COVID-19 and the Change in Lifestyle: Bodyweight, Time Allocation, and Food Choices

Gestational Weight Gain and Neonatal Biometry during the COVID-19 Pandemic: A Multicenter Observational Cohort

OBJECTIVE

 This study aimed to test the hypothesis that being pregnant and delivering during the coronavirus disease 2019 (COVID-19) pandemic was associated with changes in gestational weight gain (GWG) or frequency of small- (SGA) or large-for-gestational-age (LGA) neonates.

STUDY DESIGN

 Secondary analysis of a multicenter observational cohort comparing pregnant people who delivered during the COVID-19 pandemic (June-December 2020) to people who delivered prior to the pandemic (March-December 2019). Those with multiple gestations, fetuses with major congenital anomalies, implausible GWG values, unavailable body mass index (BMI), or who were severe acute respiratory syndrome coronavirus-2-positive were excluded. The primary outcome was frequency of optimal recommended GWG based on prepregnancy BMI. Neonatal outcomes included birth weight, ponderal index, and frequency of SGA, LGA, and small head circumference for live births. Multivariable regression analysis was used to assess associations between exposure to the pandemic and outcomes.

RESULTS

 A total of 10,717 pregnant people were included in our analysis. A total of 4,225 pregnant people were exposed to the pandemic and 6,492 pregnant people delivered prior to the COVID-19 pandemic. Pregnant people exposed to the pandemic were older and more likely to have gestational diabetes. The frequency of appropriate GWG was 28.0% during the pandemic and 27.6% before the pandemic (adjusted odds ratio [aOR]: 1.02, 95% confidence interval [CI]: 0.93-1.11). Excessive GWG was more likely (54.9 vs. 53.1%; aOR: 1.08, 95% CI: 1.001-1.17), and inadequate GWG was less likely during the pandemic (17.0 vs. 19.3%; aOR: 0.86, 95% CI: 0.77-0.95). The frequency of SGA was 5.4% during the pandemic and 6.1% before the pandemic (aOR: 0.90, 95% CI: 0.76-1.06), and the frequency of LGA was 16.0% during the pandemic versus 15.0% before the pandemic (aOR: 1.06, 95% CI: 0.95-1.18). Other neonatal outcomes including birth weight percentile (62.1 [35.8-83.2] vs. 60.2 [34.4-82.2]; adjusted mean difference (aMD) = 1.50, 95% CI: -0.28 to 3.29), ponderal index (2.6 g/cm3 [2.4-2.8] in both groups; aMD = 0.01, 95% CI: 0.00-0.02), and small head circumference for livebirths (<10th percentile [8.2 vs. 8.1%; aOR: 1.03, 95% CI: 0.89-1.19], <3rd percentile [3.5 vs. 3.1%; aOR: 1.16, 95% CI: 0.93-1.44]) were similar between groups as well.

CONCLUSION

 Being pregnant and delivering during the COVID-19 pandemic was associated with a higher likelihood of excessive GWG and a lower likelihood of inadequate GWG.

KEY POINTS

· Delivering during the COVID-19 pandemic was associated with higher likelihood of excessive GWG.. · Delivering during the COVID-19 pandemic was associated with lower likelihood of inadequate GWG.. · COVID-19 pandemic was not associated with changes in frequency of SGA or LGA..

Use of online food retail platforms throughout the COVID-19 pandemic and associated diet-related chronic disease risk factors: A systematic review of emerging evidence

Food accessibility was considerably impacted by restrictions during the coronavirus disease 2019 (COVID-19) pandemic, leading to growth in the online food retail sector, which offered contact-free delivery. This systematic review aimed to assess the change in use of online food retail platforms during COVID-19. The secondary aim was to identify diet-related chronic disease risk factors including dietary intake, eating behaviors, and/or weight status associated with the use of online food retail platforms during the pandemic. The review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42022320498) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Nine electronic databases were searched between January 2020 and October 2023. Studies that reported the frequency or change in use of online groceries, meal delivery applications, and/or meal-kit delivery services before and during the pandemic were included. A total of 53 studies were identified, including 46 cross-sectional studies, 4 qualitative studies, 2 longitudinal cohort studies, and 1 mixed-methods study. Overall, 96% (43/45) of outcomes showed an increase in the use of online groceries during COVID-19, while 55% (22/40) of outcomes showed a decrease in meal delivery applications. Eight of nine outcomes associated the use of online food retail with weight gain and emotional eating. Further research is needed to investigate the links between online food retail and obesity.

Cardiovascular health worsening in patients with autoimmune rheumatological diseases during the COVID-19 pandemic

Rheumatic autoimmune diseases are associated with a myriad of comorbidities. Of particular importance due to their morbimortality are cardiovascular diseases. COVID-19 greatly impacted the world population in many different areas. Patients with rheumatic diseases had to face changes in their healthcare, in addition to unemployment, a decrease in physical activity, social isolation, and lack of access to certain medications. This review summarizes the impact of COVID-19 pandemic on cardiovascular risk factors, comorbidities, and unhealthy behaviors in patients with rheumatic inflammatory autoimmune diseases, particularly focused on rheumatoid arthritis and systemic lupus erythematosus. Searches were carried out in MEDLINE/PubMed and Scopus from August to December 2022. Four reviewers screened the title and abstract of retrieved records. Potentially eligible reports were then reviewed in full text. Differences were reconciled by either consensus or discussion with an external reviewer. During the COVID-19 pandemic, patients with rheumatic diseases showed an increase in the prevalence of mental health disorders (43.2-57.7%), reduced physical activity (56.8%), and a worsening in eating behaviors. Alcohol intake increased (18.2%), especially in early phases of the pandemic. Smoking prevalence decreased (28.2%). Dyslipidemia and hypertension showed no changes. The pandemic and lockdown affected rheumatic patients not only in disease-related characteristics but in the prevalence of their cardiovascular comorbidities and risk factors. Lifestyle changes, such as healthy eating, physical activity, and optimal management of their rheumatic diseases and comorbidities, are essential to manage the long-lasting consequences of the COVID-19 outbreak. Key Points • During the COVID-19 pandemic, anxiety, depression, sedentarism, obesity, and a worsening in eating behaviors increased. •Patients with rheumatic diseases and comorbidities have worse clinical outcomes and a higher cardiovascular disease burden than those without them. •Comparative studies are necessary to precisely elucidate the pandemic's impact on the prevalence of cardiovascular disease, risk factors, and comorbidities in patients with rheumatoid arthritis and systemic lupus erythematosus.

Lifestyle Behaviour Changes and Associated Risk Factors During the COVID-19 Pandemic: results of the Canadian COVIDiet Online Cohort Study

BACKGROUND

The COVID-19 pandemic and related lockdowns have impacted lifestyle behaviours including eating habits and physical activity; yet few studies identified emerging patterns of such changes and associated risk factors.

OBJECTIVE

To identify patterns of weight and lifestyle behaviour change, and potential risk factors, resulting from the pandemic in Canadian adults.

METHODS

Analyses were conducted on 1,609 adults (18-89 y; 90.1% women; 81.8% White) of the Canadian COVIDiet study baseline data (May-Dec 2020). Self-reported current and pre-pandemic weight, physical activity, smoking status, perceived eating habits, alcohol intake and sleep quality were collected by online questionnaires. Based on these 6 indicator variables, latent class analysis (LCA) was used to identify lifestyle behaviour change patterns. Associations with potential risk factors including age, gender, ethnicity, education, income, chronic diseases, body image perception, and changes in stress level, living situation and work arrangement were examined with logistic regressions.

RESULTS

Participants' mean BMI was 26.1 ± 6.3 kg/m2; 60.9% had >= bachelor's degree. Since the pandemic, 35% had decreased income and 49% changed work arrangement. Most participants reported unchanged weight, sleep quality, physical activity level, smoking and alcohol consumption, yet 44% reported a perceived decrease in eating habits quality. From LCA, 2 classes of lifestyle behaviour change emerged; "healthy" and "less healthy" (probability: 0.605 and 0.395; BIC=15574.3, entropy=4.8). "Healthy" class participants more frequently reported unchanged weight, sleep quality, smoking and alcohol intake, unchanged/improved eating habits and increased physical activity. The "less healthy" class reported significant weight gain, deteriorated eating habits and sleep quality, unchanged/increased alcohol intake and smoking, and decreased physical activity. Among risk factors, body image dissatisfaction OR=8.8, 95%CI (5.3-14.7), depression OR=1.8, 95%CI (1.3, 2.5), increased stress level OR=3.4, 95%CI (2.0, 5.8) and of gender minority identity OR=5.5, 95% CI (1.3-22.3) were associated with adopting "less healthy" behaviours in adjusted models.

CONCLUSIONS

The COVID-19 pandemic appeared to have influenced lifestyle behaviours unfavorably in some, but favorably in others. Body image perception, change in stress level and gender identity were factors associated with behaviour change patterns; whether these will sustain overtime remains to be studied. Findings provide insights to develop strategies in supporting adults with poorer mental well-being in the post-pandemic context and promoting healthful behaviours during future disease outbreaks.

CLINICALTRIAL

This study was registered on ClinicalTrials.gov (NCT04407533).

Do selected lifestyle parameters affect the severity and symptoms of COVID-19 among elderly patients? The retrospective evaluation of individuals from the STOP-COVID registry of the PoLoCOV study

BACKGROUND

Older individuals tend to include less physical activity in their routine and are more prone to chronic diseases and severe medical complications, making them the most burdened group that is losing years of life due to pandemic-related premature mortality. This research aimed to assess the lifestyle factors that affect the COVID-19 course among patients ≥ 65 years old.

METHODS

The study included 568 convalescents (64.1% women and 35.9% men) with persistent clinical symptoms after isolation. The mean age was 70.41 ± 4.64 years (minimum: 65 years; maximum: 89 years). The patients completed the questionnaire during their in-person visit to the medical center. The survey included questions regarding their health status when suffering from COVID-19, basic sociodemographic data, and medical history concerning chronic conditions and lifestyle.

RESULTS

Physical inactivity (p < 0.001) and feeling nervous (p = 0.026) increased the risk of having a severe disease course. Coronary artery disease raised both the risk of a severe disease course (p = 0.002) and the number of present symptoms up to 4 weeks (p = 0.039). Sleep disturbances increased the number of symptoms during infection (p = 0.001). The occurrence of any symptoms was also associated with the female sex (p = 0.004). The severity of the course was associated with longer persistent symptoms (p < 0.001) and a greater number of symptoms (p = 0.004); those with a more severe course were also at a greater risk of persistent symptoms for up to 4 weeks (p = 0.006). Senior citizens in the third pandemic wave suffered with more severe disease (p = 0.004), while illness during the fourth (p = 0.001) and fifth (p < 0.001) waves was associated with a lower risk of persistent symptoms for up to 4 weeks. The disease duration was significantly shorter among vaccinated patients (p = 0.042).

CONCLUSIONS

Elderly COVID-19 patients should re-think their lifestyle habits to consider a physical activity level that is adjusted to their abilities, in order to decrease the risk of a severe disease course and to further limit both the number and duration of symptoms. The research was carried out in accordance with the Declaration of Helsinki, and approval from the Bioethics Committee of Lodz Regional Medical Chamber to conduct the study was obtained (approval number 0115/2021). The PoLoCOV-Study ClinicalTrials.gov identifier is NCT05018052.

Exploring the impact of COVID-19 pandemic on Americans time use related subjective wellbeing

In this study, the most recent American Time Use Surveys containing reported activity-based emotions and sensations information before (10,378 respondents in 2013) and during (6,902 respondents in 2021) the COVID-19 pandemic are used to assess if time use related individuals' subjective wellbeing (SWB) decreased in the pandemic. Given that the coronavirus has been shown to strongly influence activity decisions and social interactions, sequence analysis is applied to find daily time allocation patterns and changes in daily time allocation. Then, those derived daily patterns and other activity-travel factors, as well as social and demographic, temporal, spatial, and other contextual characteristics are added as explanatory variables in regression models of SWB measures. This provides a holistic framework of exploring the direct and indirect effects (via activity-travel schedules) of the recent pandemic on SWB while controlling for contexts such as the life assessments, daily schedule of activities, and living environment. The results show that respondents in the COVID year reported a new time allocation pattern that has a substantial amount of time at home, and they experienced more negative emotions. Three relatively happier daily patterns in 2021 contained substantial amounts of outdoor and indoor activities. In addition, no significant correlation was observed between metropolitan areas and individuals' SWB in 2021. However, comparisons among states show Texas and Florida residents experienced more positive wellbeing presumably due to fewer COVID-related restrictions.

Impact of the COVID-19 Pandemic on Meal Gathering in China

During the COVID-19 pandemic, the Chinese government adopted a series of preventative measures to control the spread of the virus. This paper studies the impact of the COVID-19 pandemic and its associated prevention methods on meal sharing in China. Meal gathering during multiple periods before and after the outbreak of COVID-19 is captured through two waves of online survey across China between March and June 2020, collecting a total of 1847 observations. We employ the difference-in-difference (DID) method to identify the causal effects of COVID-19 severity on meal sharing. The results show that relative to the same period in 2019, the frequency of meal gathering decreased sharply after the initial outbreak of the coronavirus in 2020 in both epicenters and non-epicenters. Furthermore, the impact of COVID-19 differed across different types of meal sharing. Our findings have implications for consumers, food service operators, as well as policymakers to understand the social and community impact of the pandemic and to adjust their coping strategies.

Nutritional quality and consumer health perception of online delivery food in the context of China

Background

Today, the popularization of mobile internet technology has enabled the public’s need for food convenience and diversity arising from modern fast-paced lifestyles to be met at a relatively low cost. The digital age of the restaurant industry has arrived. Online food delivery (OFD) is rapidly developing globally. However, the public’s awareness of the nutritional quality of food through OFD and their knowledge of dietary nutrition remain to be investigated.

Methods

In the context of China, this study attempts to evaluate the nutritional quality of best-selling OFD set meals (i.e., meal combos) based on the current official Chinese dietary guidelines 2022. It accomplishes this by collecting data on popular OFD restaurants among consumers in 115 Chinese universities from the restaurants’ delivery addresses. Moreover, 20,430 valid questionnaires were collected online from undergraduates, graduate students, and other young groups aged 18–30 throughout China for descriptive analysis to investigate consumers’ perceptions of the nutritional quality of food through OFD and its health impact.

Results

The results of the nutritional quality evaluation of the OFD set meals ranged widely from 15 to 85, with a mean of 36.57 out of a possible maximum score of 100; and 89.56% scored less than 50. The nutritional quality of OFD foods was thus generally low. The nutritional quality of foods was negatively correlated with their popularity among consumers.

Conclusions

Young OFD consumers generally paid low attention to dietary nutrition knowledge and seldom paid attention to nutritional quality when choosing OFD foods while the nutritional quality of OFD foods was generally low. Respondents subjectively reported that long-term consumption of OFD food caused weight gain, increased blood lipids, and gastrointestinal discomfort. They thought that the reason might be excessive oil, salt, and sugar in the food, while ignoring the balance between different types of food.

Comparative Effectiveness of East Asian Traditional Medicine for Childhood Simple Obesity: A Systematic Review and Network Meta-Analysis

Childhood obesity leads to various comorbidities and usually persists into adulthood, increasing socioeconomic burden. In the absence of a clearly effective treatment, East Asian traditional medicine (EATM) therapies have been widely used. We aimed to analyze the comparative effectiveness and safety of EATM techniques for children with simple obesity through network meta-analysis (NMA). Twelve databases were searched for randomized controlled trials (RCTs) evaluating the effect of EATMs on childhood simple obesity. Individual EATMs were ranked based on the surface under the cumulative ranking curve. The risk of bias in the individual studies and publication bias in the NMA were evaluated. Thirty-three RCTs were included. Acupuncture, chuna, chuna plus acupressure, cupping plus acupressure, herbal medicine (HM), and HM plus acupuncture significantly reduced BMI compared with lifestyle management. Based on the treatment ranking, cupping plus acupressure was optimal for BMI reduction compared with a non-medical management, followed by chuna and HM. The quality of evidence for individual findings was usually moderate to low, and no serious adverse events of EATM were reported. Cupping plus acupressure might have a large beneficial effect, and chuna or HM probably have a moderate beneficial effect on reducing BMI in children with simple obesity.

The Role of Selected Psychological Factors in Healthy-Sustainable Food Consumption Behaviors during the COVID-19 Pandemic

The COVID-19 pandemic and the consequent precautions and dispositions adopted have triggered substantial changes in daily health-related behaviors, including food consumption habits. The psychological impact of the pandemic has been considered one of the factors affecting this transition and requiring consideration when targeting healthy-sustainable behavior preservation. The present study describes the results of a survey conducted on a convenience sample of Italian residents (n = 2272) during the first phases of pandemic. The aim was to explore the daily nutritional choices and behaviors and their transformations that occurred along with the associations with psychological factors (i.e., subjective well-being, and depression, anxiety and stress symptoms). An indicator for healthy-sustainable transition (HST index) was constructed and revealed diffused transformation in dietary habits, with a large segment of the sample adopting healthier and more sustainable dietary behaviors and others showing reduced healthy-sustainable food choices. Informative relationships with the psychological variables were then found from the correlational and regression analyses. Lower levels of anxiety, depression and stress symptomatology and higher perceived subjective well-being were significantly associated with healthier-sustainable food consumption behaviors. These findings shed light on the crucial areas to be considered in future institutional interventions, ultimately ensuring favorable conditions for both healthy diet behaviors and sustainable food consumption choices.

Public Interest, Risk, Trust, and Personal Protective Equipment Purchase and Usage: Face Masks Amid the COVID-19 Pandemic

This analysis considers public interest in COVID-19-related issues as well as individuals’ risk perception and trust in society in their demand for face masks during the pandemic. Through a national survey, we examine demand during both the outbreak and the recovery stage of the pandemic and differentiate demand into purchasing and usage. The examination allows us to observe the evolvement of demand over time and stockpiling. We find that public interest and risk perception had a more significant association with mask demand during the outbreak stage, and trust was more connected with mask demand during the recovery stage. While stocking was evident in both stages, consumers were much less price sensitive in the outbreak stage. Overall, the relationship between most factors and mask demand was smaller in the recovery stage. Our research is useful for policymakers to assess the creation and termination of temporary legislation to help manage the value chain of personal protective equipment during a major public health crisis.

Consumption of selected food products by adults representing various body mass categories, during Covid-19 lockdown in Poland

OBJECTIVES

The study aimed to assess consumption of selected food products by adults with a range of body mass before and during the outbreak of the Covid-19 pandemic as well as identify factors impacting the consumption of selected foods.

METHODS

The study was conducted in a group of 690 subjects during the most severe lockdown due to Covid-19 in Poland ([Formula: see text] = 23 years of age). The dietary assessment was carried out by means of an online survey based on the Food Frequency Questionnaire (FFQ-6). The respondents were asked to provide two answers to each question, one covering a 7-day period before the lockdown and one related to a 7-day period during the lockdown.

RESULTS

During lockdown in the study group there was increase in consumption of sweets and snacks (p = 0.010), grain products (p = 0.050), fat (p = 0.007) as well as alcohol (p < 0.001). During the lockdown respondents with normal BMI increased consumption of sweets and snacks (p = 0.011), dairy products and eggs (p = 0.034), grain products (p = 0.029) and alcohol (p = 0.00). The group of overweight respondents was found to consume significantly more alcohol (p = 0.022), while those with obesity tended to consume more meat (p = 0.002), fish (p < 0.001) and lower amounts of dairy products (p = 0.003). The factors which affected intake of selected food products include age, smoking, place of residence, obesity and education.

CONCLUSIONS

Covid-19 pandemic is significantly related to the change in the frequency of intake of selected products by all adults, irrespective of their BMI. The adverse changes were particularly observed in respondents with overweight and obesity.