Pandemic measures had a strong impact on mental and physical health


Pandemic measures had a strong impact on mental and physical health


A study, published in the journal Obesity, has shown significant increases in sedentary behaviour, a reduction in physical activity levels, and an increase in anxiety and weight gain throughout the COVID-19 lockdown measures implemented earlier this year. The results were particularly significant in people with obesity.

Alternatively, there was also a substantial increase in levels of healthful eating.


The impact of stay-at-home orders

Across the world, various strategies were employed in order to limit the spread of COVID-19; mostly stay-at-home orders, quarantine, and social distancing measures. However, the impacts on other aspects of health are not completely understood.

Physical activity and eating habits were affected by the closure of gyms, restaurants, places of employment and more, and the fear of catching the virus, along with staying at home, may exacerbate stress and anxiety.

Stress during a pandemic can lead to anxiety, sleep issues, different eating habits, concentration issues, increased substance use, and the worsening of chronic health issues. These issues, along with other factors, may also lead to increased weight gain.

Researchers at Louisiana State University’s (LSU’s) Pennington Biomedical Research Center designed a global online survey in order to document changes in physical activity, sedentary behaviours, mental health, sleep, and dietary habits in adults aged 18 and older during the initial phase of the COVID-19 lockdown.

The online study was held anonymously and was available to access via Facebook, the research centre’s web page, and an email listserv. It ran from April 3rd 2020 until May 3rd 2020, and in that time over 12,000 people looked at the survey, with 7,753 results being included for analysis.

Around 95% of participants lived in the USA, UK, Australia, and Canada. The participants were predominantly white females living in a two person household, with an average age of 51.

Around 32% of the participants reported as being overweight, 34% obese, and 32% had a healthy weight. The results of the survey showed substantial lifestyle changes throughout the pandemic.



Significant lifestyle behaviour changes

Eating out four or more times per week declined by 10% while cooking at home six or more times per week increased 26% throughout the pandemic. There was also indication of significant increases in healthful eating.

Around 44% of participants reported an increase in unhealthy snacking, while around 26% of participants reported increased healthy snacking. 36% of the individuals reported declines in healthy eating, while 21% reported an increase.

The perceived increase in unhealthy eating was accompanied by trouble falling asleep, decreased physical activity, increased sedentary habits, and almost double the reported anxiety levels than those reported by participants who were eating more healthfully.

Sedentary leisure activities were reported to increase by 21 minutes on weekdays, and 17 minutes on weekends; while physical activity decreased by 18 minutes per week and declined by 112 minutes per week in terms of metabolic equivalents after adjusting for exercise intensity.

Also demonstrated by the results was that sleep onset and wake time increased by 42 and 59 minutes, respectively, and 44% of participants reported worse sleep quality, while 10% reported improved sleep quality.

75% of participants reported feeling concerned or moderately concerned for their or their family member’s health (87.5%) due to COVID-19, and symptomatic anxiety also increased by 14%.

The study has shown that health behaviours have changed disproportionately in individuals with obesity that stemmed from the lockdown orders.

“Overall, people with obesity improved their diets the most. But they also experienced the sharpest declines in mental health and the highest incidence of weight gain,” says Dr. Leanne Redman, associate executive director for Scientific Education at Pennington Biomedical Research Center.

24% of participants with obesity reported symptomatic anxiety, whereas it was only 17% of individuals with a healthy weight and overweight participants. However, it is important to note that symptomatic anxiety levels were similar in all three groups before the pandemic.

During the lockdown, 33% of participants with obesity reported weight gain, compared to 25% of the participants with a healthy weight and 21% of overweight participants.

Although obese participants had lower baseline physical activity than the other two groups of participants, the change in physical activity was the same across all three groups. Obese individuals had greater increases in sleep onset time than the other two groups, but their wake time remained the same.

A significant limitation of the study was the fact the survey was self-reported, as this could possibly introduce recall bias. The study population also had a lack of diversity, as it primarily consisted from older white adult women from similar geographic locations.



Understanding the impact

According to Dr. John Kirwan, executive director of LSU’s Pennington Biomedical Research Center:

“This study is the first to survey thousands of people across the globe on lifestyle behavior changes in response to stay-at-home orders. […] The study demonstrates that chronic diseases like obesity affect our health beyond the physical.”

Dr. Redman’s study is just one of many initiatives the center launched to help understand COVID-19’s impact and to slow its spread,” he adds.

Dr. Emily Flanagan, lead author of the study, notes that the team should take note and alter how they manage patients with obesity by making mental health screenings more frequent throughout and following the pandemic, and staying in contact via remote visits and telehealth to prevent irreversible health changes caused by the pandemic. “Virtual visits” could alleviate many of the concerns patients may have regarding the safety of face-to-face visits.

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