COVID-19-Related Home Confinement in Adults: Weight Gain Risks and Opportunities

Norms and attributions about weight gain during the COVID-19 pandemic

Objective. Weight gain was common during the first year of the COVID-19 pandemic, potentially creating a new descriptive norm about weight gain. The unique context of a global pandemic may have influenced situational attributions for weight gain that were not typical prior to the pandemic. We examined the effects of the new norm on people's views about responsibility and blame for weight gain.

Methods. In two preregistered surveys, we aimed to manipulate the salience of weight gain during COVID-19, and measured views about responsibility and blame for weight gain.

Results. Among participants who gained weight, the more common they perceived weight gain to be, the more they felt their own weight gain was understandable (b = 0.09, se = 0.04, p = 0.02), but perceived commonness didn't relate to their feelings of responsibility and blame for weight gain. For participants who didn't gain weight, the perceived commonness of weight gain was associated with less blame towards people who gained weight (b = 0.11, se= 1.46, p = 0.044), but not with responsibility for weight gain.

Conclusion. Participants believed weight gain was common during COVID, but this descriptive norm had mixed associations with attributions for one's own and others' weight gain.

Weight gain, new-onset overweight or obesity, and their influencing factors during the social distancing era of the COVID-19 pandemic

The prevalence of obesity is gradually increasing in South Korea, and the coronavirus disease 2019 (COVID-19) pandemic has accelerated the weight gain. In response to COVID-19, South Korea implemented targeted distancing measures based on the number of COVID-19 cases, rather than a full lockdown. This study focused on two subgroups that influence the rise in obesity prevalence during the early stages of the COVID-19 pandemic and explored the factors contributing to rapid weight gain in this group during this period. This cross-sectional study involved 3,462 participants recruited through the MicroEmbrain Inc. Online survey panel. Participation emails were sent by the research company to the online survey panel, and individuals who voluntarily agreed to participate responded to the survey. The participants consisted of residents aged 19 and above from Seoul, with sample distribution taking considering sex, age, and region. Height, and weight before and during the COVID-19 pandemic were self-reported. The analysis revealed that compared with that of pre-COVID-19 statistics, 11 % of all participants entered the overweight or obese categories post COVID-19, and among those who were overweight or obese before COVID-19, 42.5 % reported weight gain. Both groups had relatively younger individuals, higher stress levels, spent more time alone, and had increased usage of online platforms including online food purchasing. Post-COVID-19 wt gain among individuals with pre-existing overweight or obesity status was associated with a higher frequency of solitary drinking (odds ratio [OR] = 1.407, 95 % confidence interval [CI] = 1.024-1.932), increased online leisure time (OR = 1.336, 95 % CI = 1.063-1.678), and increased use of meal delivery services (OR = 1.307, 95 % CI = 1.026-1.664). The prevalence of obesity has continued to rise after COVID-19 pandemic, highlighting the need for interventions that mitigate the negative impact of the pandemic on health behavior.

The effect of the COVID-19 pandemic lockdown on the distribution of fat tissue and skinfold thickness in adolescents from Kraków (Poland)

BACKGROUND

The COVID-19 pandemic has significantly changed the lifestyle and dietary habits of societies worldwide. The aim of the study was to assess changes in the distribution of fat tissue and skinfold thickness in adolescents (aged 11-15) from Kraków during the COVID-19 pandemic period.

METHODS

Two cross-sectional studies conducted in 2020 and 2022 (before and after the pandemic) involved 1662 adolescents from the Kraków population. Skinfold thickness measurements were taken. The trunk adiposity index, limbs-to-trunk fat ratio and limbs-to-total skinfold ratio were calculated. Statistical analysis employed a two-way ANOVA, Tukey's HSD test and the Kruskal-Wallis test, depending on the normality of the distribution.

RESULTS

Higher skinfold thicknesses were observed in the majority of age groups in both sexes from the 2022 cohort in comparison with the 2020 cohort. Additionally, higher values of the trunk adiposity index and the limbs-to-total skinfold ratio in most age groups were observed. However, an inverse trend was observed in the limbs-to-trunk fat radio.

CONCLUSIONS

The introduced restrictions such as lockdown, remote learning, reduced physical activity and changes in dietary habits could have influenced the distribution of fat tissue and skinfold thickness amongst adolescents from Kraków.

An internet-based self-help intervention for the reduction of consumption of ultra-processed products and increase of physical activity in Mexican university population: study protocol for a randomized controlled trial

Introduction

The consumption of ultra-processed products has been associated with the etiology of various diseases, mainly metabolic diseases. On the other hand, physical activity acts as a protective factor that helps prevent the appearance of this type of disease. In addition to the physical effects, both the consumption of ultra-processed products (UPPs) and sedentary behaviors have been associated with a significant impact on people's mental health. These problems occur significantly in university students. Online internet interventions are an alternative that has the advantage of reaching a broader sample size and adapting to various problems.

Methods

A randomized controlled clinical superiority trial with two independent groups will be developed with 176 participants. Participants in both groups will be evaluated in 5 steps: (1) pretest, (2) middle of the intervention, (3) post-test, (4) follow-up at 3 months, and (5) follow-up at 6 months. In the experimental group ("UNISALUD"), participants will receive an intervention composed of 11 sessions with interactive elements such as videos, audio, and infographics created through the user experience (UX) principles and based on the health action process approach (HAPA). The participants in the control group will be on the waiting list and will receive treatment 27 days after fulfilling the inclusion criteria. Thus, participants will not receive the treatment immediately.

Discussion

The study is expected to establish the feasibility of a self-help internet-based intervention created based on the user experience methodology and the health action process model, leading to a significant decrease and increase in the consumption of UPPs, ultra-healthy products, and physical activity, respectively.

Conclusion

Internet-based interventions are scarce in Latin America. Due to their potential, this study will provide data about consumption of UPPs, physical activity, and mental health of the Mexican population, which will influence the reduction of health-related complications through prevention strategies or measures.Clinical Trial Registration:ClinicalTrials.gov, NCT05834842.

Restricted health service utilization and subsequent positive self-care behavior during the early COVID-19 pandemic in China

Background

The reallocation of health resources, epidemic prevention and control measures during the COVID-19 pandemic triggered widespread restricted health service utilization, some residents and patients tried positive self-care behavior to maintain their health, yet the efficacy of this intervention remains unclear.

Object

Based on the reasoned action approach (RAA) theory, this study aimed to investigate the correlation between self-care behavior and restricted health service utilization among adults in China, trying to discover the vulnerable groups and external and intrinsic factors that affect self-care behavior among Chinese adults.

Methods

Data on demographics, socioeconomic, health status, and self-care behavior were collected in "The Early China COVID-19 Survey," a cross-sectional anonymous online survey of the general population in China. Self-care behavior was measured by four indicators: weight control (WC), physical activity (PA), prevention behavior (PB), and online medical consultation (OMC). The multiple linear models and binary logistic regression were used to examine whether restricted health service utilization (RHSU) is associated with self-care behaviors; also, adjusted multivariate logistic regression was used to analyze subgroup heterogeneity.

Results

In total, 8,428 adult participants completed the survey, the mean OMC score was 1.51 (SD 1.34), the mean PB score was 18.17 (SD 3.44), and the proportion of participants who engaged in WC and PA was 42.30 and 62.57%, respectively. According to the multiple regression model, the RHSU was significantly positively correlated with all four indicators of self-care (WC: OR = 1.34, p < 0.001, PA: OR = 1.34, p < 0.05, MC: OR = 1.30, p < 0.001, PB: coef = 0.16, p < 0.05). We also observed some significant differences in the intensity of this relationship by subgroup analysis, precisely, OMC (high vs. moderate vs. low infection-risk level: OR = 1.48; 1.41; 1.19, p < 0.1), PA (male vs. female: OR = 1.27;1.06; p < 0.05, high vs. Moderate and low infection-risk level: OR = 1.51; 1.17; 1.02, p < 0.05), PB (Chronic disease groups vs. no: coef = 0.46; 0.1, p < 0.05).

Conclusion

Restricted health service utilization predicts more positive self-care behavior, and the intensity of partial correlation was significantly different in the subgroups of sex, actual infection risk level of the living area, and chronic diseases. These findings highlight the urgent demand for self-care behavior among Chinese adults during the pandemic and provide new insights for developing self-care and reducing the burden on the healthcare system in the long term.

Physical, psychological, and social experiences of women recovered from COVID-19 in Iran: A qualitative study

BACKGROUND

This paper aims to examine the impact of COVID-19 on various health aspects of women recovered from this disease in Ardabil province, Iran.

MATERIALS AND METHODS

This qualitative study using a content analysis approach was carried out through in-depth individual and focus group discussion using semi-structured interviews schedule in 26 women during June and August 2021. Interviews were recorded, transcribed, and MAXQDA six-stage analysis framework.

RESULTS

Negative consequences of COVID-19 were generally categorized into five main themes (including increased self-conscious excitement, perceived social stigma, depression, changes in behavioral patterns, and reduced level of quality of life) and 13 subthemes. The positive consequences were the following five themes (including the development of the spiritual attitude, increasing the importance of personal health, the rise of perceived support, increased sense of altruism, and increased financial management) and four subthemes.

CONCLUSION

Based on the findings, it is concluded that effective support by the government, society, and the medical staff could help to relieve people's psychological and social stress through providing financial aid, the right information, and training.

Patterns of eating behaviors, physical activity, and lifestyle modifications among Bangladeshi adolescents during the COVID-19 pandemic

BACKGROUND

Several safety measures like movement restrictions, closure of educational institutions, and social distancing measures continue over the world including Bangladesh during the COVID-19 pandemic. This study aimed to examine the patterns of eating behaviors, physical activity, and lifestyle modifications among adolescents during the COVID-19 pandemic residing in Bangladesh.

METHODS

A cross-sectional study was performed among 490 adolescents in Bangladesh from December 2020 to May 2021. The survey was carried out through a semi-structured web-based questionnaire that asked questions about socio-demographics (i.e., age, sex, marital status, education, residence), perceived health status and quality of life, anthropometrics (i.e., height, weight), dietary habits (i.e., frequency of eating, daily intake of certain foods, number of meals eaten daily), and physical activity (i.e., modified version of the International Physical Activity Questionnaire Short Form [IPAQ-SF]), as well as, pre- and during COVID-19 information on stress, and sleep.

RESULTS

During the pandemic, 43.7% participants reported weight gain; and 23.5% reported an increased number of meals per day during COVID-19. Additionally, the participants' eating habits diverged from the local balanced diet principles and were more akin to 'unhealthy' eating patterns. Though, during the COVID-19 pandemic, physical exercise slightly increased (>3 times/ week: 8.2% vs. 13.5%; p<0.001) compared to pre-COVID-19 period, the screen time for entertainment increased drastically (>5 hours/ week: 12.2% vs. 27.3%; p<0.001). Compared to the pre-pandemic, a sizeable proportion of individuals experienced more physical tiredness, emotional exhaustion, irritation, and stress (p<0.001) during the pandemic. During the pandemic, 47.5% of participants experienced different sleep difficulties.

CONCLUSIONS

Although lockdowns and social distancing are important safety measures to protect people from COVID-19, findings reveal that they might cause a variety of lifestyle changes, physical inactivity, and psychological issues in Bangladeshi adolescents.

Changes in eating habits and lifestyle during the first year of the COVID-19 pandemic across metropolitan regions in Brazil and Germany: A survey-based cross-sectional study

COVID-19 caused profound societal changes to cope rapidly with the new circumstances. The food market changed its quantity, quality, form, and frequency dynamics. Consequently, food-eating habits and lifestyles like physical exercise likely experienced changes. An online-based survey was conducted between June 2020 and January 2021 in the metropolitan regions of Rhine Ruhr Metropolis (RRM), Greater São Paulo (GSP), other metropolitan regions in São Paulo state (oMRSP), other Brazilian metropolitan regions (oBRMR), and the remaining urban areas in both countries (oUA), representing different contexts of Brazil and Germany. We assessed self-reported changes in physical activity level, diet quality, self-reported eating habits, and buying groceries during the first year of the pandemic. In Germany, indoor and outdoor activities increased for 34% of the respondents, while in Brazil, there was a decrease in physical activity for 50% of the participants. The Healthy Eating Index (HEI) scored higher among Brazilians (16.8) than Germans (15.2) on a 0-29 HEI scale. Increased awareness of healthy and sustainable eating habits was observed in GSP (0.7), oMRSP (0.63), oBRMR (0.7), and oUA (0.68) on a scale from no change (0) to change (1). In RRM, an increase in convenience foods was noticed (0.86). Participants reported discomfort with food purchasing due to hygiene measures and avoided going to the supermarket (0.7 on average in Brazil and 0.58 for females using the same 0-1 scale). Also, food supply at the grocery shops was reported to be often unavailable and in lower quantities. A real-time assessment of self-reported changes in eating habits and lifestyle during the lockdown in 2020 in different contexts is insightful for rethinking strategies to improve conditions in the post-COVID-19 era and prepare for future pandemics.

Lifestyle and eating habits changes among adults during COVID-19 era in Egypt: a population-based study

BACKGROUND

The 2019 recent Coronavirus is without a doubt one of the most complicated viruses to ever pose a threat to humanity. Numerous viral containment strategies forced sedentary behaviors and dietary changes that would-otherwise- increase the chances of acquiring non-communicable diseases.

OBJECTIVES

The objectives of the current study are to identify any changes in eating behaviors through the Mediterranean Diet Adherence in a sample of Egyptians throughout the COVID-19 era.

METHODS

A cross-sectional study was done on a sample of 205 Egyptians by an online self-administered questionnaire. The questionnaire included socio-demographic factors, self-reported weights and heights, a validated Arabic form of the well-known International Physical Activity Questionnaire Short Form (IPAQ-SF), a validated Arabic version of 14-items Mediterranean Diet Adherence Screener (MEDAS), in addition to a section assessing dietetic changes. The data was then analyzed using the SPSS version 20 (Statistical Package for Social Sciences).

RESULTS

The majority of the study sample were females (74.6%); had a high level of education (93.2%); and about 75% were married. Most of the participants were non-smokers, with around a 7% increased frequency of smoking after the COVID-19 pandemic. Fast food consumption was also reported by a major percentage of study participants (60%). Low Mediterranean Diet Adherence was found in 52.7%. Moreover, Physical Activity (PA) decreased to 61%. Moreover, there was a statistically significant increase seen in the participants' BMI as well as the number of sleeping hours (p = 0.001 and 0.043 respectively) after the pandemic. Both changed hunger sensation and any changes in physical activity were significantly associated with increased BMI (p < 0.001).

CONCLUSION AND RECOMMENDATIONS

A substantial proportion of the participants showed unhealthy changes in their dietary habits as well as physical activity. Consequently, this calls for urgent public health policies and interventions to guard against the consequences of such unhealthy behaviors.

Motivational interviewing for weight management among college students during COVID-19: An exploratory randomized controlled trial

Background

College students encounter challenges in managing their weight. The Coronavirus Disease 2019 (COVID-19) pandemic exacerbated the problem. The purpose of this study was to determine the effect of a motivational interviewing (MI) intervention compared to online education (control) on body composition and self-determination theory constructs among college students with overweight.

Methods

This was a randomized clinical trial of 40 college students comparing an MI versus a control group. The MI group received monthly interviews: three face-to-face interviews before the pandemic, and three video chat interviews after the outbreak of COVID-19 spanning a total of six months. The control group received six, monthly education modules. Body composition was measured by the iDexa and self-determination theory (SDT) variables were assessed with surveys.

Results

Mixed ANOVAs from pre-post revealed significant changes in fat mass (p = .03, η2 = 0.22), lean mass (p < .05, η2 = 0.18), body fat percentage (p < .01, η2 = 0.37), autonomy (p < .01, η2 = 0.38), relatedness (p < .01, η2 = 0.41), amotivation (p = .01, η2 = 0.29), external regulation (p = .02, η2 = 0.23), identified regulation (p = .02, η2 = 0.25), integrated regulation (p < .00, η2 = 0.49), and intrinsic regulation (p = .01, η2 = 0.27).

Conclusions

In this exploratory analysis, MI demonstrated a positive trend in body composition maintenance when compared to online education among overweight college students during a national pandemic. Future studies utilizing MI would enhance the literature by further investigating the relationship between MI and SDT and measuring body composition.Clinicaltrials.gov. identifier: NCT04130386.

Associations between body mass index and episodic memory for recent eating, mindful eating, and cognitive distraction: A cross-sectional study

Objectives

Eating while distracted has been associated with a higher body mass index (BMI), whereas mindful eating and episodic memory for recent eating have shown the opposite pattern. This pre-registered, global study (https://osf.io/rdjzk) compared the relative association between these variables (and four "positive controls": restraint, disinhibition, emotional eating, plate clearing) and self-reported BMI. The timing of data collection (April-May 2020) during the SARS-CoV-2 pandemic enabled an investigation of the impact of stay-at-home restrictions imposed on the UK population on the measures of eating behavior.

Methods

An online survey was completed, including: (i) demographic data (e.g., self-reported BMI), (ii) Likert ratings assessing episodic memory for recent eating, mindful eating, cognitive distraction, restrained eating, emotional eating, disinhibition and plate clearing over the last 12 months and the last 7 days (during the first UK COVID-19 lockdown), and (iii) the Mindful Eating Questionnaire (MEQ).

Results

A large adult sample participated (N = 846; mean (SD) age = 33.0 (14.3) years; mean (SD) BMI = 24.6 (5.6) kg/m2). Mindful eating (MEQ-total score) was associated with a lower self-reported BMI (β = -0.12; 95% CI = -0.20, -0.04; p = 0.004), whereas disinhibited eating was associated with a higher self-reported BMI (β = 0.30; 95% CI = 0.21, 0.38; p < 0.001). In UK participants (n = 520), consistent changes in eating behavior during lockdown were not found. For those that did experience change, decreases were reported in; emotional eating, disinhibited eating, focusing on taste during a meal (a measure of mindful eating), and using a smart phone while eating.

Conclusions

These findings provide evidence in a large global sample for associations between BMI and (i) mindful eating, and (ii) disinhibited eating. Future research should evaluate whether mindful eating demonstrates a prospective association with body weight and should consider mechanisms of action.

The relationship of within-individual and between-individual variation in mental health with bodyweight: An exploratory longitudinal study

BACKGROUND

Poor mental health is associated with obesity, but existing studies are either cross-sectional or have long time periods between measurements of mental health and weight. It is, therefore, unclear how small fluctuations in mental wellbeing within individuals predict bodyweight over short time periods, e.g. within the next month. Studying this could identify modifiable determinants of weight changes and highlight opportunities for early intervention.

METHODS

2,133 UK adults from a population-based cohort completed monthly mental health and weight measurements using a mobile app over a period of 6-9 months. We used random intercept regression models to examine longitudinal associations of depressive symptoms, anxiety symptoms and stress with subsequent weight. In sub-group analyses, we included interaction terms of mental health variables with baseline characteristics. Mental health variables were split into "between-individual" measurements (= the participant's median score across all timepoints) and "within-individual" measurements (at each timepoint, the difference between the participant's current score and their median).

RESULTS

Within-individual variation in depressive symptoms predicted subsequent weight (0.045kg per unit of depressive symptom severity, 95% CI 0.021-0.069). We found evidence of a moderation effect of baseline BMI on the association between within-individual fluctuation in depressive symptoms and subsequent weight: The association was only apparent in those with overweight/obesity, and it was stronger in those with obesity than those with overweight (BMI<25kg/m2: 0.011kg per unit of depressive symptom severity [95% CI -0.017 to 0.039]; BMI 25-29.9kg/m2: 0.052kg per unit of depressive symptom severity [95%CI 0.010-0.094kg]; BMI≥30kg/m2: 0.071kg per unit of depressive symptom severity [95%CI 0.013-0.129kg]). We found no evidence for other interactions, associations of stress and anxiety with weight, or for a reverse direction of association.

CONCLUSION

In this exploratory study, individuals with overweight or obesity were more vulnerable to weight gain following higher-than-usual (for that individual) depressive symptoms than individuals with a BMI<25kg/m2.

Is obesity and body perception disturbance related to social media addiction among university students?

Objective The use of social networks has grown substantially over the past few years and especially during COVID-19. This study aims to investigate the possible relationship between social media addiction and obesity which may lead to disturbed body perception in university students.Participants: A total of 250 undergraduates participated.Results: Social media addiction depends on the number of years of social media use, meal skipping, and increased frequency of fast food consumption. There was a significant relationship between fast-food consumption frequency and body perception. No significant relationship was found between BMI and SMAS while there was a significant relationship between SMAS and body perception.Conclusion: The findings support, social media addiction may lead to increased risk factors for obesity and as a consequence impair body perception in young adults.

Impact of COVID-19 on negative body image: Evidence based on social media data

Body experiences and conditions bear close relations to social development and human well-being. However, no consensus has been reached regarding the impact of coronavirus disease 2019 on negative body image. Investigating a reliable relationship between COVID-19 and negative body image, we developed a dictionary of negative body image to obtain panel data on body image for 31 Chinese provinces/municipalities/autonomous regions. We compared negative body image before and after the pandemic and explored the impact of pandemic severity. The prevalence of negative body image decreased following the outbreak and remained at a relatively low level for two years. After controlling regional and temporal effects, we verified epidemic severity as an important predictor of the decline in negative body image. The findings suggest that the public is likely to accept their physical appearances during lockdown due to changes in lifestyle and the fear of mortality. This research has important implications for gaining insights into the dynamic transformation of public negative body image under the influence of catastrophic public health events.

COVID-19 Pandemic Associations on Mental and Physical Health in African Americans Participating in a Behavioral Intervention

The COVID-19 pandemic has had disproportionate effects on communities of color, with higher death rates among African Americans (AA). The purpose of this study was to assess associations in African Americans' mental and physical health with the COVID-19 pandemic. Data for this study came from a larger nutrition intervention of AAs in the Southeastern United States, the Nutritious Eating with Soul study. Data collected before and after March 15, 2020 (the day when local South Carolina schools and businesses closed), were analyzed to assess the association of the pandemic on participants' stress, control of healthy eating, physical activity, and body mass index. Repeated measures analysis of covariance using full maximum likelihood estimation to handle missing data was used. At the onset of the COVID-19 pandemic, 150 participants were enrolled in the study (48.2 ± 10.6 years old, 79% female, 75% with college degree or higher). Participants' reporting of stress did not show statistically significant change over time. Cognitive control increased 1.43 points (F = 20.60, p < 0.0001) and body mass index increased 0.72 kg/m2 (F = 10.68, p = 0.001). Future longitudinal studies should investigate how the COVID-19 pandemic continues to present challenges to understanding and improving health among African Americans. The study is registered at www.clinicaltrials.gov NCT03354377.

Does obesity Kuznets curve exist in developing economies? Evidence from 38 African countries based on heterogeneous panel data analysis on income-level classification

Introduction

The global pandemic disease known as the obesity epidemic has spread throughout the planet. Particularly, Africa is facing a growing problem of obesity, and the trend is rising. This is a result of a ticking time bomb. Given the claim that multiple socio-economic factors significantly affect the diversity in obesity rates between nations, economic development can be seen as a key contributor to this variation.

Methods

Relying on the aforementioned avowal, this extant research examines the relationship between obesity and economic growth using urbanization, trade openness, and unemployment as intermittent variables within the Obesity Kuznets Curve (OKC) framework. Using panel data from 1990 to 2020, a panel of 38 African countries subdivided into income levels (Low income, Lower-middle income, and Upper-middle income) were analyzed. With the presence of residual cross-sectional reliance and slope heterogeneity, the Augmented Mean Group (AMG) econometric approach is employed.

Results

Key outcomes from the mentioned estimation method unveiled that economic growth positively impacts obesity among all the study panels. Variably, unemployment was evidenced to have a palpable positive impact on obesity concerning Low-income economies whereas on the side of the Lower-middle income panel together with Upper-middle income economies and the aggregated panel, a significant negative relationship is observed with obesity. Further, urbanization enhanced obesity in the Low-income panel and the aggregated panel of African nations, whereas an adverse effect is identified in both the Lower-middle and Upper-middle economies in Africa. Moreover, except for Low-income African economies, all the other panels of African nations in terms of income levels were noted to have a significant negative effect on obesity from trade openness.

Discussion

Finally, the long-run coefficients indicated that the OKC is valid among all panels of African countries. The study thus preferably suggests in African economies that addressing the inverted U-shape relationship between obesity and economic growth requires a multifaceted approach that considers the evolving dynamics of both factors. Policy makers should, therefore, aim to balance promoting economic growth and safeguarding public health through targeted interventions and long-term strategies.

Religion and Pandemic Weight Gain: A Refuge from the Storm?

The COVID-19 pandemic was an inherently stressful global crisis that was associated with weight gain for over 40% of the American public. Building on previous research, we draw on recently collected national survey data from the United States to examine the effects of religious attendance (both in-person and virtual), the sense of divine control, and religious/spiritual (R/S) struggles on pandemic weight gain. A series of logistic regression models were conducted. Our findings suggest that divine control and monthly in-person religious attendance were associated with a lower risk of pandemic weight gain, while R/S struggles were associated with a higher risk of weight gain. Our results reveal the complex role that religiosity can play with respect to pandemic weight gain.

Home-prepared meals among college students at-risk for food insecurity: A mixed-methods study

The ability to prepare meals at home is an important life skill with potential to improve dietary quality and reduce costs and thus may be particularly important for college students with food insecurity. However, heavy time demands, limited financial resources, and therefore other barriers such as lack of motivation to follow a healthy diet may constrain meal preparation skills. To gain greater insight into this issue, we conducted a mixed-methods study. The quantitative component assessed relationships among food security, motivation, and meal preparation skills. The qualitative component used focus groups to more closely consider college students' perceptions, values, and barriers surrounding preparing meals at home, including current practices, desired future practices, and the ways in which the campus could support their efforts. The survey (n = 226) assessed food security, meal preparation skills, and motivation (i.e., perceived ability and willingness) to consume a healthy diet. Ten focus groups (n = 60) discussed food choice, meal preparation practices, and ways in which the campus could help students develop meal preparation skills. Students with food insecurity had lower meal preparation skills and lower perceived ability to consume a healthy diet. However, a) willingness to consume a healthy diet and b) the impact of both willingness and perceived ability did not differ by food security status. Focus group data indicated that in-person and online cooking classes, information cards in the food pantry, and incentives (e.g., kitchen equipment and vouchers from local grocery stores) were popular ideas for improving home-meal preparation. A greater understanding of meal preparation skills and their interconnectedness to food choice and the campus environment may inform effective ways to support the ability and willingness of college students with food insecurity to prepare meals at home.

The impact of COVID-19 on the changes in health behaviours among Black, Asian and Minority Ethnic (BAME) communities in the United Kingdom (UK): a scoping review

BACKGROUND

The COVID-19 pandemic has led to changes in health behaviours, which include eating patterns and nutrition, smoking, alcohol consumption, sleeping patterns, physical activity and sedentary behaviour. There is a dearth of evidence reporting the impact of COVID-19 on the health behaviour of Black, Asian and minority ethnic (BAME) communities. This scoping review synthesises the available evidence on the impact of COVID-19 on the changes in health behaviours among BAME communities in the UK.

METHODS

Following a keyword strategy, 16 electronic databases were searched for articles that met the screening criteria. These articles were then reviewed in full text. Empirical studies that assessed COVID-19 related health behaviour changes among BAME communities in the UK, conducted during the COVID-19 pandemic between July 2020 and August 2021 and published in English language, were set as inclusion criteria. An initial 2160 studies were identified in the selected databases. After removing duplications and screening the title and abstracts of the 2154 studies, only 4 studies were selected to be reviewed as they met the inclusion criteria. The included studies employed different sample sizes which ranged from N = 47 to N = 30,375 and reported several health behaviour changes. Out of the 4 included studies, 3 studies included BAME groups within their sample as a subgroup while one study focused specifically on BAME groups.

RESULTS

The scoping review found that there were lower levels of physical activity among BAME groups compared to the White ethnic groups. About 41.7% of BAME groups reported drinking less alcohol than usual compared to their white counterparts who were 34%. Study participants from BAME backgrounds had the greatest effect of COVID-19 on decisions to purchase healthier food compared to those from white backgrounds whose decisions on purchasing healthier food were least affected. Some participants reported an increase in positive hygiene practices due to the COVID-19 pandemic.

CONCLUSION

COVID-19 had a significant impact on the health behaviours of BAME groups especially during the lockdowns as they reported changes to behaviour such as low levels of physical activities. Hence, it is important to promote health awareness among BAME groups to encourage healthy living. In addition, programmes such as physical fitness activities that favour BAME groups should be put in place, for example BAME women's walking groups to encourage people from BAME backgrounds to engage in physical activities. Furthermore, healthy food programmes such as food parcels can be given to people from BAME backgrounds who are not able to afford healthy food due to the impact of COVID-19. Nonetheless, the COVID-19 pandemic has increased positive hygiene among BAME groups which is important in preventing other diseases and infections.

The impact of the first COVID-19 lockdown on weight management practices in UK adults: A self-regulation perspective

This study aimed to identify the impact of the first UK COVID-19 lockdown on individuals' weight management attempts (WMA). A self-regulation theoretical framework was used to identify predictors of continuing with a WMA, and weight change during the lockdown. An online retrospective cross-sectional study was conducted after the first UK COVID-19 lockdown. The sample consisted of 166 UK adults (M:31.08, SD:12.15) that were trying to manage their weight before the lockdown started. The survey assessed changes in WMA and practices, and measured perceived stress, flexible/rigid restraint, uncontrolled eating, craving control, and self-compassion. Results showed that 56% of participants reported disruption to their WMA during the lockdown. Participants with lower levels of perceived stress and higher flexible restraint were more likely to continue their WMA. Flexible restraint was a significant predictor of weight change. Interventions that promote flexibility in weight management may be beneficial for at-risk individuals under lockdown conditions.

A clinically managed weight loss program evaluation and the impact of COVID-19

Introduction

With the prevalence of obesity increasing, many weight-loss programs were created to aid in combating the trend. The Weight Loss Clinic (WLC) was created to provide personalized support for lifestyle changes using a multidisciplinary team with medical oversight. This study evaluated the clinically-managed weight loss program at the Wellness Institute.

Methods

This was a prospective evaluation of a newly established program between January 2019-August 2020. Participants who entered the weight loss program were approached to learn about the evaluation. A total of 41 participants were included. The primary outcomes included changes in body weight and achievement of more than 5% initial body weight loss. Outcome measures were collected pre-and post-program and the data was analyzed through paired t-tests on R studio.

Results

Greater body weight-loss was seen in completers pre-COVID-19 compared to those who completed during the pandemic (Mean, ±SD; 7.51 ± 6.24 kg n = 13 p < 0.001 vs. 1.75 ± 4.43 kg n = 9, p = 0.02). Completers pre-COVID-19 demonstrated improvements in waist circumference, Framingham risk score, blood pressure, hemoglobin A1C, and body fat percentage.

Conclusions and implications

Though the sample size was small to show definitve evidence, the results may suggest the program worked well prior to the pandemic but the pandemic created barriers to weight-loss for participants.

Characteristics of Frailty in Perimenopausal Women with Long COVID-19

The aim of this study was to compare the prevalence of risk factors for frailty between perimenopausal women with long COVID-19 syndrome, women having successfully recovered from COVID-19, and controls from the community. Women with a diagnosis of long COVID-19 and at least one symptom related to the perimenopausal period, women who had successfully recovered from COVID-19, and healthy women of comparable age were included in this study. Symptom severity and functional disability were assessed with the COVID-19 Yorkshire Rehabilitation Scale, and the presence of frailty was evaluated considering the Fried criteria. A total of 195 women were included in the study, distributed over the three groups. The long COVID-19 group showed a higher prevalence of perimenopausal symptoms and impact of COVID-19. Statistically significant differences were found between the long COVID-19 group and the other two groups for the frailty variables. When studying the associations between frailty variables and COVID-19 symptom impact, significant positive correlations were found. Perimenopausal women with long COVID-19 syndrome present more frailty-related factors and experience a higher range of debilitating ongoing symptoms. A significant relationship is shown to exist between long COVID-19 syndrome-related disability and symptoms and frailty variables, resulting in an increased chance of presenting disability.

The pandemic changes daily life and ways of living: technosociality and user/families experiences

OBJECTIVES

understand the changes imposed by the COVID-19 pandemic in the daily lives of users of Primary Health Care and their families and its impact on self-care and health promotion.

METHODS

this is a holistic-qualitative multiple case study, based on the Comprehensive Sociology of Everyday Life, in which 61 users participated.

RESULTS

experiencing a new daily life in COVID-19 pandemic times, users express their feelings, adaptation to new habits and ways of living. Health technologies and virtual social networks stand out in helping with everyday tasks, in communicating with loved ones and health professionals, and in validating dubious information. Faith and spirituality arise in the face of uncertainty and suffering.

FINAL CONSIDERATIONS

it is imperative to pay close attention to the changes in daily life caused by the COVID-19 pandemic, in order to offer care directed to the singular and collective needs.

How parents share and limit their child’s access to information about COVID-19: A mixed methods online survey study

This study aimed to understand the role that parents play in sharing or limiting their child's access to information about coronavirus disease 2019 (COVID-19). A subset of data from an international mixed methods online survey study was analysed to elucidate the findings from Brazil. An online survey, conducted between April and June 2020, gathered closed and open text views from parents of children aged 7-12 years old. Quantitative data were analysed using descriptive statistics. Qualitative open text data were analysed using the three stages of the Bardin content analysis framework: pre-analysis (data organisation and initial full-content reading); exploration of the material (thematic coding to identify major motifs and develop thematic categories) and interpretation (treating the data as significant and valid). The sample consisted of 112 (89%) mothers and 14 (11%) fathers. The analysis of the parents open text resulted in two categories: 'How parents share information with their children about COVID-19' and 'How parents limit information to their children about COVID-19'. Some parents reported adopting an honest and open approach on how they shared information with their children, whilst some parents chose to minimise their child's access to information about the pandemic over concerns of the mortality related to COVID-19.

The impact of COVID-19 quarantine on lifestyle indicators in the United Arab Emirates

Introduction

COVID-19 is a virus that has spread rapidly and brought economic and social crises all around the world. The current study aimed to investigate the impact of COVID-19 quarantine on dietary habits, physical activity, food purchasing, smoking, and sleeping patterns in the United Arab Emirates.

Methods

A cross-sectional study was conducted using an online questionnaire between November 1st, 2020 and the end of January 2021. Citizens and residents of the UAE aged ≥ 18 years old were asked to complete an anonymous electronic questionnaire created via Google Forms and distributed on various platforms, such as WhatsApp, Twitter, and email. A total of 1682 subjects participated in the study.

Results

The results included that during the COVID-19 lockdown, more participants (44.4%) reported an increase in weight. This gain seems to be linked to increased food consumption [(Adjusted Odd Ratio) AOR = 1.68, 95% (Confidence Interval) CI = 1.12, 2.54, p = 0.022], decreased physical activity (AOR = 2.25, 95% CI = 1.58, 3.21, p < 0.001), and increased smoking (AOR = 1.90, 95% CI = 1.04, 3.50, p = 0.038). The groups that were most likely to gain weight included those who consumed more cereals (AOR = 1.67, 95% CI = 1.08, 2.57, p = 0.011), had an increased desire for sweets (AOR = 2.19, 95% CI = 1.50, 3.19, p < 0.001), and an increased desire for food (hunger) (AOR = 2.19, 95% CI = 1.53, 3.14, p < 0.001). In contrast, those who exercised more were more likely to lose weight (AOR = 0.61, 95% CI = 0.44, 0.86, p < 0.001) as well as those who slept over 9 h a day (AOR = 1.90, 95% CI = 0.45, 0.88, p = 0.006).

Discussion

Overall, it is essential to promote healthy habits and methods of healthy diet maintenance during stressful and unusual times when people might find it difficult to put effort into their health.

Emotional eating in relation to psychological stress during COVID-19 pandemic: a cross-sectional study in faculty of medicine, Tanta University, Egypt

BACKGROUND

Stress, anxiety, and depression resulting from the COVID-19 pandemic as well as subsequent restrictive measures had a negative impact on eating behaviors. This study aimed to determine the emotional eating behaviors and the perceived stress level and to assess the relation between them among adults in the faculty of medicine during the late period of lockdown during the COVID-19 pandemic.

METHODS

This was a cross-sectional study among 580 persons from the faculty of medicine, at Tanta University, Egypt conducted over a period of one month during the last period of partial lockdown (October 2020). A self-administered structured questionnaire consisted of five parts used in the study (sociodemographic factors, COVID-19-related parameters, nutrition-related information during the pandemic, emotional eating scale, and perceived stress scale).

RESULTS

More than two-fifths of students, employees, and staff (45.2%, 45.5%, and 44.2%, respectively) stated that their weight increased as a result of the lockdown. 50.8% of students, 42.5% of employees, and 54.6% of staff were in the moderate emotional eating groups. Similarly, the majority of students, employees, and staff reported moderate levels of stress(84%, 80.8%, and 76.1% respectively). The total emotional eating score was positively correlated with the total perceived stress scores (r = 0.13, p = 0.001*).

CONCLUSION

COVID-19 pandemic, particularly during the period of lockdown, had a negative impact on individuals' psychological stress levels and levels of emotional eating behaviors.

Dietary Habits and Lifestyle, Including Cardiovascular Risk among Vegetarians and Omnivores during the COVID-19 Pandemic in the Polish Population

Background: This study assessed how two food groups—omnivores (OMN) and vegetarians (VEGE)—differ in lifestyle changes, including dietary habits during the COVID-19 pandemic. Materials: A total of 861 persons participated in the survey and were divided into two groups: persons following a mixed diet (n = 489) and vegetarians, including vegans (n = 372). The mean age shows no significant differences. Methods: An online survey was conducted on the Polish population during the COVID-19 pandemic. Data was collected using social media; the survey was intended for adults and included separate sheets for different diets (OMN vs. VEGE). Results: The results in both groups were similar regarding the burden of premature diseases. Most respondents (~90%) did not indicate cardiovascular disease abnormalities. In the OMN group, overweight and obesity occurred more often, and the OMN group also showed a higher percentage of people reporting weight gain (OMN 42.7% vs. VEGE 35.9%). The results disclosed the VEGE group significantly more frequently chose products, i.e., vegetables (p = 0.029), legumes (p < 0.001), and dairy products or their plant substitutes (p = 0.002), compared to the OMN group. Conclusions: The VEGE group revealed the most regularities in dietary habits during the pandemic.

Despite regression of healthy lifestyle habits, weight loss after bariatric surgery is not affected during the COVID-19 pandemic

BACKGROUND

The coronavirus pandemic has caused a worldwide health crisis. Bariatric patients require extensive pre- and post-operative follow-up, which may be less feasible during public health social distancing mandates. We assessed the impact of the pandemic on the behaviors and weight loss outcomes of our pre- and post-operative bariatric patients.

METHODS

A retrospective review of a prospectively maintained database identified patients who underwent either sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) at a single institution between March 2018 and May 2020. A cohort undergoing surgery within 12 months before the pandemic as well as a cohort undergoing a medically supervised diet prior to surgery was surveyed regarding pre- and post-COVID-19 lifestyle habits. Excess weight loss (EWL) outcomes from a group of pre-COVID surgical patients were compared to that of a group of post-COVID surgical patients. Primary outcome was whether the lockdown changed 1-year weight loss outcomes. Secondary outcome was whether patient lifestyle behaviors were changed during the pandemic.

RESULTS

There was no difference in 1-year EWL between pre- and post-COVID SG patients (51.7% versus 55.9%, p = 0.35), or between pre- and post-COVID RYGB patients (88.9% versus 80.4%, p = 0.42). Pre-stay-at-home order, 91.8% endorsed physical activity compared to 80.3% post-stay-at-home order (p = 0.0025). Mean physical activity decreased from 4.2 h/week to 2.7 h/week after the stay-at-home order (p < 0.0001). Additionally, 41.3% reported worsened dietary habits post-stay-at-home order.

CONCLUSION

The COVID-19 pandemic has greatly impacted the behaviors of bariatric surgery patients. Despite deterioration of lifestyle habits, 1-year weight loss outcomes after bariatric surgery remained the same before and after the instatement of social distancing measures. In the short term, the biological effect of metabolic procedures may mask the effects of suboptimal diet and physical activity, but more studies are necessary to better assess the impact of COVID-19 on outcomes after bariatric surgery.

Dietary habits, lifestyle changes, and glycemic control in patients with type 2 diabetes mellitus during coronavirus disease 2019 (COVID-19): A cross-sectional study in Egypt

BACKGROUND

The coronavirus disease 2019 (COVID-19) lockdown had a significant effect on people's lifestyles and dietary habits resulting in a possible negative health impact, particularly for patients with type-2 diabetes mellitus (T2DM). The objective of the study was to assess the changes in dietary habits and lifestyle and how these relate to glycemic control in patients with type 2 diabetes (T2D), who attended Zagazig Diabetes Clinic, Sharkia Governorate, Egypt, during the COVID-19 pandemic.

MATERIALS AND METHODS

A total of 402 patients with T2D were included in this cross-sectional study. A semistructured questionnaire was used to collect information on socioeconomic status, dietary habits, lifestyle changes, and previous medical history. Weight and height were also measured, and hemoglobin A1C levels before and after lockdown were compared. Data analysis was performed using the SPSS. To determine statistical significance, Chi-square test was used for categorical variables whereas, paired t-test or McN-Nemar test, as appropriate, was used to compare change in HbA1c before and after lockdown. Ordinal logistic regression was used to determine factors associated with weight change, whereas binary logistic regression was used to determine factors related with glycemic control.

RESULTS

During the COVID-19 pandemic, 43.8% of the studied groups consumed more than their usual diet with an increase in fruits, vegetables, and immunity-boosting food; 57% depended on home-cooked food, 48.3% did not practice exercise. About 57% reported to have gained weight, 70.9% suffered from mental stress, and 66.7% reported inadequate sleep. Collectively, there was a statistically significant decrease in the percentage of good glycemic control in the studied groups (28.1% vs. 15.9%) before and after the COVID-19 lockdown, respectively (P < 0.001). Weight gain, physical inactivity, mental stress, and inadequate sleep were significantly associated with poor glycemic control.

CONCLUSION

COVID-19 pandemic has had a negative impact on the lifestyle and dietary habits of the studied groups. Therefore, it is very important to ensure better diabetes management in this critical period.

A pandemia muda o quotidiano e modos de viver: tecnossocialidade e experiências de usuários/famílias

RESUMO Objetivos: compreender as mudanças impostas pela pandemia de COVID-19 no quotidiano de usuários da Atenção Primária à Saúde e suas famílias e seu impacto no autocuidado e na promoção da saúde. Métodos: trata-se de estudo de casos múltiplos holístico-qualitativo, fundamentado na Sociologia Compreensiva do Quotidiano, no qual participaram 61 usuários. Resultados: vivenciando um novo quotidiano em tempos da pandemia de COVID-19, os usuários expressam seus sentimentos, a adaptação aos novos hábitos e modos de viver. As tecnologias em saúde e as redes sociais virtuais se destacam no auxílio às tarefas cotidianas, para a comunicação com entes queridos e os profissionais da saúde, e na validação de informações duvidosas. A fé e a espiritualidade surgem diante de incertezas e sofrimento. Considerações Finais: é imperativo um olhar atento às transformações no quotidiano causadas pela pandemia de COVID-19, a fim de ofertar um cuidado direcionado às necessidades singulares e do coletivo.

Changes in eating habits, sleep, and physical activity during coronavirus disease (COVID-19) pandemic: A longitudinal study in young Brazilian adult males

Background: The coronavirus disease (COVID-19) pandemic has promoted changes in lifestyle behaviors, such as food consumption, sleep, and physical activity (PA). Few longitudinal studies have investigated these changes in young adults. Aim: This study aimed to assess lifestyle behaviors before and during the COVID-19 pandemic in young adult males. Methods: 50 young adult males (18-35 years) recruited by posters and social media in Florianopolis, Brazil, provided data on food consumption, PA, and sleep in 2018-2019 (baseline) and during the pandemic in 2020 (follow-up). PA and sleep variables were assessed through self-reported questionnaires. Food records were used to evaluate food consumption. Weight was measured using Bioelectrical impedance analysis at baseline and using self-reported at follow-up. Multilevel linear regression models and generalized linear multilevel were used to test differences between baseline and follow-up. Results: The findings indicated significant changes at follow-up, compared to baseline. Decreased consumption of total fat (β = -13.32, 95% CI (-22.45; -4.18), p < 0.01), sodium (β = -1330.72, 95% CI (-1790.63; -870.82), p < 0.01), cholesterol (β = -212.99, 95% CI (-269.8; -156.18), p < 0.01), total sugars (β = -65.12, 95% CI (-80.94; -49.29), p < 0.01), alcohol, and sugar-sweetened beverage were observed. Despite that, a slight increase in weight was also observed (80.70 ± 16.37 kg vs. 82.99 ± 15.42 kg, p = 0.000748). Sleep duration increased (β = 0.7596, 95% CI (0.41; 1.11), p < 0.01), and occupational PA decreased (β = -1168.1, 95% CI (-1422.33; -913.83), p < 0.01), while domestic (β = 394.04, 95%CI (114.68; 673.39, p < 0.01)) and leisure PA (β = 499.91, 95% CI (245.28; 754.53), p < 0.01) increased. Conclusion: Our results suggest that social distancing policies positively impacted eating habits, sleep, and PA patterns. These changes are possibly linked to increased awareness of the need for a healthy lifestyle.

Factors related to moderate exercise during COVID-19 for overweight and obese individuals: A secondary analysis of HINTS data

Objective

COVID-19 has exacerbated pre-existing rates of overweight and obesity in the United States. mHealth technologies are gaining in popularity for its potential to reduce obesity, if facilitated by patient-centered communication. This study explores predictors of overweight and obese individuals' exercise levels during COVID-19.

Methods

2191 respondents who visited a doctor in the past year and self-reported being overweight were selected from the 2020 Health Information National Trends Survey (HINTS). Respondents reported their physical activity, beliefs about obesity, health tracking behaviors, and communication with providers during the pandemic. Structural equation modeling was used to explore connections among the variables.

Results

Patient-provider (e-)communication was significantly associated with changes in people's obesity-related beliefs and mHealth tracking usage, predicting moderate exercise during the pandemic.

Conclusion

The findings illustrate the need for patient-centered communication encounters to include discussions on mHealth technologies and accessible methods of engaging in physical activity.Innovation: This study examined secondary data provided by overweight and obese individuals from the early days of the COVID-19 pandemic; this population may benefit from targeted health interventions using mHealth technologies. Our findings suggest that healthcare providers should engage patients through mHealth technology and seek to improve digital health literacy to progress physical activity nationwide.

The effect of the COVID-19 pandemic on weight gain, physical activity and mental health among Turkish university students

BACKGROUND

The COVID-19 pandemic has brought many restrictions that affected Turkey as well as other countries around the world. Restrictions on education, sports activities and social activities affected students physically and psychologically.

OBJECTIVE

The aim of this study is to investigate the impact of the COVID-19 pandemic on weight gain, physical activity, and mental health among university students.

METHODS

The study included students of Pamukkale University aged between 18-25 years. Participants answered the online survey about changes in body composition and physical activity habits during the pandemic. International Physical Activity Questionnaire (IPAQ) was used to assess physical activity levels. Beck Depression Scale (BDS) was used to assess the mental health.

RESULTS

848 (546 females, 302 males) students average aged 20,72±1,63 years were included in the study. When the physical activity times before and during the pandemic were compared, a statistically significant difference was found (p < 0.05). Multivariate analyses showed that higher BDS scores (p = 0.000) were significantly associated with increased weight gain. But there was no significant association with age and changes in physical activity time.

CONCLUSIONS

The results of the study showed that the COVID-19 pandemic has a negative effect on the physical activity level, weight gain and mental health of university students. Students reported an increase in weight during the pandemic. Also, the increase in depressive symptoms is related to higher levels of weight gain. Therefore, physical activity and mental health programmes should be offered to university students as an educational and health policy.

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.

Consumed by Boredom: Food Choice Motivation and Weight Changes during the COVID-19 Pandemic

Boredom is an established cause and correlate of eating behavior. Yet, existing work offers a scattered range of plausible motivations for why this is. We examined among 302 people representative of the adult UK population what motivations they had for selecting food during the COVID-19 pandemic and how this related to boredom. As predicted, bored people choose food less for health reasons and more for convenience. Boredom reduced ethical and 'natural content' motivations for selecting food and was not associated with choosing food to regulate one's mood or to experience unfamiliarity. Boredom was also associated with greater absolute changes in weight over the course of the pandemic. Boredom did not predict weight gains or losses overall. These findings offer insights into the role that boredom plays in eating motivations in particular and health-relevant outcomes in general.

The Leading Factors of Obesity and Severe Obesity in Korean Adults during the COVID-19 Pandemic

(1) Background: During the coronavirus disease 2019 (COVID-19) pandemic, the prevalence of obesity or severe obesity has increased worldwide to the point that it has even been referred to as a new disease. However, the impacts of the pandemic on obesity or severe obesity remain unclear, thus requiring a thorough examination of the leading factors of obesity and severe obesity during this time. (2) Methods: The required dataset for this study was extracted from the eighth (2019-2020) Korea National Health and Nutrition Examination Survey (KNHNES). The survey's data for 2019 and 2020 were analyzed to confirm the leading factors of obesity and severe obesity before and after the outbreak of COVID-19. The samples were weighted, and the data were analyzed using multiple logistic regression. (3) Results: In 2020, the prevalence of obesity and severe obesity in the Korean adult population aged 19 and over, compared with the normal weight group, showed significant increases of 2.5% and 1.4%, respectively, compared with those rates in 2019 (p < 0.05). The main variables affecting the obesity prevalence in Korean adults aged 19 and over in 2020 were gender, age, sitting time per day, and walking time per day, and the factors affecting severe obesity were gender and age. Meanwhile, the daily energy intake variable had no impact on the prevalence of obesity and severe obesity. (4) Conclusions: These findings will serve as a basis to help the present management directions and treatment approaches for individuals with obesity or severe obesity in the post-COVID-19 era.

Is time-restricted eating a robust eating regimen during periods of disruptions in daily life? A qualitative study of perspectives of people with overweight during COVID-19

Background

Time-restricted eating (TRE) has been suggested as a feasible dietary strategy in individuals with overweight. Disruptions in daily life e.g., severe illness can affect engagement in lifestyle interventions to obtain healthier body weight. This study examined if and how the engagement with TRE among people with overweight was affected by the Danish COVID-19 lockdowns as an example of disruptions in daily life.

Methods

Fifteen participants with overweight enrolled in a TRE intervention, i.e. restricting all eating and drinking except water to the same daily ten-hour window, were interviewed about their experiences and engagement with TRE during COVID-19 lockdowns. Interviews were semi-structured and conducted by phone or face-to-face with safe social distancing. Data analysis was grounded in a reflexive thematic analysis approach.

Results

Daily life rhythms were disrupted by lockdowns by preventing participants from performing ordinary daily activities such as going to work, socialising, eating out or exercising. For some, this challenged their TRE engagement, while most were able to undertake the TRE eating window but reported increased snacking and consumption of take-away food within their eating window. For all, exercise habits became unhealthier. The negative impact on TRE engagement primarily occurred during daytime, as social distancing made it easier to engage with TRE during evenings.

Conclusions

This study showed that even people highly motivated to obtain healthier lifestyles practices struggled to maintain engagement with healthy behaviours, whereas sticking to the TRE window was manageable during COVID-19. TRE as a weight loss strategy was challenged which calls for more attention to supporting people in daily life to obtain healthier practices, also in case of periods of other disruptions such as divorce, serious illness etc.

Analysis on the Change of College Students' Life Pattern and its Impact during the COVID-19 Outbreak in China

Objectives: Our objective was to analyze changes in lifestyle patterns of Chinese college students at home during the COVID-19 outbreak. Methods: According to a structured online questionnaire covering socio- demographic information, anthropometric data, and changes in food intake, physical activity, and sleep during the COVID-19 outbreak, the relationships between the above data before and during the outbreak were analyzed. Results: Among the 781 participants, 38.5% had significantly increased their total food intake and 29.1% had significantly decreased their physical activity. Overall, 44% of participants reported weight gain. The average weight gain was 0.7±2.5 kg. The main causes of weight gain were increased food intake (p < .001), decreased physical activity (p < .01), and an excessive increase or reduction in sleep duration (p < .024). Conclusion: During the COVID-19 outbreak, college students' food intake was found to be increased and physical activity decreased; sleep duration was irregular, and all these factors influenced weight gain.

Food consumption changes during 2020 lockdown in Italy

The lockdown imposed to limit the diffusion of COVID-19 in Italy affected the economic situation negatively. The income of many households decreased, and people were forced to stay home. Both these factors influenced food consumption: on the one hand less income means less money for purchases, on the other, the negative psychological impact of lesser income and the pandemic shifted the consumption towards alcohol and tobacco. Using survey data, this paper shows how the negative economic shock due to lockdown, together with the restrictions imposed by it, affected the consumption of food items in a region of Norther Italy.

Impacts of COVID-19 lockdown on time allocation for sedentary and physical activities - The context of Indian university students

Introduction

Covid-19 pandemic has impacted individuals' time allocation decisions. As it is known that university students display behaviors different from the general population, very few studies have examined their activity participation and time allocation behavior during the pandemic. The present study investigates the changes in time allocations to sedentary, physically active, and eat-sleep activities before and during the pandemic.

Methods

The study hypothesizes that active mode (walk, bicycle) and transit users would compensate for the physical efforts by increasing physical activities at home during the lockdown. Students' perception of personal well-being, anxiety, and individual leisure during the pandemic and their impacts on time allocation decisions after controlling for demographic variables and temporal effects are also explored. A pan India behavioral data of 203 samples collected using an online survey conducted between May to July 2020, during India's lockdown phase, is used for analysis. A series of segmented analyses (using ANOVA's and Kruskal-Wallis Test) and empirical modeling (linear mixed-effect regression) were conducted based on the time use distribution.

Results

Findings showed that university students from low-income households and students who own a bicycle show a higher tendency to spend time in physical activities during lockdown periods. Students accessing college using active modes (before lockdown) allocate less time to sedentary and eat-sleep activities than physical activities during the lockdown period. Students' perception of Leisure items among those who use active modes is significantly different from those of private and public mode users.

Conclusions

From a policy viewpoint, such investigation would help implicitly understand and publicize the health benefits of active modes and transit and encourage their use. For instance, policymakers and transport planners can temporarily allocate less-used motorized streets (due to the pandemic) to students who prefer walking and cycling as universities still function online in India.

Tobacco smoking changes during the first pre-vaccination phases of the COVID-19 pandemic: A systematic review and meta-analysis

Background

Globally, tobacco smoking remains the largest preventable cause of premature death. The COVID-19 pandemic has forced nations to take unprecedented measures, including 'lockdowns' that might impact tobacco smoking behaviour. We performed a systematic review and meta-analyses to assess smoking behaviour changes during the early pre-vaccination phases of the COVID-19 pandemic in 2020.

Methods

We searched Medline/Embase/PsycINFO/BioRxiv/MedRxiv/SSRN databases (January-November 2020) for published and pre-print articles that reported specific smoking behaviour changes or intentions after the onset of the COVID-19 pandemic. We used random-effects models to pool prevalence ratios comparing the prevalence of smoking during and before the pandemic, and the prevalence of smoking behaviour changes during the pandemic. The PROSPERO registration number for this systematic review was CRD42020206383.

Findings

31 studies were included in meta-analyses, with smoking data for 269,164 participants across 24 countries. The proportion of people smoking during the pandemic was lower than that before, with a pooled prevalence ratio of 0·87 (95%CI:0·79-0·97). Among people who smoke, 21% (95%CI:14-30%) smoked less, 27% (95%CI:22-32%) smoked more, 50% (95%CI:41%-58%) had unchanged smoking and 4% (95%CI:1-9%) reported quitting smoking. Among people who did not smoke, 2% (95%CI:1-3%) started smoking during the pandemic. Heterogeneity was high in all meta-analyses and so the pooled estimates should be interpreted with caution (I2 >91% and p-heterogeneity<0·001). Almost all studies were at high risk of bias due to use of non-representative samples, non-response bias, and utilisation of non-validated questions.

Interpretation

Smoking behaviour changes during the first phases of the COVID-19 pandemic in 2020 were highly mixed. Meta-analyses indicated that there was a relative reduction in overall smoking prevalence during the pandemic, while similar proportions of people who smoke smoked more or smoked less, although heterogeneity was high. Implementation of evidence-based tobacco control policies and programs, including tobacco cessation services, have an important role in ensuring that the COVID-19 pandemic does not exacerbate the smoking pandemic and associated adverse health outcomes.

Funding

No specific funding was received for this study.

Gender differences in bodyweight change following COVID-19 lockdown measures in the Netherlands: a prospective longitudinal study

BACKGROUND

The current study aimed to prospectively assess bodyweight change following the implementation of lockdown measures to contain the COVID-19 pandemic in the Netherlands and to explore the potentially moderating role of gender in this association.

DESIGN

Using Dutch DNB Household Survey panel data collected between 1993 and 2020, we estimated fixed-effects regression models of bodyweight change. Models were stratified by gender and formal tests of gender differences in coefficient estimates were performed.

PARTICIPANTS

4365 women and 4583 men aged 18-65 were included in the study. The total number of observations was 41 330.

OUTCOME MEASURES

The outcome of interest was self-reported bodyweight in kilograms. Additional analyses were performed using body mass index (self-reported weight in kilograms divided by self-reported height in metres squared) as the outcome.

RESULTS

The implementation of Dutch lockdown measures in 2020 was associated with bodyweight gain of approximately 800 g in working-age women compared with the 3 prior years. Bodyweight gain in 2020 relative to the prior years was significantly stronger for women than for men (F(4, 8947)=3.9, p<0.01). No evidence of bodyweight gain in working-age men was found.

CONCLUSION

Results indicate that bodyweight gain following COVID-19 lockdown measures in the Netherlands was more pronounced among women than among men. Although necessary to contain the COVID-19 pandemic, lockdown measures may contribute to a different public health challenge in the rising prevalence of overweight and obesity.

Effects of an online home-based exercise intervention on breast cancer survivors during COVID-19 lockdown: a feasibility study

Purpose

The strict lockdown implemented due the COVID-19 pandemic is generating a great impact on wellbeing and health-related quality of life (HRQoL) in people with cancer. We aimed to evaluate the efficacy and feasibility of an online home-based exercise intervention performed during a lockdown period analysing its effects on body composition, physical fitness, and HRQoL in breast cancer survivors.

Methods

Fifteen women with breast cancer receiving hormonal therapy (55.5 ± 6.7 years) were included in the study. The exercise intervention consisted of two weekly sessions of remotely supervised functional training (60 min per day) and two weekly sessions of unsupervised aerobic training (20–30 min/session; 60–85% of maximum heart rate) for a total of 16 weeks. DXA absorptiometry was used for the assessment of body composition. Functional assessment included cardiorespiratory fitness (CRF) by Rockport walking test, upper and lower body strength (grip strength, arm curl test, and chair stand test), walking speed (brisk walking test), and agility (8-foot up-and-go test). The HRQoL was evaluated with the QLQ-BR23 questionnaire. The adherence to the intervention was measured as the percentage of online classes attended.

Results

Rate of adherence for the online exercise intervention was 90 ± 17%. The exercise intervention induced significant (p < 0.05) improvements in physical fitness: CRF (+ 9%), right arm and lower limb strength (+ 10% and + 18%, respectively) and lower limbs lean mass (+ 2% and + 3.5% for left and right leg, respectively).

Conclusion

This feasibility study suggests that an online home-based exercise intervention during COVID-19 lockdown could improve physical fitness and body composition in breast cancer survivors even in a context of heightened concern for future health.

The effects of COVID-19 stay-at-home orders on physical activity of people with obesity

OBJECTIVE

To verify the association of changes on physical activity levels during coronavirus disease 2019 (COVID-19) outbreak of individuals with normal weight and overweight/obesity, and the influence of sex in this relationship.

METHODS

This cross-sectional study (survey research) was conducted in Brazil between May 5 and May 17, 2020. Participants (n=1,828 / 1,062 women >18 years) were invited through social media to answer a structured questionnaire via Google Forms. The online assessment included self-reported responses to questions on physical activity, overall health, weight, and height. Binary logistic regression analyzed the relationship between overweight/obesity (body mass index ≥25kg/m2), the impact of COVID-19 on physical activity level, and the influence of sex.

RESULTS

Compared to normal weight people, those with overweight/obesity practice less moderate to vigorous physical activity (p<0.001). There were associations between women and men with overweight/obesity and the impact of COVID-19 on the physical activity practice compared to normal weight people, adjusted by age, education level, social isolation, and previous physical activity level (p<0.017).

CONCLUSION

The study found an association of weight and changes in physical activity levels. Individuals with overweight/obesity were more likely to have a lower physical activity level during COVID-19 pandemic, regardless of sex.

Body Fat Percentage and Normal-Weight Obesity in the Chinese Population: Development of a Simple Evaluation Indicator Using Anthropometric Measurements

Few studies explore the associations between body fat percentage (BFP) prediction and evaluation indicators for Chinese with normal-weight obesity. We aimed to explore convenient and cost-free BFP evaluation indicators to routinely monitor BFP status in Chinese patients with normal-weight obesity. Participants (N = 164) were divided into three groups according to body mass index (BMI) and BFP: normal-weight lean, normal-weight obese, and overweight and obese. Differences in body composition and circumference were compared to examine the relationship between BFP and circumference, determine a simple evaluation indicator reflecting BFP, and identify cutoff values for normal-weight obesity circumference. Significant differences in body composition and circumference were observed among the three groups. The correlation between thigh/height, hip/height, (hip + waist)/height, and BFP was stronger than that with BMI. The (hip + waist)/height ratio was the indicator most reflective of BFP (95% confidence interval: 3.004−9.018, p = 0.013), and a ratio above 1.115 (95% confidence interval: 0.936−0.992, p < 0.001) was predictive of normal-weight obesity. Furthermore, we suggest that the upper value for a normal BMI in Chinese individuals be lowered to 23.4 kg/m2 (95% confidence interval: 0.984−0.999, p < 0.001). The (hip + waist)/height ratio can be used with body mass index for a more accurate evaluations of BFP abnormalities and health risks.

Changes in physical activity associated with the COVID-19 pandemic in individuals with overweight and obesity: an interrupted time series analysis with historical controls

The objective of this study was to investigate changes in physical activity patterns associated with the COVID-19 pandemic in individuals with overweight and obesity who were participating in a school district worksite weight loss program. We conducted comparative design interrupted time series analyses on physical activity device (Fitbit) data from the 2018-2019 and 2019-2020 school years (N = 211). We administered a questionnaire in 2020 to supplement device data. After the stay-at-home orders in 2020, participants tended to decrease their weekly step count (B = -1315.7, SE = 627.7, p = .045), decrease their weekly "Lightly active minutes" (B = -39.1, SE = 12.6, p = .007), and increase their weekly "Very active minutes" compared to their counterparts from the year before (B = 7.6, SE = 3.2, p = .020). Decreased motivation, gym closures, and safety concerns were cited as barriers to physical activity. Having more time and health consciousness were cited as facilitators of physical activity. The COVID-19 pandemic was related to changes in physical activity in both positive and negative ways, revealing opportunities to promote healthy lifestyle behaviors in this population. More research is needed to determine optimal approaches to health promotion in the post-COVID-19 era.

Cross-cultural adaptation and validation of a questionnaire on eating habits and physical activity of university students in confinement due to coronavirus disease

OBJECTIVE

The purpose of the current study was to cross-culturally adapt and validate an online questionnaire to assess eating habits and physical activity of university students under confinement due to coronavirus disease (COVID-19).

DESIGN

Generation of a cross-sectional online survey to university students conducted during confinement due to COVID-19. The study was divided into two phases.

SETTINGS

Students, Chile.

PARTICIPANTS

Phase 1 considered the process of translation and back translation, expert panel, cultural adaptation and the generation of a pilot to validate a preliminary format of the questionnaire. In Phase 2, information from the instrument was collected from two hundred and sixty-eight university students, ages 16 to 30 years old, with a mean age of 21·6 (3·3) The major proportion of participants were female (82 %).

RESULTS

The adapted questionnaire was statistically validated in three dimensions: (A) eating habits and behaviours during quarantine, (B) perception of risk and (C) physical activity changes during the quarantine. The reliability of Cronbach's α for dimensions A, B and C was 0·59, 0·85 and 0·97, respectively. The complete questionnaire obtained 0·61 in internal consistency and 0·61 (0·58-0·67) ICC reliability. A statistically significant positive correlation matrix was observed.

CONCLUSIONS

This questionnaire is a practical tool to obtain accurate information about the relation of COVID-19 confinement on people's eating habits and physical activity. Therefore, it could contribute to establishing appropriate strategies to prevent negative effects on people's health.

COVID-19 Lockdown in Patients with Chronic Diseases: A Cross-Sectional Study

Background: We aimed to investigate the impact of the first COVID-19 lockdown on medication adherence, physician access, lifestyle behaviours, and mental health in patients with chronic conditions. Methods: A cross-sectional phone survey was conducted in 1274 housebound adults recruited from 8 regional chronic disease cohorts (CLEO CD study: NCT04390126). Results: Medication adherence was 97%; 305 (41%) patients declared that at least one scheduled visit with a physician was missed during the first lockdown. The main changes in lifestyle behaviours were deterioration in sleep time (duration and/or quality; 71%), increase in screen time (46%), and decrease in physical activity (46%). Nineteen percent experienced psychological distress (Kessler-6 score ≥ 5). An urban living place (OR, 1.76 vs. rural; 95% CI, 1.32−2.33; p = 10−4), worse self-reported mental health (OR, 1.62 vs. about the same or better; 95% CI, 1.17−2.25; p = 0.003), and a K6 score ≥ 5 (OR, 1.52 vs. <5; 95% CI, 1.05−2.21; p = 0.03) were independent factors associated with at least one unhealthy behaviour. Conclusions: Encouraging results were observed in terms of medication adherence. Caution is needed in chronic disease patients living in urban places as well as those presenting psychological distress and worse self-reported mental health to reduce unhealthy behaviours.

A Two-Time Point Analysis of Gut Microbiota in the General Population of Buenos Aires and Its Variation Due to Preventive and Compulsory Social Isolation During the COVID-19 Pandemic

The COVID-19 pandemic poses a great challenge to global public health. The extraordinary daily use of household disinfectants and cleaning products, social distancing and the loss of everyday situations that allow contact between individuals, have a direct impact on the transfer of microorganisms within the population. Together, these changes, in addition to those that occur in eating habits, can affect the composition and diversity of the gut microbiota. A two-time point analysis of the fecal microbiota of 23 Metropolitan Buenos Aires (BA) inhabitants was carried out, to compare pre-pandemic data and its variation during preventive and compulsory social isolation (PCSI) in 2020. To this end, 23 healthy subjects, who were previously studied by our group in 2016, were recruited for a second time during the COVID-19 pandemic, and stool samples were collected from each subject at each time point (n = 46). The hypervariable region V3-V4 of the 16S rRNA gene was high-throughput sequenced. We found significant differences in the estimated number of observed features (p < 0.001), Shannon entropy index (p = 0.026) and in Faith phylogenetic diversity (p < 0.001) between pre-pandemic group (PPG) vs. pandemic group (PG), being significantly lower in the PG. Although no strong change was observed in the core microbiota between the groups in this study, a significant decrease was observed during PCSI in the phylum Verrucomicrobia, which contributes to intestinal health and glucose homeostasis. Microbial community structure (beta diversity) was also compared between PPG and PG. The differences observed in the microbiota structure by unweighted UniFrac PCoA could be explained by six differential abundant genera that were absent during PCSI. Furthermore, putative functional genes prediction using PICRUSt infers a smaller predicted prevalence of genes in the intestinal tryptophan, glycine-betaine, taurine, benzoate degradation, as well as in the synthesis of vitamin B12 during PCSI. This data supports the hypothesis that the microbiome of the inhabitants of BA changed in the context of isolation during PCSI. Therefore, these results could increase the knowledge necessary to propose strategic nutraceutical, functional food, probiotics or similar interventions that contribute to improving public health in the post-pandemic era.