COVID-19 lockdown consequences on body mass index and perceived fragility related to physical activity: A worldwide cohort study

Effects of the COVID-19 associated United Kingdom lockdown on physical activity in older adults at high risk of cardiovascular disease: a mixed methods perspective from the MedEx-UK multicenter trial

Introduction

Physical inactivity and sedentary behaviour are linked to increased risk of cardiovascular disease, infections and dementia, as well as placing a significant economic burden on healthcare systems. The implementation of COVID-19 pandemic lockdown measures aimed at reducing virus transmission posed challenges to the opportunity to be physically active. This study investigates how the first UK COVID-19 lockdown affected objectively measured physical activity in older adults at higher risk of cardiovascular disease.

Methods

We studied 48 individuals aged 55-74 years (81.3% female) with self-reported PA levels < 90 min/week and a QRISK2 score ≥ 10 (indicative of a ≥ 10% risk of a major cardiovascular event in the next 10 years) without mild cognitive impairment or dementia. Physical activity data was collected using objective wrist-based activity monitors and analysed across three time periods, usual activity (pre-pandemic), the precautionary phase when the UK began advising on limiting social contact and finally during the first UK lockdown period was collected (27 January 2020 and 07 June 2020). Data was analysed using linear mixed effects model was used to investigate PA levels over the measured 12-week period. Effects of BMI, age, deprivation score and baseline PA levels on PA across the three measurement periods were also examined. Focus-group and individual interviews were conducted, and data were thematically analysed.

Results

Average daily step count (-34% lower, p < 0.001) and active energy expenditure (-26% lower, p < 0.001) were significantly lower during the precautionary period compared with the usual activity period. Physical activity remained low during the UK lockdown period. Participants with a lower BMI engaged in significantly more (+45% higher daily steps p < 0.001) physical activity and those over 70 years old were more physically active than those under 70 years across the 12-week period (+23% higher daily steps p < 0.007). The risk of COVID-19 infection and restrictions because of lockdown measures meant some individuals had to find alternative methods to staying physical active. Participants described a lack of access to facilities and concerns over health related to COVID-19 as barriers to engaging in physical activity during lockdown. For some, this resulted in a shift towards less structured activities such as gardening or going for a walk.

Discussion

The data presented shows that lockdown measures during the COVID-19 pandemic significantly reduced physical activity among older individuals at risk of cardiovascular disease, particularly those with a higher body mass index. To support this population group in staying active during future lockdowns, a multifaceted strategy is needed, emphasizing psychosocial benefits and home-based physical activity. The MedEx-UK study was pre-registered with ClinicalTrials.gov (NCT03673722).

Effect of COVID-19 pandemic on lifestyle and bone mineral density in young adults

OBJECTIVES

This study investigates the relationships between the COVID-19 pandemic, lifestyle factors, and their impact on bone mineral density in the radius forearm bone and the total bone mineral content in young adults from Slovakia.

METHODS

We assessed 773 Slovak young adults aged 18 to 30 years, divided into subgroups on their pandemic status. Bone mineral density (BMD) was analyzed by the QUS device (Sunlight MiniOmni™), and bone mineral content (BMC) and fat mass (FM) were measured by InBody 770 bioimpedance analyzer. Finally, linear regression analysis tested the associations.

RESULTS

Statistically significant lower speed of sound (SOS) along the length of the forearm radius bone and Z-score values was determined in participants during the COVID-19 pandemic than before it, and statistically significant lower BMC values were observed in the male group during COVID-19 than beforehand. Regression analysis confirmed the negative pandemic effect in the following indices: SOS (p < .001 for women and p = .035 for men), Z-score (p < .001 for women and p = .003 for men), and BMC (p = .024 for men). Vitamin D was a further significant SOS predictor in women at p = .029, but this association was not detected in men. In contrast, the significant male BMC predictors were pandemic presence (p = .028), physical activity (p = .028), and fat mass percentage (p = .001).

CONCLUSIONS

Significant COVID-19 pandemic effects on bone tissue were determined on bone mass density in the radius forearm bone and the total bone mineral content. These effects establish that the pandemic had a negative impact on both their bone quality and health.

Quality assessment and community detection methods for anonymized mobility data in the Italian Covid context

We discuss how to assess the reliability of partial, anonymized mobility data and compare two different methods to identify spatial communities based on movements: Greedy Modularity Clustering (GMC) and the novel Critical Variable Selection (CVS). These capture different aspects of mobility: direct population fluxes (GMC) and the probability for individuals to move between two nodes (CVS). As a test case, we consider movements of Italians before and during the SARS-Cov2 pandemic, using Facebook users' data and publicly available information from the Italian National Institute of Statistics (Istat) to construct daily mobility networks at the interprovincial level. Using the Perron-Frobenius (PF) theorem, we show how the mean stochastic network has a stationary population density state comparable with data from Istat, and how this ceases to be the case if even a moderate amount of pruning is applied to the network. We then identify the first two national lockdowns through temporal clustering of the mobility networks, define two representative graphs for the lockdown and non-lockdown conditions and perform optimal spatial community identification on both graphs using the GMC and CVS approaches. Despite the fundamental differences in the methods, the variation of information (VI) between them assesses that they return similar partitions of the Italian provincial networks in both situations. The information provided can be used to inform policy, for example, to define an optimal scale for lockdown measures. Our approach is general and can be applied to other countries or geographical scales.

Alshahrani A, Prabahar K, Veeramani VP, Amirthalingam P, F. Alqifari S, Mani V, Viswanath Reddy LK. An evaluation of knee osteoarthritis pain in the general community-Asir region, Saudi Arabia

BACKGROUND

Knee osteoarthritis (KOA) is one of the most common conditions resulting in disability, particularly in the elderly population. Osteoarthritis (OA) is the most common articular disease and the leading cause of chronic disability in the developed world.

OBJECTIVE

This study was carried out to evaluate knee pain in the Asir region of Saudi Arabia. An analytical cross-sectional survey design was adopted in the Asir region from April 2023 to August 2023 to assess the knee pain of the adult population using an anonymous online questionnaire.

RESULTS

Of 1234, 332 were men (26.90) and 902 were women (73.09). WOMAC index score category 55.34% (n = 683) of the subjects had a low risk (score <60), 28.68% (n = 354) had a moderate risk (score 60-80), and 15.96% (n = 197) had a high risk (score ≥81) for KOA. According to clinical criteria, 79.33% (n = 979) of the study subjects had OA. Age group, gender 2.17 (1. 67-2.82) [OR 2.17; 95% CI 1.67-2.82), family history of OA [OR 0.47; 95% CI 0.37-0.62], diabetes [OR 2.78; 95% CI 2.17-3.56], hypertension [OR 0.35; 95% CI 0.26-0.45] were significantly associated with the percentage of the WOMAC index score using the Chi-square test analysis (P<0.05). Therefore, the WOMAC index showed higher diagnostic precision with a statistically significant association [OR 9.31 CI 6.90-12.81] with a P< 0.0001.

CONCLUSION

KOA is more common in older, obese people who have reached the age of 50 in the Asir region, and it is more prevalent in women. Alarms the need for appropriate awareness programs for better disease prevention and health outcomes for the benefit of the community through general public health programs.

Effect of community-based group exercises combined with action observation on physical and cognitive performance in older adults during the Covid-19 pandemic: A randomized controlled trial

OBJECTIVE

This study investigates the impact of community-based exercises with action observation therapy (AOT) on the physical and cognitive performance of older adults experiencing social isolation during the COVID-19 pandemic.

METHODS

One hundred participants aged 65-80 years were randomly divided into two groups: the AOT group, which engaged in balance, strengthening, and mobility exercises guided by 15-minute action observation videos before a 45-minute exercise session, and the control group, which performed the same exercises without action observation. Both groups underwent three sessions per week for eight weeks (24 sessions in total). The assessment tools used in this study included the following: For evaluating mobility and fall risk in older adults, the Timed Up-and-Go (TUG) Test was employed. To assess functional strength of lower extremities, balance, and fall risk, the Five Times Sit-to-Stand (5XSST) Test was administered. Balance and gait were measured using the Tinetti Balance and Gait Assessment (TBGA), utilizing the Tinetti Scale. Individuals' confidence in performing daily activities without falling or losing balance was assessed using the Activities-Specific Balance Confidence Scale (ABC). Furthermore, cognitive functions across multiple domains, including attention-concentration, executive function, memory, language, visual construction skills, abstract thinking, calculation, and orientation, were evaluated using the Montreal Cognitive Assessment (MoCA) Tests.

RESULTS

Results revealed significant improvements in both groups. Group I, which received Action Observation Therapy (AOT) in addition to exercise, demonstrated superior outcomes in the 5XSit-to-Stand test (Δ = -1.92, p < 0.0001, Cohen's d = 0.77), Tinetti Balance and Gait Scale (Balance: Δ = 2.77, p < 0.0001, Cohen's d = 0.91), and Timed Up and Go test (Δ = -1.98, p < 0.0005, Cohen's d = 0.83). On the other hand, Group II, which received exercise only, exhibited substantial gains in the Tinetti Balance and Gait Scale (Walking: Δ = 0.52, p < 0.01, Cohen's d = 0.27) and Activity-Specific Balance Confidence Scale (Δ = 5.77, p < 0.0001, Cohen's d = 0.26).

CONCLUSION

These findings underscore the effectiveness of AOT-enhanced community-based exercises in enhancing both physical and cognitive performance among older adults facing social isolation during the pandemic, with Group I (AOT + exercise) showing particularly promising results.

TRIAL REGISTRATION

This study was registered with ClinicalTrials.gov Identifier: NCT04759690, ClinicalTrials Protocol ID: p3957ghb.

Preoperative multimodal prehabilitation before elective colorectal cancer surgery in patients with WHO performance status I or II: randomized clinical trial

BACKGROUND

Multimodal prehabilitation is a promising adjunct to the current surgical treatment pathway for colorectal cancer patients to further improve postoperative outcomes, especially for high-risk patients with low functional capacity. The aim of the present study was to test the effect of prehabilitation on immediate postoperative recovery.

METHOD

The study was designed as a RCT with two arms (intervention and control). The intervention consisted of 4 weeks of multimodal prehabilitation, with supervised physical training, nutritional support and medical optimization. The control group received standard of care. A total of 40 patients with colorectal cancer (WHO performance status I or II) undergoing elective surgery with curative intent were included. The primary outcome was postoperative recovery within the first 3 postoperative days, measured by Quality of Recovery-15, a validated questionnaire with a scoring range between 0 and 150 and a minimal clinically relevant difference of 8.

RESULTS

In total, 36 patients were analysed with 16 in the intervention group and 20 in the control group. The mean age of the included patients was 79 years. The overall treatment effect associated with the intervention was a 21.9 (95% c.i. 4.5-39.3) higher quality of recovery-15 score during the first 3 postoperative days compared to control, well above the minimal clinically relevant difference.

CONCLUSION

Four weeks of multimodal prehabilitation prior to elective curative intended colorectal cancer surgery in patients with WHO performance status I or II was associated with a clinically relevant improvement in postoperative recovery.Registration number: NCT04167436 (http://www.clinicaltrials.gov).

Lessons from COVID-19 pandemic: Analysis of unequal access to food stores using the Gini coefficient

COVID-19 has dramatically altered daily life worldwide, with some urban residents resorting to panic buying at the beginning of the pandemic. Large-scale lockdowns and restaurant closures have increased the need for grocery shopping. Such shifts in consumer patterns have altered supply-demand systems. Insufficient food store availability increases the likelihood of crowding and thus increases the probability of viral infection. People who live without easy access to food stores also face high infection risks when forced to travel long distances for grocery shopping. The COVID-19 pandemic has demonstrated the importance of the number and distribution of food stores to virus transmission. Food access is also a core factor of urban resilience during the pandemic. This study used the Gini coefficient to investigate the fairness of accessibility to food stores at the city and village levels, with Taipei City chosen as the research area. Different spatial scales were considered, and we calculated the equality of food access for older (≥65 years old) and non-older populations separately to determine whether one group faces greater inequality. At the city level, both older and non-older populations in Taipei have reasonable access (Gini coefficient between 0.3 and 0.4), with mean Gini coefficients of 0.3616 and 0.3655, respectively. This city-level analysis represents the overall degree of unequal access to food stores. At the village level, eight villages (1.8 %; total N = 456) had severe access inequality (Gini coefficient > 0.6) for older adults; they are located primarily in downtown or suburban areas. For the non-older population, only two villages (0.4 %; total N = 456) in suburban areas exhibit severe access inequality. The village-level analysis identified villages with low equality of access to food stores and revealed local problems that cannot be observed at the city level.

Variation in leisure sport conflicts and coping strategies depending on participation type and proximity during the COVID-19 pandemic

Introduction

New conflict types have arisen in leisure sports activities due to social regulations designed to address COVID-19. We analyze the differences in conflict-inducing factors and coping strategies across various types of leisure sports and levels of spatial proximity.

Methods

Korean adults aged between 20 and 60 years, who had participated in leisure sports activities since the COVID-19 outbreak in January 2020, were surveyed, and 508 responses were collected for analysis. The differences in leisure sports conflicts and coping strategies across the types of leisure sports participation and spatial proximity were tested.

Results

The results show that conflict due to prejudice was higher in typical indoor sports activities, such as Pilates, yoga, and gym workouts, whereas conflict due to competition or not observing etiquette was higher in indoor golf. Second, conflict due to prior expectations and prejudice was high in outdoor sports activities, such as jogging and hiking. Finally, all participants showed avoidance behavior, but it was observed more frequently in outdoor sports than indoor sports.

Discussion

The study reveals how much leisure conflict is induced by various types of leisure sports participation, particularly during outdoor activities, which usually feature a relatively low density of participants. It underscores the necessity of developing structural approaches to resolving leisure conflicts in dangerous spaces or requiring intensive management and creating new leisure sports activities.

Impact of COVID-19 pandemic on obesity among adults in Jordan

COVID-19 is a severe acute respiratory syndrome that mainly affects the human respiratory system. Unhealthy nutritional habits and obesity are expected as consequences of protective measures including quarantine. Obesity, in its growing prevalence, is a worldwide health issue associated with worsening health conditions. This is a cross-sectional study to assess the impact of the COVID-19 pandemic on obesity among Jordanian adults and across epidemiological statuses. Participants were randomly selected, and the survey was distributed on social media networking sites. A total of 672 subjects were surveyed and participated in the study between March and June 2021 via Google Form questionnaire. The results indicated that 74.4% of participants reported that they did not do any physical activity, and 43.5% changed their lifestyle and eating habits for the worse. During the COVID-19 pandemic, almost half of the participants reported an increase in hunger, consuming 3-4 meals/day, and consuming < 1 liter of water/day. Additionally, more than half of the participants reported no change in fat, cereals, and protein consumption, 46.4 % had no change in fruit and vegetable consumption, and 50.6% increased their consumption of sweets. Our results showed a significant increase in the self-reported BMI categories during the COVID-19 pandemic for all ages (p < 0.001). Change in weight and BMI was significantly associated with marital status, education level, living place, family size, family working members, and working status. Participants across all epidemiological statuses displayed a statistically significant increase in BMI. This study was conducted to observe the impacts of the COVID-19 pandemic on health behaviors and obesity among Jordanian adults and across epidemiological statuses. We found that there were significant negative changes in the lifestyle (physical activity) and eating behaviors of Jordanians during the COVID-19 quarantine which in turn increased their body weight and changed the obesity rate.

The Impact of COVID-19 on Physical Activity Among Adults in Saudi Arabia: A Cross-Sectional Study

Background

Physical inactivity has been identified as a major factor in developing and progressing chronic non-communicable diseases such as obesity. The Kingdom of Saudi Arabia ranks high worldwide in rates of obesity. During the coronavirus disease 2019 (COVID-19) pandemic, public health measures have been enforced. These included social distancing, masking, reduction of workplace daily hours, prevention of social gatherings, and home quarantine measures. These ultimately restricted the ability to perform regular physical health activities. The aim of this study is to understand the impact of COVID-19 on physical activity among adults in the Kingdom of Saudi Arabia.

Methodology

A cross-sectional study was conducted among the Saudi population. An online survey was sent through social media to gather data regarding individual physical activity before and after the start of the COVID-19 restrictions. The data were collected from March 20, 2021, until May 20, 2021, and analyzed using chi-square and paired t-test using the SAS software version 9.4.

Results

In total, 433 participants completed the survey. There were 183 (42.3%) males, and the majority of the participants were Saudi nationals (284, 65.6%). Most of the participants (181, 41.8%) were in the age group 25-35 years and 253 (58%) had bachelor’s degrees. Although the results did not show a statistically significant difference between pre- and post-COVID-19 respondents in terms of physical activity, married participants, participants from the eastern province, and participants who did not exercise regularly were all significantly impacted by lack of exercise compared to their counterparts (p < 0.05).

Conclusions

Taking measures to prevent the spread of COVID-19 is essential. Nonetheless, recommendations should be sought for physical activity during lockdowns, and large-scale research should be conducted to better understand what causes the exaggeration of sedentary lifestyles during lockdowns and how to prevent them. Further studies need to be conducted, and national guidelines should be made available in case of a future lockdown.

Impact of Prolonged COVID-19 Lockdown on Body Mass Index, Eating Habits, and Physical Activity of University Students in Bangladesh: A Web-Based Cross-Sectional Study

Objectives

This current study aims to assess the prevalence and factors associated with body mass index (BMI), dietary patterns, and the extent of physical activities among university students following the prolonged coronavirus disease 2019 (COVID-19) lockdown in Bangladesh.

Methods

A cross-sectional web-based survey was conducted between July 10 to August 10, 2021, through a pre-designed Google Form to collect the data from Bangladeshi university students (age: ≥18 years). Informed consent was electronically obtained from each participant, and a simple snowball technique was employed during the sampling. Frequency and percentage distribution, paired t-test, chi-square [χ2] test, and multinomial and binary logistic regression analyses were consecutively applied to analyze the collected data.

Results

Among the total participants (n = 1,602), 45.1% were female and 55.6% were 22-25 years' age group students. The BMI (mean ± standard deviation, SD) during the COVID-19 lockdown was 23.52 ± 7.68 kg/m2, which was 22.77 ± 4.11 kg/m2 during the pre-lockdown period (mean difference = 0.753; p < 0.001). The multinomial logistic regression analysis found a significant impact of gender [male vs. female: adjusted relative risk ratio (RRR) = 1.448; 95% confidence interval (CI) = 1.022, 2.053; p = 0.037], age (years) (<22 vs. >25: RRR =0.389, 95% CI = 0.213,0.710; p = 0.002, and 22-25 vs. >25: RRR = 0.473, 95% CI = 0.290, 0.772; p = 0.003), monthly family income (BDT) (<25,000 vs. >50,000: RRR = 0.525, 95% CI = 0.334,0.826; p = 0.005), university type (public vs. private: RRR = 0.540, 95% CI = 0.369, 0.791; p = 0.002), eating larger meals/snacks (increased vs. unchanged: RRR = 2.401, 95% CI = 1.597, 3.610; p < 0.001 and decreased vs. unchanged: RRR = 1.893, 95% CI = 1.218, 2.942; p = 0.005), and verbally or physically abuse (yes vs. no: RRR = 1.438, 95% CI = 0.977, 2.116; p = 0.066) on obesity during COVID-19 pandemic. Besides, the female students and those who have constant eating habits, were more likely to be underweight. Additionally, the binary logistic regression analysis found that the students from private universities [others vs. private: adjusted odds ratio (AOR) = 0.461, 95% CI = 0.313, 0.680; p < 0.001], urban areas (urban vs. rural: AOR = 1.451, 95% CI = 1.165, 1.806; p = 0.001), wealthier families (<25,000 BDT vs. >50,000 BDT: AOR = 0.727, 95% CI = 0.540, 0.979; p = 0.036), and who were taking larger meals/snacks (increased vs. unchanged: AOR = 2.806, 95% CI = 2.190, 3.596; p < 0.001) and had conflicts/arguments with others (no vs. yes: AOR = 0.524, 95% CI = 0.418, 0.657; p < 0.001), were significantly more physically inactive. Finally, the level of education and smoking habits significantly influenced the eating habits of university students during the extended strict lockdown in Bangladesh.

Conclusion

The current findings would be helpful tools and evidence for local and international public health experts and policymakers to reverse these worsening effects on students mediated by the prolonged lockdown. Several effective plans, programs, and combined attempts must be earnestly implemented to promote a smooth academic and daily life.

Impact of the COVID-19 pandemic on BMI: Its changes in relation to socio-demographic and physical activity patterns based on a short period

Background

The COVID-19 pandemic is undoubtedly a major threat to the world. The preventive strategies designed to minimize the virus transmission by remaining at home, being isolated, and keeping social distance, which would substantially reform people’s lifestyle, physical activity, eating habits, etc. Consequently, those measures might create a disturbance in weight management and overweight. Therefore, how the COVID-19 pandemic has changed the physical activities of individuals and its impacts on the Body Mass Index (BMI) is explored herein.

Methods

An online-based cross-sectional study collected data from 338 Bangladeshi adults in November 2020. The questionnaire included socio-demographics, health-related variables, physical activity-related variables, and diet measurement. Inferential statistics (i.e., chi-square test, McNemar test) were used to measure the associations between BMI and studied variables with a consideration of two scenarios (‘before’ and ‘during’ the pandemic inception), where p<0.05 was considered statistically significant.

Results

Results showed that the prevalence of overweight was 30.5% ‘before’ the COVID-19 pandemic, which increased to 34.9% ‘during’ the pandemic; that means 4.4% of the participants significantly gained weight after the pandemic inception. There was no significant role of socio-demographic (e.g., gender, age, current residence, occupation) or physical activity-related factors (e.g., unavailability of outdoor space, not performing regular physical exercise, exercising with a partner) in changing the BMI status after the pandemic inception. However, following a proper diet plan during the COVID-19 pandemic was observed to decrease BMI status significantly.

Conclusions

The present study suggests that a minor portion of the participants reported increasing their overweight status after the pandemic inception, whereas having a proper diet plan during the pandemic can significantly decrease BMI status. Therefore, the importance of the appropriate diet plan should be considered while implementing any policies.

Measuring the Physical Activity of Seniors before and during COVID-19 Restrictions in the Czech Republic

Social workers require a better understanding of the impact of pandemic measures on the level of physical activity of their clients to better target client activation. In this retrospective tracker-based study (two years of measurement), we examined changes in the physical activity of the elderly population (204 participants with an average age of 84.5 years) in the Czech Republic as a result of measures to prevent the spread of COVID-19. Physical activity was statistically compared according to the physical, demographic and social conditions of the participants. In addition to observing the expected activity decrease during the COVID-19 pandemic, we made several hypotheses based on the sex, age group, body mass index, type of housing (apartment or house) and size of the city of residence. We found that 33% of the 204 participants had increased levels of physical activity in the period following the COVID-19 pandemic outbreak in Central Europe. We found that the size of the city where the seniors lived and the type of housing did not affect the general level of physical activity. When comparing physical acquisition rates in each month of 2019 and 2020, we saw the largest declines in April and May 2020, that is, one month after the start of the lockdown.

Body mass index, eating habits, and various lifestyle changes in young adults during the two years of the coronavirus disease 2019 (COVID-19) pandemic

BACKGROUND

The aim of this study was to find out the perceived impact of 2 years of coronavirus disease 2019 (COVID-19) pandemic on various lifestyle behaviors (LSBs) and changes and their effect on body mass index (BMI) of young Saudi adults.

MATERIALS AND METHODS

This was a descriptive exploratory study conducted in January 2022 on 1724 students (aged 16-21 years) from multiple colleges of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. The main tools of the study were: BMI and an online 30-item LSB and changes structured questionnaire, which assessed LSB and perceived changes, 1 month immediately preceding and 2 years after the COVID-19 outbreak.

RESULTS

Our study results showed that 48% of the subjects gained weight after the pandemic. Screen time (ST) increased from 6.8 h before pandemic to 9.2 h/24 h after pandemic outbreak (P < 0.0001). However, no significant association was observed between excessive ST and increased BMI. A significant decrease in physical activity was seen after the outbreak (P < 0.001), which was positively but insignificantly associated with increased BMI (P = 0.3). A significant increase in the frequency of food intake was observed; 18.7% of the subjects reported taking ≥ 4 meals/day before the epidemic compared to 32.1% during the pandemic (P = 0.001). Decreased intake of homemade food, increased intake of junk food, and increased number of the meals/day were significantly related with increased BMI (P < 0.05). The strongest risk factor for increased BMI after the outbreak of the pandemic was ≥4 meals/day (OR=1.6; P = 0.048).

CONCLUSION

After 2 years of the pandemic, 48% of the young adults perceived they had gained weight, which was strongly associated with self-reported increase in the number of meals/day (≥4). These observations could aid the development of nutritional recommendations to maintain the health of young adults during and after the COVID-19 pandemic.

Burnout in French General Practitioners: A Nationwide Prospective Study

Background: We aimed to evaluate the prevalence of burnout among French general practitioners in private practice and to study the risk and protective factors of burnout. Methods: A nationwide cross-sectional study was conducted with French GPs working in a private practice in France who were asked to fulfil an internet questionnaire. We used the secure internet application REDCap^®. Exclusion criteria were only working in a hospital, substitute doctors, and internship students. There was a putative sample size of 88,886 GPs. We retrieved the Maslach Burnout Inventory (MBI), occupational characteristics (type of installation, emergency regulated shifts, night shifts, university supervisor, weekly hours worked, seniority), and personal characteristics such as age, gender, marital status, and number of children. Results: We included 1926 GPs among the 2602 retrieved questionnaires. A total of 44.8% of French liberal GPs were experiencing burnout, with 4.8% (95%CI 3.9–5.9%) experiencing severe burnout. The risk factors of severe burnout were male gender (RR = 1.91, 95%CI 1.15–3.16), working in a suburban area (5.23, 2.18–12.58), and having more than 28 appointments per day (1.95, 1.19–3.19). Working more than 50 h weekly showed a tendency to increase the risk of severe burnout (1.55, 0.93–2.59, p = 0.095), with a significant increase in the risk of low and moderate burnout (1.31, 1.02–1.67 and 1.86, 1.34–2.57, respectively). Protective factors were mainly resident training, which decreased the risk of both low, moderate, and severe burnout (0.65, 0.51–0.83; 0.66, 0.48–0.92; and 0.42, 95%CI 0.23–0.76, respectively). Performing home visits decreased the risk of severe burnout (0.25, 0.13–0.47), as did group practice for intermediate level of burnout (0.71, 0.51–0.96). Conclusion: GPs are at a high risk of burnout, with nearly half of them in burnout, with burnout predominantly affecting males and those between the ages of 50 and 60 years old. The main risk factors were a high workload with more than 28 appointments per day or 50 h of work per week, and the main protective factors were related to social cohesion such having a teaching role and working in a group practice with back-office support.

Effect of COVID-19 Pandemic-Induced Dietary and Lifestyle Changes and Their Associations with Perceived Health Status and Self-Reported Body Weight Changes in India: A Cross-Sectional Survey

Home confinement during the COVID-19 pandemic is accompanied by dramatic changes in lifestyle and dietary behaviors that can significantly influence health. We conducted an online cross-sectional survey to assess COVID-19 pandemic-induced dietary and lifestyle changes and their association with perceived health status and self-reported body weight changes among 1000 Indian adults in early 2021. Positive improvements in dietary habits, e.g., eating more nutritious (85% of participants) and home-cooked food (89%) and an increase in overall nutrition intake (79%), were observed. Sixty-five percent of participants self-reported increased oat consumption to support immunity. There were some negative changes, e.g., more binge eating (69%), eating more in between meals (67%), and increasing meal portion size (72%). Two-thirds of participants reported no change in lifestyles, whereas 21 and 23% reported an increase, and 13 and 10% reported a decrease in physical activity and sleep, respectively. Overall, 64 and 65% of participants reported an improvement in perceived health and an increase in body weight during the COVID-19 period compared to pre-COVID-19, respectively. The top motivations for improving dietary habits included improving physical and mental health and building immunity. In conclusion, the overall perceived health was improved and there was an increase in self-reported body weight in most participants during COVID-19. Diet emerged as the most crucial determinant for these changes.

Transnational and Transdisciplinary Lessons from the COVID-19 Pandemic

On 7 January 2020, China identified a virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [...]

COVID-19 lockdown consequences on body mass index and perceived fragility related to physical activity: A worldwide cohort study

Background

This paper is a follow‐up study continuing the COVISTRESS network previous research regarding health‐related determinants.

Objective

The aim was to identify the main consequences of COVID‐19 lockdown on Body MassIndex and Perceived Fragility, related to Physical Activity (PA), for different categories of populations, worldwide.

Design

The study design included an online survey, during the first wave of COVID‐19 lockdown, across different world regions.

Setting and participants

The research was carried out on 10 121 participants from 67 countries. The recruitment of participants was achieved using snowball sampling techniques via social networks, with no exclusion criteria other than social media access.

Main outcome measures

Body MassIndex, Physical Activity, Perceived Fragility and risk of getting infected items were analysed. SPSS software, v20, was used. Significance was set at P < .05.

Results

Body MassIndex significantly increased during lockdown. For youth and young adults (18‐35 years), PA decreased by 31.25%, for adults (36‐65 years) by 26.05% and for the elderly (over 65 years) by 30.27%. There was a high level of Perceived Fragility and risk of getting infected for female participants and the elderly. Correlations between BMI, Perceived Fragility and PA were identified.

Discussion and Conclusions

The research results extend and confirm evidence that the elderly are more likely to be at risk, by experiencing weight gain, physical inactivity and enhanced Perceived Fragility. As a consequence, populations need to counteract the constraints imposed by the lockdown by being physically active.

The impact of COVID-19 movement restrictions on physical activity in a low-income semi-rural population in Malaysia: A longitudinal study

BACKGROUND

The COVID-19 pandemic prompted movement restrictions in countries worldwide, impacting on physical activity (PA), a major non-communicable disease risk factor, and thus may have unintentional long-term health implications. In semi-rural areas of low-middle-income-countries (LMICs), where occupational activity is the main source of PA, changes in PA associated with COVID-19 restrictions are unknown. We investigated the impact of Movement Control Order (MCO) restrictions in a semi-rural region of Malaysia.

METHODS

The South East Asia Community Observatory (SEACO) is a dynamic prospective community cohort. We contacted a random sample of 1007 adults (18+) who had previously provided PA data in 2018. We asked about PA during the MCO (March-May 2020) and at the time of interview (June 2020).

RESULTS

During the MCO, PA reduced by a mean of 6.7 hours/week (95% confidence interval (CI) = 5.3, 8.0) compared to 2018, with the largest reductions among those in employment. By June, PA was 3.4 hours/week (95% CI = 2.0, 4.8) less than 2018, leaving 34% of adults currently inactive (20% in 2018). Reductions in occupational PA were not replaced with active travel or activity at home. Despite these observed reductions, most participants did not think the MCO had affected their PA.

CONCLUSIONS

Movement restrictions are associated with lower PA lasting beyond the period of strict restrictions; such longer-term reductions in PA may have a detrimental impact on health. Future MCOs should encourage people to be active, but may additionally need targeted messaging for those who don't necessarily realise they are at risk. In particular, policies developed in more affluent countries may not easily translate to LMICs.