Physical activity during COVID-19 pandemic in the Iranian population: A brief report

The Effect of Nurse-Led Intervention on Limiting Health Costs of Cardiovascular Diseases in Chinese Adults

Cardiovascular diseases (CVDs), as the leading cause of mortality worldwide, impose substantial health-related costs. Lifestyle modification through education and counseling is a key strategy in CVD management. This study aimed to evaluate the impact of a nurse-led intervention on CVDs-related health costs and lifestyle habits among Chinese adults with CVDs. A quasi-experimental study was conducted among adults with CVDs assigned to either an intervention or control group. The intervention consisted of bi-monthly sessions over a six-month period, conducted in a hospital setting by trained registered nurses. Outcomes included CVD-related health costs and lifestyle behaviors (smoking, alcohol use, physical activity, and diet), measured at baseline, post-intervention, and six-month follow-up. Data were analyzed using Analysis of covariance (ANCOVA) to compare adjusted outcomes between groups, controlling for baseline values, age, gender, and BMI. The intervention group showed a higher proportion of non-smokers (from 65.2 to 74.1%) and participants with healthy diets (from 14.8 to 27.4%). At post-intervention, they had significantly fewer cigarettes smoked (9.6 ± 0.27, 95% CI: 9.07, 10.13 in intervention group vs. 11.1 ± 0.31, 95% CI: 10.49, 11.71 in control group; p = 0.024, η² = 0.020) and higher physical activity levels (264.4 ± 5.7, 95% CI: 253.23, 275.57 in intervention group vs. 229.2 ± 6.2, 95% CI: 217.05, 241.35 in control group; p = 0.032, η² = 0.018). At follow-up, they also showed significantly lower adjusted CVD-related health costs (17.2 ± 0.41, 95% CI: 16.4, 18.0 in intervention group vs. 20.7 ± 0.46, 95% CI: 19.8, 21.6 in control group; p = 0.029, η² = 0.018), sustained reductions in cigarette use (9.5 ± 0.26, 95% CI: 8.99, 10.01 in intervention group vs. 11.2 ± 0.32, 95% CI: 10.57, 11.83 in control group; p = 0.013, η² = 0.024), and increased physical activity (260.1 ± 5.4, 95% CI: 249.52, 270.68 in intervention group vs. 229.1 ± 6.4, 95% CI: 216.56, 241.64 in control group; p = 0.016, η² = 0.021). The nurse-led intervention may help promote lifestyle improvements and contribute to reductions in CVD-related health costs.

Physical activity in adolescents of different family socioeconomic status: the moderating role of gender

Background

To investigate the association between family socioeconomic status (SES) and the physical activity (PA) levels of adolescents, as well as the moderating effect of gender on this relationship.

Methods

A total of 10,327 Chinese adolescents aged 12-17 were recruited to complete questionnaires regarding their SES and PA levels. "Physical Activity Questionnaire for Children and Adolescents Aged 7-18 Years" was utilized to examine the specific items, intensity, duration, and frequency of PA. The Kruskal-Wallis test and the Mann-Whitney U test were employed to compare PA time among adolescents across different groups. To analyze the interaction effect between gender and SES, the Scheirer-Ray-Hare test was conducted using R software. Additionally, SPSSAU was utilized to examine the moderating effect of gender and SES on PA.

Result

(1) Different intensities of PA: Overall, the times for LPA, MPA, VPA, MVPA, and TPA in the low SES group were 190 (100, 400) minutes, 190 (80, 400) minutes, 60 (0, 160) minutes, 290 (150, 570) minutes, and 580 (345, 925) minutes, respectively.The duration of PA at each intensity level in the low SES group was significantly lower compared to that in the middle and high SES groups (all P-values < 0.05). (2) Different PA types: The low SES group exhibited the shortest durations for both transportation PA (260 min) and exercise PA (155 min), while household PA was the longest (15 min)(all P-values < 0.05). (3) Moderating effect test: After controlling for relevant variables, the interaction term coefficient between gender and SES was statistically significant (B = -19.141, t = -2.059, P < 0.05).

Conclusion

Adolescents from low SES backgrounds exhibited the lowest levels of MVPA and TPA, which were mainly manifested in transportation PA and exercise PA. Gender moderates the relationship between SES and MVPA, with different SES levels having a more pronounced effect on PA in boys than in girls.

Impact of coronavirus (COVID-19) pandemic on physical activity levels in different sub-populations of Iranians: a national survey

During the COVID-19 pandemic, the level of physical activity (PA) has been reported to decrease worldwide. A sedentary lifestyle is widely recognized as a significant risk factor for various diseases, necessitating extensive big data analysis to uncover the diverse aspects linked to the COVID-19 pandemic. Therefore, the aim of this study was to investigate the impact of the COVID-19 pandemic on PA levels across diverse population subsets in Iran and to identify the barriers to PA during the fifth wave of COVID-19 outbreak. Data from 7810 individuals (50.8% male, 54.8% married, 69.6% 18-49 years) were collected using a standardized questionnaire comprising demographic details, levels of high, moderate, and low PA, daily sedentary time, PA at home, and barriers to PA. The questionnaire was distributed online via social platforms such as Telegram, WhatsApp, and Instagram. The obtained data were analyzed using the Chi-Square goodness-of-fit test and the Chi-Square test at a significance level of α < 0.05. During the COVID-19 pandemic, there was a significant decrease in the number of days/week dedicated to high, moderate, and low PA, as well as a reduction in the duration of each PA session compared to pre-pandemic levels (p < 0.001). Conversely, the duration of daily sedentary time, particularly exceeding 5 h, significantly increased post-outbreak (p < 0.001). Notably, lack of appropriate space and time constraints were identified as the primary barriers to PA during the COVID-19 pandemic (p < 0.001). In this nationally representative study, the findings underscore a substantial decline in PA levels across diverse sub-populations in Iran and an increase in sedentary behaviors during the COVID-19 crisis.

The association of mental health with physical activity and its dimensions in Chinese adults: A cross-sectional study

BACKGROUND

Selecting the most efficient type of physical activity that improves mental health can assist in choosing appropriate interventions. Hence, the objective of this study was to evaluate the associations between physical activity and its various aspects, including weekly physical activity, weekly walking and exercise sessions, and the frequency of walking and exercise per week, with the mental health of Chinese adults.

METHODS

This cross-sectional study was carried out in Hangzhou (2023) involving 512 adults aged 18 and 64. Each participant received a self-completed questionnaire comprising three sections. The initial section focused on gathering basic information about the participants, such as gender, age, annual income, and marital status. The second section consisted of the 12-item General Health Questionnaire (GHQ-12), which aimed to evaluate the mental health status of the participants. Lastly, the third section included the International Physical Activity Questionnaire-Short Version (IPAQ-SV), which assessed the metabolic equivalent (MET) of activities like walking, moderate-intensity exercises, and high-intensity exercises.

RESULTS

The study found that mental health problems affected 25.74% of adults, while physical inactivity was prevalent in 49.63% of adults. The statistical model was highly significant (F = 25.143, p < 0.001), suggesting that at least one predictor has a significant impact on mental health. The model accounted for 39% of the variance in mental health, with all variables showing predictive value. Notably, the number of walking days per week emerged as the most influential predictor of mental health (β = -0.392), followed by level of weekly physical activity in MET, the number of exercise training sessions per week, weekly exercise training in MET, and weekly walking in MET (β = -0.312, -0.301, -0.212, and -0.202, respectively).

CONCLUSIONS

Adults can allocate more days per week to walking and their usual physical activity to improve their mental health.

Exploring the Factors Influencing Premenstrual Syndrome and Its Severity: The Role of Lifestyle Determinants

Background

Women experience at least one of the Symptoms of Premenstrual Syndrome (PMS) during the menstrual cycle. The present study aimed to determine the factors that influence PMS occurrence and its severity in the medical students.

Methods

This cross-sectional study was carried out on 369 undergraduate female students of Maragheh University of Medical Sciences, Iran, between September 2021 and April 2022. The sampling method was random and participants were recruited through public announcements. The collected data included the provisional diagnosis of premenstrual syndrome, the Iranian version of Premenstrual Syndrome Screening Tool (PSST), the International Physical Activity Questionnaire (IPAQ), Food Frequency Questionnaire (FFQ), and the self-reported measurement of weight and height. All data and questionnaires were designed and then completed online by participants. The multivariable logistic regression analysis determined the potential predictors of PMS, and p-values less than 0.05 were considered significant.

Results

About 70% of participants had PMS. According to the PSST, 69% of them were positive in terms of the severity of PMS. There was a significant correlation between PMS and the severity of PMS symptoms (p<0.001), BMI (p=0.031), and dietary fat (p=0.013). The odds ratio for PMS, BMI, and dietary fat was 10.314, 1.073, and 1.008, respectively.

Conclusion

The present study demonstrated that among lifestyle factors, dietary fat and BMI play a significant role in premenstrual syndrome. Future studies are needed to identify other factors influencing its occurrence and to propose approaches for improving the quality of life of female medical students during their lifespan.

The association of back pain with physical inactivity and hypothyroidism in pregnant women

BACKGROUND

During pregnancy, structural and functional changes usually occur in the body, which has various consequences, including lower back pain (LBP) and hypothyroidism. One of the risk factors for these problems is physical inactivity.

OBJECTIVE

This study aimed to investigate the association of back pain and physical inactivity, weight gain, and hypothyroidism in pregnant women.

METHODS

In this cohort study, 420 pregnant women (26.333 ± 5.820 years old) were included. At first, participants answered this question: "Do you have any plans for pregnancy in the next month?" If the answer was yes, further evaluations were performed. The physical activity and pain intensity were measured by the International Physical Activity Questionnaire Short Form (IPAQ-S) and Visual Analogue Scale. Serum TSH was measured by automated chemiluminescence and commercial kits. Measurements were conducted before, the first, second, and third trimester of pregnancy.

RESULTS

Women reporting LBP were less engaged in physical activities and weight gained in the second and third trimesters of pregnancy was significantly higher than pregnant women without LBP (p< 0.05). TSH level and weight gained in pregnant women with low physical activity level was significantly higher than pregnant women with moderate and high physical activity (p< 0.05) (without significant difference in TSH and BMI). The physical inactivity (before: OR: 1.11 95% CI: 0.89 to 1.22; first trimester: OR: 1.09 95% CI: 1.02 to 1.59; second trimester: OR: 0.92 95% CI: 0.87 to 1.31; third trimester: OR: 1.12 95% CI: 1.02 to 1.39), TSH (OR: 0.85 95% CI: 0.57 to 1.29), and weight gain (second trimester: OR: 0.87 95% CI: 0.92 to 1.59; third trimester: OR: 1.44 95% CI: 1.02 to 1.98; p< 0.05) did predict increased pain intensity.

CONCLUSION

Using health-oriented approaches to increase physical activity and normalize thyroid function and weight gain during pregnancy can have beneficial effects on LBP.

Negative mood state in Kermanshah population during COVID-19 quarantine linked to low physical activity levels: a cross-sectional online survey study

One of the most significant consequences of the coronavirus disease (COVID-19) pandemic is the anxiety and stress it causes among the general population, which can be reduced by engaging in regular physical activity. The aim of this study was to estimate the levels of physical activity and mood state during the COVID-19 quarantine among the Kermanshah population. In this cross-sectional study, a total of 2471 subjects (1256 males and 1215 females) were selected in the population of Kermanshah in the west of Iran, using the convenience sampling method. Physical activity levels were assessed using the physical activity (PA) questionnaire short form (IPAQ-SF), and mood state was measured by the abbreviated form of the Iranian version of the standard POMS questionnaire (Bill Morgan 1979). Participants completed the online questionnaire between March 28th and May 20th, 2020. Descriptive statistics (mean, standard deviation, and percentage), and deductive (Chi-square and Spearman's correlation) were used for data analysis. our study found that the majority of participants reported decreased PA levels during the quarantine period. Specifically, 71.7% reported a decrease in moderate-intensity physical activity, 80.5% reported a decrease in high-intensity PA, and 71.3% reported a decrease in the total volume of PA. The results showed that there was a significant difference between the number of sessions (P=0.001), intensity (P=0.001), and duration of exercise (P=0.001) before and during the coronavirus. There was a significant positive relationship between low (r=0.93; P=0.001) and high (r=0.673; P=0.034) levels of PA and negative mood state. Additionally, there was a positive relationship between moderate PA level (r=0.82; P=0.001) and a positive mood states. The study suggests that the current quarantine has negatively affected the mood states of the participants. Overall, the study recommends regular PA to prevent COVID-19 while adhering to health and safety protocols.

Did the COVID-19 pandemic change the weight reduction in patients with obesity after bariatric surgery?

BACKGROUND

The COVID-19 pandemic has significantly impacted healthcare services worldwide, including bariatric surgery. There is a concern that the pandemic-induced stay-at-home orders and social restrictions may negatively affect weight reduction outcomes post-bariatric surgery. This study aimed to examine the impact of the COVID-19 on weight loss up to six months after three types of bariatric surgeries including One-Anastomosis Gastric Bypass (OAGB), RY Gastric Bypass (RYGB), and Sleeve Gastrectomy (SG) before and two time periods during the COVID-19 pandemic.

METHODS

We conducted a retrospective study using data from a comprehensive database of bariatric surgery patients in Iran. We recruited 882 patients who underwent bariatric surgery from the initiation of COVID-19 to 6 months before public vaccination (Time period 3); among them, 311 patients underwent surgery in the first six months of the pandemic (Time period 2). These patients were compared with 1368 ones in the control group who completed their 6 months follow-up before the pandemic. The study compared the BMI reduction, excess weight loss (EWL), and total weight loss (TWL) outcomes between these groups using Generalized Estimating Equations (GEE) with gamma distribution to adjust for factors that were unevenly distributed across the groups.

RESULTS

The age of participants in time periods 2 and 3 had a mean (standard deviation) of 38.97 (10.99) and 38.84 (10.71), respectively. In all groups, the majority of patients were females, accounting for 76.02%, 71.06%, and 75.74% for the control group and time periods 2 and 3, respectively. There was no significant difference between the groups in terms of weight reduction, as measured by BMI reduction, EWL, and TWL (related P values: 0.283, 0.465 and 0.169). Regression analysis indicated that higher baseline BMI values were associated with greater BMI reduction (0.04, 95% CI: 0.03-0.05), but this did not translate to higher EWL or TWL. Males showed greater BMI reduction (0.33, 95% CI: 0.18-0.49) and EWL (1.58, 95% CI: 0.79-2.37) than females, while females achieved higher TWL compared to males. Among different types of surgery, the OAGB resulted in more weight reduction among patients in the study.

CONCLUSION

In conclusion, our study reveals that bariatric surgery remains effective for weight reduction during the first 6 months of the pandemic in Iran. Implementation of pandemic protocols ensures comparable efficacy to non-pandemic times. However, caution is needed in generalizing results beyond our specific context due to study limitations. Further research is essential to comprehensively assess the pandemic's broader impact on bariatric surgery outcomes under varying conditions.

Intervention Effects of Physical Activity on Type 2 Diabetic Patients Potentially Infected with COVID-19

The coronavirus disease 2019 (COVID-19) pandemic has clearly had a great influence on the lifestyles of the population, especially on patients with type 2 diabetes mellitus. During the COVID-19 outbreak, many countries/regions implemented social-isolation measures, leading to an increase in negative behaviors and impairing the capability of diabetic patients to resist COVID-19, ultimately causing severe prognoses. Moreover, as the epidemic progressed, multiple studies emphasized the significance of physical exercise in the management of type 2 diabetic patients infected with COVID-19. In this study, we selected research from 1 December 2019 to 9 August 2023 that focused on COVID-19-infected diabetic patients to investigate the impact of type 2 diabetes on the immune functions, inflammation factor levels, lung injuries, and mental disorders of such patients, as well as to assess the risk of novel coronavirus pneumonia in these patients. Additionally, the effects of high-intensity, moderate-intensity, and low-intensity exercises on novel coronavirus pneumonia infection in type 2 diabetic patients and the mechanisms of the effects of such exercise were considered. We concluded that elderly diabetic patients with COVID-19 should perform low-intensity exercises to facilitate their recoveries. This study offers guidance for a proper understanding of the dangers of diabetes and the use of appropriate measures to reduce the risk of novel coronavirus pneumonia infections in type 2 diabetic patients.

Pomegranate (Punica granatum L.) peel extract ameliorates metabolic syndrome risk factors in patients with non-alcoholic fatty liver disease: a randomized double-blind clinical trial

INTRODUCTION

Non-alcoholic fatty liver disease (NAFLD) is a metabolic syndrome (MS)-related liver disorder that has an increasing prevalence. Thus, the aim of our study is to evaluate the effects of pomegranate peel extract (PP) supplementation on hepatic status and metabolic syndrome risk factors.

METHODS

In phase one, the hydro-alcoholic extraction of the peel of 750 kg of pomegranate (Punica granatum L.) was performed by the soaking method. Then, in phase two, NAFLD patients received 1500 mg of placebo (n = 37) or pomegranate peel capsules (n = 39) with a 500-kcal deficit diet for 8 weeks. Gastrointestinal intolerance, dietary intake, lipid and glycemic profiles, systolic and diastolic blood pressure, body composition, insulin resistance indexes, and elastography-evaluated NAFLD changes were followed.

RESULTS

The mean age of participants was 43.1 ± 8.6 years (51.3% female). Following the intervention, the mean body weight (mean changes: -5.10 ± 2.30 kg), waist circumference (-7.57 ± 2.97 cm), body mass index (-1.82 ± 0.85 kg/m2), body fat index (-1.49 ± 0.86), and trunk fat (- 3.93 ± 3.07%), systolic (-0.63 ± 0.29 cmHg) and diastolic (-0.39 ± 0.19 cmHg) blood pressure, total cholesterol (-10.51 ± 0.77 mg/dl), triglyceride (-16.02 ± 1.7 mg/dl), low-density lipoprotein cholesterol (-9.33 ± 6.66 mg/dl; all P < 0.001), fat free mass (- 0.92 ± 0.90 kg; P < 0.003), and fasting blood sugar (-5.28 ± 1.36 mg/dl; P = 0.02) decreased significantly in PP in contrast to the placebo group in the raw model and when adjusted for confounders. Also, high-density lipoprotein cholesterol (5.10 ± 0.36 mg/dl), liver steatosis and stiffness (- 0.30 ± 0.17 and - 0.72 ± 0.35 kPa, respectively, all P < 0.001) improved in the PP group. However, fasting insulin (P = 0.81) and homeostatic model assessment for insulin resistance (HOMA-IR) (P = 0.93) were not significantly different when comparing two groups during the study in the raw and even adjusted models.

CONCLUSION

In conclusion, 1500 mg pomegranate peel extract along with a weight-loss diet improved metabolic syndrome risk factors and reduced hepatic steatosis in patients with NAFLD after 8 weeks.

Gender as a determinant of physical activity levels and mental health of medical students from Poland and Belarus in the context of the COVID-19 pandemic

Background

COVID-19 pandemic has brought about unfavourable changes regarding both physical activity (PA) levels and patterns of behaviour associated with mental health. The study sought to assess PA levels and kinesiophobia in medical students from Poland and Belarus taking account of gender.

Methods

A total of 779 students (405 students from University of Grodno (UG), Belarus, and 374 students from John Paul II University of Applied Sciences (ABNS) in Biala Podlaska, Poland) took part in the study. Women constituted 74.2% of the study population. A diagnostic survey as well as two research tools, i.e., the International Physical Activity Questionnaire (IPAQ)-short form, and the Tampa Scale for Kinesiophobia (TAMPA) were employed in the study.

Results

Students from ABNS manifested significantly higher levels of PA. Taking into account gender, male respondents displayed significantly higher levels of MET-min/week (MET-metabolic equivalent of task). As for kinesiophobia, significantly higher levels were demonstrated by students from UG. Its higher levels were also noted among women.

Conclusion

The findings of the study did not reveal strong correlations between kinesiophobia and PA levels in students from Poland and Belarus in the context of different approaches to the pandemic that both countries adopted. Students from ABNS proved to be more physically active. In turn, participants from UG exhibited significantly higher levels of kinesiophobia. Gender was the factor that significantly differentiated levels of kinesiophobia, with women displaying its higher levels.

Has COVID-19 lowered physical activity practice while boosting online searches for professional exercise information?

COVID-19 is an infectious and contagious disease, caused by the SARS-CoV-2 virus. Due to the rapid spreading of the virus and its lethal consequences, the WHO declared a pandemic. One of the main strategies to treat and prevent the spreading was the stay home safe, a social isolation situation that was accompanied by the closing of fitness gyms, city parks and facilities proper to exercise. This context promoted an increase in home fitness programs and in the search for information online regarding exercise and health. So, the objective of this study was to understand the effects of the pandemic on physical activity behavior and online information search regarding exercise programs. Data collection was through a google forms questionnaire, all procedures were approved by the University ethics committee and we collected data from 1065 participants. Our results showed that the participants main behavior was maintained, 80.7% of our sample were active before the pandemic and only 9.7% of this group stopped being active. On the other hand we registered 7% of participants that started exercise after the pandemic installation. Information about exercise was searched outside social media by 49.6% of the participants with 32.5% using social media. 56.1% would look only for professional advice, interestingly 11.4% of the participants were active without any kind of advice. We concluded that Covid-19 pandemic installation affected negatively the population physical activity behavior and increased awareness about the importance of exercise as a health strategy.

Health-related factors of the Iraqi adult population during the 2020 COVID-19 pandemic: physical activity, eating behavior, quality of life, general health, and mood states cross-talk

BACKGROUND

The lockdown and social distancing caused by Coronavirus disease 2019 (COVID-19) may have changed Physical Activity Level (PAL), eating behavior, and health habits due to long-term confinement worldwide.

OBJECTIVE

This study aimed to evaluate the PAL, eating behavior, Quality of Life (QoL), General Health (GH), and mood states during COVID-19 confinement in a large sample of Iraqi adults.

METHODS

3738 healthy adults (age 18-70 years) residing in Halabjeh, Iraq answered the online questionnaires including the short form of international physical activity, GH, three-factor eating (TFEQ-R18), and a short form of the profile of mood states (POMS-SF) questionnaires. Data analysis was done by Chi-square, and Spearman's correlation using SPSS statistical software at a significant level of (P < 0.05).

RESULTS

The results showed unfavorable PAL, eating behavior, QoL, GH, and mood states in the total population. Low PAL was observed in 69.96% of the men and 75.99% of the women; only 3.60% of the men and 0.77% of the women had a high PAL. There was a significantly positive relationship between low PAL and the incidence of COVID-19 both in men and women (P = 0.801; r = 0.001; and P = 0.682; r = 0.011), respectively; While a significant negative relationship was observed between the moderate and high PAL and the incidence of COVID-19 in men (P = 0.011; r=-0.682 and P = 0.027, r=-0.589), and women (P = 0.001; r=-0.796 and P = 0.018, r=-0.623). No significant relationships were observed between PAL and eating behavior (men: P = 0.086; r = 0.256 and women: P = 0.365, r=-0.121); While, the results show significant positive relationships between PAL with QoL in men (P = 0.012; r = 0.623) and women (P = = 0.001; r = 0.837). based on the results, significant negative relationships between PAL with GH and mood state scores were observed in both men (P = 0.001; r=-0.837 and P = 0.001, r=-0.786) and women (P = 0.010; r=-0.652 and P = 0.001, r=-0.745), respectively.

CONCLUSIONS

The Iraqi adult population showed low PAL, GH, QoL, and mood state during COVID-19 which might be due to the confinement. Also, the significant relationships between low PAL with GH, and mood state recommends physical activity as a valuable health optimizing factor during the COVID-19 pandemic.

The Impact of COVID-19 Pandemic on Physical Activity Levels Among Health Care Workers: Longitudinal Results From the SHAHWAR Study

OBJECTIVE

The aim of the present study was to investigate physical activity (PA) changes during the COVID-19 pandemic among health care workers.

METHODS

In a follow-up study, staff PA was compared before and during the COVID-19 pandemic. Logistic regression model was used to determine the related factors with PA changes.

RESULTS

Total PA (MET minutes a week) among participants (n = 449) showed a statistically significant decrease during the pandemic compared with before the pandemic: 3785.5 ± 2237.09 versus 2363 ± 2452.90, P < 0.0001. Although transport-related PA decreased in medical and administrative department staff (3851 ± 22.83.4 vs 2446.7 ± 2477.6, P < 0.0001 and 3593.8 ± 2094.3 vs 2122.6 ± 2373.8, P < 0.0001, respectively), the decrease was associated with employment in the administrative and nonshift sectors with odds ratios of 2.37 (1.38 to 4.08) and 2.04 (1.28 to 3.26), respectively.

CONCLUSION

Promoting PA at home and leisure is especially recommended to achieve the recommended PA levels.

How will the way we live look different in the wake of the COVID-19 pandemic? A nutrition survey in Greece

Background: As we move towards a post-pandemic society, a question arises: How will the way we live look different in the wake of the COVID-19 pandemic? Aim: The aim of this survey was to evaluate changes in eating habits and other lifestyle behaviours (i.e., exercise and smoking) of people of almost all ages, who live in Greece, during the COVID-19 pandemic. Methods: A web-based survey using conventional sampling was conducted from during December 2020, in Greece. A total of 2258 individuals, aged 17 years and older voluntarily participated (912 (40%) men). Results: 89 (3.94%) of the participants reported that they had, or currently have been diagnosed with COVID-19. Moreover, 36.4% of the participants reported that they have changed their dietary habits during the pandemic towards a healthier diet - those participants had median age of 35 years, were of both sexes, 17% had co-morbidities and 69% with higher education level; moreover, 19% of those participants have started or increased the frequency of receiving dietary supplements that enhance the immune system, 34% of the participants reported that they gained weight during the pandemic period, whereas 19.8% reported that they have lost weight, and 37% of the participants reported that they have started or increased, as compared to the pre-pandemic time, their frequency of physical activities. Conclusions: The COVID-19_pandemic seems to have forced people to discover again habits and traditions towards a more natural and healthier way of living. Long-term consequences and the evolution of these lifestyle changes after the COVID-19 pandemic have to be evaluated relevant to their implications in public health.

The impact of COVID-19 pandemic restrictions on physical activity and mental health status of Iranian people

Background

Coronavirus-19 (COVID-19) is a highly contagious disease caused by acute respiratory syndrome that can negatively impact physical activity as well as mental health of people in the world. Since Iran is one of the countries deeply affected by the COVID-19 pandemic, therefore, the aim of this study was to investigate the impact of the COVID-19 pandemic restrictions on physical activity behaviours, as well as on mental health indicators among Iranian people.

Methods

In this cross-sectional study, 335 participants were included (155 males, mean age = 30.06 ± 14.58 years). Participants were selected through the convenience sampling from different parts of Iran mainly through virtual social networks and filled out an electronic questionnaire in the form of Google Form online survey measuring physical activity behaviours (The International Physical Activity Questionnaire; IPAQ; Short Form) and two mental health indicators–self-esteem (Rosenberg self-esteem scale) and social physical anxiety (7-items social physique anxiety scale). The questionnaires were provided to the participants in the spring of 2021 for 15 days and they were asked to answer it in two periods before the outbreak of coronavirus (winter 2020) and the period during the outbreak of coronavirus (spring 2021).

Results

The results showed that participants reported significant differences from before to during the pandemic in all three variables of physical activity (significant decreases), self-esteem (significant decreases), and social physical anxiety (significant increases) regardless of participants’ gender. The results of correlation test between changes in physical activity and changes in mental health indicators showed that COVID-19 pandemic negatively impacted self-esteem and social physical anxiety. However, we have not found any significant association of physical activity’s change with social physical anxiety or self-esteem’s changes before and during the pandemic.

Conclusions

The findings of the present study indicate a detrimental effect of the COVID-19 pandemic on the physical activity and mental health among Iranian people. Public policies aiming to buffer the negative impact on COVID-19 Iranians’ health are urgently needed.

The effect of the COVID-19 pandemic on weight gain, physical activity and mental health among Turkish university students

BACKGROUND

The COVID-19 pandemic has brought many restrictions that affected Turkey as well as other countries around the world. Restrictions on education, sports activities and social activities affected students physically and psychologically.

OBJECTIVE

The aim of this study is to investigate the impact of the COVID-19 pandemic on weight gain, physical activity, and mental health among university students.

METHODS

The study included students of Pamukkale University aged between 18-25 years. Participants answered the online survey about changes in body composition and physical activity habits during the pandemic. International Physical Activity Questionnaire (IPAQ) was used to assess physical activity levels. Beck Depression Scale (BDS) was used to assess the mental health.

RESULTS

848 (546 females, 302 males) students average aged 20,72±1,63 years were included in the study. When the physical activity times before and during the pandemic were compared, a statistically significant difference was found (p < 0.05). Multivariate analyses showed that higher BDS scores (p = 0.000) were significantly associated with increased weight gain. But there was no significant association with age and changes in physical activity time.

CONCLUSIONS

The results of the study showed that the COVID-19 pandemic has a negative effect on the physical activity level, weight gain and mental health of university students. Students reported an increase in weight during the pandemic. Also, the increase in depressive symptoms is related to higher levels of weight gain. Therefore, physical activity and mental health programmes should be offered to university students as an educational and health policy.

Prevalence of physical activity using validated tools among adults during the COVID-19 pandemic in the Eastern Mediterranean region: A systematic review and meta-analysis

Many interventions have been taken around the world to limit the spread of COVID-19. These interventions have affected people's lifestyles such as physical activity. The aim of this systematic review and meta-analysis was to determine the prevalence of physical activity using validated tools among adults during the COVID-19 pandemic in the Eastern Mediterranean region. A systematic literature review and meta-analysis were conducted in October 2021. We searched three electronic databases (Web of Science, Scopus, and PubMed) for English-language original articles of observational studies (cross-sectional, case-control, and cohort studies) with original data reporting the prevalence of physical activity among adults in 22 countries from EMR during the COVID-19 pandemic. Hoy's risk of Bias tool was applied to assess the biases in individual studies. The result was reported as a percentage for prevalence. A meta-analysis was conducted using the random-effect model with a 95% confidence interval. A total of 363 articles were retrieved. Finally, 15 articles were selected and included in the statistical analysis. The selected studies included 16,585 participants. The result of the meta-analysis showed that the overall physical activity was 51.6% (95% confidence interval: 42.1, 61: p = 0.745). The result of subgroup analysis based on different tools was 60.2%, 39.5%, 36.3%, 39.4%, and 55.2% for Global Physical Activity Questionnaire , The Godin-Shephard Leisure-Time Physical Activity Questionnaire, International Physical Activity Questionnaire, International Physical Activity Questionnaire-BREF, and International Physical Activity Questionnaire-short form, respectively. Our study highlights the urgent need for large-scale measurement and reporting of physical activity and the use of standard tools that can allow for the regular assessment and screening of the PA prevalence to support evidence-informed policy and programs development at both national and regional levels.

The effect of berberine and fenugreek seed co-supplementation on inflammatory factor, lipid and glycemic profile in patients with type 2 diabetes mellitus: a double-blind controlled randomized clinical trial

BACKGROUND

Type 2 Diabetes mellitus is one of the most common chronic diseases in the world and has many complications. Due to the importance of using alternative therapies in managing symptoms of this disease, the present study was designed and conducted to investigate the effect of co-supplementation of berberine and fenugreek in patients with type 2 diabetes mellitus.

METHODS

A randomized controlled clinical trial was conducted on 50 patients with type 2 diabetes mellitus. Participants were randomized in the intervention group, which received 3 capsules/day of 500 mg (300 mg of berberine + 200 mg of fenugreek seed powder) or placebo for 12 weeks. Biochemical and anthropometric variables were measured at the beginning and end of the study.

RESULTS

We observed that fasting insulin, HbA1C, and hs-CRP significantly decreased in the intervention group compared to the baseline. The mean difference in insulin resistance (-0.32 vs. 0.15), fasting blood sugar (-14.40 vs. 1.68), and fasting insulin (- 2.18 vs. 1.34) were clinically significant in comparison to the control group. Almost all domains of SF-12 scores were significantly higher in the intervention group than in the placebo group.

CONCLUSIONS

The combination of berberine and fenugreek seed can improve cardio-metabolic status in patients with diabetes and support the anti-diabetic and anti-inflammatory role of herb in the improvement of quality of life.

Impact of COVID-19 pandemic on physical activity level and screen time is associated with decreased mental health in Brazillian adults: A cross-sectional epidemiological study

The objective was to verify whether the impact of COVID-19 on physical activity and screen time was associated with the impact on quality of life and symptoms of anxiety and depression in a sample of Brazilian adults. The invitation was made through social networks and the collection was carried out through electronic research. There was a decrease in quality of life and physical activity, and an increase in symptoms of anxiety and depression and screen time. These findings are important for new strategies that promote physically active habits during the pandemic .

The Influence of Obesity on Nutrition and Physical Activity during COVID-19 Pandemic: A Case-Control Study

Obesity is one of the important risk factors for a severe course of COVID-19. Maintaining a healthy body weight through diet and physical activity is a reasonable approach to preventing a SARS-CoV-2 infection or in alleviating its course. The goal of the study was to determine the influence of obesity on nutrition and physical activity during the COVID-19 pandemic. A total of 964 respondents, including 227 individuals with a body mass index (BMI) ≥30 kg/m2 were evaluated in this study. In the case of 482 respondents, including 105 individuals (21.8%) with BMI ≥ 30 kg/m2, the data were collected during the pandemic period from 1 June to 31 August 2020. The remaining 482 individuals were the “pre-pandemic” group, selected via propensity score matching (PSM) out of the 723 National Health Program study participants whose data was collected in 2017−2019. The evaluated dietary health factors were quantitatively similar in patients with BMI of either <30 kg/m2 or ≥30 kg/m2 and showed no significant changes during the pandemic. The diets of those who suffered from obesity prior to the pandemic showed the evaluated unhealthy nutritional factors to be less pronounced in comparison with those of individuals with BMI < 30 kg/m2. During the pandemic, the BMI ≥ 30 kg/m2 group showed a significant increase in the overall calorie intake (by 319 kcal; p = 0.001) and an increased consumption of total carbohydrates 299.3 ± 83.8 vs. 252.0 ± 101.5; p = 0.000), sucrose (51.7 ± 30.0 vs. 71.6 ± 49.9; p = 0.000), plant protein (26.3 ± 12.1 vs. 29.3 ± 8.3; p = 0.040), total fat (73.1 ± 42.6 vs. 84.9 ± 29.6; p = 0.011) and saturated fatty acids (29.5 ± 16.4 vs. 34.3 ± 13.9; p = 0.014) in comparison with the pre-pandemic period. The energy and nutritional value of the diets of BMI < 30 kg/m2 individuals did not change between the pre-pandemic and pandemic period. Before the pandemic, the level of leisure physical activity of the BMI ≥ 30 kg/m2 group was significantly lower than of those with BMI < 30 kg/m2. Such differences were not observed in the levels of physical activity at work or school. The pandemic did not alter the amount of physical activity either during leisure time or at work/school in individuals with BMI ≥ 30 kg/m2. However, respondents without obesity exercised significantly less during the pandemic than before. In conclusion, the pandemic altered the diets and levels of physical activity in the Polish population, with dietary changes observed in individuals with BMI ≥ 30 kg/m2 and changes in physical activity observed in those with BMI < 30 kg/m2.

A Cross-Sectional Study on Self-Perceived Health and Physical Activity Level in the Spanish Population

One-third of the Spanish population over 15 years of age did not achieve a reasonable amount of physical activity (PA) before the COVID-19 pandemic. We aim to analyse the associations between the PA level (PAL) and self-perceived health (SPH) in the Spanish population aged 15−69 years during the pre-pandemic period. A cross-sectional study was conducted using the Spanish National Health Survey 2017 (ENSE 2017) data, with 17,777 participants. We carried out a descriptive analysis, analysed intergroup differences with non-parametric statistical tests, and calculated the Odds Ratio (OR) and Relative Risk (RR) of having a negative SPH according to PAL. In addition, correlations between PAL and SPH were studied, finding associations between them (p < 0.001). Thus, performing moderate and intense PA was related to better SPH than just walking or inactive. Weak and moderate correlations were found between PAL and SPH (p < 0.001). We also found high ORs and RRs of negative SPH as PAL decreased. Moderate and intense PA were related to positive SPH, while the risk of negative perception in inactive people was higher.

Physical Activity Behavior During the COVID-19 Outbreak in Individuals with Type 2 Diabetes: Role of Social Support and Other Covariates

OBJECTIVES

This study was performed to investigate whether social support and other psychological predictors were associated with physical activity during the prolonged social isolation due to the coronavirus disease 2019 outbreak in Iran.

METHODS

This cross-sectional study was performed on 494 individuals with type 2 diabetes (T2D) in a diabetes specialty clinic. The questionnaire package comprised five parts, including sociodemographic and clinical characteristics, physical activity level, diabetes-specific social support, feelings of isolation, and diabetes-related distress. Clinical and hemoglobin A1c data were obtained from electronic medical records. Descriptive statistics, Pearson's chi-square test, and multivariable logistic regressions were conducted to analyze the data.

RESULTS

Approximately 71% of the participants participated in low/insufficient levels of physical activity. The participants who received support from family/friends (odds ratio [OR] = 1.77; 95% confidence interval [CI]: 1.47 - 2.74), diabetes care team (OR = 1.42; 95% CI: 1.15 - 1.77), and neighbors (OR = 1.53; 95% CI: 1.20 - 2.08) were more likely to have sufficient physical activity than those who did not receive these supports. There was also an association between physical activity behavior with feelings of isolation and diabetes distress.

CONCLUSIONS

This study points to the importance of social support as an amplifier mechanism for the maintenance of physical activity behavior in individuals with T2D during critical times.

The COVID-19 Conundrum: Keeping safe while becoming inactive. A rapid review of physical activity, sedentary behaviour, and exercise in adults by gender and age

Background

Coronavirus (COVID-19) has severely impacted lifestyles worldwide. Responses to COVID-19 have intentionally restricted the factors that encourage regular and frequent PA; opportunity, capability and motivation. However, the effects of these restrictions are likely to have differed by gender and age and different intensities of PA. This rapid review builds on previous evidence by synthesising the global impact of COVID-19 on adult PA through specific intensities and types of PA and evaluating this by gender and age.

Methods

A rapid systematic search of seven electronic databases (PubMed, MEDLINE, CINAHL, SPORTDiscus, Academic Search Complete, APA PsycInfo, and APA PsycArticles) was performed from December 2019 to January 2021. Studies investigating adult change in PA, exercise or sedentary behaviour due to COVID-19 were included.

Results

From an initial database search identifying 3,863 articles, 66 remained for synthesis after applying eligibility criteria. Results demonstrate decreases among all intensities and types of PA—walking (6 out of 7 papers), moderate-only (5 out of 6 papers), vigorous-only (5 out of 6 papers) and MVPA (4 out of 5 papers); as well as overall PA (14–72% participants reported a decrease). Reflecting that COVID-19 responses were designed to have universal effects, they also achieved whole-society decreases in PA behaviour, accented in older age groups.

Conclusion

There is a universal need to address the low levels of PA post-COVID-19. The consequences of decreased PA across all intensities has powerful, potentially recoverable, impacts. Universal declines have implications for public health officials and PA advocates for post-COVID-19 initiatives to promote PA.

Lifestyle and eating habits before and during COVID-19 quarantine in Brazil

OBJECTIVE

To assess changes in daily habits, food choices and lifestyle of adult Brazilians before and during the COVID-19 pandemic.

DESIGN

This observational study was carried out with Brazilian adults through an online questionnaire 5 months after the social distance measures implementation. The McNemar, McNemar–Bowker and Wilcoxon tests were used to investigate differences before and during the COVID pandemic period, adopting the statistical significance of P < 0·05.

SETTING

Brazil.

PARTICIPANTS

Totally, 1368 volunteers aged 18+ years.

RESULTS

The volunteers reported a lower frequency of breakfast, morning and lunch snacks (P < 0·05) and a higher frequency of evening snacks and other meal categories during the pandemic period (P < 0·05). The results showed an increase in the consumption of bakery products, instant meals and fast food, while the consumption of vegetables and fruits decreased (P < 0·005). There was a significant increase in the frequency of consumption of alcoholic beverages (P < 0·001), but a reduction in the dose (P < 0·001), increased frequency of smoking (P = 0·007), an increase in sleep and screen time in hours and decrease in physical activity (P < 0·001).

CONCLUSIONS

It was possible to observe an increase in screen time, hours of sleep, smoking and drinking frequency. On the other hand, there was a reduction in the dose of alcoholic beverages but also in the practice of physical activity. Eating habits also changed, reducing the performance of daytime meals and increasing the performance of nighttime meals. The frequency of consumption of instant meals and fast food has increased, while consumption of fruits and vegetables has decreased.

Prospective analysis of physical activity levels and associated fitness factors amid COVID-19 pandemic and social-distancing rules. A special focus on adolescents

Objective

Physical activity is a significant health determinant and is likely to be influenced by social-distancing rules imposed by authorities during the COVID-19 pandemic. This study explored gender-based differences in physical activity levels (PALs) and associated factors amid COVID-19 pandemic in adolescents.

Methods

In this prospective analysis, 112 healthy adolescents (15.63 ± 1.21 years) participated. They were assessed at the baseline (before the announcement of COVID-19 as a global pandemic) for anthropometry, fitness status, and PALs (baseline-PALs), and next at the follow-up (three months of imposed social-distancing rules) for PALs (follow-up-PALs) over an internet-based platform through the Physical Activity Questionnaire for Adolescents.

Results

A significant PALs decline was evidenced for the whole sample (P < .001) and such a decline was predominantly affected by significant PALs reduction among males (P < .001) rather than in females (P = .06). The fitness variables (explosive power, muscle endurance, flexibility, and aerobic endurance) were consistently positively correlated with the baseline- and follow-up-PALs in both genders with particularly prominent associations of PALs with explosive power and aerobic endurance.

Conclusion

Physical literacy is necessary for PALs preservation, given the remarkable PALs decreases among adolescents during challenging circumstances such as the COVID-19 pandemic.

Predisease Physical Activity Level and Current Functional Capacity in Patients With COVID-19: Relationship With Pneumonia and Oxygen Requirement

BACKGROUND

During the COVID-19 pandemic, restrictive measures can reduce physical activity. The purpose of this study was to evaluate predisease physical activity and current functional capacity in patients with and without the presence of pneumonia and oxygen requirement in Turkish survivors of COVID-19.

METHODS

Among the COVID-19 patients admitted to the hospital, 100 patients were selected. Data about predisease physical activity (by short-form International Physical Activity Questionnaire), oxygen requirement and presence of pneumonia, and current functional capacity (by the 6-min walking test) were collected. Continuous and categorical variables were compared with the Mann-Whitney U and χ2 test, respectively (P < .05).

RESULTS

The predisease physical activity levels and current functional capacity of patients with pneumonia and oxygen requirement were significantly lower than patients without pneumonia and oxygen requirement (P < .05). However, there was no significant difference between males and females (P > 0.05). Pneumonia and oxygen requirement was more common in the older adults (P < .05). Also, a significant correlation was found between age with predisease physical activity (r = .530, P = .000) and current functional capacity (r = -.346, P = .000) and predisease physical activity level with current functional capacity (r = .523, P = .001).

CONCLUSION

The physical activity level may be related to the severity of COVID-19 disease.

Perceived barriers to physical activity during the 2nd lockdown in a northeastern state of Brazil

Background

The practice of physical activity has been recommended during the pandemic period of COVID-19 as a way of preventing the worsening of physical and mental health. After the increase in COVID-19 cases in Brazil and the new lockdown decrees, many people have reported that they are unable to engage in physical activity during the lockdown.

Aims

The present study aimed to investigate the barriers to physical activity in the 2nd lockdown in the state of Ceará, Northeast Brazil.

Methods

1036 (55.6% women) residents of the state of Ceará, Northeastern Brazil participated in the study. For data collection, a questionnaire was used including sample characterization questions, physical activity, and barriers to physical activity during the 2nd lockdown in the state of Ceará. This instrument was made available by Google Forms, between March 8th and 19th, 2021. Descriptive statistics and logistic regression were used for data analysis.

Results

The three most relevant barriers were: Lack of motivation (7.3%), lack of space at home (5.9%) professional instructions (2.8%). The lack of space at home barrier was associated with age (OR = 2.56; CI 95% 1.05-6.02) and living in the capital (OR = 2.53; CI 95% 1.26-5.33). The barriers, taking care of children (OR = 3.75; CI 95% 1.37-10.2) and increased time spent on daily activities (OR = 2.20; CI 95% 1.02-4.74) were associated with living in the metropolitan region.

Conclusion

The lack of motivation, space at home, and professional instruction showed as being limiting factors to physical activity during the lockdown, indicating plans of action aimed at encouraging the practice of physical activity during a pandemic period.

COVID-19 pandemic-induced physical inactivity: the necessity of updating the Global Action Plan on Physical Activity 2018-2030

To prevent and reduce inactivity, the World Health Organization (WHO) designed a global plan called Global Action Plan on Physical Activity 2018–2030 (GAPPA) in 2017. In this plan and according to the state of physical activity in 2016, actions and goals were set. However, the world is facing a COVID-19 pandemic, which has affected various aspects of lifestyle, including physical activity. Some studies have shown that physical activity reduced during the pandemic. For this reason, the WHO should review the GAPPA and update goals and actions according to the state of physical activity in 2020.