Changes in the clustering of unhealthy movement behaviors during the COVID-19 quarantine and the association with mental health indicators among Brazilian adults

Impact of the COVID-19 confinement on movement behaviors among French young children: the ONAPS national survey

BACKGROUND

The present study examines the effects of the COVID-19 confinement on health-related behaviors (physical activity, sedentary behaviors) of young French children.

METHODS

Parents of 348 French children under 6 years of age completed an online survey launched during the first days of the initial COVID-19-related confinement. They were asked to indicate whether their kids increased, decreased or maintained their physical activity level, time spent in sedentary behaviors, and sleep time. Information regarding the configuration of their home environment (access to outdoor facilities, implantation area) and lifestyle habits (solitary activity, parents' solicitation; nap time; night waking episodes and night duration) were also collected.

RESULTS

A total of 25.0% of the children were reported to decrease, 24.7% maintained and 50.3% increase their physical activity during the confinement. Greater proportions of kids who had access to a collective (51.4%) or individual (53.7%) outdoor area increased their physical activity. Regardless of the housing situation (urban, suburban or rural) or access to outdoor facilities, the majority of children increased their screen time (60.4%). Two-thirds (66.7%) of parents reported nap time remained unchanged for their kids. Fifty-one percent of parents admitted a link between teleworking and their kids' screen time.

CONCLUSIONS

Health behaviors were differentially impacted in very young kids during a confinement period. Importantly, a majority of parents admitted a causal effect of telecommuting on their kids' screen exposure. The present results also show that the proneness to increase physical activity during confinement is positively related to access to a favorable outdoor environment.

Changes in lifestyle and physical and mental health related to long-confinement due COVID-19: a study during the first and second pandemic waves in Mexico and Chile

We investigate changes in lifestyle, physical, and mental health during the confinement period of the first and second waves of COVID-19, as well as their relation to sociodemographic parameters and confinement status. Sociodemographic data and information regarding changes in their lifestyle behavior and changes in body weight and physical activity (PA) were collected. The SF-36 questionnaire was implemented for measuring the domains related to physical health (PH) and mental health (MH). The growth frequency of weight gain in the Mexican (4.8%) and Chilean (10.9%) populations was observed during the second wave. The MH component decreased in the Mexican and the Chilean population (p < 0.05). Moreover, the MH decreased significantly according to the degree of confinement (p < 0.01). Although some sociodemographic factors were related to the presence of a very low score (<50 scores) for the MH component during the first wave, it is perceived as a higher relative risk during the second wave in both populations. The long confinement due to COVID-19 is associated to negative changes in nutritional and physical lifestyle behavior, affecting mainly the MH component.

Psychological and psychosocial determinants of COVID Health Related Behaviours (COHeRe): An evidence and gap map

Background

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has resulted in illness, deaths and societal disruption on a global scale. Societies have implemented various control measures to reduce transmission of the virus and mitigate its impact. Individual behavioural changes are crucial to the successful implementation of these measures. Common recommended measures to limit risk of infection include frequent handwashing, reducing the frequency of social interactions and the use of face coverings. It is important to identify those factors that can predict the uptake and maintenance of these protective behaviours.

Objectives

We aimed to identify and map the existing evidence (published and unpublished) on psychological and psychosocial factors that determine uptake and adherence to behaviours aimed at reducing the risk of infection or transmission of COVID-19.

Search Methods

Our extensive search included electronic databases (n = 12), web searches, conference proceedings, government reports, other repositories including both published peer reviewed, pre-prints and grey literature. The search strategy was built around three concepts of interest including (1) context (terms relating to COVID-19), (2) behaviours of interest and (3) terms related to psychological and psychosocial determinants of COVID Health-Related Behaviours and adherence or compliance with recommended behaviours, to capture both malleable and non-malleable determinants (i.e. determinants that could be changed and those that could not).

Selection Criteria

This Evidence and Gap Map (EGM) includes all types of studies examining determinants of common recommended behaviours aimed at mitigating human-to-human spread of COVID-19. All potential malleable and non-malleable determinants of one or more behaviours are included in the map. As part of the mapping process, categories are used to group determinants. The mapping categories were based on a previous rapid review by Hanratty 2021. These include: 'behaviour', 'cognition', 'demographics', 'disease', 'emotions', 'health status', 'information', 'intervention', and 'knowledge'. Those not suitable for categorisation in any of these groups are included in the map as 'other' determinants.

Data Collection and Analysis

Results were imported to a bibliographic reference manager where duplications of identical studies gathered from multiple sources were removed. Data extraction procedures were managed in EPPI-Reviewer software. Information on study type, population, behaviours measured and determinants measured were extracted. We appraised the methodological quality of systematic reviews with AMSTAR-2. We did not appraise the quality of primary studies in this map.

Main Results

As of 1 June 2022 the EGM includes 1034 records reporting on 860 cross-sectional, 68 longitudinal, 78 qualitative, 25 reviews, 62 interventional, and 39 other studies (e.g., mixed-methods approaches). The map includes studies that measured social distancing (n = 487), masks and face coverings (n = 382), handwashing (n = 308), physical distancing (n = 177), isolation/quarantine (n = 157), respiratory hygiene/etiquette (n = 75), cleaning surfaces (n = 59), and avoiding touching the T-zone (n = 48). There were 333 studies that assessed composite measures of two or more behaviours. The largest cluster of determinants was 'demographics' (n = 730 studies), followed by 'cognition' (n = 496 studies) and determinants categorised as 'other' (n = 447). These included factors such as 'beliefs', 'culture' and 'access to resources'. Less evidence is available for some determinants such as 'interventions' (n = 99 studies), 'information' (n = 101 studies), and 'behaviour' (149 studies).

Authors' Conclusions

This EGM provides a valuable resource for researchers, policy-makers and the public to access the available evidence on the determinants of various COVID-19 health-related behaviours. The map can also be used to help guide research commissioning, by evidence synthesis teams and evidence intermediaries to inform policy during the ongoing pandemic and potential future outbreaks of COVID-19 or other respiratory infections. Evidence included in the map will be explored further through a series of systematic reviews examining the strength of the associations between malleable determinants and the uptake and maintenance of individual protective behaviours.

Lifestyle changes during the COVID-19 pandemic in Brazil: results from three consecutive cross-sectional web surveys

OBJECTIVE

The importance of a healthy lifestyle in preventing morbidity and mortality is well-established. The COVID-19 pandemic brought about significant lifestyle changes globally, but the extent of these changes in the Brazilian population remains unclear. The objective of this study was to evaluate changes in lifestyle among the Brazilian general population during the first year of the pandemic.

DESIGN

Three consecutive anonymous web surveys were carried out: survey 1 (S1)-April 2020, S2-August 2020 and S3-January 2021.

SETTING

Brazil.

PARTICIPANTS

The study included 19 257 (S1), 1590 (S2) and 859 (S3) participants from the general population, who were ≥18 years, of both sexes, with access to the internet, self-reporting living in Brazil and who agreed to participate after reading the informed consent.

PRIMARY OUTCOME

Lifestyle changes were assessed using the Short Multidimensional Instrument for Lifestyle Evaluation-Confinement (SMILE-C). The SMILE-C assesses lifestyle across multiple domains including diet, substance use, physical activity, stress management, restorative sleep, social support and environmental exposures. We used a combination of bootstrapping and linear fixed-effect modelling to estimate pairwise mean differences of SMILE-C scores overall and by domain between surveys.

RESULTS

In all the surveys, participants were mostly women and with a high education level. Mean SMILE-C scores were 186.4 (S1), 187.4 (S2) and 190.5 (S3), indicating a better lifestyle in S3 as compared with S1. The pairwise mean differences of the overall SMILE-C scores were statistically significant (p<0.001). We also observed a better lifestyle over time in all domains except for diet and social support.

CONCLUSIONS

Our findings indicate that individuals from a large middle-income country, such as Brazil, struggled to restore diet and social relationships after 1 year of the pandemic. These findings have implications for monitoring the long-term consequences of the pandemic, as well as future pandemics.

Brazilian Adaptation of the Coronavirus Anxiety Scale: A Psychometric Investigation of a Measure of Coronaphobia

This study examined the psychometric properties of a Brazilian adapted version of the Coronavirus Anxiety Scale (CAS-BR) in a sample of adults in Brazil. Confirmatory factor analyses demonstrated that the CAS-BR produces a reliable (α = .84), unidimensional construct whose structure was shown to be invariant across gender, race, and age. However, some items of the CAS-BR were stronger indicators of the coronavirus anxiety construct for women and younger adults. Although the CAS-BR demonstrated evidence of discrimination ability for functional impairment (AUC = .77), Youden indexes were low to identify a clinical cut-score. Construct validity was demonstrated with correlations between CAS-BR scores and measures of functional impairment, generalized anxiety, and depression. Exploratory analyses revealed that CAS-BR total scores were higher among women and participants with a history of anxiety disorder. These findings are consistent with previous investigations and support the validity of CAS-BR for measuring coronavirus anxiety with Brazilian adults.

Social Media Use and Its Association with Mental Health and Internet Addiction among Portuguese Higher Education Students during COVID-19 Confinement

The use of social media was one of the most common way to keep in touch with friends and family during confinement. For higher education students, the fact that their universities were closed was a major change in their lives. The aim of this study is to relate the prevalence and type of social media with Internet addiction and mental health of university students in a district of Portugal during COVID-19 confinement. Mental health was studied by applying the reduced version of the Mental Health Inventory (MHI-5) and to measure the Internet use and dependence, the Internet Addiction Test (IAT) was used. The study (cross-sectional, descriptive, and correlational) used an online questionnaire, conducted on Google^® Forms and the link was sent to 4450 students, in the months of April to June 2020, during the confinement. A total of 329 valid questionnaires were obtained. We can conclude that regarding mental health, students in the 18-24 age group, single or divorced and who are not in a relationship, and with worse academic results, show worse levels of mental health. It is noteworthy that the students with the same characteristics also have the highest levels of addiction to internet.

Evaluation of psychosocial status and nutritional awareness in municipal employees during the coronavirus disease 2019 outbreak: A cross-sectional study

Background: Coronavirus disease 2019 emerged in China in December 2019 as a disease spreading from person to person by rapid droplet transmission, and which eventually evolved into a pandemic. Aim: This study aims to examine the psychosocial state, nutritional awareness, and physical activity level of municipal employees who provided services under changing working conditions during the coronavirus disease 2019 pandemic. Methods: A total of 220 employees working in two different municipalities in Istanbul were included in this study during March and April of 2021. For data collection, a questionnaire form was used. The form consisted of questions about the demographics and nutritional awareness of individuals, the Coronavirus-19 Phobia Scale, and the International Physical Activity Questionnaire (short form). Results: The mean total coronaphobia score was 51.08 ± 14.47 with the mean score for women being significantly higher than that for men (p < 0.05). The mean score obtained by the responses of participants to questions about nutritional awareness during the pandemic was significantly higher than the mean score referring to the period before the pandemic. The examination of the physical activity level of employees revealed that 62.4% of the men and 60% of the women were physically inactive during the pandemic. Conclusion: It was found that the coronaphobia scores of municipal employees during the coronavirus disease 2019 pandemic were at an average level, their nutritional awareness levels increased in general compared to the pre-pandemic period, and municipal employees were mostly inactive physically during the pandemic.

Impact of COVID-19 pandemic on physical activity level and screen time is associated with decreased mental health in Brazillian adults: A cross-sectional epidemiological study

The objective was to verify whether the impact of COVID-19 on physical activity and screen time was associated with the impact on quality of life and symptoms of anxiety and depression in a sample of Brazilian adults. The invitation was made through social networks and the collection was carried out through electronic research. There was a decrease in quality of life and physical activity, and an increase in symptoms of anxiety and depression and screen time. These findings are important for new strategies that promote physically active habits during the pandemic .

Factors Associated With Depression and Anxiety in Korean Adolescents During the COVID-19 Pandemic

OBJECTIVE

This study was performed to identify factors associated with depression and anxiety among Korean adolescents during the coronavirus disease (COVID-19) pandemic.

METHODS

We conducted a cross-sectional study of 1,898 Korean adolescents (55.2% male, 44.8% female) ranging in age from 12 to 17 years (mean±standard deviaion age, 15.4±2.6 years). Depression and anxiety were defined as a Patient Health Questionnaire-9 score ≥10 and Generalized Anxiety Disorder-7 score ≥10, respectively. Other questionnaires included sociodemographic data, psychosocial stresses, and experiences in association with COVID-19. Psychiatric scales included Gratitude Questionnaire-6, Perceived Stress Scale-10, and UCLA Loneliness Scale-3.

RESULTS

The prevalence rates of depressive and anxiety symptoms among participants were 13.8% and 21.0%, respectively. Multivariable logistic regression analysis revealed that female sex, fear of COVID-19 infection, low gratitude were risk factors for depression. Fear of COVID-19 infection, increased TV watching time, and academic-related stress were risk factors for anxiety.

CONCLUSION

Depression and anxiety were prevalent during the pandemic in Korean adolescents, and were associated with fear of COVID-19 infection. Providing appropriate information on COVID-19, helping adolescents manage academic-related stress and maintain daily life patterns, and implementing interventions to foster gratitude are important for preventing depression and anxiety in Korean adolescents.

How do Vaccinators Experience the Pandemic? Lifestyle Behaviors in a Sample of Italian Public Health Workers during the COVID-19 Era

Public health workers (PHWs) have experienced substantial workload changes because of their role in managing measures to limit the spread of COVID-19. The study’s aim was to assess lifestyle changes in Italian PHWs during the pandemic. PHWs attending an annual meeting completed an anonymous questionnaire assessing their sociodemographic and behavioral characteristics and lifestyle changes during the pandemic. A total of 1000 questionnaires were completed. Most participants (63.5% women, mean age 40 ± 13.1 years) were of normal weight (61.5%), non-smokers (81.9%), had a total screen time of ≥5 h/day (83.1%), and slept at least 6 h/night (88.7%). Approximately one-third consumed sweet foods every day (30%) and did not engage in physical activity (34.6%). Current sweet food consumption, physical activity, and sleep were associated with changes in these behaviors in the last 2 years (Tau-b = 0.155; Tau-b = −0.175; Tau-b = −0.276, respectively, p < 0.001). An increase in remote working was associated with worse sleep (odds ratio (OR) 2.065, 95% confidence interval (CI) 1.482–2.877) and diet (OR 1.982, 95% CI 1.385–2.838), and increased tablet/PC use (OR 3.314, 95% CI 2.358–4.656). Health promotion measures are needed to support the adoption of healthy lifestyles in this population during the current pandemic.

Stress and Physical Inactivity: Two Explosive Ingredients for the Heart in COVID-19 Pandemic Times

BACKGROUND

Coronavirus disease 2019 (Covid-19) pandemic is a global health crisis that has culminated in thousands of deaths. In order to reduce the spread of the Sars-CoV-2 virus, governments of several countries have adopted social isolation as a strategy. However, social isolation has culminated in deleterious effects on the population's health, including increased physical inactivity, stress and, consequently, adverse changes in body composition, cardiorespiratory capacity, muscle strength, physical functionality, and vascular events, which are increasingly pointed out as the main determinants of cardiovascular health. Staying physically active during lockdown is a challenge, especially for the population with a higher risk of mortality from COVID-19, who are still encouraged to maintain social distance until there is a vaccine available. Strategies to avoid physical inactivity and reduce stress levels can promote cardiovascular protection and must be considered during COVID-19 time.

OBJECTIVE

The aim of this paper is to discuss the risks of physical inactivity and stress for the cardiovascular system during the COVID-19 pandemic and propose strategies to protect cardiovascular health.

CONCLUSION

A home-based training protocol could be an interesting and effective strategy for the population who need to remain physically active and safe at home.

The Independent, Joint, and Additive Associations of Physical Activity and Self-Compassion on Depression Symptoms Among Chinese College Students

Background

Physical activity and self-compassion are closely related to individuals' mental health (eg, depression). However, most studies only examined their independent roles in mental health without considering the potential interaction between the two variables. The present study aimed to investigate the independent and joint associations between physical activity (PA) and self-compassion (SC) on depression symptoms and examine the additive interaction between PA and SC.

Methods

A cross-sectional design was utilized in the present descriptive study. By recruiting participants via social media platforms, 1846 Chinese college students completed International Physical Activity Questionnaire Short Form, the Self-Compassion Scale-Short Form, the 9-item Patient Health Questionnaire, and items regarding socio-demographic information. Independent and joint roles of low-level PA (LPA) and low-level SC (LSC) on depression symptoms were examined by logistic regression models. Additive interaction between LPA and LSC on depression symptoms was examined by the following indices: relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S). Socio-demographic variables were included in the models as covariates.

Results

Both LPA (OR = 1.47 [1.16, 1.86]) and LSC (OR = 5.74 [3.89, 8.45]) were independently associated with higher probability of depression symptoms. Combining LPA and LSC led to an additive interaction and greatly increased the odds of depression symptoms (OR = 9.62 [5.38, 17.22]; RERI = 2.47 [0.19, 4.75], AP = 0.25 [0.05, 0.44], S = 1.38 [1.02, 1.87]).

Conclusion

Both LPA and LSC were associated with an increased risk of depression symptoms. Moreover, combining LPA and LSC may develop an additive risk for depression symptoms. Future research and clinical intervention could integrate PA and SC to find a better way to resist depression symptoms.

Impact of the COVID-19 Pandemic on Sedentary Time and Behaviour in Children and Adults: A Systematic Review and Meta-Analysis

The aim of this meta-analysis was to quantify the change in sedentary time during the COVID-19 pandemic and its effect on health outcomes in the general population. One thousand six hundred and one articles published after 2019 were retrieved from five databases, of which 64 and 40 were included in the systematic review and meta-analysis, respectively. Studies were grouped according to population: children (<18 years), adults (18–64 years) and older adults (>65 years). Average sedentary time was calculated, with sub-analyses performed by country, behaviour type and health outcomes. Children were most affected, increasing their sedentary time by 159.5 ± 142.6 min day⁻¹, followed by adults (+126.9 ± 42.2 min day⁻¹) and older adults (+46.9 ± 22.0 min day⁻¹). There were no sex differences in any age group. Screen time was the only consistently measured behaviour and accounted for 46.8% and 57.2% of total sedentary time in children and adults, respectively. Increases in sedentary time were negatively correlated with global mental health, depression, anxiety and quality of life, irrespective of age. Whilst lockdown negatively affected all age groups, children were more negatively affected than adults or older adults, highlighting this population as a key intervention target. As lockdowns ease worldwide, strategies should be employed to reduce time spent sedentary. Trial registration: PROSPERO (CRD42020208909).

Older Adults' Daily Activity and Mood Changes Detected During the COVID-19 Pandemic Using Remote Unobtrusive Monitoring Technologies

Background and Objectives

The coronavirus disease 2019 (COVID-19) pandemic has limited older adults' access to in-person medical care, including screenings for cognitive and functional decline. Remote, technology-based tools have shown recent promise in assessing changes in older adults' daily activities and mood, which may serve as indicators of underlying health-related changes (e.g., cognitive decline). This study examined changes in older adults' driving, computer use, mood, and travel events prior to and following the COVID-19 emergency declaration using unobtrusive monitoring technologies and remote online surveys. As an exploratory aim, the impact of mild cognitive impairment (MCI) on these changes was assessed.

Research Design and Methods

Participants were 59 older adults (41 cognitively intact and 18 MCI) enrolled in a longitudinal aging study. Participants had their driving and computer use behaviors recorded over a 5-month period (75 days pre- and 76 days post-COVID emergency declaration) using unobtrusive technologies. Measures of mood, overnight guests, and frequency of overnight travel were also collected weekly via remote online survey.

Results

After adjusting for age, gender, and education, participants showed a significant decrease in daily driving distance, number of driving trips, highway driving, and nighttime driving, post-COVID-19 as compared to pre-COVID-19 (p < .001) based on generalized estimating equation models. Further, participants spent more time on the computer per day post-COVID-19 (p = .03). Participants endorsed increases in blue mood (p < .01) and loneliness (p < .001) and decreases in travel away from home and overnight visitors (p < .001) from pre- to post-COVID-19. Cognitive status did not impact these relationships.

Discussion and Implications

From pre- to post-COVID-19 emergency declaration, participants drove and traveled less, used their computer more, had fewer overnight visitors, and reported greater psychological distress. These results highlight the behavioral and psychological effects of stay-at-home orders on older adults who are cognitively intact and those with MCI.

Adverse Collateral Effects of COVID-19 Public Health Restrictions on Physical Fitness and Cognitive Performance in Primary School Children

The aim of the present study was to evaluate whether the COVID-19-related confinement and social restrictions affected the levels of physical fitness and academic achievement in primary school French children. A total of 206 primary school children (106 before confinements and 100 after restrictions) completed a test battery evaluating their anthropometric characteristics, body compositions, activity preferences, cognitive performances and physical fitness. The performance of the Standing Long Jump was better at T0 (169.9 ± 142.5 cm) compared to T1 (135.2 ± 31.4 cm) (p = 0.0367), and the Medicine Ball Throw performance declined from T0 to T1 (297.3 ± 81.1 cm vs. 249 ± 52 cm; p < 0.0001). Motor skills (26.9 ± 6.2 s vs. 30.9 ± 5.4 s; p < 0.0001), the shuttle-run test (stages completed), Maximal Aerobic Speed, and the estimated VO_2max were lower at T1 compared to T0 (p < 0.0001). Executive functioning was found to be greater at T0 compared to T1 (p < 0.0001). Explicit liking or wanting for sedentary or physical activities did not change between T0 and T1. Both overall physical fitness and cognitive performance drastically declined among primary school French children with the COVID-19-related public health restrictions, which reinforces the need to urgently develop preventive strategies in anticipation of further mitigation measures.

Binge Watching during COVID-19: Associations with Stress and Body Weight

Binge watching is becoming increasingly common and may impact energy balance and body weight. The COVID-19 pandemic has created conditions conducive to binge watching and increased stress. We investigated relationships between COVID-related stress and binge watching behaviors, and potential variation in this relationship by body weight. Adults (n = 466) completed a cross-sectional online survey assessing binge watching behaviors during and before the pandemic, COVID-related stress, and body weight. Participants reported an increase in binge watching frequency from before to during the pandemic (F1,401 = 99.970, p < 0.001), with rates of high binge watching ("3-4 times per week" to "3 or more times per day") increasing from 14.6% to 33.0%. Binge watching episode duration increased from 3.26 ± 1.89 h to 3.92 ± 2.08 h (p < 0.001). The increase in binge watching frequency was greatest in individuals with obesity and high stress (F 4,401 = 4.098, p = 0.003). Participants reporting high stress reported higher frequency of eating while binge watching, as well as higher levels of negative emotional triggers, consequences to binge watching, and lack of control over binge watching (all p < 0.001). Our results show that binge watching increased during the pandemic, with greater increases among individuals reporting higher COVID-related stress, especially those with obesity, and concomitant effects on eating, and highlight a need for interventions to minimize the obesogenic impact of binge watching during the pandemic.

Exercise behavior patterns and associations with subjective well-being during the COVID-19 pandemic: A cross-sectional study in Brazil

Introduction

The COVID-19 pandemic has affected the behavior and practice of planned and structured physical exercises. This study aimed to investigate the association between changes in physical exercise behavior and subjective well-being during the COVID-19 pandemic in Brazil.

Methods

This cross-sectional study was performed in Brazil and included a total of 595 individuals recruited through social media platforms, personal and professional contacts. Each participant responded to self-completed questionnaire via an online survey between March 29 and May 7, 2020. The characteristics of physical exercise (frequency, intensity, and duration) were collected before and during the pandemic. The subjective state of mood was measured through the Profile of Mood States (POMS) questionnaire during the pandemic. A generalized linear model was employed for the analysis.

Results

Exercising during the pandemic only promoted protective effects on the subjective mood. An exercise frequency of 3-5 days/week was associated with improved vigor and between 6-7 days/week with improved vigor and total mood when compared to not exercising at all (p < .005). A moderate intensity was associated with improved vigor, and a high intensity with improved vigor, total mood, and less fatigue in comparison to low-intensity exercise programs (p < 0.05). Maintaining the same duration of exercise sessions during the pandemic was associated with lower scores of depression/anxiety, fatigue and irritability, and improved vigor and total mood, while performing longer sessions with improved vigor when compared to short exercise sessions (p < .005).

Conclusion

Regular exercising during the pandemic promotes positive changes in the subjective well-being. Our results reinforce the need for adopting and maintaining a physical exercise routine during the COVID-19 pandemic as a protective effect on mental health.

Sleep as a Priority: 24-Hour Movement Guidelines and Mental Health of Chinese College Students during the COVID-19 Pandemic

Research on the combined role of 24-hour movement behaviors (sleep, sedentary behavior [SB], and physical activity) in adult mental health, though important, is in its infancy. In the context of Canadian 24-hour movement guidelines integrating quantitative recommendations for sleep, SB, and moderate-to-vigorous physical activity (MVPA), this study aimed to examine the associations between meeting guidelines and mental health among college students. The study used a cross-sectional sample of 1846 Chinese college students surveyed online in August 2020. Through network analysis and multivariate analysis of covariance, the individual and combined associations between meeting 24-hour movement guidelines and the levels of depression and anxiety after adjusting sociodemographic factors were analyzed. Results indicated that meeting the sleep guideline had stronger associations with depression and anxiety than meeting the SB or MVPA guideline. Specifically, compared to meeting no guidelines, meeting the sleep guideline (alone or in combination with other guidelines) was associated with significantly lower levels of depression and anxiety; meeting both SB and MVPA guidelines was also associated with a significantly lower level of depression. Hence, meeting more guidelines, especially adhering to a healthy sleep routine, may play an important role in promoting the mental health of young adults.

Mental health problems among Chinese adolescents during the COVID-19: The importance of nutrition and physical activity

Mental health problems are common among adolescents and greatly influenced by stressful events. This study sought to assess the prevalence and correlates of insomnia, depressive and anxiety symptoms among Chinese adolescents during the COVID-19.

METHOD

Cross-sectional study (N = 1,794 adolescents, mean age = 15.26) was conducted in May 2020. An online survey was used to collect socio-demographic data, COVID-related fear (COVID-fear), nutrition, physical activity (PA) level and the symptoms of insomnia, depression and anxiety.

RESULTS

The prevalence of insomnia, depressive and anxiety symptoms was 37.80%, 48.20% and 36.70%, respectively, among Chinese adolescents during the pandemic. Generalized linear models revealed that female, left behind children, and students with greater COVID-fear tended to report symptoms of insomnia, depression and anxiety concurrently. After adjusting for socio-demographic factors and COVID-fear, better nutritional status and moderately active PA were both associated with lower levels of depressive and anxiety symptoms, while highly active PA was associated with lower levels of insomnia, depressive and anxiety symptoms.

CONCLUSIONS

These findings suggest that more attention should be paid to psychological health among adolescents while combating COVID-19. To promote adolescents' mental health, educators should help adolescents develop a healthy lifestyle with balanced diet and regular exercise.

THE EFFECT OF PHYSICAL FITNESS TO CHANGE HUMAN HEALTH AND IMPROVE THE QUALITY OF LIFE

ABSTRACT Introduction People need to strengthen their bodies through leisure sports to prevent diseases. Physical fitness exercise is conducive to maintaining a good physical and mental state and establishing a good interpersonal relationship. Exercise can keep people happy. Object According to the actual needs of people’s physical fitness exercises, this article uses the correlation analysis method to carry out an empirical analysis on the effect of physical fitness exercises on the quality of life. Method The paper puts forward a model based on indicators combined with correlation analysis by constructing a hypothetical model of the effect of physical fitness exercise. We analyzed the reasons and influencing factors of people participating in physical fitness exercises. Results The influencing indicators of people’s participation in sports to improve the quality of life are gender, age, and disposable income. Conclusion People playing sports can enhance the quality and quality of life. Level of evidence II; Therapeutic studies - investigation of treatment results.

The impact of sitting time and physical activity on mental health during COVID-19 lockdown

Objective

The primary aim of this study was to investigate the association between physical activity (PA) and sitting time on adults’ mental health (i.e., depression, anxiety and wellbeing) and the influence of mediators and confounders.

Methods

An online survey was disseminated in the UK between May and June 2020. A total of 284 participants (33.5 ± 12.4 years) self-reported their PA, sitting time and mental health through validated questionnaires.

Results

Multiple stepwise regression analysis revealed that being of younger age, female, on a lower income, with one or more comorbid health conditions, with a previous diagnosis of mood disorder and increased sitting time independently correlated with higher depression scores (F (13,219) = 12.31, p < 0.001), and explained 42% of the variance. Similar results were found for wellbeing where socio-demographic, health outcomes and sitting time influenced the subjective wellbeing (F (14,218) = 5.77, p < 0.001, 27% variance), although only socio-demographic and health outcomes contributed to the variation in anxiety score (F (13,219) = 7.84, p < 0.001, 32% variance). PA did not explain variation when sitting time was taken into account in any of the models. Combined analysis revealed that participants with lower sedentary time (< 8 h) and with both low or moderate and high PA presented a significantly lower depression score [low PA: (B = −2.7, 95% CI −4.88, −0.52); moderate and high PA (B = −2.7, −4.88, −0.52)].

Conclusion

Sitting time was strongly associated with adverse mental health during COVID-19 lockdown and should be considered in future public health recommendations.

Associations of Sociodemographic Factors and Health Behaviors with the Emotional Well-Being of Adolescents during the COVID-19 Pandemic in Brazil

This cross-sectional study utilizes data from a nationwide web-based survey aimed to identify the factors affecting the emotional well-being of Brazilian adolescents aged 12–17 during the period of school closures and confinement. Data collection took place from 27 June to 17 September 2020. We used the “virtual snowball” sampling method, and students from private and public schools were included. A total of 9470 adolescents were analyzed. A hierarchical logistic regression model was used to find the factors associated with reporting at least two of three self-reported problems—sadness, irritability, and sleep problems. The main proximal factor was loneliness (AdjOR = 8.12 p < 0.001). Problems related to school closures also played an important role. Regular intake of fruits and vegetables, as well as physical activity, demonstrated a positive influence on emotional well-being, while excessive screen time (AdjOR = 2.05, p < 0.001) and alcohol consumption negatively affected outcomes (AdjOR = 1.73, p < 0.001). As for distal variables, less affluent adolescents were the most affected, and males reported fewer emotional problems than females. Uncertainty regarding the disease in a context of socioeconomic vulnerability, together with rises in unhealthy behaviors and isolation from their immediate social circles, have negatively affected adolescents’ emotional status throughout the COVID-19 pandemic.

Eating habits, lifestyle behaviors and stress during the COVID-19 pandemic quarantine among Peruvian adults

BACKGROUND AND AIMS

The coronavirus disease 2019 (COVID-19) outbreak has led to an unprecedented public health crisis. In Peru, although the quarantine is no longer mandatory, it was during the first months of 2020. To date, no studies have assessed the impact of the COVID-19 on the eating patterns and lifestyle context in the country. We aimed to describe the eating habits, lifestyle behaviors and stress during the COVID-19 pandemic quarantine among Peruvian adults.

METHODS

We conducted a cross-sectional study. We used an online survey to collect information regarding eating habits, self-perceived stress and sedentary lifestyle among adults over 18 years of age residing in Lima-Peru and who complied with strict home quarantine. We presented our data according to the weight variation of the participants.

RESULTS

A total of 686 were finally included in the study. The 82.9% were female, the median BMI was 25.97 kg/m2 (IQR: 23.37-29.41) and 68.2% reported a significant variation in their weight (38.9% increased and 29.3% lost weight). All bad habits were significantly associated with weight gain, except for prolonged fasting. Additionally, a sitting time longer than usual (p = 0.001), being in front of a screen for more than five hours in the last week (p = 0.002), and most of the stressful scenarios were significantly associated with weight gain.

CONCLUSION

Almost four out of ten participants gained weight during the quarantine. This was associated with unhealthy eating habits, physical inactivity, and stressful scenarios.

Impact of the COVID-19 Pandemic on Older Adults: Rapid Review

BACKGROUND

The COVID-19 pandemic has drastically changed the lives of countless members of the general population. Older adults are known to experience loneliness, age discrimination, and excessive worry. It is therefore reasonable to anticipate that they would experience greater negative outcomes related to the COVID-19 pandemic given their increased isolation and risk for complications than younger adults.

OBJECTIVE

This study aims to synthesize the existing research on the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults. The secondary objective is to investigate the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults with Alzheimer disease and related dementias.

METHODS

A rapid review of the published literature was conducted on October 6, 2020, through a search of 6 online databases to synthesize results from published original studies regarding the impact of the COVID-19 pandemic on older adults. The Human Development Model conceptual framework-Disability Creation Process was used to describe and understand interactions between personal factors, environmental factors, and life habits. Methods and results are reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement.

RESULTS

A total of 135 records were included from the initial search strategy of 13,452 individual studies. Of these, 113 (83.7%) studies were determined to be of level 4 according to the levels of evidence classification by the Centre for Evidence-Based Medicine. The presence of psychological symptoms, exacerbation of ageism, and physical deterioration of aged populations were reported in the included studies. Decreased social life and fewer in-person social interactions reported during the COVID-19 pandemic were occasionally associated with reduced quality of life and increased depression. Difficulties accessing services, sleep disturbances, and a reduction of physical activity were also noted.

CONCLUSIONS

Our results highlight the need for adequate isolation and protective measures. Older adults represent a heterogeneous group, which could explain the contradictory results found in the literature. Individual, organizational, and institutional strategies should be established to ensure that older adults are able to maintain social contacts, preserve family ties, and maintain the ability to give or receive help during the current pandemic. Future studies should focus on specific consequences and needs of more at-risk older adults to ensure their inclusion, both in public health recommendations and considerations made by policy makers.

Physical Activity and Sedentary Behavior of Elderly Populations during Confinement: Results from the FRENCH COVID-19 ONAPS Survey

Introduction: A national confinement was imposed in France in March 2020 during 55 days to prevent the spread of the virus and protect vulnerable people such as older individuals. This study aimed to describe the movement behaviors, and their determinants, of elderly people (≥ 65 years) during the confinement.Methods: An online survey was conducted from April 1^st, 2020 to May 6^th, 2020 by the National Observatory for Physical Activity and Sedentary behaviors. This study compared the level of physical activity (PA), sitting and screen time before and during the confinement and identified the impact of initial PA, sedentary profiles of the participants and housing conditions.Results: 1,178 people were included in this study. Reaching PA recommendations before lock-down was associated with the change in PA level during lock-down (p < .001). Besides, geographic location was associated with the change in PA, sitting time and screen time during lock-down (respectively p = .03, p = .02, p = .02).Conclusion: This study confirm the negative impact of confinement on senior movement behaviors, whether or not they met with public health recommendations prior to the pandemic. The housing conditions of older people must be also taken into future public health policies.

Possible favorable lifestyle changes owing to the coronavirus disease 2019 (COVID-19) pandemic among middle-aged Japanese women: An ancillary survey of the TRF-Japan study using the original "Taberhythm" smartphone app

Coronavirus disease 2019 (COVID-19) has had a global effect on people’s lifestyles. Many people have become physically inactive and developed irregular eating patterns, which leads to unhealthier lifestyles and aggravation of lifestyle-related diseases; these in turn increase the severity of COVID-19. Prior to the COVID-19 pandemic, we developed a smartphone application called “Taberhythm” to investigate eating patterns, physical activity, and subjective feelings of happiness. We aimed to compare lifestyle data before and during the first phase of the COVID-19 pandemic to objectively assess lifestyle changes during quarantine. A total of 464 smartphone users (346 women, 35 ± 12 years old, body mass index [BMI] 23.4 ± 4.5) participated in Period A (January 7 to April 28, 2019) and 622 smartphone users (533 women, 32 ± 11 years old, BMI 23.3 ± 4.0) participated in Period B (January 6 to April 26, 2020). Compared with Period A, there was a sharp decline in physical activity during Period B (4642 ± 3513 vs. 3814 ± 3529 steps/day, p<0.001), especially during the final 9 weeks in both periods (4907 ± 3908 vs. 3528 ± 3397 steps/day, p<0.001); however, there were large variations in physical activity among participants. We found a surprising trend during Period B toward increased happiness among women aged 30–50 years, the group most affected by stay-at-home policies that led to working from home and school closure. Moreover, daily eating duration declined in this population. Additionally, there was a positive association of happiness with steps per day in Period B (ρ = 0.38, p = 0.02). Despite the many negative effects of the COVID-19 pandemic, subjective feelings of happiness among middle-aged Japanese women tended to increase, which indicates that some favorable lifestyle changes that could be adopted during quarantine in the ongoing COVID-19 pandemic.

Effect of the COVID-19 lockdown on physical activity and sedentary behaviors in French children and adolescents: New results from the ONAPS national survey

Introduction

In France March 14, 2020 a national lockdown was imposed in France for 55 days to prevent the spread of COVID-19 and all schools were closed. This study aimed to investigate the effects of home confinement as a result of  lockdown on the activity (physical activity and sedentary behaviors), and their determinants, on French children (6-10 years) and adolescents (11-17 years).

Methods

The National Observatory for Physical Activity and Sedentary behaviors launched an online survey from April 1^st, to May 6^th, 2020 using popular social networks and websites. It compared the level of physical activity (PA), sitting and screen time before and during the lockdown and identified the impact of the initial PA (active vs. inactive), sedentary (high vs. low) profiles of the participants and their housing conditions.

Results

6,491 children were included in this study. Initially active children and adolescents decreased their PA more than those initially inactive (p>0.001), while those who met the sitting time recommendations increased more their sitting time during lockdown (p<0.001). The same applied to screen time (p<0.001). Living in an urban environment was associated with a decrease in PA (p<0.001), an increase in sitting time (p<0.001) and children's screen time (p=0.002) during lockdown.

Conclusion

This study showed the deleterious effects of confinement caused by lockdown on physical activity and sedentary behaviors. Housing conditions were associated with lifestyle behaviors over this period of lockdown. Future public health policies should consider these results.

Physical inactivity and elevated TV-viewing reported changes during the COVID-19 pandemic are associated with mental health: A survey with 43,995 Brazilian adults

OBJECTIVE

To analyze the associations of physical activity and TV-viewing reported changes during the COVID-19 pandemic quarantine with mental health among Brazilian adults with and without depression.

METHODS

Data of 43,995 Brazilian adults from a cross-sectional, nationwide behavior research were used. Participants reported the frequency on loneliness, sadness (feel sad, crestfallen or depressed) and anxiety (feel worried, anxious or nervous) feelings during the pandemic period. Frequency and duration of physical activity as well as duration of TV-viewing before and during the pandemic period were also reported. We created four categories of reported changes in physical activity (1-consistently active, 2-become active, 3-become inactive or 4-consistently inactive) and TV-viewing (1-consistently high, 2-become low, 3-become high or 4-consistently high). Participants also reported previous diagnoses of depression [yes (PD) or no (nPD). Logistic regression models separating people with and without depression were created.

RESULTS

Compared to consistently active participants, to become inactive during the pandemic was associated with a higher odds for loneliness [nPD:OR:1.32 (95%CI,1.02-1.70); PD:2.22 (1.21-4.06)], sadness [nPD:1.34 (1.01-1.77); PD:2.88 (1.54-5.36)], and anxiety [nPD:1.71 (1.30-2.25); PD:2.55 (1.20-5.42)]. Also, people with depression and consistently physically inactive presented higher odds for loneliness and sadness. Compared to consistently low TV-viewing, participants that become with high TV-viewing showed higher odds for loneliness [nPD:1.59 (1.37-1.86)], sadness [nPD:1.68 (1.44-1.96); PD:1.61 (1.21 to 2.15)] and anxiety [nPD:1.73 (1.48-2.02); PD:1.58 (1.12-2.23)].

CONCLUSIONS

Reported increases in physical inactivity and TV-viewing during the COVID-19 pandemic were associated with poorer mental health indicators. People with depression and consistently physically inactivity were more likely to present loneliness and sadness.

Moving More and Sitting Less as Healthy Lifestyle Behaviors are Protective Factors for Insomnia, Depression, and Anxiety Among Adolescents During the COVID-19 Pandemic

PURPOSE

This study aimed to investigate associations of physical activity time (PAT) and sitting time (ST) independently and jointly with insomnia, depressive and anxiety symptoms among Chinese adolescents in the context of COVID-19.

METHODS

A cross-sectional study including 965 adolescents (mean age = 15.26, SD = 0.46) was conducted in May 2020. PAT, ST and the symptoms of insomnia, depression and anxiety were assessed with the International Physical Activity Questionnaire Short Form, the Youth Self-Rating Insomnia Scales, the 9-item Patient Health Questionnaire and the Generalized Anxiety Disorder scale via an online survey platform. Logistic regression was used to analyze the association between COVID-19-related fear, PAT, ST and combinations of PAT and ST with insomnia, depressive and anxiety symptoms.

RESULTS

COVID-19-related fear was associated with higher odds of insomnia, depressive and anxiety symptoms. PAT was associated with lower odds of insomnia and depressive symptoms, while ST was associated with higher odds of these three symptoms. After combining PAT and ST, the group with both low PAT and high ST was set as the referent. For insomnia, groups with low ST reported significantly lower odds of symptoms. For depression, groups with high PAT and/or low ST reported lower odds of symptoms. Regarding anxiety, only the group with both high PAT and low ST reported lower odds of symptoms. Generally, group with both high PAT and low ST reported lower odds of the three symptoms than the referent.

CONCLUSION

COVID-19-related fear was a risk factor for developing insomnia, depressive and anxiety symptoms among Chinese adolescents. Fortunately, moving more and sitting less were good for sleep and mental health in Chinese adolescents during the pandemic. Educators should help adolescents to be more physically active in their daily life in the primary prevention of adolescent insomnia, depression and anxiety.