Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey

Change in leisure-time physical activity and perception of weight gain during the COVID-19 pandemic: results from the ELSA-Brasil Cohort

Introduction

Objective: this study aimed to identify the association between changes in Leisure-Time Physical Activity (LTPA) and Perceived Weight Gain (PWG) during the COVID-19 pandemic among participants enrolled in the Longitudinal Study of Adult Health (ELSA-Brasil). Methods: an observational longitudinal study utilizing data from the ELSA-Brasil, Wave 3 - W3 (2017-2019), and Wave-COVID - WC (July/2020 to February/2021). LTPA was assessed using the International Physical Activity Questionnaire, collected at both time points, while PWG was evaluated through a questionnaire in WC. Statistical analyses were performed using the SPSS 21.0, with significance set at p < 0.05. Results: among 4402 adults (57.8 % women), after adjusting for potential confounding variables, individuals who reduced their LTPA levels to the extent of changing their classification were more likely to experience PWG - specifically, those who were moderately active in W3 and became sedentary in WC (OR = 1.5 [95 % CI, 1.2-1.9]) or had low LTPA in WC (OR = 1.6 [95 % CI, 1.2-2.1]), and those who were highly active in W3 and presented a low level of LTPA in WC (OR = 2.3 [95 % CI, 1.05-5.4]). Conclusion: our findings suggest that individuals who engaged in LTPA (moderately and highly levels) during W3 but transitioned to insufficiently active or sedentary lifestyles during the WC, were more likely to experience PWG.

Food Insecurity, Health, and Socioeconomic Status: Results from the University of the Basque Country, Spain

Background/Objectives: Food insecurity (FI) is the 'limited or uncertain availability of nutritionally adequate and safe foods'. Although the literature suggests a strong association between FI, socioeconomic status (SES), and health, the nature of their relationship is not well specified in vulnerable population groups such as university students. To address this gap, this study aimed to assess the prevalence of FI among university students, examine its association with various health outcomes, and explore the potential mediating effect of SES. Methods: This cross-sectional survey included a convenience sample of 394 participants from the University of the Basque Country UPV/EHU (Spain). Data on SES, demographic and lifestyle factors, and health outcomes were collected between December 2021 and January 2022, using a questionnaire developed by the Food Insecurity among European University Students during the COVID-19 Pandemic (FINESCOP) consortium. Internal consistency of the questionnaire was assessed at the UPV/EHU using Cronbach's α. FI was measured using the Food Insecurity Experience Scale (FIES) from the FAO, which was validated through testing of Rasch model assumptions. Results: Overall, 19% of university students were food insecure, with 2.5% experiencing moderate and 0.8% experiencing severe FI. Adjusted linear regression models showed that FI was associated with a higher body mass index (BMI), poorer self-rated health, and worsening health during the pandemic. SES mediated the relationship between FI and health outcomes, with the strongest mediation observed for BMI (indirect association: B = 0.25, 95% CI = -0.17-0.75; total association: B = 1.85, 95% CI = 0.14-3.56; 15.3% of mediation). Conclusions: FI is prevalent among UPV/EHU students, and it is associated with multiple negative health outcomes, partly explained by SES. To effectively address FI, higher education institutions should consider implementing comprehensive strategies. For future research, longitudinal studies would be recommended to systematically monitor FI and examine causal relationships.

Association between smoking status and changes in health behaviours during the COVID-19 lockdown: a cross-sectional study in Israel

OBJECTIVES

To explore the association between smoking status (current vs former), changes in smoking habits (among current smokers only) and negative changes in dietary and physical activity habits during the initial COVID-19 lockdown in Israel.

DESIGN

A secondary analysis of an online cross-sectional study (6 April 2020 to 28 April 2020). Dependent variables included deteriorations in dietary habits score and odds of reporting worsening of physical activity habits during the first COVID-19 lockdown. The study analysed the association between these variables and 'smoking status' (current vs former) and, within smokers, changes in smoking habits, using multivariate logistic and linear regression models. For changes in physical activity habits, there was a significant interaction with baseline physical activity levels (p=0.04), therefore, analysis was stratified accordingly.

SETTING

Online data collection.

PARTICIPANTS

660 participants, current or former smokers in Israel, Hebrew speakers and ≥18 years old.

PRIMARY OUTCOMES

Self-reported negative changes in dietary habits and physical activity during the first COVID-19 lockdown.

RESULTS

The sample (n=660) included 66.2% (n=437) current smokers and 33.8% (n=223) former smokers. Among current smokers, 43.5% (n=190) indicated an increase in their smoking habits. Of all respondents, 25% (n=170) reported a negative dietary change and 48% (n=192) spent less time engaging in physical activity, with 66% (n=437) reporting increased levels of stress. No significant association was found between smoking status and the dietary habits score in the multivariate linear regression (B=-0.046, CI -0.493 to 0.401, reference group: former smokers). This indicates that being a current smoker was associated with a non-significant 0.046 point decrease in the dietary habits score compared with former smokers. Similarly, no significant association was found between smoking status and odds of reporting worsening of physical activity, even after stratifying by baseline physical activity levels. Among participants who currently smoke, no significant association was found between changes in smoking habits and the dietary habits score (B=0.391, 95% CI -0.061 to 0.843, p=0.090, reference group: those who smoke the same or less) or with odds of reporting worsening of physical activity (OR=1.16, 95% CI 0.688 to 1.956, p=0.577, reference group: those who smoke the same or less).

CONCLUSION

Among current and former smokers, high rates of negative health habit changes were found, emphasising the need for interventions during future crises. Smoking status and/or changes in smoking habits among current smokers were not associated with negative changes in dietary and physical activity habits.

Predictive factors of health related quality of life in children and adolescents with celiac disease: An Italian multicenter study on behalf of the SIGENP

BACKGROUND

In pediatric patients, celiac disease (CD) may influence the health-related quality of life (HRQoL).

AIMS

The study aimed to assess HRQoL and further characterise the clinical factors associated with reduced HRQoL, in a large multicenter pediatric cohort with CD.

METHODS

The disease-specific questionnaire CD Dutch Questionnaire (CDDUX) and the generic questionnaire Paediatric Quality of Life Inventory (PedsQL) were used to assess the HRQoL. Clinical and sociodemographic characteristics were analyzed, univariate and multivariate analysis were conducted.

RESULTS

Eleven different Italian pediatric centers and 871 families were involved. Mean age at interview was 12.9 ± 2.9 years. The mean total CDDUX score of CD patients was 47.1 ± 18.8, revealing a neutral HRQoL (47.1 ± 18.8), and a good to very good HRQoL according to the PedsQL (81.4 ± 12.6), parents indicated lower scores (p = 0.03) with both questionnaires (CDDUX 45.1 ± 18.6 and PedsQL 79.9 ± 14.5). Patients with lower HRQoL were mainly female, living in Northern Italy, with lower parent's education level and non-biopsy diagnosis of CD. In multivariate analysis, the main predictor of lower CDDUX score was non-biopsy diagnosis.

CONCLUSIONS

The HRQoL in a large cohort of Italian children is reported as neutral-good. This indicates a high level of adaptive behaviors in response to the daily challenges of CD. Parents tend to underestimate their children's HRQoL. Specific clinical factors, including non-biopsy diagnosis, may be associated to lower HRQoL.

Effects of Covid-19-related anxiety on overeating and weight gain in a diverse college sample

The outbreak of the Covid-19 pandemic has been linked with caloric overeating and weight gain. We employed a mediation analysis to determine whether pandemic-associated overeating was a direct effect of Covid-19-related anxiety (affect regulation theory) or mediated by a coping mechanism of escape eating (escape theory). A diverse pool of college students participated in a repeated cross-sectional study during three separate waves: May 2021 (wave 1, n = 349), December 2021 (wave 2, n = 253), and March 2022 (wave 3, n = 132). The results revealed a significant indirect effect of Covid-19-related anxiety on high-caloric overeating mediated by escape eating, but no direct path between Covid-19-related anxiety and caloric overeating. Analysis of racial/ethnic status uncovered significantly greater Covid-weight gain in Hispanic participants compared with White, Black, and Asian participants. Our results suggest that Covid-19 weight gain is a byproduct of a mediated escape mechanism differentially affecting racial/ethnic groups.

Goal Setting and Attainment in a Randomised Controlled Trial of Digital Health-Assisted Lifestyle Interventions in People with Kidney and Liver Disease

INTRODUCTION

Goal setting is an effective strategy in altering fitness and dietary behaviours. The goal attainment scale (GAS) is a patient-reported outcome measure that can be used to quantify goal achievement. The GAS has not been extensively assessed in lifestyle intervention trials. This study aimed to describe the goal setting process and assess the impact of a digital exercise and diet service and self-efficacy on goal attainment in people with chronic disease and at increased cardiometabolic risk.

METHODS

This study presents a single-centre, 26-week, randomised controlled trial (RCT) comparing standard care to digital health technologies (text messages, nutrition/exercise app, video consultations with dietitian and/or exercise physiologist). The comparator group was offered dietitian review (per standard care), and both groups received a wearable activity monitor. Individualised goal setting was facilitated prior to randomisation. Goal importance, performance measures, and self-efficacy were determined by participants. Goal outcome and 'Change in GAS' scores, reflecting the difference between baseline and follow-up performance, were calculated using validated formulae.

RESULTS

Goal setting was completed and reviewed by 66 participants, with a median age of 51 years and 56% being male. The most common goals related to weight loss (46%), fitness (29%), and diet (15%). Most participants (62%) reported improvements in their goals, with most improvements in dietary (71%), fitness (52%), and weight loss (39%) goals. There was no significant difference in goal outcomes between intervention and comparator groups (p = 0.99). There was, however, a significant correlation between nutrition self-efficacy and dietary goal achievement (p = 0.04).

CONCLUSIONS

The novelty and feasibility of goal setting and attainment were demonstrated in this RCT of lifestyle interventions in people with chronic disease. Though the intervention did not significantly improve goal attainment, most participants reported improvements in their lifestyle goals. There were greater improvements in dietary goals than in fitness or weight loss goals. Participant-led goal setting with GAS and participant self-efficacy has potentially important applications in future lifestyle modification research and clinical implementation endeavours.

Food safety and consumption patterns in the Campania region during the COVID-19 emergency

The objective of this study was to evaluate the association between consumers' experience of COVID-19 and changes in their food purchasing decisions during the lockdown as a result of their risk perception. An online questionnaire was created to analyze consumer purchasing behavior and awareness during the pandemic. At the end of the online administration period, the replies collected were downloaded. A descriptive analysis of the data was carried out through the construction of tables of individual variables; for each variable, the patterns, frequencies, and percentages with which they occurred were determined. Subsequently, a multiple correspondence analysis (MCA) was conducted; this is one of the most widely used statistical techniques for the "multiple" analysis of qualitative or mixed data collected through questionnaires. The final extraction of the completed questionnaires returned the replies of 114 individuals. In the MCA, not all the variables of the matrix were considered, as they were not proportional to the number of individuals. We considered 7 active variables and 1 supplementary variable, which contributed to the formation of factors. The most notable pattern was that those people who were most worried about the risk of contagion not only sanitized their purchases but also reduced their online purchases and deliveries, believing that these measures could reduce the risk of contagion.

Adherence to the Mediterranean Diet Among Families from Four Countries in the Mediterranean Basin

Background/Objectives: The cultural and socioeconomic changes to which societies are exposed can alter individuals' lifestyles and dietary habits. The nutritional patterns of Mediterranean countries may also be affected by these factors at varying levels, depending on the changing social characteristics of the countries. This study aimed to determine Mediterranean diet (MedDiet) adherence among family members from four Mediterranean countries (Türkiye, Spain, Italy, and Lebanon). Methods: The survey was structured around sociodemographic data, family relationships, the Mediterranean diet adherence screener (MEDAS), the Mediterranean lifestyle index (MEDLIFE), the Mediterranean diet quality index (KIDMED), and the obstacles and drivers of MedDiet adherence. Results: The data were obtained from adults (n = 812), with the contribution of their children (n = 500) if they had any. According to the MEDAS, 22% of the adults strongly adhered to the MedDiet. Similar results were obtained when Mediterranean lifestyle adherence was analyzed using the MEDLIFE score, with 20% of the adults presenting a strong adherence, while significantly stronger adherence was found in Lebanon than in the other countries. Regarding the children and adolescents, around 30% presented strong adherence to the MedDiet. Price, availability, and accessibility were significant obstacles, whereas the perceptions of health and diet quality were identified as the drivers of the MedDiet. Conclusions: Overall, our results highlight the need for national policies to reduce the economic burden of healthy food options while encouraging equitable access to re-popularize the MedDiet pattern. Future research should focus on intervention strategies tailored to different age groups and socioeconomic backgrounds, the long-term impact of family-based strategies, and the cultural influences on MedDiet adherence.

New Dietary Trends-Meal Kit Delivery Services as a Source of Nutrients: A Scoping Review

Producers and distributors of meal kits promote their products by emphasising customisation and a health-conscious approach to eating. Consumers of these services expect that, for an appropriate fee, they will receive a nutritious and flavourful meal, tailored to their individual needs and conveniently delivered to their homes. This raises the question of whether meal kit companies meet these expectations and whether their products are prepared with the level of care claimed in their advertisements. This scoping review aims to present available evidence that offers insight into the nutritional content, safety, and acceptability of meal kit delivery services. In this context, we have identified 15 publications. To the best of our knowledge, this is the first scoping review to focus specifically on meal kits. The findings highlight the significant potential of meal kits and may contribute to efforts to enhance their quality. Available research on meal kit delivery services was conducted using calculation methods. Nutritional value studies involving analytical methods and intervention studies are necessary in order to expand the understanding of the potential of meal kits role in whole-food nutrition.

Impact of Lifestyle Changes on Body Weight Gain During Nationwide Lockdown Due to COVID-19 Pandemic

Background: During the coronavirus disease 2019 (COVID-19) pandemic, people in Japan were urged to stay at home as much as possible, and this resulted in significant changes in lifestyle behavior. The new lifestyle included factors affecting both energy intake and energy consumption, and it is now thought that weight gain during the lockdown was the result of complex effects. The aim of this study was to determine the relationships among lifestyle habits, laboratory data, and body weight gain during the lockdown using medical check-up data. Methods: A total of 3789 individuals who had undergone consecutive medical check-ups during the period from 2018 to 2020 were included in this study. Participants whose body weight had increased by 5% or more were divided into two groups: a before-lockdown group (participants who had gained weight between 2018 and 2019) and an after-lockdown group (participants who had gained weight between 2019 and 2020). Physical measurements, laboratory data, and answers to six questions about lifestyle habits, for which information was obtained from the records from medical check-ups, were compared in the two groups. Results: There was no significant difference between the distribution of weight changes in 2018-2019 before the lockdown and the distribution of weight changes in 2019-2020 after the lockdown. The before-lockdown and after-lockdown groups both included about 7% of the total participants (279 and 273 participants, respectively). Diastolic blood pressure and levels of AST, ALT, and LDL-C were significantly higher in the after-lockdown group than in the before-lockdown group. The percentages of participants with alcohol consumption and exercise habits were significantly higher in the after-lockdown group than in the before-lockdown group, and an analysis by gender showed that the differences were significant for women but not for men. Conclusions: The distributions of weight changes before and during the COVID-19 pandemic were similar. Exercise habits and alcohol consumption might have been unique factors causing weight gain during the COVID-19 pandemic, particularly in women. Our findings suggest that the impact of behavioral restrictions and lifestyle changes during a pandemic may be different in men and women.

The impact of smartphone addiction on mental health and its relationship with life satisfaction in the post-COVID-19 era

Following the COVID-19 outbreak, smartphone usage among quarantined Chinese college students surged significantly, leading to a growing dependency on their devices and adversely impacting their emotional well-being. Consequently, the negative emotions associated with smartphone addiction have emerged as critical factors influencing students' life satisfaction. However, the psychological mechanisms linking these emotional effects to life satisfaction, as well as potential sustainable educational interventions, remain insufficiently explored. This study assessed a sample of 322 undergraduates (51.6% male) using the Mobile Phone Addiction Index (MPAI), the Depression, Anxiety, and Stress Scale (DASS-21), and the Satisfaction With Life Scale (SWLS) to construct a mediation model. The aim was to examine the relationships between smartphone addiction, negative emotions, and life satisfaction. Results revealed that smartphone addiction was significantly positively correlated with negative emotions (r = 0.332, p < 0.01), while negative emotions were significantly negatively correlated with life satisfaction (r = -0.391, p < 0.01). Among these negative emotions, depression emerged as a key factor, intensifying smartphone dependence and detrimentally affecting overall life satisfaction. The mediation analysis demonstrated that smartphone addiction contributes to the development of negative emotions, which in turn reduce life satisfaction. Students with higher levels of smartphone addiction reported heightened negative emotions, leading to more pessimistic coping strategies and, ultimately, a decline in mental health and life satisfaction. This study provides valuable insights into the impact of smartphone addiction on college students' life satisfaction and offers actionable educational recommendations to mitigate its harmful effects, promoting healthier and more sustainable lifestyles for students.

The impact of COVID-19 pandemic on sarcopenic obesity among children between 6 and 10 years of age: a prospective study

This study aims to examine the effects of physical activity, eating habits, sleep patterns, and media use on children's body composition during the COVID-19 pandemic, as well as the relationship of these factors with sarcopenic obesity (SO). This prospective cross-sectional study has involved 431 healthy male and female child participants aged between 6 and 10 years during the COVID-19 pandemic lockdown period. The daily routines of participants, including their dietary habits, levels of physical activity, and media usage patterns, have been assessed. The anthropometric measurements taken included body weight, height, body mass index (BMI), and skinfold thickness assessments. Body composition analyses have been conducted using the bioelectrical impedance (BIA) method to determine the total body fat and muscle mass as well as the fat percentage. It has identified obesity in 25.2% and SO in 9.5%. Children with SO have had mean BMI SDS of 2.67 ± 0.4 and mean waist circumference of 78.5 ± 9 cm. Fruit consumption OR = 2.68, 95% CI (1.13-6.31), the number of household members OR = 0.54, 95% CI (0.35-0.84), the duration of sitting time OR = 1.17, 95% CI (1.02-1.36)], and junk food consumption OR = 1.27, 95% CI (1.03-1.57)] have been found to be effective in the development of SO.

CONCLUSION

The COVID-19 pandemic has had a significant impact on the body composition of children, resulting in an increased prevalence of obesity and sarcopenic obesity. This research highlights the critical importance of engaging in regular physical activity, consuming a balanced diet, and obtaining sufficient sleep, particularly during times of crisis.

WHAT IS KNOWN

• Sarcopenic obesity is a complex metabolic condition characterized by reduced muscle mass and increased adipose tissue. • COVID-19 pandemic-related physical inactivity potentially has led to adverse effects on muscle mass composition.

WHAT IS NEW

• First comprehensive assessment of sarcopenic obesity development in children during the COVID-19 pandemic, utilizing advanced bioelectrical impedance analysis (BIA) to evaluate changes in muscle mass and adipose tissue. • Systematic evaluation of the impact of sedentary lifestyle and dietary habits on sarcopenic obesity during the unprecedented lockdown period.

Impact of the COVID-19 pandemic on tobacco product consumption and behavioral patterns from a low-middle income country perspective: A qualitative study

INTRODUCTION

Previous studies investigating socioeconomic status and tobacco consumption during the COVID-19 pandemic were survey-based. To extend knowledge beyond prevalence rates and trends of tobacco consumption, qualitative research is needed to identify individual's experiences. There is a critical gap within this context, particularly in low-middle income countries. The aim of the study was to perform a qualitative analysis on consumption patterns of tobacco users from a low-middle income country during the COVID-19 pandemic, and to identify factors influencing motivation to quit tobacco products during the pandemic and the perceptions of self-risk for complications of tobacco consumption and COVID-19.

METHODS

A qualitative study was conducted in São Paulo, Brazil in September 2020. We used a focus group with semi-structured interviews. Participants were invited to answer questions about behavioral and consumption patterns of tobacco products during early stages of COVID-19 pandemic. Two investigators independently performed triangulation of content of the transcripts. Data were analyzed using inductive content analysis.

RESULTS

Eighteen participants were evaluated (66.7% males) with mean age 34.1 ± 14.9 years. Many participants presented high levels (33.3%) of nicotine dependence. Thematic analysis of participants' narratives resulted in two themes: Theme 1: Behavioral and psychological factors impacting consumption; and Theme 2: Consumption patterns, dependence, and information. Open-coding process resulted on four codes: 1) Behavioral and lifestyle changes; 2) Psychological and motivational factors; 3) Consumption patterns and dependence; and 4) Information exposure and awareness. Nine categories were generated from the codes.

CONCLUSIONS

Behavioral and consumption patterns varied significantly in tobacco users in Brazil during the early stages of the COVID-19 pandemic, ranging from increases to no changes. Individuals consuming tobacco products showed awareness about the harmful effects of smoking and COVID-19 complications.

Effects of Covid-19 pandemic on nutritional habits, lifestyle changes and dental trauma frequency of children with autism: a cross-sectional study

BACKGROUND

The Covid-19 pandemic has disrupted daily routines and lifestyle habits, affecting the psychological well-being and dietary habits of individuals, especially children with autism spectrum disorder (ASD). This study aims to evaluate the susceptibility of children with ASD to changes in nutritional habits, lifestyle, and dental trauma during the pandemic related with oral health and compare them with healthy children.

METHODS

This study, conducted at Istanbul University, involves children aged 3-14 diagnosed with ASD at the Department of Child and Adolescent Psychiatry, and healthy children who visited the Department of Pedodontics. Parents provide written informed consent, and a questionnaire covering various aspects of their child's health and habits is used. Intraoral examinations are conducted for both groups, recording any trauma history or signs, and evaluating possible causes and risk factors. All data were obtained and analysed by SPSS software program version 23.0 with descriptive statistics calculation, Chi square test, Kolmogorov Smirnov, the Mann-Whitney U test, t test and McNemar test was used with p value fixed at 0.05.

RESULTS

The results show significant differences between children with ASD and the control group in terms of dental health. Children with ASD had lower dmft and DMFT indices, indicating better dental health (p = 0.005). However, the frequency of dental trauma was similar between the groups (p = 0.685). Additionally, the control group exhibited more significant changes in dietary habits during the pandemic, with a higher tendency for snacking throughout the day (p = 0.027). During lockdowns, parents of children with ASD were statistically more likely to provide junk food when their child was irritable (p < 0.001). Changes in physical activity levels also differed, with a more pronounced decrease in the control group (p < 0.001). Furthermore, children with ASD experienced a statistically significant higher rate of disruption in daily routines and inability to participate in social activities and courses (p < 0,001).

CONCLUSION

This study sheds light on the unique challenges faced by children with ASD, particularly in terms of dental health and related behaviors. It underscores the importance of interventions to ensure optimal oral health outcomes for this population, especially during periods of disruption like the Covid-19 pandemic.

Prevalence and factors of COVID-19 among children in Hunan, China, following the deregulation of epidemic control: an observational study in epidemiology

OBJECTIVES

To investigate the prevalence and factors of COVID-19 infection in children aged 0-6 years within Hunan Province following the deregulation of epidemic control.

DESIGN

This is an observational study in epidemiology, using an on-site questionnaire survey to investigate the current status of COVID-19 infection and its influencing factors in children aged 0-6 years in Hunan Province from 16 February to 24 March 2023.

SETTING

Multi-stage stratified sampling method was applied in this study. The regions were categorised as developed, medium and underdeveloped. One municipality was selected from each category. In each municipality, one district and one county were chosen for cluster sampling.

PARTICIPANTS

Children aged 0-6 years in Hunan Province.

RESULTS

A total of 78 115 children aged 0-6 years were enrolled in this study, of 30 659 (39.2%) had a confirmed positive SARS-CoV-2 test result or related clinical symptoms. The majority of COVID-19 infections in children were of mild type (92.0%), and very few were severe and critical (0.4% and 0.1%). The majority (74.6%-88.7%) of children had minimal lifestyle behavioural changes after infected with COVID-19. Parents of the child working as a staff member (OR=0.654, 95% CI: 0.603, 0.709) and civil servant (OR=0.865, 95% CI: 0.794, 0.941), living in a rural area (OR=0.384, 95% CI: 0.369, 0.400) and no COVID-19 exposure (OR=0.108, 95% CI: 0.104, 0.113) were protective factors for COVID-19 infection in children.

CONCLUSION

Children experienced a large number of COVID-19 infections following the deregulation, fewer severe cases and fewer changes in lifestyle. Easing epidemic control measures in the later stage of the pandemic did not aggravate the consequences of the epidemic.

Effect of Mediterranean diet and physical activity on healthcare professional depression, burnout and professional fulfillment during COVID-19

Objectives. The mental health of healthcare professionals, especially during the COVID-19 pandemic, is a critical concern. This study investigates the prevalence of burnout and professional fulfillment, depression and the relationship between physical activity and adherence to the Mediterranean diet with depression, burnout and professional fulfillment among healthcare professionals. Methods. Data were collected through a web-based survey of 567 healthcare professionals. Logistic regression analysis with age and sex adjustment was employed to analyze the results. Results. The prevalence of depression was 44%, burnout stood at 66% and professional fulfillment was reported at 28%. Adherence to the Mediterranean diet was linked to a reduced risk of depression (odds ratio [OR] 0.63, 95% confidence interval [CI] [0.41, 0.96], p = 0.033) and physical activity was also associated with a lower risk of depression (OR 0.49, 95% CI [0.32, 0.75], p = 0.001). Furthermore, adherence to the Mediterranean diet was associated with a reduced risk of burnout (OR 0.49, 95% CI [0.25, 0.98], p = 0.045). Conclusion. This study highlights the positive impact of physical activity and the Mediterranean diet as lifestyle factors on depression and burnout. These findings have implications for screening, follow-up and timely interventions to support the mental well-being of healthcare professionals.

Weight gain, poor mental health and increased sedentary hours among Malaysian adults during the COVID-19 pandemic

BackgroundThe Movement Control Orders (MCO) in Malaysia due to the COVID-19 pandemic had a profound impact on the lifestyle behaviours, weight changes, and mental health of the population.AimTo determine the changes in physical activity, sedentary behaviour, body weight status and mental health status among Malaysian adults before and during the pandemic.MethodsA total of 338 Malaysian adults participated in this cross-sectional online study. Sociodemographic and anthropometric data were self-reported. Physical activity and sedentary behaviour were assessed using International Physical Activity Questionnaire-Short Form (IPAQ-SF) while the Perceived Stress Scale (PSS-10), Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder Assessment (GAD-7) were used to examine stress, depression and anxiety, respectively. All statistical analysis was performed using SPSS version 28.0.ResultsThe results showed an average weight gain of 0.6 kg among the participants with 45.5% of them experiencing weight gain. In addition, sedentary behaviour (p < 0.001), PSS-10 score (p < 0.001), PHQ-9 score (p = 0.002) and GAD-7 score (p = 0.001) were significantly increased during the COVID-19 pandemic whereas the level of physical activity was significantly decreased (p = 0.003) during the pandemic. Weight changes during the pandemic were found to be associated with age, sedentary hours, and PHQ-9 score. Through binary logistic regression, sedentary hours (AOR = 1.068, 95% CI = 1.002-1.139, p = 0.043) were identified to be a risk factor for weight gain during the pandemic.ConclusionThe findings suggested that public health interventions to prevent weight gain should focus on strategies to increase physical activity for sedentary lifestyles.

Psychosocial status and COVID-19 outcome are significantly associated

Covid-19 pandemic raised both physical and mental threat to human. Globally, 607,497,755cases of infection and 6,492,948 deaths were recorded until August, 2022. The psychosocial-conditions in pre-infection-period might influence disease. Here, we delineate the impact of socio-economic status, pre- or post- Covid-19 psychosocial and other factors (lockdown/self-isolation/diagnosis)on this disease outcome. Pre-Covid mental-status (depression-anxiety, tobacco-smoking and suicide-mortality), quality-of-life (QOL) and Global-Health-Security (GHS) were correlated with total-infection and case-fatality-rate (CFR) in > 170 countries. The database of World-Health-Organization/World-Bank/United-Nations and the Johns-Hopkins-Center for Health-Security was utilized. The Student's t test, multivariate-ANOVA, correlation and linear-regression were performed. Psychological wellbeing indicators (happiness/GSH/QOL) and mental-impairments like depression-anxiety positively correlated with infection and CFR (p < 0.05-p < 0.001). The happiness-index positively associated with QOL/GSH/anxiety and depression. Higher CFR was noticed in congested/populated territories. Canonical regression strongly suggests this result. Variable host-virus interactions associated with race/ethnicity and body-composition. Positive correlations between mental state-QOL and anxiety-depression paralleled with adverse outcome of Covid-19.

Sleep Alterations in the Population of the Metropolitan Area of Mexico and Their Association with Lifestyle Changes During COVID-19 Confinement

Home confinement due to Coronavirus Disease 2019 (COVID-19) led to lifestyle changes that increased sleep disturbances, particularly in areas with higher infection and mortality rates. This study is a retrospective study based on data collected through an online survey conducted during the COVID-19 confinement. It aims to analyze changes in sleep quantity and quality and their association with lifestyle changes in the metropolitan area of Mexico City. A total of 899 adults from this area completed an online questionnaire between June 2020 and February 2021. This study assessed sleep quantity, sleep quality, insomnia symptoms, and lifestyle changes during the confinement period. Results showed that sleep quantity increased (7.10 ± 1.37 vs. 7.43 ± 1.42 h, p < 0.0001), with more participants, especially young adults and women, reporting later bed and wake-up times. The Pittsburgh Sleep Quality Index increased by 1.4 units, with poor sleep quality associated with lifestyle during confinement. Insomnia symptoms, sleep latency, and poor sleep quality also increased, particularly in women. Males and those without chronic comorbidities were less likely to experience poor sleep quality, while tobacco use and later bedtimes increased this risk. This study concludes that, while sleep quantity increased, sleep quality declined, particularly among young adults, women, and those with unhealthy lifestyles. These findings could guide sleep health initiatives tailored to specific lifestyle changes in different population groups.

Beneficial effects and possible mechanism of intake coffee for COVID-19: A meta-analysis and molecular docking

BACKGROUND

To systematically evaluate the effectiveness of regular coffee intake in the prevention or treatment of COVID-19 infection, and to explore its possible mechanism of action using computer molecular docking technology.

METHODS

We searched for relevant ClinicalTrials.gov, Cochrane Library, PubMed, Web of Science, Embase, and China Biomedicine, Wanfang, CNKI, VIP databases to summarize studies on the effectiveness of coffee in preventing or treating COVID-19. The search period lasted until August 1, 2024. The 2 researchers screened the literature and data using Rev Man 5.4 software (the Cochrane Collaboration, 2020) for data analysis and used Schrodinger 2018-1 software to explore possible mechanisms of action.

RESULTS

A total 5 studies with 39,290 participants were included. The results showed that compared with the control group that drank less or no coffee, the experimental group that drank more than 1 cup of coffee per day had significantly higher benefit rates (RD = 0.17, 95% confidence intervals [CI] = 0.08-0.27, P = .0005), including lower infection rates and improved recovery rates from COVID-19 (RD = 0.24, 95% CI = 0.13-0.35), P < .0001). Molecular docking showed that CGA and caffeine present in coffee could combine with key amino acid residues of ACE2 or 3CL proteins to form hydrogen bonds.

CONCLUSIONS

Regular consumption of coffee may have certain preventive or therapeutic effects on COVID-19, and the mechanism of action may be that CGA or/caffeine in coffee may be related to the formation of hydrogen bonds by key amino acid residues such as ARG273/HIE345 of ACE2 and CYS145 of 3CL. Owing to the limited number and quality of the included studies, the effect evaluation needs to be further confirmed using clinical randomized controlled trials. The exact mechanism of action requires further verification at the molecular level, both inside and outside cells.

Comparative determination of factors affecting attitude level towards healthy nutrition

Healthy eating habits are critical to the health and well-being of future generations. Many people worldwide do not receive enough vitamins and minerals due to malnutrition To eliminate these, it is necessary to determine the factors that support people's healthy eating habits. This study was conducted to determine the factors that affect healthy eating habits. There are three external factors to the study: (1) being an expert in food and drink, (2) having received formal education in health, and (3) receiving professional support (dietician support) in nutrition. The level of healthy eating was evaluated based on nutritional knowledge, feelings about nutrition, positive eating habits, and poor eating habits. In this context, an online survey was applied to 425 employees in the health sector (202 people) and the food and beverage sector (223 people). The data obtained were analyzed comparatively. The study results showed that the level of nutritional knowledge was equal in both groups. However, it was concluded that food and beverage sector employees were more sensitive to feelings about nutrition, positive eating, and poor eating habits than healthcare sector employees. While food and beverage sector employees are expected to constantly deal with food, which causes desensitization, it has been observed that they are stable and resistant to healthy eating. It has been concluded that although they have not received any formal health training, the information they have obtained through professional support (dietician) accelerates the process of developing healthy eating behaviors. This result has strengthened the power of the education variable affecting healthy nutrition. In addition, sensitivity to healthy nutrition is catalyzed by the professional profession. Dietician support indirectly reinforces this attitude. Thus, it has contributed to the development of healthy nutrition literature.

The Rising Burden of Childhood Obesity: Prevention Should Start in Primary School

Background: The increasing rates of childhood obesity (CO) are an ongoing problem. We focused on the adherence to the Mediterranean diet (MD), physical activity, and sleep habits of preschool children in order to investigate the relationship between lifestyle habits and health outcomes through parental perception. Methods: In the context of "EpPOI: Education to prevent CO", we investigated physical activity (PA) and sleep hygiene using an online survey for caregivers. Parents also completed the Mediterranean Diet Quality Index for children and adolescents (Kid-Med) questionnaire. Results: A total of 5.3% of the interviewees achieved a score indicating an adequate adherence to the MD. Additionally, 50.5% of children ate sweets every day, and 80% skipped breakfast. We also found that the parents' perceptions of their children's PA were a predictor of MD adherence, and PA was also positively correlated with fruit consumption [p < 0.034], vegetable consumption [p < 0.015], and fish consumption [p < 0.005]. Conclusions: Parents seem to be oriented towards a healthy lifestyle, but the children's level of adherence to the Mediterranean diet is poor. CO prevention requires a synergic effort that includes an adherence to healthy eating patterns such as the MD and a greater awareness of parents on the importance of adopting a healthy lifestyle at an early age.

Coping Strategies Among Healthcare Workers During the COVID-19 Pandemic: Emotional Responses, Challenges, and Adaptive Practices

Background and Objectives: The COVID-19 pandemic has posed unprecedented challenges to healthcare workers, leading to significant psychological distress, altered health-related behaviors, and reliance on various coping mechanisms. Understanding these impacts is critical for developing targeted interventions to support healthcare professionals. This study aimed to evaluate the psychological stressors, emotional responses, changes in healthy behaviors, and coping mechanisms employed by healthcare workers during the COVID-19 pandemic. The study further examined differences across demographic and professional groups and explored correlations between stressors, coping strategies, and emotional outcomes. Materials and Methods: A cross-sectional survey was conducted among 338 healthcare workers, including physicians and nurses, in urban and rural healthcare settings during the pandemic. Data were collected using validated instruments to measure emotional responses (anxiety and anger), lifestyle behaviors (dietary habits, sleep patterns, physical activity, and smoking), and coping strategies. Statistical analyses included descriptive, inferential, and correlation techniques to assess relationships between variables. Results: Fear of infecting family members (M = 3.36, SD = 0.86) and concerns about inadequate protective equipment (M = 2.80, SD = 0.95) were the most significant stressors, strongly associated with heightened anxiety and anger. Changes in healthy behaviors were observed: 69.2% maintained a healthy meal schedule, 56.5% reported disrupted sleep patterns, and only 39.6% engaged in regular physical activity. Among smokers (27.5%), 31.1% increased smoking as a maladaptive coping strategy, while 21.1% reduced smoking. Nurses predominantly relied on emotion-focused strategies, such as religious coping and venting, whereas physicians favored problem-focused strategies like planning and active coping. Social support emerged as a protective factor, mitigating stress and facilitating adaptive coping. Conclusions: The study revealed significant psychological and behavioral impacts on healthcare workers during the COVID-19 pandemic. Key stressors included the fear of infecting family members, concerns about inadequate protective measures, and the prolonged uncertainty of the pandemic, which contributed to heightened levels of anxiety and anger. Changes in healthy behaviors, such as disrupted sleep patterns, decreased physical activity, and increased reliance on maladaptive coping mechanisms, further underscored the multifaceted challenges faced by healthcare professionals. Although the acute phase of the pandemic has passed, the long-term consequences on the mental health and well-being of healthcare workers remain critical concerns. Further research is essential to develop effective strategies for monitoring, preventing, and addressing psychological distress among healthcare professionals, ensuring their preparedness for future public health crises.

Long-term trends and patterns in ultra-processed food consumption among Korean adults from 1998 to 2022

Ultra-processed foods are linked to adverse health outcomes, making it crucial to monitor consumption trends. Despite rising consumption due to Westernized diets in Asia, long-term studies targeting Asian adults are lacking. Thus, we analyzed ultra-processed food consumption trends among Korean adults from 1998 to 2022. Additionally, we compared intakes before and during the pandemic to evaluate the potential impact of the COVID-19 pandemic. Furthermore, we compared the nutrient profiles of ultra-processed and non-ultra-processed food group intakes. This study used data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 1998 to 2022, classifying food into four NOVA groups. Dietary intake was assessed In 2020-2022, ultra-processed foods had a higher proportion using a single 24-hour recall for 96,447 individuals aged 20 years or older. Sampling weights were applied to adjust for the complex survey design and non-responses. We calculated the weighted means and confidence intervals for the proportion of energy intake by NOVA food groups and various nutrient profiles. The proportion of energy intake from ultra-processed foods among Korean adults steadily increased from 17.41% in 1998-2005 to 26.71% in 2016-2019 (mean difference: 9.30% [95% CI, 8.62-9.98%]), but declined for the first time during the pandemic, falling to 25.33% (mean difference: -1.39% [95% CI, -2.18% to -0.59%]). In 2020-2022, ultra-processed foods had a higher proportion of calories from carbohydrates (62.12% vs. 58.81%) and fats (28.22% vs. 22.31%) but a lower proportion from protein (10.32% vs. 17.26%) compared to non-ultra-processed foods. From 1998 to 2022, the fat content of both ultra-processed and non-ultra-processed foods significantly increased, rising from 26.24 to 28.15% for ultra-processed foods (mean difference: 1.91% [95% CI, 1.33-2.49%]) and from 16.81 to 22.26% for non-ultra-processed foods (mean difference: 5.45% [95% CI, 4.99-5.91%]). This study examined 25-year trends in ultra-processed food consumption among South Koreans, showing a consistent increase in energy intake from ultra-processed foods until the COVID-19 pandemic, during which it declined for the first time. However, this decline may be temporary, underscoring the need for sustained efforts to reduce ultra-processed food consumption.

Prevalence and factors associated with overweight and obesity in cats in veterinary hospitals in France during the COVID-19 pandemic

OBJECTIVES

The present study aimed to determine the evolution of the percentage of overweight and obese cats during the COVID-19 pandemic in France, and to identify factors associated with excess weight to inform the development of targeted prevention strategies.

METHODS

Cat owners visiting the veterinary hospitals of Maisons-Alfort and Toulouse between 2020 and 2022 for their pets' vaccinations were invited to answer a comprehensive questionnaire to gather general information about themselves and their cat, including details of its lifestyle, activity and diet. Only healthy adult cats were included in the study. During the vaccination consultation, veterinarians recorded the body condition score, muscle condition score and weight of each cat. This study followed a protocol adapted from a French study conducted in 2006 to allow analysis of any changes over time.

RESULTS

Of the 274 cats included in the study, 9.1% were underweight, 43.4% had an ideal body condition and 47.5% were overweight. Factors positively linked to overweight included age, being crossbred, being a male and having an owner who underestimated the cat's body condition. Living with a child and having a high activity score as rated by the owner were associated with ideal body condition. The prevalence of cats with a sedentary lifestyle and the number of overweight cats had both increased since the previous study in 2006. Additionally, changes in cats' diets and lifestyles over time, including those influenced by the COVID-19 pandemic, have led to an increase in exclusive dry food consumption compared with the 2006 study.

CONCLUSIONS AND RELEVANCE

Important changes in cats' diet and lifestyle occurred between 2006 and 2020-2022. This study emphasises the need for further investigation into the duration of the impacts of the COVID-19 pandemic on feline wellbeing. Educating owners on their cat's body condition and encouraging cats to be active can be effective strategies for maintaining feline health in response to ongoing global changes.

The Impact of Rural Alimentation on the Motivation and Retention of Indigenous Community Health Workers in India: A Qualitative Study

Background

Rural health care delivery remains a global challenge and India is no exception, particularly in regions with Indigenous populations such as the state of Jharkhand. The Community Health Centres in Jharkhand, India, are staffed by Indigenous workers who play a crucial role in bridging the health care gap. However, their motivation and retention in these challenging areas are often influenced by a complex mix of sociocultural and environmental factors. One such significant but understudied influencing factor is alimentation, or nutrition, in rural settings. Previous studies have identified several motivators, including community ties, cultural alignment, job satisfaction, and financial incentives. However, the role of alimentation in their motivation and retention in rural areas has not been sufficiently explored.

Objective

This study aims to explore how the strong bond with locally produced food products impacts the retention of Indigenous community health workers (CHWs) in Jharkhand, India, and shed light on a crucial aspect of rural health care workforce sustainability.

Methods

This study adopted a phenomenological research design to explore the lived experiences and perspectives of Indigenous CHWs in Jharkhand. A purposive sampling method was used to select CHWs who had worked in rural areas for at least five years. Data were collected through semistructured interviews, focusing on the participants' experiences of rural alimentation and how it influences their motivation and retention for rural health care. The interviews were audio recorded, transcribed, and analyzed using thematic analysis to identify common themes and patterns in their experiences related to nutrition and retention.

Results

The study revealed that rural alimentation plays a significant role in both the motivation and retention of CHWs in Jharkhand. CHWs who experienced consistent access to local food reported higher job satisfaction, better physical well-being, and a stronger commitment to their roles. It has also been perceived that consuming nutrient-dense food products decreases the risk of chronic illness among rural populations. Additionally, community support systems related to alimentation were found to be crucial in maintaining motivation, with many CHWs emphasizing the importance of local food availability and cultural ties. The findings suggest that improving access to organic nutrition can positively influence the retention of CHWs in rural areas.

Conclusions

Indigenous communities have unique food habits and preferences deeply rooted in agriculture and arboriculture. Their traditional eating practices are integral to their rich cultural heritage, with significant social, symbolic, and spiritual importance. This study highlights the critical role of rural alimentation in motivating and retaining CHWs in rural Community Health Centres in Jharkhand. Therefore, addressing organic versus conventional food in rural health care policies plays a vital role in improving the retention rates of CHWs. By recognizing the interconnectedness of nutrition and workforce sustainability, health care systems can better support Indigenous CHWs and continue delivering health care services.

Factors associated with individual-level changes in BMI as a result of COVID-19 in the general- and migrant-origin populations in Finland

AIMS

There is limited information on changes in body mass index (BMI) due to the COVID-19 pandemic among persons of migrant origin. The aim of the present study was to examine factors associated with changes in BMI among the general- and migrant-origin populations in Finland.

METHODS

Longitudinal data to explore individual-level changes in self-reported BMI among migrant-origin persons (N = 3313) were obtained from the FinMonik Survey conducted in 2018 and the MigCOVID Survey conducted 2020-2021. Data for the general population reference group were obtained from the FinHealth 2017 Study conducted 2017-2018 and its follow-up conducted in 2020 (N = 2982). Logistic regression was applied to examine whether age, sex, education, economic activity, length of residence in Finland, language skills, smoking, alcohol usage, sleep, physical activity, snacking, and fruit and vegetable consumption were associated with an increase or decrease in BMI. A change in BMI was defined as a 5% or greater increase or decrease.

RESULTS

Twenty-seven per cent of the migrant-origin population experienced an increase in BMI, while 14% had a decrease in BMI. These results corresponded to figures observed among the general population in Finland (27% and 14%). Persons of migrant origin who were other than students or employed faced greater odds of an increase in BMI of at least 5% (OR = 1.71). In the general population, an increase in BMI of at least 5% had greater odds of occurring among women (OR = 1.61), those who were other than students or employed (OR = 1.68), those who increased their alcohol intake (OR = 1.64), those who increased their snacking (OR = 1.40) and decreased their fruit and vegetable intake (OR = 1.85).

CONCLUSIONS

Most examined factors applied differently to general- and migrant-origin populations and by migrant-origin group. These differences must be considered when planning future public health promotion efforts, particularly those during crisis situations.

Food security and dietary intake of a cohort of South African students during COVID-19

Background

Food insecurity among students was a global concern even before the coronavirus disease 2019 (COVID-19) pandemic. Food security comprises having access to sufficient, safe and nutritious food at all times. The COVID-19 containment measures negatively influenced economies, impacting citizens' food security.

Aim

This study aimed to investigate the food security of a cohort of South African students during the COVID-19 pandemic.

Setting

The sample included Health Science students from a university in Central South Africa.

Methods

A mixed-method study was performed using questionnaires and focus group discussions. The questionnaire and focus group discussions investigated similar areas and were supported by literature. Ethical clearance was obtained.

Results

Food insecurity existed among 84% of questionnaire participants. Dietary intake changed, with mainly a decrease in sugary and salty snacks. Focus group participants indicated an increase in the intake of starchy foods and reverted to binge eating. Dietary intake changes were attributed to poor availability and limited resources, for example money and electricity. Few participants were aware of or utilised available support services.

Conclusion

The isolated, confined and extreme (ICE) environment that resulted from COVID-19 negatively impacted students' dietary intake and food security. Institutions should implement measures to support students' intake of healthy foods during ICE events.

Contribution

This study provides significant insights into the dietary intake and food security of a cohort of Health Science students during COVID-19. It highlights the need for improved institutional and government food relief interventions during future pandemics. Therefore, this study contributes to the second sustainable development goal namely: zero hunger.

Lifestyle and Health Behavior Changes in the COVID-19 Pandemic: A Role for Mental Health Symptoms and Diagnosis and Daily Life Difficulties During Lockdown in Lebanon

Several studies report significant changes in lifestyle habits during the COVID-19 pandemic, yet results are largely heterogeneous across populations. We examined changes in lifestyle and health behaviors during the first COVID-19 lockdown in Lebanon and assessed whether mental and physical health indicators and outbreak- and lockdown-related factors are related to these changes. Data come from a cross-sectional online survey (May-June 2020) which assessed changes in smoking, alcohol, diet, eating behavior, physical activity, sleep hours, sleep satisfaction, social media use, self-rated health, and life satisfaction (n = 494). We examined these changes' association with current depressive and anxiety symptoms, presence of physical and mental disorders, outbreak-related worries, and lockdown-related factors using regression models adjusted for sociodemographic and socioeconomic covariates. Most prevalent changes were increased social media use (63.2%) and decreased life satisfaction (54.9%) and physical activity (53.4%). Higher depressive and anxiety symptoms, higher daily life difficulties, and presence of diagnosed mental disorder were related to worsening of almost all behaviors. Participants with higher outbreak worries had less healthy diet and increased social media use. Higher adherence to lockdown and preventive measures were associated with increased social media use and lower life satisfaction, respectively. Results show a clear clustering of negative lifestyle and health behavioral changes with current mental health symptoms, existing mental health disorder, and daily life challenges during lockdowns. Findings highlight the importance of tracking higher-risk mental health subgroups to mitigate further adverse impact on mental and physical health.

Antidiabetic phytochemicals: an overview of medicinal plants and their bioactive compounds in diabetes mellitus treatment

Diabetes mellitus (DM) is a group of metabolic disorders characterized by hyperglycemia due to insufficient insulin secretion or action. Contributing factors include genetic predisposition, obesity, family history, inactivity, and environmental risks. Type 2 diabetes mellitus (T2DM), the most common form, involves impaired insulin secretion by pancreatic β-cells, leading to insulin resistance. By 2045, it is projected that India and China will have approximately 134.3 and 110.8 million diabetic individuals, respectively. Although synthetic drugs are effective in managing DM, they often come with side effects. Consequently, plant-based phytochemicals with antidiabetic properties are gaining attention. Research indicates that around 115 medicinal plants (MPs) have antidiabetic effects, particularly those from the Fabaceae, Liliaceae, and Lamiaceae families. Bioactive compounds like alkaloids, triterpenoids, flavonoids, and phenolics are known to combat DM. Traditional medicinal systems, particularly in developing countries, offer effective DM management. This review highlights the importance of MPs and their bioactive compounds in treating diabetes and underscores the need for further research to commercialize plant-based antidiabetic drugs.

The Impact of the COVID-19 Pandemic in the Interrelationships Among Mental Health, Nutritional Status and Lifestyle Factors of Older Adults: A Cross-Sectional Study in the Pre- and Post-Covid Periods

BACKGROUND/OBJECTIVES

The COVID-19 pandemic has led to detrimental effects on diverse aspects of the mental and physical health of the general population worldwide. The elderly are more susceptible to COVID-19 infection compared to younger age groups. In this aspect, the purpose of the current survey is to evaluate the effect of the COVID-19 pandemic on the interrelationships among the sociodemographic and anthropometric characteristics, depressive behavior, quality of life, cognition status, physical activity and nutritional status of older adults.

METHODS

The present study constitutes a comparative, cross-sectional study of 4162 older adults (mean age ± standard deviation: 72.13 ± 8.1 years and 75.22 ± 8.2 years in the pre- and post-COVID-19 periods, respectively, and a male/female ratio of almost 1:1). We used validated questionnaires to assess depression, cognition function, quality of life, physical activity and nutritional status of the elderly in the pre-Covid and post-Covid periods. Relevant questionnaires were also used for collecting sociodemographic data, while anthropometric data were measured using standard protocols.

RESULTS

The present study finds that the COVID-19 pandemic influenced, in an independent manner, residence location, smoking status, overweight/obesity and abdominal obesity, depressive behavior, quality of life, cognition behavior, physical activity levels and nutritional status of the elderly. The COVID-19 pandemic was also related to employment and living status as well as family economic status. Nevertheless, the above three relationships were insignificant in the multivariate analysis.

CONCLUSIONS

The COVID-19 pandemic exerted deleterious effects on several aspects of the mental and physical health of the elderly, which appeared to strongly persist in the post-Covid period. Future prospective population-based and well-organized surveys should be conducted to establish whether there is a causality long-term effect of the COVID-19 pandemic on diverse aspects of the mental and physical health of the elderly.

Changes in Lifestyle Behaviors, Shopping Habits and Body Weight Among Adults in Cyprus and Greece During COVID-19 Lockdown: A Cross-Sectional Study

Background: During the COVID-19 pandemic, people were asked to stay at home. Places where people interacted such as schools, universities, and cafes were closed, and all gatherings were forbidden. Only stores offering fast-moving consumer goods were open, so citizens could purchase all food categories. The aim of this cross-sectional study was to investigate the effect of the COVID-19 lockdown on the eating and buying habits of consumers in Cyprus and Greece, and any changes in their lifestyles. Methods: An online survey including 1011 participants took place using an electronic questionnaire. Results: The results showed that lockdown significantly affected individuals by increasing weight gain (p < 0.01). The explanatory investigation of related lifestyle habits and nutrition traits showed that the dietary patterns behind these changes included increased meal frequency (p < 0.05)-even without an increased appetite-and subsequent increases in both purchases (p < 0.05) and consumption of several food groups (p < 0.05). Moreover, even though exercise per se was not discontinued due to COVID-19, it was apparent that exercise type was altered to adapt to the relevant restrictions (p < 0.05). Conclusions: In conclusion, the COVID-19 lockdown significantly affected Cypriots and Greeks in many aspects like their eating behavior, food purchasing habits, and lifestyle, all resulting in increased weight and potentially adverse health outcomes.

Gender and sex differences in adherence to a Mediterranean diet and associated factors during the COVID-19 pandemic: a systematic review

Background

The COVID-19 pandemic has led to significant lifestyle changes, including alterations in dietary habits and increases in sedentary behavior. The Mediterranean diet (MD) has been associated with various health benefits, which are especially important given the health challenges posed by the pandemic. During the pandemic, an overall shift towards consuming more highly processed foods has been observed.

Methods

This systematic review investigated adherence to MD during the COVID-19 pandemic, focusing on gender differences and factors influencing adherence to MD in the general public. The literature search focused on papers published between January 1, 2019, and July 8, 2024, across various databases such as Web of Science (WOS), Scopus, PubMed MEDLINE, and PsycINFO.

Results

Following the PRISMA guidelines, this search identified 14,347 references, of which 5,734 were duplicates. After a thorough multi-level screening process, 29 studies, encompassing 55,242 participants, met the inclusion criteria. While seven studies reported that men adhered to a MD more than women during the COVID-19 pandemic, 12 studies also indicated that women had higher adherence to a MD compared to men. Nine studies, however, found no significant gender differences in MD adherence. Additionally, older age, higher education levels, higher socioeconomic status, and increased physical activity were linked to greater adherence to a MD in the pandemic context.

Conclusion

Gender-specific differences in dietary behavior are influenced by factors such as socioeconomic status, gender roles, and pandemic phases as well as biases in sample composition and methodological weaknesses. Significant gaps in the evidence, particularly concerning sexual and gender minorities, are highlighted.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=421727.

Dietary habits and weight change during the second wave of the COVID-19 pandemic among the Egyptian population

BACKGROUND

The pandemic of coronavirus disease-19 (COVID-19) has a profound influence on the health of the population. This study aimed to assess the weight changes and its relation to the dietary habits and physical activity among adult Egyptian population during the second wave of COVID-19 pandemic.

MATERIALS AND METHODS

This cross-sectional study was conducted using anonymous online questionnaire. The questionnaire was distributed across Egypt via community-based networks, social and institutional emailing lists, and professional organizations to collect data on sociodemographic, clinical history, dietary and lifestyle habits, physical activity, anthropometric measurements, and stressing factors.

RESULTS

The study participants (n = 1000) had a median (interquartile range) age of 34.0 (23.0-40.0) years, with 18.7% males, 96.6% having university or postgraduate education. Among them, 69.1% reported weight gain, 21.3% no change, and 9.6% weight loss. Weight loss was predicted by following COVID-19 pandemic reports daily [adjusted odds ratio (AOR) = 0.50 (95% CI, 0.27-0.93), p = 0.03], monthly income change [AOR = 2.52 (95% CI, 1.51-4.22), p < 0.001], starting antidepressants [AOR = 3.57 (95% CI, 1.08-11.76), p = 0.03], and increase in social media use [AOR = 1.81 (95% CI, 1.05-3.13), p = 0.03]. Weight gain was predicted by starting a diet during the second wave of COVID-19 pandemic [AOR = 1.57 (95% CI, 1.11-2.21), p = 0.01], physical activity during the second wave of COVID-19 pandemic [AOR = 0.49 (95% CI, 0.35-0.69), p < 0.001], and unhealthy food intake [AOR = 0.40 (95% CI, 0.28-0.57), p < 0.001] CONCLUSIONS: More intervention programs aiming to improve dietary habits and increase physical activity should be rapidly implemented to reduce the consequences of the pandemic on the Egyptians to keep healthy weight.

Exploring lifestyle and dietary pattern shifts among Saudi adults during COVID-19 pandemic: insights from a cross-sectional examination

Background

Since the emergence of COVID-19 and the subsequent imposition of lockdown and movement restrictions, the world has witnessed fundamental lifestyle changes including alterations in dietary patterns and food consumption habits. Here, we investigated how the COVID-19 lockdown impacted dietary patterns and eating behaviors in the Saudi population.

Methodology

This cross-sectional study enrolled 427 participants aged 18 years or more, with 258 of them completing the survey. The survey included questions about demographic and dietary patterns during the COVID-19 lockdown. Data were collected and dietary behaviors before and during the lockdown in Jeddah, Saudi Arabia, were analyzed.

Results

The number of participants who considered lunch as their primary meal significantly decreased (p < 0.001) during the COVID-19 lockdown (74%), compared to before it (86%). By contrast, the number of participants who considered dinner as their primary meal remained almost unchanged (p = 0.079) during (79.1%) and before (84.1%) the lockdown. However, snack consumption significantly increased (p < 0.001) while fast-food consumption significantly decreased (p < 0.01) during the lockdown period. Our results also revealed a significant increase (p < 0.01) in water and coffee intake during the lockdown, with a significant rise in dessert consumption (p < 0.01).

Conclusion

Our results demonstrate that the COVID-19 lockdown caused a marked shift in dietary patterns and eating behaviors among the Saudi population. Notable changes were observed in overall food preferences after the lockdowns were imposed, with reduced consumption of fast foods and increased fluid intake.

Unveiling the interplay of medical professionalism, mental well-being and coping in medical students: a qualitative phenomenological study

BACKGROUND

Medical students face significant stress and challenges that impact their professional development by affecting their levels of medical professionalism (MP), coping ability, and mental well-being (MWB). Given the high-stakes environment of medical education, understanding the interplay between these factors is crucial. This study aims to explore undergraduate medical students' lived experiences of MP, coping strategies (CSs), and MWB to inform the development of effective support systems.

METHODS

A qualitative phenomenological study was conducted using Focus Group Discussions (FGDs) to capture the lived experiences of 40 medical students from first, third, and fifth years of study. Participants, selected through purposive sampling, represented diverse backgrounds (with 27 females, 18 fifth-year students, and 30 Malays). Seven FGDs, each with 5-10 participants, were conducted via Zoom©, yielding comprehensive qualitative data. An inductive coding approach was applied through iterative transcript analysis to ensure robust findings.

RESULTS

Analysis revealed two themes related to MWB: 'mental well-being issues,' highlighting persistent mental health challenges, and 'happiness,' illustrating factors that sustain well-being. CSs were categorized into 'positive coping,' including seeking support, and 'negative coping,' such as denial. For MP, two themes emerged: 'inter-medical professionalism,' focusing on communication with others, and 'intra-medical professionalism,' emphasizing ethical self-conduct.

CONCLUSION

The interplay between CSs, MP, and MWB is complex and deeply intertwined. The findings highlight the importance of developing targeted interventions to support medical students in managing stress, maintaining professionalism, and enhancing their mental well-being throughout their training. Future research should further explore these themes to inform policy and curriculum development in medical education.

CLINICAL TRIAL NUMBER

Not applicable.

Comparative Analysis of Dietary Behavior in Children and Parents During COVID-19 Lockdowns in Greece: Insights from a Non-Representative Sample

BACKGROUND/OBJECTIVES

Home isolation measures during the COVID-19 lockdown periods may have influenced individuals' lifestyles. The COVEAT study aimed to identify differences in children's and their parents' dietary behavior, children's body weight and parental body mass index (BMI) between two lockdown periods implemented in Greece.

METHODS

In total, 61 participants (children 2-18 years and their parents) completed questionnaires about their lifestyle, body weight and height, and family socio-demographic data, during both lockdown periods (LDs) implemented in Greece (LD1 in March-May 2020; LD2 in December 2020-January 2021).

RESULTS

No significant differences in parents' BMI and fluctuations in children's/adolescents' body weight and BMI were observed in LD2 compared to LD1. Regarding dietary behavior, in LD2 fewer parents were found to have dinner and prepared home meals and more families reported to order fast food. Furthermore, a significant decrease in the consumption of fresh and prepacked juices and an increase in fast-food consumption were observed for children/adolescents in LD2 compared to LD1.

CONCLUSIONS

The findings of the COVEAT study indicate that each lockdown period had a different impact on children's/adolescents' and their parents' dietary behavior, with less favorable changes observed in LD2, suggesting that the implementation of additional lockdowns may have had a negative impact on individuals' lifestyles.

Temporal trends, gender, and ethnoracial disparities in mortality from pulmonary emphysema: A retrospective nationwide analysis

Emphysema, a significant global health issue, involves abnormal lung enlargement and wall destruction, affecting 9% to 12% of people worldwide. In the United States (US), 2 million people live with emphysema, with numbers expected to rise. Data on mortality trends and disparities associated with demographic factors is limited, underscoring our study's focus on analyzing these patterns in US adults. This study examined death certificates from the CDC WONDER database for individuals aged 25 and older who died with emphysema (J43) between 1999 and 2020. Age-adjusted mortality rates (AAMRs) and annual percent change were calculated by year, gender, age group, race/ethnicity, geographic region, and urbanization status. Between 1999 and 2020, there were 484,095 reported deaths among emphysema patients. The overall AAMR decreased from 18.5 to 7.2 per 100,000 population, with an annual decrease of 8% from 2008 to 2015, followed by a slight recent increase. Analyzing by age groups, older adults had the highest AAMR of 42. Men had significantly higher AAMRs than women (13.4 vs 7.8). By race, non-Hispanic (NH) White patients had the highest AAMRs (11.3), followed by NH American Indian or Alaska Native (8.2), NH Black (7.7), Hispanic (3.9), and NH Asian or Pacific Islander patients (3.1). Nonmetropolitan areas had higher AAMRs compared to metropolitan areas (11.7 vs 9.8). Emphysema mortality has decreased overall but recently increased slightly. Higher rates are seen among older adults, men, NH White patients, and nonmetropolitan residents. Policies are needed to continue reducing these death rates and to address these disparities.

Lifestyle Habits and Nutritional Profile of the Spanish Population: A Comparison Between the Period During and After the COVID-19 Pandemic

The aim of this study was to investigate the changes in habits regarding the health and lifestyle of the Spanish population during and after the COVID-19 pandemic. A cross-sectional design was used. Data were collected during the pandemic from 22,181 participants and after the pandemic from 3907 participants using the NutSo-HH Scale, assessing demographic, nutritional, and lifestyle variables. Key findings reveal a slight increase in exercise duration (+6.61%) post-pandemic, along with reductions in fried food (-3.57%), juice (-6.45%), and alcohol consumption (-9.66%). Conversely, there were notable increases in the consumption of ultra-processed foods (+2.16%), soft drinks (+6.47%), and coffee/energy drinks (+38.95%). Sleep quality, body image, and self-perceived health showed minor declines. These findings indicate that despite some positive behavioral changes, there is still a significant dependence on unhealthy dietary choices, negatively impacting both mental and physical health. The results highlight the need for public health strategies which encourage healthier eating, increased physical activity, and better sleep quality to reduce the long-term effects of lifestyle changes brought on by the pandemic. Focused interventions are necessary to curb the rising consumption of ultra-processed foods and sugary beverages while fostering overall well-being. This study underscores the vital role of ongoing surveillance and customized public health initiatives to enhance general health in the post-pandemic era.

Body composition and nutritional status in nursing home residents during the COVID-19 lockdown: a 15-month follow-up

Since the beginning of the corona virus disease (COVID-19) pandemic, nursing home residents had been under strict quarantine, which greatly affected their lifestyle and health. In this follow-up study, we analysed whether lifestyle changes during the lockdown had an impact on their body composition and nutritional status. For this purpose we determined body composition, nutritional status, and osteosarcopenic adiposity (OSA) prevalence in 24 volunteer nursing home residents just before the February 2020 COVID-19 lockdown and about 15 months into the lockdown. Body composition (total bone mass, lean and fat tissue components) was assessed with bioelectrical impedance. OSA was established if the participants had sarcopenia, osteopenia, and adiposity. Information on dietary habits, weight loss, and selfperception of health were obtained with the Mini Nutritional Assessment (MNA) form, while nutritional status was assessed with the MNA-Short Form (SF). At baseline, OSA was determined in 14 participants and at the follow-up in 16 participants. The results show an overall decrease in bone and lean tissues and increase in fat tissue. There were significantly more participants with a normal nutritional status than those at risk of malnutrition or malnourished (p=0.045). Our findings suggest that negative changes in body composition during the pandemic are owed to age rather than to changes in lifestyle caused by the pandemic. Regular monitoring of body composition in nursing homes may help to preserve the health of older people in general and particularly in cases of possible future lockdowns.

Modelling the cost differential between current and healthy diets according to household education level in Belgium

This study aims to estimate the cost differential between current and healthy diets, overall and by household education level. Data from the 2014-2015 Belgian National Food Consumption Survey and food prices from the 2014 GfK ConsumerScan panel were linked. The DIETCOST programme was used to model healthy, isocaloric healthy and current diets. For the reference household, the average daily diet cost was 20.1€ (95%CI: 19.9-20.4) for current diets, 20.9€ (95%CI: 20.6-21.2) for healthy isocaloric diets (+3.9% vs. the current diets) and 22.5€ (95%CI: 22.3-22.8) for healthy diets (+12.0%). In low-educated households, the cost of current and of healthy isocaloric diets was similar (19.2€ (95%CI: 19.0-19.5) vs. 19.3€ (95%CI: 19.0-19.6)), whereas in high-educated households, the cost of healthy isocaloric diets (22.0€; 95%CI: 21.8-22.3) was higher than the cost of current diets (21.2€; 95%CI: 20.9-21.4)). Though needing validation, this finding is valuable for interventions aimed at improving dietary habits in disadvantaged populations.

Assessing through a longitudinal study of dietary habits among Romanian school children: effects of COVID-19 pandemic as well as of a school based educational program for promotion of healthy nutrition

PURPOSE

The outbreak of COVID-19 has forced implementation of safety measures, leading to changes in people's lives. This study investigated several dietary habits among Romanian children before and during the pandemic. Also, it assessed the effectiveness of an educational program promoting healthy diet and evaluated factors influencing certain eating habits.

METHODS

A longitudinal study was conducted in schools. Students were assigned to Control and Intervention groups. Data were collected at baseline (T1) (October -November 2019, 880 children) and post-intervention (T2) (December 2020-February 2021, 484 students). 350 children participated in both assessments.

RESULTS

Baseline measurements revealed inadequate consumptions of fruits, vegetables, dairy products, and increased intake of soft drinks and sweets. At follow-up, the Intervention showed significant improvements on average intake of fruits and vegetables and in children eating ≥ 5 servings/day, compared to its baseline. Regarding self-perceptions on dietary habits during confinement, children from both groups reported healthier behaviors, with a significant decrease of comfort food. Compared to the Control group, Intervention increased its average intake of fruits and vegetables, consumed more ≥ 5 portions/day, reduced the number ≥ 2 cups/day of carbonated beverages and ≥ 3 portions/day of sweets. Age, gender, weight management, body mass index were associated with dietary habits at T1. Age, gender, Intervention group, weight management influenced eating patterns at T2. Eating behaviors at T1 influenced dietary habits at T2.

CONCLUSION

Our program demonstrated positive changes in students' dietary habits, despite challenges of COVID-19. Results highlight the role of health education and emphasize the importance of integrating such programs consistently in schools.

Long-term effects of COVID-19 pandemic on physical activity and eating behaviour of the Italian population: a longitudinal study

BACKGROUND

Restrictive measures due to the Covid-19 pandemic strongly impacted lifestyle and daily behaviour. The purpose of this longitudinal retrospective study was to investigate short-term and long-term effects of Covid-19 pandemic on physical activity and eating habits of the Italian population investigating three time periods: pre-, during- and post-lockdown.

METHODS

A sample of 2773 adults recruited through social media provided data by an online survey administered from July to October 2023. Participants completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the Mediterranean Diet Adherence Screener (MEDAS) and provided information about eating habits, socio-demographic and anthropometric characteristics.

RESULTS

There was a significant increase (p < 0.001) in mean BMI from pre-pandemic period (24.53 ± 5.34 Kg/m2) to post-pandemic period (25.22 ± 6.0 Kg/m2). Physical Activity significantly decreased during the pandemic period compared to the pre-pandemic period (χ² = 271.97; p < 0.001; φ = 0.31) with an increase in inactive subjects from 25.7% to 52.8%. In the post pandemic period, there was an increase in the level of Physical Activity compared to the pandemic period (χ² = 413.61; p < 0.001; φ = 0.39) with a reduction of inactive subjects from 52.8% to 25.6%. Adherence to Mediterranean Diet score significantly (p < 0.001) increase from pre-pandemic (7.18 ± 1.58) to during-pandemic (7.29 ± 1.69) and post-pandemic (7.75 ± 1.63) periods with significant differences emerged in the consumption of single MEDAS items during the pandemic period by different BMI classes. Consumption of seasonal fruit and vegetables, water intake, the preparation/consumption of traditional or local dishes and the time dedicated for dinner and lunch significant increase (p < 0.001) during pandemic.

CONCLUSIONS

The Covid-19 pandemic changed people's lifestyles, but in different ways for Physical Activity and diet. During the pandemic there was a negative effect for PA that decreased while the time spent sitting increased. This seems to be a temporary effect as, after the end of the phase of mandatory restrictions, it returns to the original level. The lockdown period improved the quality of the Italian population's eating habits, with an increase in adherence to the Mediterranean diet even after the end of the pandemic showing a rediscovery of traditional dishes, increase in consumption of seasonal products, greater preference for local products and more time spent preparing meals.

Lifestyles of Palestinians during the COVID-19 pandemic: A cross-sectional study

Background: Although the COVID-19 epidemic was linked to movement limitations and a sense of risk among the general public, changes in lifestyle and mental health were not examined among Palestinians. The study aimed to investigate changes in a group of Palestinians' lifestyles and mental health. Methodology: A translated questionnaire about demographics, mental health difficulties, and lifestyle choices was created using Google Forms and distributed over social media and academic platforms. SPSS 21 was used to analyze the data. Results: The participants' mean age was 25 9 years, 67% were women, and 47% were city dwellers. About 82% had a bachelor's degree. Infection with COVID-19 was present in 13% of study group, COVID-19 infection caused the death of a relative in 13% of study group, and commitment to limits was present in 14% of study group. Negative emotions like despair, hopelessness, and worry were extremely common. Despite eating a few fruits and vegetables and drinking a lot of soft beverages, study participants were generally active. Conclusion: The COVID-19 pandemic is associated with a negative impact on lifestyle and mental well-being.

Association Between Dietary Habit Changes and COVID-19 Prophylaxis During the Pandemic Among Japanese Maintenance Hemodialysis Patients

BACKGROUND

Following COVID-19, dietary habits have been altered frequently along with other societal lifestyle modifications. However, changes in the dietary habits of maintenance hemodialysis patients (MHPs) before and during COVID-19 have not been investigated.

METHODS

A total of 132 MHPs were assessed for changes in their dietary habits before and during the pandemic and their association with COVID-19 prevention. Logistic regression models were used to calculate the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for the risk of COVID-19. A multivariate logistic regression analysis was performed.

RESULTS

Approximately 27% (36 of 132) of the MHPs modified their dietary habits. Following COVID-19, the frequency of eating out decreased, and that of eating in increased significantly for dinner. However, there was no change in dietary habits for breakfast and lunch. Multivariate analysis revealed an inverse correlation between the number of eating takeout and COVID-19; that is, more eating of takeout was associated with a lower risk of contracting COVID-19.

CONCLUSIONS

Comparing before and after the pandemic, there was a shift from eating out to eating in for dinner. However, the frequency of eating takeout played a role in preventing COVID-19, suggesting that the person preparing the meal may be a more important factor than where the meal is eaten when the main route of infection is household transmission.

Prevalence of overweight and obesity in 6-15-year-old boys and girls before the COVID-19 pandemic: results from anthropological research 2001-2019 in the Czech Republic

OBJECTIVE

Childhood overweight and obesity has been a major global problem for a long time, with a steadily increasing prevalence of obesity and a growing number of cases of serious health complications associated with childhood obesity. The main objective of the study is to assess the prevalence of overweight and obesity in boys and girls before the COVID-19 pandemic in the Czech Republic.

METHODS

Body height, weight, BMI, and body composition (fat free mass, skeletal muscle mass, body fat, visceral fat area) were assessed in a cohort of 4,475 subjects (2,180 boys and 2,295 girls) aged 6-15 years. Somatic status was assessed by standardized anthropometry and body composition was determined by bioelectrical impedance. The subjects were classified according to BMI in percentile bands (up to 3rd percentile, P3-10, P25-75, P75-90, P90-97, above 97th percentile). Statistical analysis was performed using the software TIBCO Statistica 14.0.015.

RESULTS

During growth, statistical differences in the proportion of fat-free mass and fat fractions were found between boys and girls. In boys, there is an increase in muscle mass, in girls, there is an increase in the proportion of fat fraction. Sexual differentiation is pronounced during pubertal growth. By their BMI, 10.32% of the boys and 7.36% of the girls were categorized as overweight, and 8.12% of the boys and 7.71% of the girls were categorized as obese. Using bioelectrical impedance analysis and the percentage of fat fraction, 21.61% of the boys and 21.87% of the girls were categorized as obese; 5.96% of the boys and 8.19% of the girls were found to have visceral adipose tissue posing a health risk (more than 100 cm2). From 2002 to 2019, there was a significant increase of 3.72% in the overweight category for boys and 1.36% for girls, while the obesity category showed an increase of 3.62% for boys and 4.91% for girls.

CONCLUSION

The results confirm the increasing negative trend of overweight and obesity in the BMI and the relative body fat categories in children aged 6-15 years. Greater attention and monitoring of the effectiveness of preventive measures is needed to slow and stop the obesity epidemic which has health, social and economic impacts on the entire society.

Athletes preferences and willingness to pay for innovative high-protein functional foods

The growing number of athletes in the population leads to an increasing demand for high-protein functional foods to which food industries are trying to respond with new products and strategies that can meet the needs of athletes. An experimental auction was performed to elicit athletes' willingness to pay for an innovative high-protein bread, correlating it to specific food values. For a deeper understanding of the determinants of respondents' choices for high-protein bread and preferences regarding food values, the combination of Best-Worst Scaling and Cluster Analysis was used. The Cluster Analysis identified five different groups of athletes, each characterised by specific preferences and willingness to pay. Participants with high attention for the nutritional aspect and needs related to sports activity, are willing to pay more than the other ones. The investigated issue is crucial for customizing marketing strategies and meeting the needs of different athlete segments.

Contribution of Shockwave Therapy in the Functional Rehabilitation Program of Patients with Patellofemoral Pain Syndrome

Background: Patellofemoral pain syndrome is a condition with an increasing incidence in recent years, being known as the most common cause of knee pain in adults and adolescents. Undiagnosed and untreated, this condition can worsen over time. The aggravation leads to an increase in the intensity of the pain and the risk of injury, along with an increase in stress on the other joints of the lower limb. The objective of this study was to evaluate the contribution of shockwave therapy to a functional rehabilitation programme for patients with patellofemoral pain syndrome. Materials and Methods: The study was carried out on a group of 64 subjects (32 males and 32 females), aged between 20 and 39 years. The subjects were divided into two groups: 32 subjects who followed a program of functional rehabilitation based on low- and medium-frequency electrotherapy, ultrasound and laser therapy, along with a physical therapy program lasting approximately 3 weeks, and 32 subjects who followed a functional rehabilitation program based on shockwave therapy and specific physical therapy exercises lasting approximately 3 weeks. Results: Following the protocols applied to the two groups, the pain reported by the patients decreased, while the functional parameters of the knee improved, better results being obtained in the group that performed shock wave therapy together with specific physical therapy programs (Cohen Index 5916, p < 0.001). Conclusions: This study indicates that radial shockwave therapy combined with physiotherapy may provide additional benefits for patellofemoral syndrome, including greater pain reduction and improved joint mobility, compared to traditional treatments. However, further research is needed to confirm these findings and their broader clinical applicability.

The Impact of the COVID-19 Pandemic: A Longitudinal Analysis of Body Weight Variations and Their Implications for Daily Habits

Assessing changes in lifestyle, dietary habits, eating behaviors, and stress during the pandemic and their impact on weight is crucial for developing effective interventions. This study investigated weight variations among Brazilians and associated habit changes over nine months during the COVID-19 pandemic. An online questionnaire was applied (T0/T1, T2). Weight variation classifications were determined from T0 to T1 and evaluated longitudinally for changes in lifestyle, dietary habits, food consumption, eating behavior, and perceived stress using generalized estimating equations (p < 0.05). Out of 453 participants, 23.6% lost weight, 18.1% maintained their weight, 26.0% gained up to 2.4 kg, and 32.2% gained ≥ 2.5 kg. Weight loss was associated with decreased food consumption and increased stress at T2. The group that gained up to 2.4 kg reported reduced food intake, snacking, meal preparation, and candy consumption but increased stress at T2. Those gaining ≥ 2.5 kg initially increased food consumption, snacking, meal preparation, hamburgers/canned products, sugary drinks, instant meals/snacks, candies, and fast food consumption at T1, all of which were reduced at T2, along with a decrease in uncontrolled and emotional eating. Although the pandemic initially affected daily habits differently based on weight changes, participants-especially those who gained more weight-tended to revert to pre-pandemic habits.