Impact of COVID-19 lockdown on health parameters and muscle strength of older women: A longitudinal study

The impact of the COVID-19 pandemic on Mediterranean diet adherence: A narrative systematic review

BACKGROUND

The COVID-19 pandemic upended many aspects of daily life. For some individuals, this was an opportunity to re-evaluate their life and make better choices, while others were overwhelmed with stressors, leading to a deterioration in mental and physical health.

AIM

The aim of this narrative systematic review is to explore the effects of the COVID-19 pandemic on Mediterranean diet adherence.

METHODS

A systematic literature search was carried out on PubMed, Scopus and Web of Science electronic databases utilising the search terms 'Mediterranean diet' AND 'COVID-19'. This yielded 73 articles that fulfilled the inclusion criteria.

RESULTS

The data suggests that a substantial proportion of individuals adhered less to the Mediterranean diet during the COVID-19 lockdown period. However, individuals receiving some form of lifestyle intervention had better adherence to the Mediterranean diet than their unassisted counterparts.

CONCLUSION

This emphasises the importance of professional support during times of crisis to avoid deterioration of a population's health.

The Long-Term Effect of COVID-19 Infection on Body Composition

BACKGROUND

The effect of COVID-19 infection versus the indirect effect of the pandemic on body composition remains unclear. This study investigates the long-term changes in body composition in COVID-19 survivors compared to a contemporary control group.

METHOD

This is a prospective study involving adults who underwent a pre-pandemic whole-body DXA scan (DXA#1) between 2017 and 2019. Participants were asked to return for a repeat whole-body DXA scan (DXA#2) after the pandemic. Detailed data were collected including their medical and COVID-19 history. Inflammation markers and fasting lipids were measured. For those participants who experienced a COVID-19 infection between the two DXAs, DXA#2 was acquired at least one year after COVID-19 infection.

RESULTS

Overall, 160 adults were enrolled; 32.5% females, 51.8% non-white, with mean age of 43.2 years. Half (n = 80) of the participants experienced a COVID-19 infection between their two DXA scans (COVID-19+ group), and the other half had never had COVID-19. COVID-19-negative participants displayed an increase in annualized trunk fat (g) [922.5 vs. 159.7; p = 0.01], total fat (g) [1564.3 vs. 199.9; p = 0.2], and LBM (g) [974.9 vs. -64.5; p = 0.0002] when compared to the COVID-19+ group. However, among the COVID-19+ group, no differences were seen in annualized trunk fat, total fat mass, or LBM between those with PASC and without (p > 0.05).

CONCLUSION

During the pandemic, both the COVID-19 survivors and the COVID-19-negative group exhibited increases in weight, total fat, and trunk fat, likely associated with pandemic-linked lifestyle modifications. However, only COVID-19 survivors displayed a decline in lean body mass over the same period, regardless of PASC symptoms.

The Effect of Resistance Training with Outdoor Fitness Equipment on the Body Composition, Physical Fitness, and Physical Health of Middle-Aged and Older Adults: A Randomized Controlled Trial

This study examined the effect of outdoor-fitness-equipment-based resistance training on the health parameters of middle-aged and older adults, as well as analyzing the effect of age on the results found. A total of 149 volunteers were randomly assigned to the training (TG) and control (CG) groups. The TG performed two weekly sessions of resistance training for 8 weeks using outdoor fitness equipment, while the CG continued with their regular daily activities. Body composition was measured using DXA, and the maximal isometric voluntary contraction in knee extension, elbow flexion, and hand grip were assessed, along with the 4 m walk test, the Timed Up and Go Test, and the Short Form 36 Health Survey Questionnaire. The TG showed a significant increase in the lean mass index (p = 0.002) and maximal isometric voluntary contraction in both legs (p < 0.001) and arms (p < 0.001), as well as in physical functioning (p < 0.001) and the role physical dimension (p = 0.006) of the Short Form 36 Health Survey Questionnaire, compared to the CG, which showed a decrease in all these variables. In addition, the TG showed a greater decrease in fat mass (p < 0.001), fat mass index (p = 0.003), and the Timed Up and Go Test (p < 0.001) than the CG. Age conditioned the evolution of most of the variables analyzed (p < 0.05). In conclusion, resistance training with outdoor fitness equipment may be useful for improving the health of middle-aged and older adults, although age is a factor that could influence the adaptations found.

Physical and psychological effects of outdoor fitness equipment training on middle-aged and older adults: study protocol of a randomised controlled trial

This project will investigate the effectiveness of an 8-week outdoor fitness equipment (OFE) programme on health parameters in healthy community-dwelling middle and older adults, corresponding to the present paper to the study protocol, which follows a single-blind randomised controlled trial design. The training intervention will involve participation in an OFE programme implemented over 8 weeks, two sessions/week. Rating of perceived exertion, heart rate, training volume and adherence to the exercise programme will be registered each session. The control group will not receive any structured exercise programme. Blinded examiners will evaluate before and after the training programme muscle strength with both maximum knee extension and elbow flexion isometric tests, handgrip strength test and five time sit-to-stand test; cardiovascular fitness with 400-metre walking test; postural stability with the balance tests of the short physical performance battery (SPPB) battery; dynamic balance with Timed Up and Go (TUG) test; body composition with dual-energy X-ray absorptiometry; functional performance by gait speed, TUG and SPPB battery; blood pressure; and sagittal spine disposition and pelvic tilt. Information will also be collected about demographic characteristics, health-related quality of life, satisfaction with life and adherence to the Mediterranean diet questionnaires. After that, sarcopenia, osteoporosis and fracture risk will be calculated. The results derived from this research will increase the knowledge of the effectiveness of OFE training for improving the health of healthy community-dwelling middle and older adults.

Eighteen-Month Changes in Physical Activity, Body Weight, Quadriceps Strength, and Gait Biomechanics during the COVID-19 Pandemic

PURPOSE

This study assessed the effects of the COVID-19 pandemic restrictions/lockdowns on physical activity levels, body mass, quadriceps strength, and gait biomechanics over 18 months.

METHODS

Ten healthy men were assessed at baseline (~14 wk before first lockdown) and 17.9 ± 0.3 months later (<1 wk after second lockdown). At both times, physical activity levels, body mass, and quadriceps strength were acquired using the International Physical Activity Questionnaire, a force plate, and a dynamometer, respectively. Gait data were also acquired using a motion capture system and force plates during self-paced walking, from which spatiotemporal parameters, knee angles, and external moments were computed. Baseline and follow-up measurements were compared using two-tailed paired t -tests ( α = 0.05).

RESULTS

At follow-up, participants spent less time doing vigorous physical activity (∆ = -76 ± 157 min·wk -1 , P = 0.048), exhibited a tendency toward increased sedentary time (∆ = +120 ± 162 min·d -1 , P = 0.056), weighed more (∆ = +2.5 ± 2.8 kg, P = 0.021), and showed a trend toward reduced quadriceps strength (∆ = -0.29 ± 0.45 (N·m)·kg -1 , P = 0.071) compared with baseline. At follow-up, participants walked slower (∆ = -0.09 ± 0.07 m·s -1 , P = 0.005), had greater knee flexion angles at heel strike (∆ = +2.2° ± 1.8°, P = 0.004) and during late stance (∆ = +2.2° ± 1.8°, P = 0.004), had reduced knee extension moments (∆ = -0.09 ± 0.09 (N·m)·kg -1 , P = 0.012) and knee internal rotation moments (∆ = -0.02 ± 0.02 (N·m)·kg -1 , P = 0.012) during late stance.

CONCLUSIONS

Healthy men exhibited reduced physical activity levels, increased body weight, a tendency toward reduced quadriceps strength, and altered gait biomechanics over the initial 18 months of the COVID-19 pandemic-alterations that could have far-reaching health consequences.

Impact of 3 months of detraining after high intensity exercise on menopause-related symptoms in early postmenopausal women - results of the randomized controlled actlife project

Regular exercise might reduce postmenopausal symptoms, however even short-moderate periods of absence from exercise training might significantly reduce these positive effects. The aim of the study was thus to determine detraining effects on postmenopausal symptoms after a 3-month detraining period in early post-menopausal women. After 13 months, the exercise group (EG: n = 27; 54.6 ± 2.0; 23.6 ± 3.3 kg/m²) had to abruptly stop their supervised, facility-based, high intensity aerobic and resistance group exercise conducted three times per week due to the COVID-19 pandemic and the corresponding lockdown of all training facilities in Germany. In parallel, the control group (CG: n = 27; 55.6 ± 1.6 years, 25.2 ± 5.2 kg/m²) had to terminate their low-intensity exercise program performed once per week. Study endpoint as determined after 3 months of detraining was menopausal symptoms as determined by the Menopausal Rating Scale II (MRS II). The intention to treat principle with multiple imputation was applied. After 13 months of intense multicomponent exercise and significant exercise-induced effects on menopausal symptoms, a further 3 months of detraining resulted in non-significant deteriorations (p = .106) in the exercise group, while non-significant improvements were observed in the control group (p = .180). Corresponding group differences were significant (p = .036) after detraining. Of importance, self-reported individual outdoor activities increased by about 40% in both groups during the three-month lock-down period. Three months of absence from a supervised high-intensity group exercise protocol resulted in detraining effects on postmenopausal symptoms even when outdoor physical activity was increased significantly.

Trial registration number

ClinicalTrials.gov: NCT03959995.

Associations between sedentary behavior and negative emotions in adolescents during home confinement: Mediating role of social support and sleep quality

Background

Prolonged periods of sedentary behaviour, for instance, engendered by home confinement in Shenzhen city, has led to negative mental health consequences, especially in adolescents. Previous research suggests, in general, that sedentary behavior can increase negative emotions. However, the specific mechanism driving the relationship between sedentary behavior and negative emotions is still relatively unclear. Social support and sleep quality might partly explain the effect of sedentary behavior on negative emotions. Thus, the current study aimed to examine the associations between sedentary behavior and negative emotions, and to investigate if social support and sleep quality mediate such a relationship.

Method

During home confinement due to the COVID-19 Omicron variant outbreak, 1179 middle and high school students in Shenzhen were invited to voluntarily complete an e-questionnaire, including the 21-item Depression Anxiety Stress Scale (DASS-21), the short form of the International Physical Activity Questionnaire (IPAQ-SF), the Social Support Rating Scale (SSRS) and the Pittsburgh Sleep Quality Index (PSQI). Data from 1065 participants were included in the analysis.

Results

We observed significant sex-related and demografic-related differences in emotional (e.g., anxiety, stress and social support) and other outcome variables (e.g., sitting duration and PSQI score). Furthermore, sedentary behavior, social support, and sleep quality were associated with negative emotions (p < .01), even after controlling for sex, age, only-child case, body mass index, and metabolic equivalent level. In addition, social support and sleep quality partially mediated the association between sedentary behavior and negative emotions.

Conclusion

The findings of the current study suggest that social support and sleep quality partially mediate the relationship between sedentary behavior and negative emotions in middle and high school students during home confinement in Shenzhen city.

Effects of physical distancing by COVID-19 pandemic on diet quality, neurological and immunological markers, and fecal microbiota of Brazilian older women

Physical distancing was used to prevent transmission of COVID-19, however there are concerns that this may promote harmful impacts on health, such as reduced levels of physical practice and changes in food intake and gut microbiota composition. This study evaluated the impacts of 6 months physical distancing on Brazilian older women upon body mass index (BMI), strength, physical activity level (IPAQ), eating habits, neurological markers (brain-derived neurotrophic factor-BDNF and cortisol), cytokines (IL-2, IL-5, IL-6, IL-10, interferon-IFN-γ, tumor necrosis factor-TNF-α), aging-associated markers (vascular endothelial growth factor-VEGF, insulin-like growth factor-IGF-1, klotho and thymic stromal lymphopoietin-TSLP), besides specific groups of fecal microbiota. Fifteen women, over 60 years old, residents of São Paulo state (Brazil), were evaluated in March and in September 2020. The older adult women, with a mean age 66 ± 6.2 years presented significantly increased BMI and high effect size for non-protective foods consumption, reduced light physical activity and strength 6 months following the physical distancing. Furthermore, the serum concentration of IFN-γ, IGF-1, and IFN-γ/IL-5 were significantly higher, while lower concentration of IL-2 and IL-5 were observed 6 months after the physical distancing. Significant increase was noted only to Blautia spp. abundance after 6 months of physical distancing. Several correlations were observed at both before and after physical distancing, however, interestingly, many of them were lost or inverted 6 months following, while new ones emerged. Taken together, these results showed that lifestyle changes and stress conditions addressed by physical distancing from the COVID-19 pandemic impacted the health of older women included in the present study. Therefore, future follow-up studies are essential to propose interventions in order to restore the health conditions observed before the pandemic period, and thus to maintain the quality of life of older adults in different socioeconomic contexts.