-PA and Voc-PA was higher in males (p = 0.002, p < 0.001) than females in 2020; females reported higher other PA (p = 0.001). Change in BMI was inversely associated with change in both DQ and PA (p < 0.001 for both). In this sample of US adults, early adaptations to the COVID-19 pandemic included improved DQ and BMI. Whether these short-term improvements were maintained warrant further investigation.

Change of Dietary and Lifestyle Habits during and after the COVID-19 Lockdown in Cyprus: An Analysis of Two Observational Studies

Background: People’s dietary and lifestyle habits appeared to be influenced by restrictive measures imposed in response to the COVID-19 pandemic. This study examines the differences in dietary and lifestyle habits during and after the lockdown measures in Cyprus. Methods: Two online cross-sectional surveys were conducted, using a self-administered, anonymous questionnaire to collect information on sociodemographic and anthropometric characteristics, smoking habits, physical activity, and dietary habits. The first survey was conducted between 6 April 2020 and 20 June 2020 (during national lockdown) while the second survey was conducted between 27 October 2021 and 20 January 2022 (post-lockdown). Results: A total of 2503 individuals participated in the study. A higher consumption of fruits, vegetables, legumes/pulses, fish, and poultry was identified during lockdown compared to the period after the lockdown. Moreover, a greater daily intake of olive oil and a lower consumption of alcohol was found during the confinement period compared to the post-confinement period. During lockdown, most participants (43.0%) never or rarely used delivery services, while the largest proportion of the participants after lockdown used delivery services 1−3 times per month (37.0%) (p < 0.001). During lockdown, around 66% of the participants were physically active, compared to 55.5% after lockdown (p < 0.001). Furthermore, when compared to those with a normal BMI, more overweight and obese respondents ordered food 1−2 times per week in both periods (p < 0.001). Conclusions: Dietary and lifestyle habits of the participants were healthier throughout the lockdown period than after the end of the restrictive measures due to the COVID-19 pandemic. It is critical to encourage the Cypriot population to maintain the healthy dietary and lifestyle habits established during the lockdown in their daily lives after the confinement.

Beweg-Gründe im Alter

Hintergrund

Körperliche Bewegung gilt als ein Schlüsselfaktor für die Gesundheitserhaltung im Alter, wobei die COVID-19-Pandemie („coronavirus disease 2019“), wie Studien zeigen, zu einer Reduktion der körperlichen Aktivität beigetragen hat und es nun Überlegungen bedarf, wie eine (Re‑)Aktivierung der älteren Bevölkerung gelingen kann. Ein Ansatz ist hierbei zu fragen, welche Faktoren körperliche Aktivität bereits vor der Pandemie positiv beeinflusst haben, um diese durch Interventionen gezielt anzusprechen.

Fragestellung

Ziel der vorliegenden Untersuchung ist es, in einer multivariaten Analyse jene wichtigen Faktoren körperlicher Aktivität zu identifizieren, um so (Re‑)Aktivierungschancen aufzuzeigen.

Material und Methode

Die hierfür durchgeführte Analyse mittels multipler logistischer Regression stützt sich auf Daten einer standardisierten, repräsentativen Telefonbefragung (n = 2042) der 60-jährigen und älteren Bevölkerung im österreichischen Bundesland Niederösterreich, die im Frühsommer 2019 durchgeführt wurde.

Ergebnisse

Ein positiver Gesundheitszustand sowie motivationale Faktoren erhöhen die Chance auf regelmäßige körperliche Aktivität. Die soziale Komponente sowie die Überzeugung, dass Sport der Gesundheit guttut, steigern ebenfalls die Wahrscheinlichkeit, Bewegung zu machen. Soziodemografische Faktoren abseits des Einkommens konnten im Modell hingegen nicht als signifikante Prädiktoren identifiziert werden.

Schlussfolgerungen

Um die (Re‑)Aktivierungschancen zu erhöhen, bedarf es Maßnahmen, welche die körperliche Aktivität als Mittel zu unterschiedlichen Zwecken älterer Menschen begreifen.

Impact of COVID-19 pandemic on eating styles: A population based-survey during the first lockdown in Italy

Background

The Coronavirus disease (COVID-19) pandemic has had a strong impact on eating behavior. To maintain health and well-being, correct nutrition is essential, especially when the immune system is under pressure.

Objective

The aim of this study was to evaluate the correlation between emotional aspects and the eating behavior of a group of people living in Sicily during the lockdown due to COVID-19.

Methodology

We used a cross-sectional survey design with an anonymous online questionnaire, administered through technological means.

Results

During the COVID-19 pandemic, 91 participants experienced high stress (PSS = 18.14 ± 4.1), and eating was associated with emotional behaviors (DEBQ EM = 41.74 ± 10.9). Stress correlated positively with the emotional and external aspects of eating behaviors.

Conclusion

The present study showed that the COVID-19 lockdown caused high stress with a worsening in eating behaviors. The study participants had difficulty in adequately coping with some emotions and feelings, developing an 'addiction' to food.