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Stocker R, Gupta A, Taylor GS, Shaw JA, West DJ. Adapting to compromised routines: Parental perspectives on physical activity and health for children and adolescents with type 1 diabetes in the UK during COVID-19 lockdown. J Pediatr Nurs 2024; 77:e242-e250. [PMID: 38658303 DOI: 10.1016/j.pedn.2024.04.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/10/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE To determine how COVID-19 lockdown impacted physical activity (PA) levels, wellbeing, and diabetes management in children (aged 0-17 years) with type 1 diabetes (T1D), from the perspectives of their parent/guardian. DESIGN AND METHODS This qualitative descriptive study is part of a larger, parallel mixed-methods design study, which incorporated a cross-sectional survey and semi-structured one-to-one interviews. Interviewees were recruited from the survey, which was distributed to parents of children/adolescents with T1D in the UK. Interviews explored diabetes management, mental and physical wellbeing, changes in PA levels, sleep quality before/during lockdown, and the effects of lockdown on the individual and their family. The interviews were transcribed and the data were analysed thematically. RESULTS 14 interviews were conducted with parents. Thematic analysis generated a central theme of routine disruption, with four further themes on diabetes management routines, harnessing the opportunities of lockdown, weighing up risk, and variable impact on wellbeing. CONCLUSIONS Maintaining or increasing PA during COVID-19 lockdown was associated with better diabetes management, sleep, and wellbeing for children/adolescents with T1D, despite significant disruption to established routines. Use of technology during the pandemic contributed positively to wellbeing. PRACTICE IMPLICATIONS It is crucial to emphasize the significance of maintaining a well-structured routine when treating patients with type 1 diabetes. A consistent routine, incorporating regular physical exercise and good sleep hygiene, will help with managing overall diabetes control.
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Affiliation(s)
- Rachel Stocker
- School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom.
| | - Alisha Gupta
- Population Health Sciences Institute, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom; University Hospital of North Tees, Hardwick Rd, Hardwick, Stockton-On-Tees TS19 8PE, United Kingdom.
| | - Guy S Taylor
- Population Health Sciences Institute, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom.
| | - James A Shaw
- Population Health Sciences Institute, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom; Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.
| | - Daniel J West
- Population Health Sciences Institute, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom.
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Poon ETC, Fang Y, Chung LMY, Chan CKM, Or PPL, Sun F. A scoping review of physical activity-based interventions for obesity management in children and adolescents during the COVID-19 pandemic. Int J Obes (Lond) 2024; 48:302-314. [PMID: 38086902 DOI: 10.1038/s41366-023-01433-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 11/10/2023] [Accepted: 11/24/2023] [Indexed: 02/28/2024]
Abstract
Overweight and obesity have emerged as global health issues among children and adolescents. Restrictions related to the COVID-19 pandemic have aggravated the threat of paediatric obesity due to the prevalent reduction in physical activity (PA) in children and adolescents. However, this has also created an opportunity for healthcare professionals to explore new strategies to address this persistent problem. A systematically conducted scoping review was performed on 15 online databases to summarise and analyse the design, efficacy, and feasibility of PA-based weight management interventions for children and adolescents during the pandemic. Finally, we reviewed 23 eligible studies that were published between 2021 and 2023. The included interventions were presented to 1938 children and adolescents and 355 parents using a virtual or virtually blended face-to-face approach during the pandemic. The intervention design included a basic PA programme with three optional components (nutritional education, sociopsychological counselling, and medication consultations). Implementation generally resulted in favourable changes in body mass index (BMI) and/or body size or composition (primary outcomes), as well as health behaviours, physical health or fitness, and individual well-being (secondary outcomes). A longer duration of exposure to the intervention, female sex, and older age were associated with a higher efficacy of the included interventions. Moreover, the interventions showed high feasibility, with medium-high participant attendance, high acceptance/satisfaction in both children and adolescents and their parents and teachers, and strong participant engagement. This may be related to the high accessibility of health information, timely social support, and enhanced self-efficacy. In conclusion, both the virtual and blended delivery of well-planned weight management interventions during the pandemic show promise for the treatment and control of paediatric obesity. The lessons learned from the pandemic may help improve the design of future interventions and inform the proper integration of new technologies that have emerged in the post-pandemic world.
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Affiliation(s)
- Eric Tsz Chun Poon
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China.
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Louisa Ming Yan Chung
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Carmen Ka Man Chan
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Peggy Pui Lai Or
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Fenghua Sun
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
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Morat B, Lucidarme N, Gibert A, Harbulot C, Lachaume N, Gréteau S, Basmaci R. Impact of lockdown on children with type-1 diabetes: returning to the community was associated with a decrease in HbA1c. Front Pediatr 2023; 11:1245861. [PMID: 38188912 PMCID: PMC10769491 DOI: 10.3389/fped.2023.1245861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024] Open
Abstract
Background In March 2020, a 2-month lockdown of the entire population has been declared in France to limit the spread of COVID-19. Sudden changes in daily life can impact the glycemic control of patients with type 1 diabetes (T1D), especially children and adolescents. We aimed to assess the impact of the lockdown on glycemic control in children and adolescents with T1D. Methods Children with T1D were prospectively recruited in two pediatric centers from May 11 to August 1, 2020. At inclusion, patients and/or parents were asked to fill in a form assessing the patient's lifestyle during the lockdown and a medical case report form was filled in by clinician. The mean of the three last glycated hemoglobin (HbA1c) values obtained before lockdown (HbA1c_mean; before March 17, 2020) was compared to the first HbA1c value measured after the lockdown (HbA1c_after; from May 11 to August 1, 2020). Univariable and multivariable analyses were performed, as appropriate, to identify factors associated with glycemic changes during lockdown. Results One-hundred-and-eighteen children and adolescents (median age was 14.1 years, 50% males) with T1D (median time from diagnosis was 4.1 years) were enrolled in the study. No significant difference was observed between medians of HbA1c_mean and HbA1c_after values (8.37% [7.88; 9.32%] vs. 8.50% [7.70; 9.50%], respectively; p = 0.391). Returning to the community was a protective factor [OR 0.31 (0.09-0.94); p = 0.045]. Patients having increased HbA1c were more frequently in contact with a suspected case of COVID-19 [OR 9.07 (2.15-53.66); p = 0.006], whereas patients having decreased HbA1c had the feeling of increase number of hypoglycemia [OR 0.19 (0.05-0.57); p = 0.006]. Conclusion In our patients, HbA1c before and after the lockdown was stable. In subgroup analysis, returning to the community was a protective factor. In addition, feeling of hypoglycemia was more frequent in the patients with decreased HbA1c.
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Affiliation(s)
- Benjamin Morat
- Service de Pédiatrie-Urgences, AP-HP, Hôpital Louis-Mourier, Colombes, France
| | - Nadine Lucidarme
- Service de Pédiatrie Générale, AP-HP, Hôpital Jean-Verdier, Bondy, France
| | - Auriane Gibert
- Service de Pédiatrie Générale, AP-HP, Hôpital Jean-Verdier, Bondy, France
| | - Carole Harbulot
- Service de Pédiatrie-Urgences, AP-HP, Hôpital Louis-Mourier, Colombes, France
| | - Noémie Lachaume
- Service de Pédiatrie-Urgences, AP-HP, Hôpital Louis-Mourier, Colombes, France
| | - Stéphanie Gréteau
- Service de Pédiatrie-Urgences, AP-HP, Hôpital Louis-Mourier, Colombes, France
| | - Romain Basmaci
- Service de Pédiatrie-Urgences, AP-HP, Hôpital Louis-Mourier, Colombes, France
- Université Paris Cité, Inserm, IAME, Paris, France
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4
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Puci MV, Cavallo C, Gatti A, Carnevale Pellino V, Lucini D, Calcaterra V, Zuccotti G, Lovecchio N, Vandoni M. International fitness scale (IFIS): association with motor performance in children with obesity. PeerJ 2023; 11:e15765. [PMID: 37547723 PMCID: PMC10399561 DOI: 10.7717/peerj.15765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/27/2023] [Indexed: 08/08/2023] Open
Abstract
Background Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health; and compared with their normal-weight peers, these individuals tend to have a lower level of self-confidence, and consequently lower physical activity adherence. Due to these self-perceived barriers, the aim of our study was to evaluate the efficacy of an online training program on self-reported physical fitness (SRPF) in children with obesity (OB). Methods A total of 32 children with OB carried out physical fitness (PF) tests and were asked to complete the International Fitness Enjoyment Scale (IFIS) questionnaire. The physical fitness tests were the Standing Broad Jump (SBJ), the 6-Min Walking Test (6MWT) and the 4 × 10 m sprint test. Children participated in a 3-weekly 60-min training session through Zoom platform. Before the beginning of the training protocol, OB children were compared with normal weight (NW) ones for PF batteries and the IFIS questionnaire. Changes in performances after the training were assessed by paired Student t and Wilcoxon tests. Results After the online training program children increased their performance in 6MWT (mean difference (MD) = 54.93; p < 0.0001) in SBJ (MD = 10.00; p = 0.0001) and in 4 × 10 m sprint test (MD = -0.78; p < 0.0001). No differences were found in children's physical fitness perception. Discussion Our study highlighted how a structured online training program can lead to improvements in PF of children with OB. Instead, the lack of differences in SRPF after the training suggests interesting questions to be explored on the aspects linked to self-perception. Therefore, even if our training protocol could not directly improve SRPF in children with obesity, the enhancement of their PF could be a starting point for achieving this result with a longer training period and consequently improve PA participation for children with OB.
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Affiliation(s)
- Mariangela Valentina Puci
- Clinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
- Biostatistics and Clinical Epidemiology Unit, Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, Pavia, Italy
| | - Caterina Cavallo
- Exercise and Sports, LUNEX International University of Health, Lussemburgo, Lussemburgo
| | - Alessandro Gatti
- Laboratory of Adapted Motor Activity (LAMA)-Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA)-Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- Department of Industrial Engineering, University of Roma “Tor Vergata”, Rome, Italy
| | - Daniela Lucini
- BIOMETRA Department, University of Milan, Milan, Italy
- Exercise Medicine Unit, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Valeria Calcaterra
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, Milan, Italy
- Department of Internal Medicine, University of Pavia, Pavia, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, Milan, Italy
- Department of Biomedical and Clinical Science, University of Milan, Milan, Italy
| | - Nicola Lovecchio
- Department of Human and Social Science, University of Bergamo, Bergamo, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA)-Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
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Barlow SE, Lorenzi A, Reid A, Huang R, Garigipati P, Messiah SE. Successful Virtual Delivery of a Group Childhood Healthy Weight Program. Child Obes 2022; 18:576-578. [PMID: 35363044 DOI: 10.1089/chi.2022.0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Because of the COVID-19 pandemic, the Get Up & Go program, an established effective 10-week healthy weight program for children ages 6-14 years provided free to families, has offered the option of a synchronous virtual delivery. Pre- and postassessments include a parental questionnaire about child's health behaviors, and weight and height measurements of children. Over 3 cycles, 116 and 107 families registered for virtual and in-person delivery, respectively, with 70 (60.3%) and 84 (78.5%) attending ≥1 session (p = 0.003). More families in virtual delivery spoke Spanish (41.4% vs. 22.6%, p = 0.01), but children did not differ in age, gender, and severe obesity status, and baseline behavior scores and graduation rates were similar. Improvement from baseline in BMIp95 was -3.71 [standard deviation (SD) 5.26] for virtual delivery and -1.95 (3.69) (p = 0.06) for in-person. Behavior questionnaire improvement [+15.9 (12.9) vs. +14.2 (12.0), p = 0.51] did not differ. The virtual implementation demonstrated good effect and may be useful in nonpandemic environments.
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Affiliation(s)
- Sarah E Barlow
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Health, Dallas, TX, USA
| | - Anna Lorenzi
- Enterprise Care Management, Children's Health, Dallas, TX, USA
| | - Aleksei Reid
- Enterprise Care Management, Children's Health, Dallas, TX, USA
| | - Rong Huang
- Research Administration, Children's Health, Dallas, TX, USA
| | - Priya Garigipati
- School of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sarah E Messiah
- Center for Pediatric Population Health, UTHealth School of Public Health, Dallas, TX, USA
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Becsei D, Kiss E, Szatmári I, Arató A, Reusz G, Szabó AJ, Bókay J, Zsidegh P. A retrospective analysis of metabolic control in children with PKU in the COVID-19 era. Mol Genet Metab Rep 2022; 32:100897. [PMID: 35845719 PMCID: PMC9284369 DOI: 10.1016/j.ymgmr.2022.100897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 11/30/2022] Open
Abstract
Background Patients with phenylketonuria (PKU) must maintain a lifelong natural protein-restricted diet to prevent neuro-cognitive damage. Early diagnosis is established with newborn screening, with diet subsequently controlled by regular phenylalanine (Phe) monitoring. During the COVID-19 pandemic, significant lockdown measures were introduced that may have influenced the above. Aim of our study To establish whether the diagnosis was delayed in neonates during the pandemic. In addition, metabolic control was further assessed during the COVID-19 pandemic era (CE) compared to the same period a year prior (non-COVID-19 era, NCE). The lockdown periods (LD) were also compared with unrestricted periods (URP). Patients, methods Six neonates born during the CE and eight neonates born during NCE were included in the newborn screening analysis. Seventy-two classical PKU patients aged 2–18 years and categorized as children (2–12 years; 51 patients) and adolescents (>13 years; 21 patients) were included in the metabolic control analysis. The frequency of dried blood spot (DBS) sampling and Phe levels were assessed according to the different periods. Results There was no diagnostic or therapeutic delay in reaching the recommended Phe range in neonates born during CE compared to those born in NCE (median [interquartile range, IQR]: 23.5 [22.5–24] vs. 22 [18.0–27] days, p = NS). The cumulative DBS sampling frequency in children increased by 9.9% in the CE while no change was noted in the adolescent group. The median Phe level increased significantly in both age groups in the CE, but remained within the recommended target range. During CE, changes in Phe levels differed in the two age groups: children had the highest median Phe in the second lockdown period (LD2), while the adolescents had an increased Phe in URP. There were significant negative correlations between DBS sampling frequencies and Phe levels in both age groups in NCE (children: r − 0.43, p = 0.002; adolescents r = −0.37, p = 0.012), and in adolescents in CE (r = −0.62, p = 0.006). Conclusion The pandemic did not impact newborn metabolic screening. The increased frequency of DBS sampling in CE and good target Phe levels suggest a better compliance in a very sensitive period. Since many factors may impact metabolic control in the different age groups, further studies are needed to analyse their respective role.
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Key Words
- CE, COVID-19 era
- CLD1, control to lockdown period 1
- CLD2, control to lockdown period 2
- COVID, coronavirus disease
- COVID-19 pandemic
- CURP, control to unrestricted period
- DBS, dried blood spot
- IQR, interquartile range
- LD, lockdown
- Lockdown
- MS/MS, tandem mass spectrometry
- Metabolic control
- NCE, non-COVID-19 era
- Phenylketonuria
- SARS, Severe Acute Respiratory Syndrome,
- URP, unrestricted period
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Affiliation(s)
- Dóra Becsei
- 1st Department of Pediatrics, Semmelweis University, Bókay János u. 53-54, Budapest 1083, Hungary
| | - Erika Kiss
- 1st Department of Pediatrics, Semmelweis University, Bókay János u. 53-54, Budapest 1083, Hungary
| | - Ildikó Szatmári
- 1st Department of Pediatrics, Semmelweis University, Bókay János u. 53-54, Budapest 1083, Hungary
| | - András Arató
- 1st Department of Pediatrics, Semmelweis University, Bókay János u. 53-54, Budapest 1083, Hungary
| | - György Reusz
- 1st Department of Pediatrics, Semmelweis University, Bókay János u. 53-54, Budapest 1083, Hungary
| | - Attila J Szabó
- 1st Department of Pediatrics, Semmelweis University, Bókay János u. 53-54, Budapest 1083, Hungary.,ELKH-SE Pediatrics and Nephrology Research Group, Budapest, Hungary
| | - János Bókay
- 1st Department of Pediatrics, Semmelweis University, Bókay János u. 53-54, Budapest 1083, Hungary
| | - Petra Zsidegh
- 1st Department of Pediatrics, Semmelweis University, Bókay János u. 53-54, Budapest 1083, Hungary
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Effects of an Online Supervised Exercise Training in Children with Obesity during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159421. [PMID: 35954777 PMCID: PMC9368250 DOI: 10.3390/ijerph19159421] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/28/2022] [Accepted: 07/28/2022] [Indexed: 02/01/2023]
Abstract
COVID-19 restrictions have dramatically reduced the active lifestyle and physical activity (PA) levels in the whole population, a situation that can contribute to weight gain and to develop obesity. To improve physical fitness (PF) in children with obesity during COVID-19 restrictions, sport specialists started to deliver physical training through tele-exercise. For these reasons, the aim of this study was to evaluate the effects of a 12-week online supervised training program in children with obesity on different PF components and PA levels. We enrolled a total of 40 Caucasian children (9 F/31 M; aged 11 ± 1.9 years) with obesity. The data collection consisted of a series of anthropometric measures, the PAQ-C questionnaire, and PF tests, valid and reliable tools to assess PF in children. We used a Wilcoxon’s t-test and a Student’s t-test, as appropriate, to assess the differences before and after the training protocol. A total of 37 patients completed the training protocol and were considered in the analysis. Our results show an improvement in all the PF tests, a reduction in the BMI z-score, the waist circumference, and in the waist-to-height ratio, and an increased PA level. In conclusion, the results of our study show that an online supervised training program is effective to promote PA, improving PF and reducing the BMI z-score in children with obesity.
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Carnevale Pellino V, Lovecchio N, Puci MV, Marin L, Gatti A, Pirazzi A, Negri F, Ferraro OE, Vandoni M. Effects of the lockdown period on the mental health of elite athletes during the COVID-19 pandemic: a narrative review. SPORT SCIENCES FOR HEALTH 2022; 18:1187-1199. [PMID: 35693326 PMCID: PMC9174028 DOI: 10.1007/s11332-022-00964-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/11/2022] [Indexed: 11/25/2022]
Abstract
Purpose This review aimed to assess the effects of COVID-19 pandemic lockdown on mental health to elite athletes. The emotional background influenced their sport career and was examined by questionnaires. Methods We included original studies that investigated psychological outcomes in elite athletes during COVID-19 lockdown. Sixteen original studies (n = 4475 participants) were analyzed. Results The findings showed that COVID-19 has an impact on elite athletes’ mental health and was linked with stress, anxiety and psychological distress. The magnitude of the impact was associated with athletes’ mood state profile, personality and resilience capacity. Conclusion The lockdown period impacted also elite athletes’ mental health and training routines with augmented anxiety but with fewer consequences than the general population thanks to adequate emotion regulation and coping strategies.
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Affiliation(s)
- Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA)- Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, Pavia, Italy
- Department of Industrial Engineering, University of Tor Vergata Rome, Rome, Italy
| | - Nicola Lovecchio
- Department of Human and Social Science, University of Bergamo, Bergamo, Italy
| | - Mariangela V. Puci
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, Pavia, Italy
| | - Luca Marin
- Laboratory of Adapted Motor Activity (LAMA)- Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, Pavia, Italy
- Laboratory for Rehabilitation Medicine and Sport (LARMS), 00133 Rome, Italy
- Department of Research, ASOMI College of Sciences, Marsa, 2080 Malta
| | - Alessandro Gatti
- Laboratory of Adapted Motor Activity (LAMA)- Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, Pavia, Italy
| | - Agnese Pirazzi
- Laboratory of Adapted Motor Activity (LAMA)- Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, Pavia, Italy
| | - Francesca Negri
- Laboratory of Adapted Motor Activity (LAMA)- Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, Pavia, Italy
| | - Ottavia E. Ferraro
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, Pavia, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA)- Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, Pavia, Italy
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9
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Vandoni M, Codella R, Pippi R, Carnevale Pellino V, Lovecchio N, Marin L, Silvestri D, Gatti A, Magenes VC, Regalbuto C, Fabiano V, Zuccotti G, Calcaterra V. Combatting Sedentary Behaviors by Delivering Remote Physical Exercise in Children and Adolescents with Obesity in the COVID-19 Era: A Narrative Review. Nutrients 2021; 13:4459. [PMID: 34960011 PMCID: PMC8706684 DOI: 10.3390/nu13124459] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/06/2021] [Accepted: 12/10/2021] [Indexed: 02/07/2023] Open
Abstract
The coexistence of childhood obesity (or its risk) and COVID-19 pandemic put children and adolescents in greater risk to develop respiratory and cardiovascular diseases. In fact, the restrictions introduced to limit the spread of the virus had detrimental effects on various lifestyle components, especially in young population. This resulted in augmented levels of physical inactivity and sedentary behaviors and a reduced time spent in play outdoors or sport practices. Contrariwise, the increased use of technology led clinicians, teachers, and trainers to maintain relations with obese children/adolescents so as to reduce sedentary behaviors and the associated health risks. This narrative review aims to describe the role of Telehealth and Tele-exercise as useful tools in the management of pediatric obesity during COVID-19 pandemic. Telehealth and Tele-exercise were effective in promoting self-monitoring and behavioral changes, including adherence to exercise training programs in children and adolescents. Moreover, tele-exercise platforms such as applications or exergames allowed flexible scheduling, limiting the infection risks.
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Affiliation(s)
- Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (V.C.P.); (A.G.)
| | - Roberto Codella
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20138 Milan, Italy;
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy
| | - Roberto Pippi
- Healthy Lifestyle Institute, C.U.R.I.A.Mo. (Centro Universitario Ricerca Interdipartimentale Attività Motoria), Department of Medicine and Surgery, University of Perugia, 06126 Perugia, Italy;
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (V.C.P.); (A.G.)
- Department of Industrial Engineering, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Nicola Lovecchio
- Department of Human and Social Science, University of Bergamo, 24127 Bergamo, Italy;
| | - Luca Marin
- Laboratory for Rehabilitation Medicine and Sport (LARMS), 00133 Rome, Italy;
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta;
| | - Dario Silvestri
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta;
| | - Alessandro Gatti
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (V.C.P.); (A.G.)
| | - Vittoria Carlotta Magenes
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (V.F.); (G.Z.); (V.C.)
| | - Corrado Regalbuto
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Valentina Fabiano
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (V.F.); (G.Z.); (V.C.)
- Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (V.F.); (G.Z.); (V.C.)
- Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
| | - Valeria Calcaterra
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (V.F.); (G.Z.); (V.C.)
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy;
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10
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Calcaterra V, Verduci E, Vandoni M, Rossi V, Di Profio E, Carnevale Pellino V, Tranfaglia V, Pascuzzi MC, Borsani B, Bosetti A, Zuccotti G. Telehealth: A Useful Tool for the Management of Nutrition and Exercise Programs in Pediatric Obesity in the COVID-19 Era. Nutrients 2021; 13:3689. [PMID: 34835945 PMCID: PMC8618189 DOI: 10.3390/nu13113689] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/17/2021] [Accepted: 10/19/2021] [Indexed: 12/18/2022] Open
Abstract
The COVID-19 pandemic has led to the implementation of policies that mandate various restrictions on daily life, including social distancing, the closure of public services and schools, and movement limitations. Even though these restrictive measures decreased the COVID-19 spread, they may have detrimental effects on various lifestyle components such as physical inactivity, sedentary behavior, and dietary habits, influencing the maintenance of weight and contributing to obesity among children and adolescents. The coexistence of childhood obesity and COVID-19 and changes in the bioecological environment have put children and adolescents at increased risk for developing obesity and exacerbating the severity of this disorder. The use of telehealth technology is a modern approach useful for the delivery of health care services by health care professionals, where distance is a critical factor. Telehealth is effective in promoting increased self-monitoring and behavioral change, and provides the opportunity to perform online nutritional support and exercise training programs to promote a healthy lifestyle and reduce sedentary behaviors in children and adolescents. Telehealth, including tele-exercise and tele-nutrition, has the potential to address many of the key challenges in providing health services, including in patients with obesity during the COVID-19 outbreak. This narrative review aims to describe the role of telehealth as an opportunity in the management of pediatric obesity in the COVID-19 era, and to deliver nutrition and exercise programs for the maintenance of health.
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Affiliation(s)
- Valeria Calcaterra
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Elvira Verduci
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
- Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (V.C.P.)
| | - Virginia Rossi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Elisabetta Di Profio
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (V.C.P.)
| | - Valeria Tranfaglia
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Martina Chiara Pascuzzi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Barbara Borsani
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Alessandra Bosetti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
- Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
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11
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Mazzolani BC, Smaira FI, Astley C, Iraha AY, Pinto AJ, Marques IG, Cordeiro Amarante M, Rezende NS, Sieczkowska SM, Franco TC, Miranda LCDA, Lindoso L, Helito AC, Oba J, Queiroz LB, Pereira RMR, Roschel H, Silva CA, Gualano B. Changes in Eating Habits and Sedentary Behavior During the COVID-19 Pandemic in Adolescents With Chronic Conditions. Front Pediatr 2021; 9:714120. [PMID: 34966698 PMCID: PMC8711628 DOI: 10.3389/fped.2021.714120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 11/05/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Among healthy adolescents, school closures and home confinement were shown to increase unhealthier eating habits and sedentary behavior. It remains unknown to which extent the pandemic has impacted the lifestyle of adolescents with chronic conditions. Thus, the aim of this study is to report on the impact of the COVID-19 outbreak on eating habits and sedentary behavior among adolescents with multiple chronic conditions (n = 347) from a tertiary, referral hospital vs. healthy peers. Methods: This observational study was conducted in São Paulo (Brazil) between July and October 2020, period in which a set of social distancing measures to contain the pandemic. Results: The main findings of this study were that adolescents with chronic conditions and health peers showed important changes in eating habits (e.g., more often cooking and eating in front of television than before quarantine). Also, 86.8% of adolescents with chronic conditions and 91.6% of healthy adolescents reported increasing screen time during pandemic. No major differences were observed between patients and controls. Conclusions: Adolescents with chronic conditions and healthy peers exposed to pandemic showed substantial changes in lifestyle, stressing the need for specific care to mitigate poor eating habits and excessive sedentary behavior for patients and healthy adolescents.
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Affiliation(s)
- Bruna Caruso Mazzolani
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Fabiana Infante Smaira
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Camilla Astley
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Amanda Yuri Iraha
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Ana Jessica Pinto
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Isabela Gouveia Marques
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Milla Cordeiro Amarante
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Nathalia Saffioti Rezende
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Sofia Mendes Sieczkowska
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Tathiane Christine Franco
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Luana Cristina do Amaral Miranda
- Instituto da Criança e do Adolescente, Hospital das Clinicas da Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Lívia Lindoso
- Instituto da Criança e do Adolescente, Hospital das Clinicas da Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Alberto Carame Helito
- Instituto da Criança e do Adolescente, Hospital das Clinicas da Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Jane Oba
- Instituto da Criança e do Adolescente, Hospital das Clinicas da Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Ligia Bruni Queiroz
- Instituto da Criança e do Adolescente, Hospital das Clinicas da Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Rosa Maria R Pereira
- Rheumatology Division, Hospital das Clinicas da Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Clovis Artur Silva
- Instituto da Criança e do Adolescente, Hospital das Clinicas da Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil.,Rheumatology Division, Hospital das Clinicas da Faculdade de Medicina (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, Rheumatology Division, School of Physical Education and Sport, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Disciplina de Reumatologia, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brazil.,Food Research Center, University of São Paulo, São Paulo, Brazil
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