Obesity, eating behavior and physical activity during COVID-19 lockdown: A study of UK adults

Rising Prevalence of Urinary Incontinence and Nocturia Amid the COVID-19 Pandemic

BACKGROUND

Urinary incontinence (UI) and nocturia are common lower urinary tract symptoms (LUTS) that significantly affect quality of life. The COVID-19 pandemic has introduced behavioral, psychological, and physiological disruptions that may have exacerbated the prevalence of these conditions. Additionally, these changes may also be influenced by long-term sequelae of COVID-19 infection or other concurrent factors. However, large-scale investigations into these trends are limited.

METHODS

Data from the National Health and Nutrition Examination Survey (NHANES) between 2017 and 2023 were used to analyze the prevalence of LUTS, including stress urinary incontinence (SUI), urgency urinary incontinence (UUI), mixed urinary incontinence (MUI), and nocturia, before (2017-2020) and during the pandemic (2021-2023). Age-adjusted prevalence trends were analyzed overall and by sex and race/ethnicity. Sensitivity analysis included data from 2013 to 2016 to differentiate natural trends from pandemic-related impacts.

RESULTS

The prevalence of SUI, UUI, MUI, and nocturia significantly increased during the pandemic compared to pre-pandemic levels (p < 0.0001). SUI rose from 24.89% to 29.65%, UUI from 20.80% to 28.65%, MUI from 9.17% to 16.83%, and nocturia from 26.96% to 34.78%. These trends were consistent across sexes and racial groups. Sensitivity analysis confirmed that these increases exceeded natural trends, suggesting a potential pandemic-related effect.

CONCLUSION

This study reveals a significant rise in the prevalence of LUTS, including SUI, UUI, MUI, and nocturia, during the COVID-19 pandemic. Further research is needed to determine whether these changes stem from the direct physiological effects of COVID-19 infection or are influenced by broader pandemic-related factors such as lifestyle changes, healthcare disruptions, and psychological stress.

COVID- 19 vaccination reduces new-onset fibromyalgia risk in survivors

BACKGROUND

Numerous studies have demonstrated that COVID-19 is associated with an increased risk of new-onset fibromyalgia (FM), which not only significantly impacts patients' quality of life but also places a substantial burden on healthcare systems. However, no studies have yet investigated whether COVID-19 vaccination may mitigate the risk of developing new-onset FM in individuals who have survived COVID-19. This study aimed to assess the potential effect of COVID-19 vaccination in reducing the risk of new-onset FM among COVID-19 survivors.

METHODS

We utilized the data resources from the TriNetX platform to compare 90,508 COVID-19 survivors who received the COVID-19 vaccine with 90,508 unvaccinated survivors. The Cox proportional hazards regression model was used to estimate the hazard ratio (HR) and its corresponding 95% confidence interval (CI). The incidence was calculated using the Kaplan-Meier survival analysis method. Furthermore, we conducted detailed subgroup analyses and sensitivity analyses.

RESULTS

The cohort analysis of the present study revealed a significant reduction in the risk of new-onset FM among COVID-19 survivors who received the COVID-19 vaccine, compared to the unvaccinated group (HR 0.84; 95% CI 0.71-0.99). Notably, the results of the subgroup analysis indicated that the COVID-19 vaccine exerted a protective effect against the development of new-onset FM in males, individuals with a body mass index (BMI) < 30, and those with comorbid depression and anxiety.

CONCLUSIONS

Our findings suggest that COVID-19 vaccination may play a protective role in reducing the risk of new-onset FM among COVID-19 survivors. The findings may indicate the importance of targeting vaccination to specific subgroups, such as males, individuals with lower BMIs, and those with mental health conditions, including depression and anxiety. This approach may enhance the protective effects of the vaccine and further reduce the incidence of long-term health complications associated with COVID-19. Further research is needed to validate these observations.

Lessons learned from the lived experiences of people living with obesity during the first COVID-19 lockdown in the United Kingdom

BACKGROUND

Quantitative studies have shown that people living with obesity experienced deteriorations in mental health and health-related behaviours during the first UK's Coronavirus Disease-2019 (COVID-19) lockdown. However, there is a lack of qualitative research exploring their lived experiences during this period.

METHODS

Thematic analysis of large-scale free-text survey data was conducted to understand the challenges faced by adults with obesity during the first UK's COVID-19 lockdown.

RESULTS

Among 543 participants, 467 (86%) responded to the free text questions. The majority were female (87.8%), with a mean age of 51.6 (SD 9.9) years. Of these, 65.3% has a body mass index ≥40 kg/m2, and 57.7% were not enroled in weight management services. Five overarching themes and 10 sub-themes were identified with the five key themes being (1) increased fear and anxiety, (2) the impact of obesity being classified as 'high risk', (3) disruption in weight management services, (4) the impact on health-related behaviours, and (5) the adverse impact on mental health. Participants expressed fear of contracting COVID-19 and concerns about weight gain. UK Government messages linking obesity with severe COVID-19 complications exacerbated feelings of shame and stigma. The reduced provision of weight management services caused further health concerns, highlighting the need for digital health technologies for continued support. Participants reported changes in shopping, diet, physical activity, and sleep patterns, leading to deteriorated mental health.

CONCLUSION

People living with obesity experienced distinct challenges during the first COVID-19 lockdown, affecting their ability to practice and maintain health-related behaviours.

Association between smoking status and changes in health behaviours during the COVID-19 lockdown: a cross-sectional study in Israel

OBJECTIVES

To explore the association between smoking status (current vs former), changes in smoking habits (among current smokers only) and negative changes in dietary and physical activity habits during the initial COVID-19 lockdown in Israel.

DESIGN

A secondary analysis of an online cross-sectional study (6 April 2020 to 28 April 2020). Dependent variables included deteriorations in dietary habits score and odds of reporting worsening of physical activity habits during the first COVID-19 lockdown. The study analysed the association between these variables and 'smoking status' (current vs former) and, within smokers, changes in smoking habits, using multivariate logistic and linear regression models. For changes in physical activity habits, there was a significant interaction with baseline physical activity levels (p=0.04), therefore, analysis was stratified accordingly.

SETTING

Online data collection.

PARTICIPANTS

660 participants, current or former smokers in Israel, Hebrew speakers and ≥18 years old.

PRIMARY OUTCOMES

Self-reported negative changes in dietary habits and physical activity during the first COVID-19 lockdown.

RESULTS

The sample (n=660) included 66.2% (n=437) current smokers and 33.8% (n=223) former smokers. Among current smokers, 43.5% (n=190) indicated an increase in their smoking habits. Of all respondents, 25% (n=170) reported a negative dietary change and 48% (n=192) spent less time engaging in physical activity, with 66% (n=437) reporting increased levels of stress. No significant association was found between smoking status and the dietary habits score in the multivariate linear regression (B=-0.046, CI -0.493 to 0.401, reference group: former smokers). This indicates that being a current smoker was associated with a non-significant 0.046 point decrease in the dietary habits score compared with former smokers. Similarly, no significant association was found between smoking status and odds of reporting worsening of physical activity, even after stratifying by baseline physical activity levels. Among participants who currently smoke, no significant association was found between changes in smoking habits and the dietary habits score (B=0.391, 95% CI -0.061 to 0.843, p=0.090, reference group: those who smoke the same or less) or with odds of reporting worsening of physical activity (OR=1.16, 95% CI 0.688 to 1.956, p=0.577, reference group: those who smoke the same or less).

CONCLUSION

Among current and former smokers, high rates of negative health habit changes were found, emphasising the need for interventions during future crises. Smoking status and/or changes in smoking habits among current smokers were not associated with negative changes in dietary and physical activity habits.

Compulsive Exercise and Changes in Physical Activity Among Females: A Longitudinal Analysis During the First 12 Months of the COVID-19 Pandemic

This study had two aims; first to explore changes in compulsive exercise among adult females across the first year of the COVID-19 pandemic, and second, to explore how changes to physical activity early in the pandemic impacted compulsive exercise. Participants were 174 adult females who completed online surveys four times (T1-T4) during the first 12 months of the pandemic. Participants reported changes in physical activity (T1) and completed the compulsive exercise test (CET) at each time point (T1-T4). Mixed ANOVAs with time (T1-T4) and group (did versus did not report changes in physical activity) as factors revealed that compulsive exercise significantly differed across timepoints for the whole sample. Furthermore, females who reported that their physical activity levels had changed early in the pandemic reported higher levels of CET Weight Control Exercise compared to those who reported no change. No significant interactions were found. Among this sample of adult females, attitudes towards exercise changed during the first year of the pandemic, which may reflect the impact of varying lockdown restrictions. Additionally, changes to physical activity early in the pandemic were linked with exercising to control body weight. This suggests that externally influenced changes in physical activity may be an influential factor in the development of compulsive exercise. This may have implications for understanding and managing risk in a range of transition situations that impact upon physical activity.

Impact of the COVID-19 Pandemic and Control Measures on Screening and Diagnoses of Type 2 Diabetes in British Columbia

INTRODUCTION

In British Columbia (BC), Canada, COVID-19 and associated control measures impacted routine care for patients with diabetes. Some of these measures may have impacted timely screening and diagnosis of type 2 diabetes. We assessed the impact of control measures on screening and diagnosis of type 2 diabetes in BC.

METHODS

We used data from the BC COVID-19 Cohort, which includes COVID-19 and healthcare administrative data on all residents of BC. We assessed and compared screening (≥40 yrs) and diagnosis (≥18 yrs) of diabetes among the adult population during the pandemic period (1 April 2020-31 December 2022), with 1 January 2016-31 March 2020 used as a historical reference period. We used interrupted time series with generalized additive models to evaluate the impact of policy measures on screening and diagnoses trends.

RESULTS

We observed an initial decline in the mean number of screenings and diagnoses. In the third post-policy phase (January 2022-December 2022), there was a 4.8% (-5.1, 15.4) increase in screenings while after an initial reduction in diabetes diagnoses, we observed a significant increase of 31.6% (17.8, 46.6) in the third post-policy phase. Further stratification by age and sex showed the entire increase in diagnoses trends was driven by younger females with a 56.4% (25.1, 92.9) and 58.7% (38.2, 81.3) increment in diagnoses in the 18-29 and 40-49 age groups, respectively.

CONCLUSIONS

The initial reduced number of screenings and diagnoses followed by the significant upward trend in diabetes diagnoses in the later post-policy phase have important clinical and public health implications. Further research is needed to understand the post-pandemic increase in diabetes among females.

The collateral effects of the COVID-19 pandemic: A gender-specific systematic review of disordered eating behaviour in the general population

OBJECTIVE

The COVID-19 pandemic initiated public health measures, impacting mental health and exacerbating disordered eating behaviours (DEB). This study aims to fill gaps in understanding DEB in the general population during the pandemic, emphasising gender dynamics and the experiences of gender and/or sexual minority (SGM) individuals.

METHOD

A systematic literature review followed PRISMA guidelines to investigate DEB during the pandemic, focusing on gender-sensitive analyses and SGM populations. Outcomes from the included studies were synthesised to identify patterns and associations related to DEB, particularly considering gender dynamics and SGM experiences.

RESULTS

Significant gender associations with DEB were observed, with women consistently exhibiting higher scores. SGM populations also showed elevated DEB symptoms. Longitudinal studies indicated changes in DEB over time, with some decreases observed among men.

CONCLUSIONS

The review underscores significant gender differences in DEB during the pandemic, with women exhibiting higher symptom levels. Lockdown measures had nuanced impacts on DEB, varying across studies. Various factors including pandemic-related stressors influenced DEB. Consideration of these factors can inform tailored interventions for DEB in the general population. Overall, the review enhances our understanding of how gender intersects with the pandemic's impact on DEB, emphasising the need for diverse approaches to address these behaviours.

American society for preventive cardiology 2024 cardiovascular disease prevention: Highlights and key sessions

Groundbreaking strategies for preventive cardiology were showcased at the 2024 American Society for Preventive Cardiology (ASPC) Congress on Cardiovascular Disease (CVD) Prevention held in Salt Lake City, Utah, from August 2nd to 4th, 2024. The event featured 69 moderators and 13 scientific sessions comprised of 98 topics, 36 satellite events, 133 poster presentations, and 27 lifestyle classes. The conference highlighted innovative strategies focused on integrating cardiovascular, kidney, and metabolic health, presenting a cohesive approach for managing complex, interrelated conditions. Pivotal studies have addressed the role of lipid-lowering therapies, the benefits of early statin initiation, and the importance of precision medicine in preventing CVD. The ASPC's emphasis on translating this research into practical clinical tools has the potential to revolutionize preventive care strategies, making strides toward reducing the burden of CVD globally and improving long-term patient outcomes through personalized and early intervention approaches.

Do pandemics influence food choice motives, diet, and health behaviors? Evidence from a cross-sectional survey in Pakistan during the COVID-19 pandemic

BACKGROUND

COVID-19 has significantly impacted the health and well-being of individuals by influencing their diet and lifestyle. Therefore, this study was designed to compare the dietary and health practices pre- and post-COVID-19 infection and to study the association of changes in dietary and health practices with the change in food choice motives.

METHODS

An online cross-sectional survey was conducted, and retrospective data was gathered from 259 recovered cases of COVID-19 aged 18-50 years in Pakistan. The survey questionnaire included socio-demographic information, adherence to Pakistan dietary guidelines, Breslow's health practices, and food choice motives. Shapiro-Wilk test was used to analyze the normality of data. McNemar's test and Wilcoxon sign ranked test were used to determine the change in the dietary practices, health practices, and food choice motives scores pre- and post-COVID-19 infection. Spearman correlation and multiple linear regression were used to study the relation between the changes in dietary practices, health practices, and food choice motives.

RESULTS

Dietary practices improved (mean ± SD: 0.17 ± 1.56), and health practices deteriorated (mean ± SD: -0.18 ± 1.36) after COVID-19 infection. The importance of convenience, health, mood, natural content, weight control, familiarity, and ethical concerns while choosing food increased after suffering from COVID-19. Improvement in dietary practices was correlated with health practices (r = 0.32), convenience (r = 0.15), health concern (r = 0.16), mood (r = 0.18), and natural content of food (r = 0.15). Changes in dietary practices were found to be negatively associated (p = 0.043, B=-0.145) with the price of food.

CONCLUSION

We conclude that the food choice motives of the Pakistani population changed during COVID-19. This change in food choice motives was found to be related to dietary and health practices.

Emotional Eating and Mental Health Among Lebanese University Students During COVID-19 Outbreak

Background and Aim: Emotional eating (EE) is the uncontrollable desire to eat in response to negative emotions such as anxiety, irritation, or depression. The 2019 coronavirus (COVID-19) pandemic and strict quarantine raised the likelihood of mental symptoms and, as a consequence, EE. The main objective of this study was to assess the extent of EE and mental health among Lebanese university students and to identify the main correlates of EE. Methods: A cross-sectional study was undertaken between March and April 2021. Overall, 356 Lebanese university students aged between 18 and 25 years completed an online questionnaire that assesses EE and mental state, as well as health and eating habits. Results: The total mean EE score was 33.82 (±8.52). The main predictors of EE among university students were a higher grade point average (GPA) (p=0.010), higher body mass index (BMI) (p < 0.001), consuming more fats (p=0.013), and eating more sweets and cookies (p=0.010). In addition, depression, anxiety, and stress were highly prevalent among Lebanese university students during the pandemic (43.8%, 51.7%, and 91.6%, respectively). Conclusion: This study provides evidence of the negative impact of the COVID-19 outbreak on emotional well-being and eating behaviors among Lebanese university students. Targeted nutrition education programs that address the cultural and economic realities of Lebanese students, as well as psychological counseling offered by the universities, would be of interest to improve the diet quality and emotional well-being of the students.

Exploring Self-Reported Physical Activity Levels and Physical Fitness in Italian Children: A Mediation and Moderation Analysis

BACKGROUND/OBJECTIVES

Skill-related physical fitness is a crucial factor influencing health status during childhood. Starting from the lack of knowledge in the field of skill-related physical fitness and levels of physical activity in Southern Italy, this cross-sectional study aims to explore the mediating and moderating influence of PAL on the association between BMI and skill-related physical fitness.

METHODS

The sample (N = 387 students; male = 196, age = 12.2 ± 0.87 yrs; female = 191, age = 12.3 ± 0.93) was recruited from schools in the Apulia Region. The assessment included standing long jump (SLJ), 2 kg medicine ball throw (MBT) and 10 × 5 shuttle run (10 × 5) as indicators of physical fitness, and a self-report for measuring daily physical activity (PAL). A 2 (gender) × 3 (BMI cutoff)-factorial ANOVA was performed to highlight differences between groups for physical fitness components and PAL. Then, mediation and moderation models were created, establishing BMI as the independent variable, physical fitness tests as dependent variables, and PAL as the mediator and moderator variable.

RESULTS

The findings showed higher physical fitness and PAL in male and female normal-weight groups than in those who were overweight and obese. Mediation analysis revealed that higher PAL improved performance in SLJ (b = 0.091, p < 0.01, R2 = 17.16%), led to a modest understanding of the variation in MBT (ΔR2 = 0.026), and significantly reduced the time spent to perform 10 × 5 (p < 0.0, R2 = 10.72%).

CONCLUSIONS

Despite the obtained results, future research is needed to further understand the association between physical fitness and the sociocultural determinants of physical activity to guide institutional policies and interventions to prevent poor health habits.

Global, regional and national burdens of chronic kidney disease due to T1DM and T2DM among adolescents and young adults aged 10-35 years from 1990-2021: A trend analysis based on the global burden of disease study 2021

BACKGROUNDS

Chronic kidney disease (CKD) is a major complication of diabetes, which is rising among adolescents and young adults worldwide, but data on the trends of these diseases are sparse. This study examined the burden of CKD due to type 1 diabetes (CKD-T1D) and type 2 diabetes (CKD-T2D) among those aged 10-35 from 1990 to 2021 on global, regional, and national levels.

METHODS

Using Global Burden of Disease 2021 data, joinpoint regression analysis and decomposition analysis were employed to identify significant changes in CKD-T1D and CKD-T2D trends, including incidence, prevalence, mortality, and disability-adjusted life years (DALYs).

RESULTS

Globally, CKD-T1D incidence rose until 2019 before declining, while CKD-T2D incidence declined initially, then increased after 2019. Males generally had higher values of all indicators, except for CKD-T1D prevalence, which was higher in females. Central Latin America saw the largest mortality increase, while Oceania had the highest mortality rates. Oceania countries reported the highest DALYs for both CKD types in 2021.

CONCLUSION

The burden of CKD-T1D and CKD-T2D showed a pandemic-related shift. Middle-SDI countries face high incidence and mortality, while high-SDI countries report lower mortality but higher prevalence. Public health interventions are especially needed in low and middle-SDI countries and island nations.

Illness attitudes and the flourishing of university students of South Korea in a pandemic: a cross-sectional descriptive study

Since the onset of the Coronavirus-19 (COVID-19) pandemic in 2019, the virus has continued to experience periodic resurgences, and the evolution of new variants remains unpredictable. The greatest anxiety in Korean is now related to novel diseases, with a significant increase from 2.9% in 2018 to 32.8% in 2022. Excessive health concerns during the pandemic can lead to negative health behavior, highlighting their impact on well-being. This study aimed to identify how illness attitudes perceived by students during the pandemic influence their flourishing lives, and to examine the effects of health-promoting behaviors and social support on this relationship. A cross-sectional study was conducted using self-report questionnaires of 226 university students aged 18 to 35 years. We found that mental health issues among university students can hinder their flourishing growth in both the present and the future, while social support and health-promoting behavior act as sequential mediators between illness attitudes and flourishing. Healthcare professionals should offer flexible interventions that encourage health behaviors even in constrained environments and collaboration with social support within meaningful relationships is also required.

How exercise frequency affects BMI: a nationwide cross-sectional study exploring key influencing factors, including dietary behavior

Purpose

Body Mass Index (BMI) is an important indicator for assessing obesity and related health risks. With the rapid socio-economic development and changes in lifestyle, abnormal BMI (such as underweight, overweight, and obesity) has become an increasingly serious public health issue. This study aims to explore the impact of exercise frequency on BMI among Chinese adults aged 19 to 59, and to analyze the role of dietary behaviors in regulating BMI, providing a basis for BMI intervention strategies.

Method

The study employs a multi-stage sampling method across 23 provinces, provincial capitals, and four municipalities in China, randomly selecting 120 cities from each region. Online surveys were conducted using Wenjuanxing by trained surveyors.

Result

A total of 8,611 individuals participated in the survey. Among them, 1,066 (12.38%) had a BMI < 18.5, 5,354 (62.18%) had a BMI between 18.5 and 23.9, and 2,191 (25.44%) had a BMI ≥ 24. Factors such as gender, age, marital status, monthly household income, smoking, and alcohol consumption significantly affected BMI (p < 0.05). The overall impact of exercise on abnormal BMI was -0.003, with a direct effect of -0.005. The mediating effect of dietary behaviors between exercise and abnormal BMI was 0.002, accounting for 92.48% of the total effect.

Conclusion

This study highlights the widespread prevalence of abnormal BMI among individuals aged 19 to 59 in China. A single exercise intervention may be insufficient to effectively improve abnormal BMI; thus, it should be combined with strategies aimed at enhancing dietary behaviors.

Exploring lifestyle and dietary pattern shifts among Saudi adults during COVID-19 pandemic: insights from a cross-sectional examination

Background

Since the emergence of COVID-19 and the subsequent imposition of lockdown and movement restrictions, the world has witnessed fundamental lifestyle changes including alterations in dietary patterns and food consumption habits. Here, we investigated how the COVID-19 lockdown impacted dietary patterns and eating behaviors in the Saudi population.

Methodology

This cross-sectional study enrolled 427 participants aged 18 years or more, with 258 of them completing the survey. The survey included questions about demographic and dietary patterns during the COVID-19 lockdown. Data were collected and dietary behaviors before and during the lockdown in Jeddah, Saudi Arabia, were analyzed.

Results

The number of participants who considered lunch as their primary meal significantly decreased (p < 0.001) during the COVID-19 lockdown (74%), compared to before it (86%). By contrast, the number of participants who considered dinner as their primary meal remained almost unchanged (p = 0.079) during (79.1%) and before (84.1%) the lockdown. However, snack consumption significantly increased (p < 0.001) while fast-food consumption significantly decreased (p < 0.01) during the lockdown period. Our results also revealed a significant increase (p < 0.01) in water and coffee intake during the lockdown, with a significant rise in dessert consumption (p < 0.01).

Conclusion

Our results demonstrate that the COVID-19 lockdown caused a marked shift in dietary patterns and eating behaviors among the Saudi population. Notable changes were observed in overall food preferences after the lockdowns were imposed, with reduced consumption of fast foods and increased fluid intake.

Impact of COVID-19 lockdown on dietary habits and weight among Tunisian adults

BACKGROUND

COVID-19 lockdown measures have profoundly altered lifestyle habits, exposing individuals to significant health risks Aim: This study aims to assess the impact of quarantine measures in Tunisia, with a focus on examining changes in dietary habits, levels of physical activity, psychological patterns, and factors contributing to weight gain.

METHODS

This is a cross-sectional study involving 1,016 participants and employed a mixed-methods approach to gather data on dietary habits, physical activity levels, and psychological indicators. Statistical analyses, including binary logistic regression, were conducted to identify independent risk factors associated with weight gain during the quarantine period.

RESULTS

Approximately 36.4% of participants reported experiencing weight gain, with a notable prevalence among younger age groups. Increased consumption of sweets, pasta, and fried foods, coupled with reduced intake of water, vegetables, and fruits, were associated with weight gain. Furthermore, a decline in physical activity levels and elevated scores of anxiety and depression were observed among individuals who reported weight gain. Binary logistic regression highlighted snack frequency, fried food consumption, and pasta intake as significant independent risk factors for weight gain.

CONCLUSION

The results underscore the importance of understanding the complex impacts of lockdowns on lifestyle habits and mental health to guide future interventions, which are necessary to mitigate adverse health consequences and promote healthy lifestyles in the post-pandemic period.

The gendered impact of Covid-19 on health behaviours and mental health: Evidence from the UK

The purpose of this paper is to assess whether the COVID-19 pandemic affected the health behaviours of men and women differently, and to estimate whether the associations between health behaviours and mental health differed by gender. By employing nationally representative panel data (UKHLS) and a difference-in-differences strategy, we provide evidence that the pandemic adversely affected health behaviours among women more than men in the UK. Compared to men, women were 3.2 percentage points less likely to adopt a healthy lifestyle and reported 0.09 fewer healthy behaviours (corresponding to 7.0 per cent of a standard deviation) during the pandemic. These changes are primarily driven by smaller improvements rather than absolute declines in health behaviours for women compared to men. The changes in health behaviours among women appear to persist over time when lockdown policies were relaxed. Importantly, we find that the pandemic considerably weakened the protective effect of health behaviours on mental health for women but not for men. For women, adopting a healthy lifestyle was strongly correlated with mental health before the pandemic, but this relationship was no longer significant during the pandemic. This loss in significance corresponds to a 0.61-points decline in the GHQ-12 Likert score, equivalent to 10.5 per cent of a standard deviation. However, we observe a partial return of the protective effect of health behaviours on mental health once lockdown measures had eased.

Lifestyle Habits and Nutritional Profile of the Spanish Population: A Comparison Between the Period During and After the COVID-19 Pandemic

The aim of this study was to investigate the changes in habits regarding the health and lifestyle of the Spanish population during and after the COVID-19 pandemic. A cross-sectional design was used. Data were collected during the pandemic from 22,181 participants and after the pandemic from 3907 participants using the NutSo-HH Scale, assessing demographic, nutritional, and lifestyle variables. Key findings reveal a slight increase in exercise duration (+6.61%) post-pandemic, along with reductions in fried food (-3.57%), juice (-6.45%), and alcohol consumption (-9.66%). Conversely, there were notable increases in the consumption of ultra-processed foods (+2.16%), soft drinks (+6.47%), and coffee/energy drinks (+38.95%). Sleep quality, body image, and self-perceived health showed minor declines. These findings indicate that despite some positive behavioral changes, there is still a significant dependence on unhealthy dietary choices, negatively impacting both mental and physical health. The results highlight the need for public health strategies which encourage healthier eating, increased physical activity, and better sleep quality to reduce the long-term effects of lifestyle changes brought on by the pandemic. Focused interventions are necessary to curb the rising consumption of ultra-processed foods and sugary beverages while fostering overall well-being. This study underscores the vital role of ongoing surveillance and customized public health initiatives to enhance general health in the post-pandemic era.

Changes in food and drink purchasing behaviour in England during the first 3 months of the COVID-19 pandemic: an interrupted time series analysis

OBJECTIVE

This study examined changes food and drink purchasing during the first 3 months of the COVID-19 pandemic in England, and if changes varied by population subgroups.

DESIGN

We investigated changes in take-home food and drink purchasing and frequency of out-of-home (OOH) purchasing using an interrupted time series analysis design. The start of pandemic restrictions (the intervention) was defined as 16 March 2020, when first announced in the UK.

SETTING

London and the North of England.

PARTICIPANTS

1245 households reporting take-home and 226 individuals reporting OOH purchases between January 2019 and mid-June 2020 from the GB Kantar Fast Moving Consumer Goods Panel.

RESULTS

The marginal mean estimate of total take-home energy purchased was 17·4 % (95 % CI 14·9, 19·9) higher during the pandemic restriction period compared with the counterfactual. Increases of 35·2 % (95 % CI 23·4, 47·0) in take-home volume of alcoholic beverages and 1·2 % (95 % CI 0·1, 2·4) in foods and drinks high in fat, salt and sugar were observed. Reductions in purchased energy from fruit and vegetables (-7·3 %, 95 % CI -10·9, -3·6), ultra-processed foods (-4·0 %, 95 % CI -5·2, -2·8) and in OOH purchasing frequency (-44·0 %, 95 % CI -58·3, -29·6) were observed. Changes in chocolate and confectionery, soft drink and savoury snack purchases levelled off over time. Changes in all studied outcomes varied by sociodemographic characteristics and usual purchasing.

CONCLUSIONS

Pandemic restrictions were associated with positive and negative changes in food and drink purchasing, which differed by individual characteristics. Future research should ascertain if changes persist and translate into changes in health.

Impact of physical indicators on ocular development in preschool children

Objective

Understanding the impact of early childhood physical growth on visual development is crucial, as this period marks a critical phase for foundational physical and ocular maturation. The aim of the current study was to investigate the associations between the anthropometric indicators of height, weight, and body mass index (BMI), as well as visual acuity, refraction, and ocular biometrics, in Chinese preschool children.

Methods

This cross-sectional study consisted of 1,477 Chinese 3- to 6-year-old preschool children from nine kindergartens in Tongzhou District, Beijing. Demographic data, height and weight were measured according to a standard protocol, and BMI was calculated. Refractive error was measured via autorefraction in eyes under cycloplegia. Axial length (AL), anterior chamber depth (ACD), lens thickness, and corneal curvature were measured via an IOL Master. The axial length-corneal radius (AL-CR ratio) was defined as the AL divided by the mean corneal radius of curvature. Multivariate linear regression models were used to explore the cross-sectional associations between physical indicators (height, weight and BMI) and visual acuity and ocular developmental parameters in boys and girls.

Results

Compared with the children in the fourth quartile for height for a given age and sex, the visual acuity in the fourth quartile was 0.08 less, the refraction was 0.11 D more negative (1.22 D versus 1.33 D), the axial length was 0.62 mm longer, the anterior chamber depth was 0.18 mm deeper, the lens thickness was 0.13 mm thinner, the corneal radius of curvature was 0.1 mm less, and the AL-CR ratio was higher after adjustments were made for age and weight. The association between BMI and visual acuity was statistically significant in girls but not in boys. Older and more obese children had better visual acuity (p < 0.001) after adjustments were made for age.

Conclusion

Height and higher BMI remained independently related to VA condition, AL and ACD elongation, and corneal flattening in preschool children after controlling for various covariates. These results provide critical insights into pediatric ocular health and emphasize the importance of early detection and intervention in both physical and ocular health in early childhood development.

Weight trends among adults with diabetes or hypertension during the COVID-19 pandemic: an observational study using OpenSAFELY

BACKGROUND

COVID-19 pandemic restrictions may have influenced behaviours related to weight.

AIM

To describe patterns of weight change among adults living in England with type 2 diabetes (T2D) and/or hypertension during the pandemic.

DESIGN AND SETTING

An observational cohort study using the routinely collected health data of approximately 40% of adults living in England, accessed through the OpenSAFELY service inside TPP.

METHOD

Clinical and sociodemographic characteristics associated with rapid weight gain (>0.5 kg/m2/year) were investigated using multivariable logistic regression.

RESULTS

Data were extracted on adults with T2D (n = 1 231 455, 43.9% female, and 76.0% White British) or hypertension (n = 3 558 405, 49.7% female, and 84.3% White British). Adults with T2D lost weight overall (median δ = -0.1 kg/m2/year [interquartile range {IQR} -0.7-0.4]). However, rapid weight gain was common (20.7%) and associated with the following: sex (male versus female: adjusted odds ratio [aOR] 0.78 [95% confidence interval {CI} = 0.77 to 0.79]); age (older age reduced odds, for example, aged 60-69 years versus 18-29 years: aOR 0.66 [95% CI = 0.61 to 0.71]); deprivation (least deprived Index of Multiple Deprivation [IMD] quintile versus most deprived IMD quintile: aOR 0.87 [95% CI = 0.85 to 0.89]); White ethnicity (Black versus White: aOR 0.95 [95% CI = 0.92 to 0.98]); mental health conditions (for example, depression: aOR 1.13 [95% CI = 1.12 to 1.15]); and diabetes treatment (non-insulin treatment versus no pharmacological treatment: aOR 0.68 [95% CI = 0.67 to 0.69]). Adults with hypertension maintained stable weight overall (median δ = 0.0 kg/m2/year [IQR -0.6-0.5]); however, rapid weight gain was common (24.7%) and associated with similar characteristics as in T2D.

CONCLUSION

Among adults living in England with T2D and/or hypertension, rapid pandemic weight gain was more common among females, younger adults, those living in more deprived areas, and those with mental health conditions.

Evaluation of depression, anxiety, risky eating behaviors, eating habits and physical activity after the COVID-19 pandemic among adolescents in Mexico City

Introduction

Introduction: during the pandemic, an increase in symptoms of depression and anxiety, as well as lifestyle changes in adolescents has been reported. Objectives: to evaluate anxiety and depression symptoms, risky eating behaviors (REB), eating habits and physical activity after the COVID-19 pandemic in Mexican adolescents; to associate the study variables with the development of REB. Methods: a study was performed with a sample of 2,710 adolescents. The Hospital Anxiety and Depression Scale (HADS) and the Questionnaire to measure Risky Eating Behaviors were applied; eating habits and physical activity were evaluated. A Multivariate Logistic Regression analysis was performed to evaluate an association between study variables and REB. Results: it was found that 34.4 % and 47.2 % of the adolescents presented symptoms of depression and anxiety, respectively. Furthermore, 10.6 % had REB and 18.1 % were at risk of REB. The combined prevalence of overweight and obesity was 46.5 %; only 13.1 % of the participants had healthy eating habits and 18.2 % adequate physical activity. Symptoms of depression (p < 0.0001), anxiety (p < 0.0001), higher BMI (p < 0.0001), female sex, excessive consumption of sugary drinks, eating outside the home (p < 0.0001), and lifestyle (p = 0.001) were associated with REB. Conclusions: confinement caused chaos on the lifestyle of adolescents as well as their psychological health. It is essential to develop educational programs that involve government authorities, parents and health agencies to reinforce the topics of healthy eating, physical activity and mental health in the country's secondary schools.

The Multiple Challenges of Nutritional Microbiome Research During COVID-19-A Perspective and Results of a Single-Case Study

The global coronavirus disease 2019 (COVID-19) pandemic has affected multiple aspects of people's lives, which may also influence the results of studies conducted during this period across diverse research domains. This particularly includes the field of nutritional science, investigating the gut microbiota as a potential mediator in the association between dietary intake and health-related outcomes. This article identifies the challenges currently facing this area of research, points out potential solutions, and highlights the necessity to consider a range of issues when interpreting trials conducted during this period. Some of these issues have arisen specifically because of the measures implemented to interrupt the spread of small acute respiratory syndrome coronavirus 2 (SARS-CoV-2), while others remain relevant beyond the pandemic.

Relationship between physical activity and neighborhood environment in preschool children during COVID-19.-A cross-sectional study using 24-hour activity records

Maintaining physical activity and the development of physical and cognitive functions are essential especially in vulnerable populations such as children. Considering the substantial impact of the COVID-19 epidemic on preschool children and the lack of research focusing on this age group, this study examined the duration of physical activity among preschool-aged children on weekend days and its relationship with the environment. This study was conducted between October and November 2021, with the cooperation of 357 parents of preschoolers attending kindergartens, nurseries, and childcare centers. Physical activity was assessed using a 24h physical activity record. A questionnaire was used to collect basic data on the neighborhood environment. Stepwise multiple regression analysis was used to analyze the relationship between the five physical activity measures (sedentary time, screen time, indoor playing time, outdoor playing time, and going out time) and the questionnaire data. Our findings revealed a relationship between physical activity and the neighborhood environment; however, the R2 values were low. Despite low prediction accuracy, the results of this study were similar to those of previous studies, indicating a positive correlation of physical activity with the absence of undulating roads, a crime-free environment, and safety around the home. Overall, these findings emphasize the need for providing children with opportunities for outdoor physical activity and play in the context of the COVID-19 recovery phase for adherence to the relevant guidelines.

Food purchase and consumption behavior during the COVID-19 pandemic lockdown in Bangladesh: association between sociodemographic composition

BACKGROUND

Bangladesh suffered a severe COVID-19 wave from June to August 2021, which forced the government to impose emergency nationwide lockdown measures for three months with discontinuities. The sudden lockdown strongly affected the dietary preferences, financial circumstances, and social interactions of citizens.

METHODS

In this comprehensive study, we collected sociodemographic information as well as data on food purchase and consumption behaviors from 1,350 adults in Bangladesh during the weeks of enforced confinement. The association between the sociodemographic factors (viz., gender, age, education status, income, occupation, and household size) and food purchase and consumption behaviors were determined by conducting bivariate and multivariate logistic regression models reporting as odds ratios.

RESULTS

The descriptive result reveals that 49.63% of the participants experienced wage reductions, with many people enduring reductions of up to 75%; 12.22% lost their jobs. Besides, a decline in the frequency of shopping was observed by 35.04%; and 24.52% avoided outdoor shopping during the pandemic period. Additionally, 28.74% of participants purchased less overall, while 19.48% purchased significantly fewer items per trip compared to the pre-pandemic period. The multivariate analysis shows a prominent increase in online grocery shopping (OR: 4.03, 95% CI: 2.38-6.83, p < 0.001) and meal delivery services (OR = 5.19, 95% CI = 3.21-7.17, p < 0.001) among higher educated individuals compared to the individuals having no institutional education. The personnel having formal jobs purchased 2.34 times more from online grocery sites (95% CI = 0.34-4.08, p = 0.003) compared to the unemployed one. In contrast, a notable increase in panic buying and stockpiling was observed, driven by scarcity and escalating prices of essential food items. The frequency of meals with families, active engagement in meal preparation, and the exploration of novel recipes also increased notably.

CONCLUSIONS

The consumption of takeaway food and inter-meal snacks increased significantly with the education level of individuals. These findings highlighted that a prolonged pandemic could magnify economic vulnerability in Bangladesh.

Physical activity, weight management, and mental health during COVID-19 lockdown: A cross-sectional study of healthcare students in China

BACKGROUND

There is growing evidence that the social blockade brought about by the COVID-19 pandemic has dramatically affected college students' physical activity; however, their weight management behaviors and mental health have not been fully explored, especially among healthcare students. This study aimed to assess physical activity, weight management behaviors, and mental health among healthcare students during the campus lockdown and to analyze the factors influencing physical activity.

METHODS

A cross-sectional survey of 1,216 healthcare students from March 24, 2022, to April 11, 2022. To collect information about students' physical activity, weight management behaviors, and mental health, they were asked to complete the Physical Activity Questionnaire-Short Form (IPAQ-SF), 11 issues related to weight management behavior, and the World Health Organization 5-Item Well-Being Index (WHO-5) questionnaire. Binary logistic regression was performed to determine the factors influencing physical activity.

RESULTS

Almost half of the participants had low levels of physical activity (45%), the mean score for weight management behavior was 39.55±6.26, and 54.6% had low levels of well-being. Healthcare students without exercise habits during the non-epidemic period reported lower levels of physical activity (OR = 1.81; 95%CI = 1.41-2.34, P<0.001). Participants with poor weight management behavior were more likely than other participants to report lower levels of physical activity (OR = 0.92; 95%CI = 0.90-0.94, P < 0.001). Likewise, the odds of being physically inactive were higher among the happier participants (OR = 0.98; 95%CI = 0.96-0.99, P = 0.031).

CONCLUSIONS

During the COVID-19 lockdown, most healthcare students in Gansu province lack physical exercise and have a low health level. Significant correlation factors for low physical activity levels were grade level, non-lockout exercise habits, weight management level, and well-being. These findings demonstrate the importance of developing targeted policies and programs encouraging physical activity among medical students.

A Longitudinal Study on Body Image Perception and Size among Italian Early Adolescents: Changes over Time and Discrepancies between Genders

BACKGROUND/OBJECTIVES

The discrepancy between the current perceived body image (BI) and beauty ideals leads to dissatisfaction, which is believed to be common among adolescents. This study aimed to investigate the stability in BI perceptions and dissatisfaction during early adolescence. Another aim was to highlight differences in dissatisfaction according to Body Mass Index (BMI) and inconsistencies in weight status perception.

METHODS

Two hundred and nine participants (mean age at first survey: 11.33 ± 0.38 years) were enrolled in this longitudinal study with three years of follow-up. Data on size and BI perceptions were collected through individual interviews. Stature and weight were directly measured.

RESULTS

Findings indicated significant changes over three years in anthropometric traits but not in weight status prevalence or BI perception and dissatisfaction, except for the ideal figure in males and weight control in females. The results also indicated a significant difference in BI perception and dissatisfaction by BMI categories. Self-reported body measurements were found to be unreliable with a weak-to-moderate agreement between self-perceived and actual weight status.

CONCLUSIONS

BI perception appears quite stable across the three years considered. Dissatisfaction is similar in both genders, although a tendency toward different gender aesthetic ideals is already appreciable in early adolescence. We suggest that the lower frequency of normal-weight adolescents compared with peers in previous studies is attributable to the effects of the recent pandemic. Given the growing dissatisfaction with increasing BMI and misinterpretations of weight status, school actions to promote a healthy lifestyle and positive BI should be undertaken.

Emotional eating and mental health of nurses working in Lebanese hospitals during the double crisis

The 2019 coronavirus (COVID-19) pandemic and strict quarantine increased the likelihood of mental symptoms and abnormal eating behaviours. This study aimed to assess the magnitude of emotional eating (EE) among nurses working in Lebanese hospitals and its association with mental health. A cross-sectional study was conducted among nurses aged between 18 and 50 years working in Lebanese hospitals during the COVID-19 outbreak and the economic crisis. A total of 303 nurses consented to participate. The mean EE score was 28.56 (±8.11). The results of this study revealed that 53.8% of the nurses reported depression, 58.1% suffered from anxiety and 95.1% experienced either moderate or severe stress. The study concluded that females (β = 8.112, P = 0.004), non-smokers (β = -4.732, P = 0.01) and depressed nurses (β = 0.596, P = 0.046) had a higher tendency towards EE. Additionally, it was found that EE was associated with weight gain (β = 6.048, P = 0.03) and increased consumption of fried foods (β = 5.223, P = 0.001). Females experienced more stress (β = 2.244, P = 0.003) and anxiety (β = 1.526, P = 0.021) than their male counterparts. With regard to mental health, depression was associated with weight gain (β = 2.402, P = 0.003) and with lower consumption of healthy foods such as nuts (β = -1.706, P = 0.009) and dishes prepared with sofrito sauce (β = -1.378, P = 0.012). These results can help the health authorities to design preparedness plans to ensure proper mental and physical well-being of nurses during any unforeseen emergencies.

A Structural Equation Modelling Approach to Examine the Mediating Effect of Stress on Diet in Culturally Diverse Women of Childbearing Age

Background: Stress has been shown to be associated with poor nutrition among young women. However, studies around the topic have major limitations in their methodologies and the role of confounding factors within this association remains unclear in the literature. Objective: To investigate the associations between stress and dietary quality/patterns in a culturally diverse population of childbearing-aged women. Methods: A secondary analysis of data from two studies conducted in UK and Lebanon was performed using Structural Equation Modelling (SEM) to explore the role of country context, socio-economic status, and physical variables. Participants were healthy women of childbearing age (n = 493). Variables measured were dietary intake, stress, physical activity, sociodemographic variables, and Body Mass Index. These were included in the SEM analysis to examine the mediating effect of stress. Results: The results showed that, among all variables, only country had a significant effect on dietary quality and patterns through the mediatory effect of stress. Participants from Lebanon were found to have higher stress levels compared to participants from the UK, and this contributed to a lower adherence to a Mediterranean diet. Conclusions: This study shows that for women of childbearing age, having a good diet quality/pattern is dependent on stress levels and country context.

Reduction in physical activity during Covid-19 lockdowns predicts individual differences in cognitive performance several months after the end of the safety measures

Prior studies suggest that the reductions in physical activity during Covid-19-related lockdowns impacted physical and mental health. Whether reductions in physical activity that occurred during lockdowns also relate to cognitive functions such as memory and attention is less explored. Here, we investigated whether changes in physical activity (PA) that occurred during and following Covid-19-related lockdowns could predict a variety of measures of cognitive performance in 318 young adults. Participants were assessed on their engagement in PA before, during, and after lockdowns. They also completed tests of cognitive control, working memory, and short-term memory following lockdown(s). As expected, engagement in PA decreased during lockdown and returned to near baseline levels thereafter. Decreases in PA during lockdown predicted individual differences in cognitive performance following lockdown. Greater reductions in PA during lockdown were associated with lower scores on the go/no-go task, a measure of cognitive control ability, and the n-back task, a measure of working memory performance. Larger post-lockdown increases in PA were associated with higher scores on the same tasks. Individual differences in pandemic-related stress and insomnia also predicted cognitive outcomes. These findings suggest that reductions of PA can predict cognitive performance, and underscore the importance of maintaining PA for cognitive health, especially in situations such as lockdowns.

Changes in suicide-related tweets before and during the COVID-19 pandemic in France: The importance of social media monitoring in public health prediction

INTRODUCTION

The COVID-19 pandemic impacted mental health, as demonstrated by numerous studies. In recent years, especially during the pandemic, the use of social networks, including Twitter, increased. This suggests that this media could help with mental health monitoring, as attested by previous studies.

METHOD

We conducted a multidisciplinary study on French tweets that were posted between January 1, 2019, and December 31, 2021. We selected the tweets via the Twitter API (Application Programming Interface) using five keywords relating to suicide: want to die, suicidal ideation, commit suicide, suicidal, and suicide attempt. A word frequency analysis was performed, and the data were compared with the number of emergency visits for suicidal ideation before and during the COVID-19 pandemic as recorded by the French national suicide observatory.

RESULTS

We observed that 189,005 tweets were related to suicide in 2019, 261,993 in 2020 (+38.62% of that observed in 2019), and 301,177 in 2021 (+59.35% of that observed in 2019). We also observed an increase in the number of tweets containing control words in 2020 (+30.07% of that observed in 2019), but in 2021, the number almost fell back to the level of that in 2019 (+5.96% of that observed in 2019). Furthermore, the difference between both ratios (of suicide-related tweets and of tweets containing control words) was most significant during the third lockdown. The change in the number of suicide-related tweets followed a curve that overlapped with the change in the number of emergency visits following suicidal ideations, as reported by the French national suicide observatory. In conclusion, Twitter can be an adequate and reliable tool for screening for suicidal ideation in the general population.

Physical Activity and Sedentary Time Among U.S. Adolescents Before and During COVID-19: Findings From a Large Cohort Study

Introduction

Evidence suggests that adolescents engage in less physical activity during the summer break. Less is known regarding physical activity during the summer months of the COVID-19 pandemic.

Methods

Utilizing data from the Adolescent Brain Cognitive Development study, the authors examined daily activity measured by Fitbit Charge 2 devices before and after the onset of the COVID-19 pandemic during school and summer months. Linear models estimated activity during pre-COVID-19 school, pre-COVID-19 summer, COVID-19 school, and COVID-19 summer.

Results

Participants (N=7,179, aged 11.96 years, 51% female, 51% White) accumulated 8,671.0 (95% CI=8,544.7; 8,797.3) steps, 32.5 (95% CI=30.8, 32.3) minutes of moderate-to-vigorous physical activity, and 507.2 (95% CI=504.2, 510.2) minutes of sedentary time. During COVID-19 school, adolescents accumulated fewer daily steps and minutes of moderate-to-vigorous physical activity (-1,782.3 steps [95% CI= -2,052.7; -1,511.8] and -6.2 minutes [95% CI= -8.4, -4.0], respectively). Adolescents accumulated more minutes of daily sedentary time (29.6 minutes [95% CI=18.9, 40.3]) during COVID-19 school months than during the pre-COVID-19 school months. During pre-COVID-19 summer months, adolescents accumulated 1,255.1 (95% CI=745.3; 1,765.0) more daily steps than during COVID-19 months. Boys accumulated more daily steps and moderate-to-vigorous physical activity (2,011.5 steps [95% CI=1,271.9; 2,751.0] and 7.9 minutes [95% CI=1.4, 14.4], respectively) during the summer before COVID-19 than in summer during COVID-19. Both girls and boys accumulated more minutes of sedentary time during COVID-19 school months (47.4 [95% CI=27.5, 67.3] and 51.2 [95% CI=22.8, 79.7], respectively) than during COVID-19 summer months.

Conclusions

Societal restrictions during COVID-19 negatively impacted activity levels in the U.S., particularly during the summer months during COVID-19.

Performance trends and goal achievement of health indicators in Gyeongsangbuk-do and Daegu Metropolitan City

The core goal of South Korea's health policy is equity. To this end, regional disparities in health indicators must be identified. However, as an in-depth analysis of health disparities and health indicators in Gyeongsangbuk-do and Daegu Metropolitan City is lacking, this study examined the trends in performance and goal achievement in health indicators. Data collected from 2011 to 2022 for 31 cities and counties in the Gyeongbuk region (23 regions in Gyeongsangbuk-do and eight regions in Daegu Metropolitan City) were analyzed to examine 28 health indicators across three categories: health behavior, health outcomes, and healthcare utilization. The data were analyzed using SPSS/WIN 23.0. The findings for health indicators showed significant and persistent gaps in health levels in Gyeongsangbuk-do, particularly in health behavior (31.3% and 68.7%), health outcomes (33.3% and 55.6%), and healthcare utilization (33.3% and 100%), in Gyeongsangbuk-do and Daegu Metropolitan City, respectively. Central government is vital for infrastructure development and financial assistance to effectively enhance health services in the local communities of Gyeongsangbuk-do.

On-line pilates program as an alternative to conventional rehabilitation therapy for people with multiple sclerosis, pilot study

INTRODUCTION

Restrictions in physical activity during Covid-19 pandemic had an impact on exercise activities on people with chronic diseases such as multiple sclerosis, for whom regular exercise is important for managing the disease. Therefore, alternative forms of exercise and rehabilitation were in high demand. The aim of pilot study was to verify the feasibility and potential effect of an online Pilates exercise programme for people with mild to moderate disability due to multiple sclerosis.

METHODS

The exercise programme was scheduled for 12 weeks (2 times a week for 45 min of Pilates exercise combined with 30 min of aerobic activity based on participants preferences). The participants' adherence and the anthropometric parameters (weight, BMI, waist circumference) and the functional tests (Single-Leg Stance Test, Sit to Stand Test) were measured together with the patient reported outcomes to monitor patient's psychological well-being and exercise effect (General Self-efficacy Scale and Activity Balance Confidence Scale).

RESULTS

The total number of 22 women with multiple sclerosis completed the pilot programme. The exercise program proved to be feasible. After 12 weeks of the online Pilates exercise programme significant improvements were found only in the parameter waist circumference (p = 0.03) and in the functional test Sit to Stance (p = 0.01). For the other tests, despite some improvement (self-efficacy and subjective perceived balance performance), there was no significant statistical difference.

CONCLUSION

The online Pilates exercise programme supervised by a physiotherapist is feasible for people with mild to moderate neurological disability. It seems to have a positive impact on the anthropometric parameters, but this result needs to be evaluated on larger sample of patients.

Consensus study on UK weight management services' response to COVID-19: best practices in outpatient management, governance and digital solutions

BACKGROUND

The COVID-19 pandemic put unprecedented pressure on weight management services. These services were required to adapt to continue to provide care for people living with obesity. This study sought to develop consensus recommendations on the best practice solutions adopted by weight management services in the United Kingdom during the COVID-19 pandemic.

METHODS

This study utilised a semi-structured interview and a modified Delphi methodology to develop a consensus of best practice recommendations identified by specialist weight management services during the pandemic.

RESULTS

Twenty-three healthcare professionals working in weight management service across the United Kingdom participated in the study. Analysis of interview transcripts identified four key thematic domains: outpatient, patient education and support, perioperative care and team working. Of the initial 43 unique recommendations, 30 reached consensus agreement. Outpatient recommendations focused on communication strategies, patient self-monitoring and remote patient tracking. Patient education and support recommendations addressed the development of online educational resources and support groups. Perioperative care recommendations emphasised case prioritisation, waiting list support and postoperative care. Team working recommendations targeted the use of digital collaboration tools and strategies for effective teamwork.

CONCLUSION

Developing consensus recommendations on best practice is a critical step for weight management and outpatient services to achieve higher standards of care. These recommendations provide a springboard for departmental discussions, paving the way for improved experiences for individuals living with obesity as they progress along their weight management journey.

Mediterranean Diet adherence, physical activity level, and quality of life in patients affected by thyroid diseases: Comparison between pre- and post-lockdown assessment

Background

SARS-CoV-2 pandemic resulted in lifestyle change of world's population because of the measures adopted by governments to contain the virus spread.

Design and Methods

This study examined whether lockdown impacted anthropometric indices, Mediterranean Diet (MD) adherence, Physical Activity Level (PAL), and Quality of Life (SF-12) in a cohort of 116 patients (96 F, aged 57.2 ± 13.1 years) affected by thyroid disorders. Before lockdown, data were collected during the endocrinological examination; after lockdown they were collected through a tele-phone interview (via video call).

Results

Data revealed an overweight condition in 59% of patients, with no significant differences between the two observations (BMI values: 26.5 ± 4.9 vs 26.6 ± 4.9 kg/m2), whereas waist circumference values significantly increased over time (93.3 ± 12.6 vs 94.4 ± 12.5 cm; p = 0.003). Moreover, a lower adherence to the MD (PREDIMED score: 7.3 ± 1.8 vs 7.0 ± 1.8; p = 0.003) and a significant increase of sitting time (6.4 ± 3.2 h/die vs 9.0 ± 4.2; p < 0.001) were observed. A not significant decrease in PAL, which revealed a sedentary condition in pre- and post-lockdown (648 and 562 METs/week respectively), was found. The SF-12 score did not show relevant changes between the two observations.

Conclusion

Our study highlights that patients with thyroid diseases are often sedentary and exhibit a high prevalence of over-weight, underscoring the need for a systematic anthropometric evaluation and, at times, lifestyle interventions.

COVID-19 lockdown and lifestyles: A narrative review

Background

The primary objective worldwide during the coronavirus disease 2019 (COVID-19) pandemic had been controlling disease transmission. However, lockdown measures used to mitigate transmission affected human behavior and altered lifestyles, with a likely impact on chronic non-communicable diseases. More than a year into the pandemic, substantial peer-reviewed literature emerged on altered lifestyles following the varying lockdown measures imposed globally to control the virus spread. We explored the impact of lockdown measures on six lifestyle factors, namely diet, physical activity, sleep, stress, social connectedness, and the use of tobacco, alcohol, or other harmful substances.

Methods

We comprehensively searched PubMed and the World Health Organization's global literature database on COVID-19 and retrieved 649 relevant articles for the narrative review. A critical interpretative synthesis of the articles was performed.

Results

Most of the articles included in the review identified the negative effect of lockdown measures on each of the lifestyle factors in many parts of the world. Encouraging lifestyle trends were also highlighted in a few articles. Such trends can positively influence the outcome of lifestyle-related chronic diseases, such as obesity and diabetes.

Conclusions

The lockdown associated with COVID-19 has largely had a negative impact on the lifestyles of individuals and communities across many countries and cultures. However, some individuals and communities also initiated positive lifestyle-related behavioral changes. If the knowledge generated by studying the impact of COVID-19-related lockdowns on the six lifestyle factors is further consolidated, it could improve chronic disease outcomes. This will help better understand lifestyle behaviors amidst crises and assist in redesigning extreme public health measures such as lockdowns.. It is up to governments, communities, and healthcare/academic entities to derive benefit from lessons learned from the pandemic, with the ultimate objective of better educating and promoting healthy lifestyles among communities.

Score of fear of COVID-19 and physical activity level are related to the habitual consumption of dietary supplements

The measures implemented to contain the COVID-19 pandemic resulted in both behavioral and lifestyle changes. The "Changes in Lifestyle-Related Behavior" instrument was developed to assess lifestyle-related behaviors in the Indian population. However, considering current knowledge, this instrument was not adapted for the Brazilian population. In addition, the relationship between fear of COVID-19 and consumption of dietary supplements has not yet been evaluated. Thus, we aimed to investigate the relationship between the use of dietary supplements with lifestyle behavior and the fear of COVID-19, as well as assess the psychometric properties of the Brazilian version of the "Changes in Lifestyle-Related Behavior" instrument. An online questionnaire assessed sociodemographic, occupational, anthropometric, physical activity (International Physical Activity Questionnaire-short form), fear of COVID-19, and lifestyle behavior data from 416 Brazilian adults (237 females; 18-60y). Mann-Whitney, Chi-square test, exploratory, and confirmatory analyses were applied. Exploratory and confirmatory analyses showed a satisfactory adequacy level of the questionnaire (CMIN/DF = 2.689; Cronbach's α = 0.60) with 5 domains ('Bad eating behavior'; 'Healthy eating'; 'Sleep quality'; 'Interest in cooking'; 'Number of portions and meals'). Lower fear of COVID-19 scores and higher levels of physical activity were found in participants who reported previous dietary supplement intake during the pandemic; in addition, the group that did not ingest dietary supplements reported greater changes in stress and anxiety levels during the pandemic (p<0.05). The intake of dietary supplements before the pandemic was associated with greater energy expenditure and better coping with the fear of COVID-19 during the pandemic. Additionally, the Changes in Lifestyle-Related Behavior tool can be used to assess lifestyle-related variables during the pandemic.

The association between COVID-19 related income loss and diet quality: The mediating role of distress

The COVID-19 lockdowns saw many individuals lose income, experience distress and increase intake of foods that would typically be considered less 'healthy' (more processed and less fresh produce). Establishing whether there are direct and indirect links between these variables would be of benefit in preparing for similar future events but also has implications for the current global financial climate, where many are experiencing relative decreases in income. Adults in two locations (UK and Australia) (N = 917) completed online questionnaires to explore the impact of the first COVID-19 lockdown on their change in income, emotional wellbeing (depression, anxiety, stress, loneliness), resilience and diet quality. A structural equation model revealed that income loss was indirectly associated with diet quality via distress. As such, the greater the loss of income experienced, the more distress reported; distress was then directly associated with a less nutritious diet. This pattern of results existed when data from both countries were combined but also when they were modelled individually. Our findings indicate that where individuals experience a sudden reduction of income there are likely to be negative consequences for both mental and physical health. It is plausible that these findings would extend to other circumstances in which sudden loss of income may be experienced such as reductions in state social care, rising inflation and interest rates and sudden increases to the general cost of living.

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.

Physical activity levels during COVID-19 pandemic and its associated factors in patients with Chagas disease

Background

A better understanding of the consequences of the Coronavirus Disease 2019 (COVID-19) pandemic on lifestyle of patients with Chagas disease (ChD) is of paramount importance to facilitate the implementation of intervention strategies tailored to this specific population.

Objective

The present study aimed to evaluate the level of physical activity (PA) in Chagas disease (ChD) patients during the Coronavirus Disease 2019 (COVID-19) pandemic and its main associated factors.

Methods

This is a cross-sectional study with 187 patients of both sexes, aged ≥18 years, followed in a national infectious disease center (Rio de Janeiro, Brazil). The level of PA was determined by the International Physical Activity Questionnaire short version and expressed in terms of total volume of physical activity (PA) (MET-minutes per week). Individuals were classified as physically active following the 2020 World Health Organization PA guideline. The exposure variables were age, sex, race, marital status, schooling, income per capita, number of rooms per domicile, number of residents per domicile, body mass index, clinical form of ChD, COVID-19 antibodies, comorbidities, self-reported anxiety, self-reported depression, self-reported fear, and self-reported sadness. The association between the exposure variables with total PA (as a continuous variable) was determined using univariate and multivariate linear regression models.

Results

Mean age was 61.1 ± 11.6 years. Most (62%) were women and self-declared their race as mixed (50.8%). The percentage of physically active individuals according to was 52%. The variables independently associated with total PA levels were non-white race (Exp β = 1.39; 95% CI 1.02 to 1.90), dyslipidemia (Exp β = 0.73; 95% CI 0.56 to 0.95) and self-reported depression during quarantine (Exp β = 0.71; 95% CI 0.52 to 0.96).

Conclusion

Non-white race was positively associated with total levels of PA, while dyslipidemia, and self-reported depression during quarantine were negatively associated with total levels of PA. The identification of associated factors can facilitate the development of tailored strategies to increase PA levels ChD patients.

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.

More Adult Women than Men at High Cardiometabolic Risk Reported Worse Lifestyles and Self-Reported Health Status in the COVID-19 Lockdown

BACKGROUND

The COVID-19 lockdown represented an immense impact on human health, which was characterized by lifestyle and dietary changes, social distancing and isolation at home. Some evidence suggests that these consequences mainly affected women and altered relevant ongoing clinical trials. The aim of this study was to evaluate the status and changes in diet, physical activity (PA), sleep and self-reported health status (SRH) as perceived by older adult men and women with metabolic syndrome during the COVID-19 lockdown.

METHODS

We analyzed data from 4681 Spanish adults with metabolic syndrome. We carried out a telephone survey during May and June 2020 to collect information on demographics, dietary habits, PA, sleep, SRH and anthropometric data.

RESULTS

The mean age of participants was 64.9 years at recruitment, and 52% of participants were men. Most participants (64.1%) perceived a decrease in their PA during confinement. Regarding gender-specific differences, a higher proportion of women than men perceived a decrease in their PA (67.5% vs. 61.1%), Mediterranean diet adherence (20.9% vs. 16.8%), sleep hours (30.3% vs. 19.1%), sleep quality (31.6% vs. 18.2%) and SRH (25.9% vs. 11.9%) (all p < 0.001).

CONCLUSIONS

The COVID-19 lockdown affected women more negatively, particularly their self-reported diet, PA, sleep and health status.

Impact of the COVID-19 pandemic lockdown on Body Mass Index: a three-year follow up study in 6,156 Chinese college students

Background

The novel coronavirus disease 2019 as the most pervasive and consequential pandemic in recent years, has exerted significant impacts on human health, including aspects related to body weight. Objectives: This study aims to assess the influence of the lockdown measures implemented during the COVID-19 pandemic on Chinese college students' Body Mass Index (BMI) through a three-year cohort study.

Methods

We recruited 6156 college students (n = 4,248, 69% male, and n = 1,908, 31% female, with an average age of 18.68 ± 0.86 yr.) from a University in China to participate in this three-year cohort study. All of the subjects took the same physical fitness tests from 2019 to 2021 (pre-lockdown, during lockdown and post-lockdown). Participants' height and weight data were objectively measured by Tongfang Health Fitness Testing Products 5000 series. A paired t-test was performed in the analysis.

Results

During the lockdown, there is 4.2% increase of BMI among the college student (p<0.001). Moreover, males had a greater overall mean BMI rate increase of 4.74% (p<0.001) than females (2.86%, p<0.001). After the lockdown, there is 0.94% increase of BMI among the college student (p<0.001). However, females had a greater overall mean BMI rate increase of 1.49% (p<0.001) than males (0.72%, p<0.001). During this period, the obese and overweight group's growth rate from 2019 to 2020 was smaller than the normal and underweight group, which were 2.94% (p<0.001), 3.90% (p<0.001), 4.44% (p<0.001) and 5.25% (p<0.001), respectively.

Conclusion

BMI increased both during and post-lockdown periods among Chinese college students. However, during the lockdown, participants with higher BMI groups appeared to have a diminished BMI growth rate compared to those with lower BMI. After the lockdown, participants with higher BMI levels appeared to have an augmented BMI growth rate. Public policy action is needed to increase the level of physical activity of Chinese college students and take action to improve students' physical fitness performance after the lockdown.

Unveiling the lockdown effects: exploring behavior, dietary habits and weight changes in rural Egypt during COVID-19 lockdown: a cross-sectional retrospective study

BACKGROUND

The COVID-19 lockdown significantly impacted dietary habits and body weights globally, particularly in Egypt, where 57.03% of the population resides in rural areas, despite lack of information. The study examines the impact of COVID-19 lockdown on the weight changes of the rural Egyptian population through behavioral, physical, and dietary changes.

METHODS

A cross-sectional online survey using Microsoft Forms was distributed in Delta regions in Egypt. The questionnaire used a modified version of the validated 14- items PREDIMED MedDiet Adherence Screener (MEDAS). The first part of the questionnaire addressed sociodemographic variables whereas the second one included questions related to dietary, behavioral and weight changes of participants. These changes were statistically tested for significance in relation to BMI, gender, home living, current job and family history of obesity.

RESULTS

A total of 306 participated in the study (70% females, 13% obese, 95% living with family, 56% university students, and 36% with family history of obesity). Obese showed a significant increase in sweet intake whereas underweight and normal weight people displayed a significant decrease in eating desire. Both females and males showed significant increase in consumption of fruits and vegetables with significant decrease in soft drink. However, women showed a significant decrease in sport activity relative to men. Participants living with family showed an increase in sweet intake while those living alone explored an increase in meal frequency. Employers revealed a significant decrease in sport activities and people with family history of obesity reported more sleeping times than those without family history of obesity.

CONCLUSION

During Covid-19 quarantine, Egyptians' eating habits improved, but daily routines were disrupted. Raising awareness about obesity and providing guidance on maintaining activity, energy, and mood is crucial for future quarantine situations.

Life changes, self-prevention, knowledge and mental health among inflammatory bowel disease patients during COVID-19 pandemic: a cross-sectional study

Background

With the COVID-19 pandemic going to be COVID-19 endemic, the negative impact of COVID-19 on the mental health of IBD patients cannot be ignored. This study aimed to investigate the occurrence of anxiety and depression in IBD patients during the COVID-19 pandemic and analyze the factors associated with mental health.

Methods

Patients registered at the IBD center were enrolled. Electronic questionnaires about the IBD patient's demographic information, basic knowledge of COVID-19, public self-prevention measures, daily life changes, and anxiety and depression were distributed.

Results

Two hundred and fifteen IBD patients finished this study and reported to have anxiety (27%) or depression (34%). During the COVID-19 pandemic, 10.2% of IBD patients reported their diet changes, 58.5% of IBD patients changed their daily physical activities from 3.27 ± 3.252 h to 2.30 ± 2.78 h, 33.7% of IBD patients changed their sleeping duration from 7.99 ± 1.322 h to 8.18 ± 1.447 h. IBD patients' waiting time for admission (OR: 3.688, 95%CI: 1.003-13.554), regularly oral medicine administration (OR: 18.407, 95%CI: 1.975-171.530) and diet changes (OR: 6.167, 95%CI: 2.158-17.626) were positively correlated with anxiety or depression. IBD patients' timely periodic infusion of biological agents (OR: 0.586, 95%CI: 0.413-0.830) was negatively correlated with anxiety or depression. IBD patients' knowledge of COVID-19, public self-prevention, physical activities, and sleep duration changes showed no significant correlation with anxiety and depression, all p values > 0.05.

Conclusion

The main factors of IBD patients' mental health were diet changes, waiting time for admission, taking oral medicine regularly, and timely periodic infusions of biological agents. Ensuring the supply of routine treatment and medication for IBD patients and establishing systemic online IBD self-management programs would be the focus of major public health events.

Trends in weight gain recorded in English primary care before and during the Coronavirus-19 pandemic: An observational cohort study using the OpenSAFELY platform

BACKGROUND

Obesity and rapid weight gain are established risk factors for noncommunicable diseases and have emerged as independent risk factors for severe disease following Coronavirus Disease 2019 (COVID-19) infection. Restrictions imposed to reduce COVID-19 transmission resulted in profound societal changes that impacted many health behaviours, including physical activity and nutrition, associated with rate of weight gain. We investigated which clinical and sociodemographic characteristics were associated with rapid weight gain and the greatest acceleration in rate of weight gain during the pandemic among adults registered with an English National Health Service (NHS) general practitioner (GP) during the COVID-19 pandemic.

METHODS AND FINDINGS

With the approval of NHS England, we used the OpenSAFELY platform inside TPP to conduct an observational cohort study of routinely collected electronic healthcare records. We investigated changes in body mass index (BMI) values recorded in English primary care between March 2015 and March 2022. We extracted data on 17,742,365 adults aged 18 to 90 years old (50.1% female, 76.1% white British) registered with an English primary care practice. We estimated individual rates of weight gain before (δ-prepandemic) and during (δ-pandemic) the pandemic and identified individuals with rapid weight gain (>0.5 kg/m2/year) in each period. We also estimated the change in rate of weight gain between the prepandemic and pandemic period (δ-change = δ-pandemic-δ-prepandemic) and defined extreme accelerators as the 10% of individuals with the greatest increase in their rate of weight gain (δ-change ≥1.84 kg/m2/year) between these periods. We estimated associations with these outcomes using multivariable logistic regression adjusted for age, sex, index of multiple deprivation (IMD), and ethnicity. P-values were generated in regression models. The median BMI of our study population was 27.8 kg/m2, interquartile range (IQR) [24.3, 32.1] in 2019 (March 2019 to February 2020) and 28.0 kg/m2, IQR [24.4, 32.6] in 2021. Rapid pandemic weight gain was associated with sex, age, and IMD. Male sex (male versus female: adjusted odds ratio (aOR) 0.76, 95% confidence interval (95% CI) [0.76, 0.76], p < 0.001), older age (e.g., 50 to 59 years versus 18 to 29 years: aOR 0.60, 95% CI [0.60, 0.61], p < 0.001]); and living in less deprived areas (least-deprived-IMD-quintile versus most-deprived: aOR 0.77, 95% CI [0.77, 0.78] p < 0.001) reduced the odds of rapid weight gain. Compared to white British individuals, all other ethnicities had lower odds of rapid pandemic weight gain (e.g., Indian versus white British: aOR 0.69, 95% CI [0.68, 0.70], p < 0.001). Long-term conditions (LTCs) increased the odds, with mental health conditions having the greatest effect (e.g., depression (aOR 1.18, 95% CI [1.17, 1.18], p < 0.001)). Similar characteristics increased odds of extreme acceleration in the rate of weight gain between the prepandemic and pandemic periods. However, changes in healthcare activity during the pandemic may have introduced new bias to the data.

CONCLUSIONS

We found female sex, younger age, deprivation, white British ethnicity, and mental health conditions were associated with rapid pandemic weight gain and extreme acceleration in rate of weight gain between the prepandemic and pandemic periods. Our findings highlight the need to incorporate sociodemographic, physical, and mental health characteristics when formulating research, policies, and interventions targeting BMI in the period of post pandemic service restoration and in future pandemic planning.

Obese-friends club: a gamified virtual quasi-experiment for obesity control in adolescents during the COVID-19 pandemic

Purpose

The COVID-19 pandemic has sparked concerns about weight management because of the changes in population lifestyle. As previous studies suggest, these changes can affect adolescents to a greater degree, especially as schools shut down. Designing a method for weight management that accounts for the specific conditions of the pandemic can help students attend to their physical conditions during the pandemic.

Method

An online gamified peer pressure group on WhatsApp was employed to help 10th-grade boys in a high school in Tehran, Iran. The available sample consisted of 15 main group students and 13 control students. A paired t-test examined the difference between each group's initial and final state as well as the group's final state. Additionally, an ANCOVA test was done to ensure that the observed effect was because of the intervention.

Results

The initial BMI for the intervention group (µ = 30.68, δ = 3.23) and the control group (µ = 29.73, δ = 3.23) were the same (p = 0.468). Two dropouts in the intervention group were found after forty days. A significant difference between the intervention group's steady and final states (p = 0.027) was detected; however, this difference was not significant in the control group (p = 0.634).

Conclusion

Online gamified social groups can play a key role in adolescents' weight management during the COVID-19 pandemic.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-023-01340-z.