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Caretto A, Pintus S, Petroni ML, Osella AR, Bonfiglio C, Morabito S, Zuliani P, Sturda A, Castronuovo M, Lagattolla V, Maghetti A, Lapini E, Bianco AM, Cisternino M, Cerutti N, Mulas CA, Hassan O, Cardamone N, Parillo M, Sonni L. Determinants of weight, psychological status, food contemplation and lifestyle changes in patients with obesity during the COVID-19 lockdown: a nationwide survey using multiple correspondence analysis. Int J Obes (Lond) 2022; 46:1280-1287. [PMID: 35306529 PMCID: PMC8933751 DOI: 10.1038/s41366-022-01100-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 12/12/2021] [Accepted: 02/14/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The corona virus disease 2019 (COVID-19) pandemic forced most of the Italian population into lockdown from 11 March to 18 May 2020. A nationwide survey of Italian Clinical Nutrition and Dietetic Services (Obesity Centers or OCs) was carried out to assess the impact of lockdown restrictions on the physical and mental wellbeing of patients with obesity (PWO) who had follow-up appointments postponed due to lockdown restrictions and to compare determinants of weight gain before and after the pandemic. METHODS We designed a structured 77-item questionnaire covering employment status, diet, physical activity and psychological aspects, that was disseminated through follow-up calls and online between 2 May and 25 June 2020. Data were analyzed by multiple correspondence analysis (MCA) and multiple linear regression. RESULTS A total of 1,232 PWO from 26 OCs completed the questionnaires (72% female, mean age 50.2 ± 14.2 years; mean BMI 34.7 ± 7.6 kg/m2; 41% obesity class II to III). During the lockdown, 48.8% gained, 27.1% lost, while the remainder (24.1%) maintained their weight. The mean weight change was +2.3 ± 4.8 kg (in weight gainers: +4.0 ± 2.4 kg; +4.2% ± 5.4%). Approximately 37% of participants experienced increased emotional difficulties, mostly fear and dissatisfaction. Sixty-one percent reduced their physical activity (PA) and 55% experienced a change in sleep quality/quantity. The lack of online contact (37.5%) with the OC during lockdown strongly correlated with weight gain (p < 0.001). Using MCA, two main clusters were identified: those with unchanged or even improved lifestyles during lockdown (Cluster 1) and those with worse lifestyles during the same time (Cluster 2). The latter includes unemployed people experiencing depression, boredom, dissatisfaction and increased food contemplation and weight gain. Within Cluster 2, homemakers reported gaining weight and experiencing anger due to home confinement. CONCLUSIONS Among Italian PWO, work status, emotional dysregulation, and lack of online communication with OCs were determinants of weight gain during the lockdown period.
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Affiliation(s)
- A Caretto
- Endocrinology, Metabolic diseases and Clinical Nutrition, Ospedale Perrino, Brindisi, Italy.
| | - S Pintus
- Bariatric Surgery Center, ARNAS Brotzu, Cagliari, Italy
| | - M L Petroni
- Metabolism and Clinical Nutrition Unit, IRCCS Policlinico S. Orsola, Alma Mater University of Bologna, Bologna, Italy
| | - A R Osella
- Epidemiology and Statistics, IRCCS Saverio De Bellis, Castellana Grotte, BA, Italy
| | - C Bonfiglio
- Epidemiology and Statistics, IRCCS Saverio De Bellis, Castellana Grotte, BA, Italy
| | | | - P Zuliani
- Obesity Day Center, Sorrento, NA, Italy
| | - A Sturda
- Endocrinology, Metabolic diseases and Clinical Nutrition, Ospedale Perrino, Brindisi, Italy
| | | | - V Lagattolla
- Endocrinology, Metabolic diseases and Clinical Nutrition, Ospedale Perrino, Brindisi, Italy
| | - A Maghetti
- Metabolism and Clinical Nutrition Unit, IRCCS Policlinico S. Orsola, Alma Mater University of Bologna, Bologna, Italy
| | - E Lapini
- Obesity Rehab Unit, Ospedali Privati Forli, Forlì, Italy
| | - A M Bianco
- U.O.C. Igiene degli Alimenti e della Nutrizione ASP, Potenza, Italy
| | - M Cisternino
- Clinical Nutrition, IRCCS "S. De Bellis", Castellana Grotte, BA, Italy
| | - N Cerutti
- UOSD Medicina Generale a Indirizzo Dietologico ASST, Pavia, Italy
| | - C A Mulas
- Clinical Dietary Service "Holy Spirit" Hospital Casale Monferrato ASLAL, Alessandria, Italy
| | - O Hassan
- UOSD Diabetology, San Camillo Hospital -, Roma, Italy
| | | | - M Parillo
- Azienda ospedaliera S. Anna S. Sebastiano, Caserta, Italy
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Pironi L, Maghetti A, Zolezzi C, Ruggeri E, Incasa E, Gnudi S, Pizzoferrato A, Barbara L, Miglioli M. Bone turnover in patients on home parenteral nutrition: alongitudinal observation by biochemical markers. Clin Nutr 1996; 15:157-63. [PMID: 16844027 DOI: 10.1016/s0261-5614(96)80234-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/1996] [Accepted: 03/26/1996] [Indexed: 11/17/2022]
Abstract
In order to characterize biochemical markers of bone turnover in home parenteral nutrition(HPN) patients, 8 adult patients on HPN for benign intestinal failure were studied at 0, 6 and 12 months by evaluating serum osteocalcin (bone formation marker), urinary hydroxylysyl pyridinoline, lysyl pyridinoline and beta-galactosyl hydroxylysine (bone resorption markers), serum PTH, Calcitonin, 25 vitD, 1-25vitD, serum and urinary minerals, body weight, rehabilitation degree and HPN characteristics. Three patients entered the study 2-3 months after the beginning of HPN. Their features of bone turnover were homogeneous, characterized by increased resorption associated with normal or increased formation, at baseline, and normalization of resorption associated with an increase or a parallel decrease of formation, at 6 months. At 12 months, the patterns were similar to those observed at 6 months. The patients were not of the same sex and age and had different underlying diseases and types of intestinal failure, HPN composition and serum vitamin D levels. They had weight gain that was already present at baseline and the positive outcomes of the rehabilitation and clinical status in common. Five patients entered the study more than 1 year after the beginning of HPN. They showed heterogeneous features of bone turnover that were stable throughout the study, characterized by increased resorption associated with low or normal formation in two cases, low normal resorption associated with low or normal formation in three. In one patient, who had increased resorption and low formation, the bone turnover appeared to be explained by the nutritional and clinical outcomes, which were negative. These results appeared consistent with those obtained in previous studies by bone histomorphometry, indicating that bone turnover of short-term HPN patients differed from that of long-term patients, and suggesting that the early months of HPN were associated with increased bone resorption.
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Affiliation(s)
- L Pironi
- Department of Internal Medicine and Gastroenterology, St. Orsola Hospital, University of Bologna, V. Massarenti 9, 40138 Bologna, Italy
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Pironi L, Maghetti A, Ruggeri E, Incasa E, Gnudi S, Barbara L, Miglioli M. Bone mineral density in home parenteral nutrition (HPN): a follow-up study. Clin Nutr 1993. [DOI: 10.1016/0261-5614(93)90321-t] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Pironi L, Miglioli M, Paganelli G, Ruggeri E, Santucci R, Maghetti A, Di Febo G, Barbara L. Effect of long term total parenteral nutrition on morphological and cytoproliferative pattern of human small intestinal mucosa. Clin Nutr 1991. [DOI: 10.1016/0261-5614(91)90246-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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