How Has the COVID-19 Pandemic Changed BMI Status and Physical Activity - Its Associations with Mental Health Conditions, Suicidality: An Exploratory Study

Global Overview of Suicidal Behavior and Risk Factors among General Population during the COVID-19 Pandemic: A Systematic Review and a Meta-Regression

The COVID-19 pandemic has significantly impacted mental health worldwide, leading to increased rates of suicidal behavior. This systematic review and meta-regression aim to investigate the global prevalence and risk factors associated with suicidal behaviors in the general population during the pandemic. The study included 202 articles from January 1, 2019, to October 31, 2023, sourced from databases such as Embase, MEDLINE, CINAHL, Web of Science, and Cochrane Library. The meta-analysis revealed a prevalence of 13.5% for suicidal ideation, 10.4% for suicide attempts, and a death rate of 0.5%, translating to 4.52 per 100,000 person-years. Significant risk factors identified include being transgender, young adults (18-44 years), unmarried status, low education, retirement, living alone, low social support, a history of suicide attempts, substance use, depression, anxiety, PTSD, sleep problems, poor perceived physical health, loneliness, quarantine, and residing in the Americas or multiple regions. The findings underscore the urgent need for targeted mental health interventions during pandemics, focusing on high-risk groups such as young adults, transgender individuals, those with low social support, and people with mental health issues. This comprehensive analysis provides valuable insights for policymakers and healthcare providers to develop effective strategies to mitigate the heightened risk of suicide during global health crises.

The Association Between Obesity, Chronic Inflammation, Metabolic Disorders and Mood Disorders Among Patients up to 12 Months After Hospitalization for SARS-CoV-2

BACKGROUND/OBJECTIVES

The relationship between BMI, inflammation, and mental health is complex. A high BMI, especially obesity, is associated with chronic inflammation, which can lead to mental disorders such as depression. Inflammatory cytokines affect neurotransmitters and the stress axis, worsening mental health. Obesity and mental disorders can mutually reinforce each other. New findings show that inflammation can lead to neurobiological changes, and the gut microbiota may play a key role. Obesity has been implicated as a factor in the high mortality and duration of influenza-like illnesses, even in people who do not have other chronic diseases that may increase the risk of complications. The aim of this study was to determine the associations between BMI and chronic inflammation, metabolic disorders, depression, and anxiety in patients hospitalized with COVID-19 up to 12 months after hospitalization.

METHODS

The study included 248 participants previously hospitalized for SARS-CoV-2 infection up to 12 months after hospitalization. The study was conducted in a multistage design using a diagnostic survey, anthropometric measurements, and laboratory methods.

RESULTS

A statistically significantly higher BDI-II score was observed among women. Statistical analysis showed a statistically significant higher GAD-7 score among women and those over 75 years of age.

CONCLUSIONS

Higher BMI among subjects is often associated with elevated values of inflammatory markers and immune cells, such as WBC, neutrophils, monocytes, and CRP, as well as higher blood glucose levels. These associations may be related to the chronic inflammation and metabolic disorders that often accompany obesity. Lymphocytes and eosinophils may show more varied relationships depending on individual factors and specific health conditions. It is therefore important to continue research in this area.

Association between a changeable lifestyle, sedentary behavior, and suicide risk: A systematic review and meta-analysis

BACKGROUND

Suicide and self-injury have become increasingly serious public health crises. Yet current evidence about the association between sedentary behavior (SB) and suicide is inconclusive. We explore the relationship between SB and suicide behavior to provide intervention measures to change the risk factors of the latter.

METHODS

We searched PubMed, Embase, Cochrane Library, and Web of Science from database inception to September 10, 2023. Adjusted odds ratios (ORs) with 95 % confidence intervals (CIs) were used as effect measures. Subgroup analysis was conducted based on gender, regions and countries, age, and study type.

RESULTS

A total of 13 studies were included. According to the meta-analysis of suicide type, compared with individuals without sedentary behavior, individuals with sedentary behavior have a higher risk of suicide attempt (OR = 1.23, 95%CI: 1.15-1.37, p < 0.001), suicide ideation (OR = 1.47, 95%CI:1.28-1.68, p < 0.001) and suicide plan (OR = 1.30, 95%CI:1.16-1.44, p < 0.001). We conducted multiple subgroup analyses for different suicidal behaviors. The analysis found that SB can increase the risk of suicide attempt in different subgroups of different genders, different research centers, Africa, and adolescents; SB can increase the risk of suicide ideation in the subgroups of different genders and ages, different research centers, Asia and Africa; SB can increase the risk of suicide plan in the subgroups of different genders, multi-center study, Africa, and adolescents.

LIMITATIONS

Future research should focus on objective SB measurement and explore its dose-response relation and time limit.

CONCLUSION

A sedentary lifestyle is associated with suicide behavior risk, with varying effects across age groups and regions, as evidenced in both single-center and multi-center studies.

A Cross-Sectional Study Exploring the Relationship Between BMI and Nursing Students' Emotional Well-Being During the COVID-19 Pandemic

Background

Having a weight problem can cause emotional distress, especially in students, who suffer from both issues at a high rate. As a result of the COVID-19 pandemic's negative impact on society, these problems can be significantly impacted. The study aims to investigate the relationship between nursing students' BMI and their mental well-being.

Methods

A cross-sectional study was conducted on 423 students from the second through fourth baccalaureate years of Science of Nursing program - KSA. The instrument for the study was an online questionnaire distributed to the students via Google Forms during the academic year 2021-2022 to collect data on the emotional state of students directly as a result of COVID-19 restrictions and limitations. The statistical analysis was carried out through Chi-square test was used to compare categorical data between groups and the Pearson coefficient is used to determine the correlation between two quantitative variables with normal distribution.

Results

There is a significant correlation between BMI with depression score, anxiety score and stress score. Higher BMI indicated 6.4 times more likeliness to have depression than lower BMI (OR = 6.4). Students who had higher BMI were 2.7 times more likely to have anxiety than those who had lower BMI (OR = 2.7), and 9.4 times more likely to have stress than those who had lower BMI (OR = 9.4).

Conclusion

Study findings indicate that nursing students' BMI increases as depression, anxiety, and stress increase. During the COVID-19 pandemic, participants reported increased weight due to increased stress levels and increased eating. Students in nursing should be aware of the importance of adopting healthy habits and following a healthy lifestyle.

Psychological responses and dietary changes of residents during the local outbreak of COVID-19 in the post-epidemic era: A cross-sectional study

The coronavirus disease 2019 (COVID-19) pandemic has had a dramatic impact on the psychological state and dietary behavior of individuals. Many previous studies have discussed the psychological and dietary problems during the first COVID-19 pandemic. However, few papers have discussed them during the local COVID-19 outbreak in the post-epidemic era. To explore the psychological responses and the influencing factors, dietary changes and the relationship with psychological responses during the local COVID-19 outbreak in the post-epidemic era. Methods: A total 3790 residents were surveyed by online questionnaire to collect information about social demography, health status, local outbreak related information, lifestyle changes, anxiety and depression. Binary logistic regression was used to discuss the influencing factors of anxiety and depression. Kendall tau-b correlation coefficient was used to discuss the relationship between anxiety, depression and dietary changes. Self-perceived physical condition, chronic disease, lockdown or quarantine, fear of COVID-19, changes in smoking, drinking and physical activity were the influencing factors of anxiety and depression. The top 3 foods with increased intake were drinking water, fresh fruits and fresh vegetables, while the top 3 foods with reduced intake were puffed foods, fried foods and sugary foods. Dietary changes were correlated with generalized anxiety disorder-7 and patient health questionnaire-9 scores. These findings provide experience and clues for local governments to improve the psychological status and dietary habits of residents during the local COVID-19 outbreak in the post-pandemic era.

The impact of the COVID-19 pandemic on lifestyle patterns: Does gender matter?

Background

The COVID-19 pandemic has significantly impacted individuals to deviate from normal lifestyle behaviors. But, there is a paucity of studies conducted in Bangladesh assessing how lifestyle patterns (i.e., smoking, drug use, physical exercise) have changed after the pandemic, which was investigated in this study.

Methods

An online-based cross-sectional survey was conducted among a total of 756 Bangladeshi young adults between April 1 and 13, 2020. Lifestyle patterns data were collected based on two periods from the COVID-19 pandemic inception point in the country, (i) '1 year before', and (ii) '1 year after'. Basic descriptive statistics (i.e., frequency and percentages) and Chi-square tests were performed to examine the associations of the independent variables in relation to lifestyle patterns.

Results

A 0.2 and 4.7% reduction in smoking and physical exercise, respectively, was observed after the pandemic. But the prevalence of drug use was 1.5% before the COVID-19 pandemic, which rose to 1.9% during the pandemic; representing a 0.4% increment. The changes in lifestyle patterns before and during the COVID-19 pandemic was statistically significant only for physical exercise. Of the gender, male participants were more prevalent in smoking, drug use, and performing physical exercise in both periods.

Conclusion

It is suggested to increase awareness concerning adverse effects of drug use and not performing physical exercise, where the gender-based focus is highly appreciated.

Urban parks as a potential mitigator of suicide rates resulting from global pandemics: Empirical evidence from past experiences in Seoul, Korea

Globally, the increased suicide rate of the general population has become a concern not only because of the COVID-19 pandemic, but also because of its associated socioeconomic insecurity, loss of jobs, and economic shocks. This study employed robust fixed-effects panel models to empirically identify the mitigating effects of infectious diseases, via urban parks, on the suicide rate, and to examine gender differences in this regard, based on previous experiences in Seoul, Korea. We found that the differentiating mitigating effect did not significantly affect suicide rates during the 2015 MERS epidemic. However, during the 2009 H1N1 pandemic, wherein the number of confirmed cases was very high and diffused nationwide, urban parks significantly reduced the suicide rates for both men and women. The role of parks as a mitigator was more enhanced in cities with a high number of confirmed cases if it was associated with economic shocks. However, this effect was significant only in the suicide rates of men, not women. During a pandemic, urban parks can help maintain social interaction and sustain physical activities (i.e., walking and exercise) while maintaining physical distance. National and local governments should develop urban parks to actively control the suicide rate influenced by movement restriction measures inevitably occurring during the spread of infectious diseases.

Impact of Prolonged COVID-19 Lockdown on Body Mass Index, Eating Habits, and Physical Activity of University Students in Bangladesh: A Web-Based Cross-Sectional Study

OBJECTIVES

This current study aims to assess the prevalence and factors associated with body mass index (BMI), dietary patterns, and the extent of physical activities among university students following the prolonged coronavirus disease 2019 (COVID-19) lockdown in Bangladesh.

METHODS

A cross-sectional web-based survey was conducted between July 10 to August 10, 2021, through a pre-designed Google Form to collect the data from Bangladeshi university students (age: ≥18 years). Informed consent was electronically obtained from each participant, and a simple snowball technique was employed during the sampling. Frequency and percentage distribution, paired t-test, chi-square [χ2] test, and multinomial and binary logistic regression analyses were consecutively applied to analyze the collected data.

RESULTS

Among the total participants (n = 1,602), 45.1% were female and 55.6% were 22-25 years' age group students. The BMI (mean ± standard deviation, SD) during the COVID-19 lockdown was 23.52 ± 7.68 kg/m2, which was 22.77 ± 4.11 kg/m2 during the pre-lockdown period (mean difference = 0.753; p < 0.001). The multinomial logistic regression analysis found a significant impact of gender [male vs. female: adjusted relative risk ratio (RRR) = 1.448; 95% confidence interval (CI) = 1.022, 2.053; p = 0.037], age (years) (<22 vs. >25: RRR =0.389, 95% CI = 0.213,0.710; p = 0.002, and 22-25 vs. >25: RRR = 0.473, 95% CI = 0.290, 0.772; p = 0.003), monthly family income (BDT) (<25,000 vs. >50,000: RRR = 0.525, 95% CI = 0.334,0.826; p = 0.005), university type (public vs. private: RRR = 0.540, 95% CI = 0.369, 0.791; p = 0.002), eating larger meals/snacks (increased vs. unchanged: RRR = 2.401, 95% CI = 1.597, 3.610; p < 0.001 and decreased vs. unchanged: RRR = 1.893, 95% CI = 1.218, 2.942; p = 0.005), and verbally or physically abuse (yes vs. no: RRR = 1.438, 95% CI = 0.977, 2.116; p = 0.066) on obesity during COVID-19 pandemic. Besides, the female students and those who have constant eating habits, were more likely to be underweight. Additionally, the binary logistic regression analysis found that the students from private universities [others vs. private: adjusted odds ratio (AOR) = 0.461, 95% CI = 0.313, 0.680; p < 0.001], urban areas (urban vs. rural: AOR = 1.451, 95% CI = 1.165, 1.806; p = 0.001), wealthier families (<25,000 BDT vs. >50,000 BDT: AOR = 0.727, 95% CI = 0.540, 0.979; p = 0.036), and who were taking larger meals/snacks (increased vs. unchanged: AOR = 2.806, 95% CI = 2.190, 3.596; p < 0.001) and had conflicts/arguments with others (no vs. yes: AOR = 0.524, 95% CI = 0.418, 0.657; p < 0.001), were significantly more physically inactive. Finally, the level of education and smoking habits significantly influenced the eating habits of university students during the extended strict lockdown in Bangladesh.

CONCLUSION

The current findings would be helpful tools and evidence for local and international public health experts and policymakers to reverse these worsening effects on students mediated by the prolonged lockdown. Several effective plans, programs, and combined attempts must be earnestly implemented to promote a smooth academic and daily life.

Impact of the COVID-19 pandemic on BMI: Its changes in relation to socio-demographic and physical activity patterns based on a short period

Background

The COVID-19 pandemic is undoubtedly a major threat to the world. The preventive strategies designed to minimize the virus transmission by remaining at home, being isolated, and keeping social distance, which would substantially reform people’s lifestyle, physical activity, eating habits, etc. Consequently, those measures might create a disturbance in weight management and overweight. Therefore, how the COVID-19 pandemic has changed the physical activities of individuals and its impacts on the Body Mass Index (BMI) is explored herein.

Methods

An online-based cross-sectional study collected data from 338 Bangladeshi adults in November 2020. The questionnaire included socio-demographics, health-related variables, physical activity-related variables, and diet measurement. Inferential statistics (i.e., chi-square test, McNemar test) were used to measure the associations between BMI and studied variables with a consideration of two scenarios (‘before’ and ‘during’ the pandemic inception), where p<0.05 was considered statistically significant.

Results

Results showed that the prevalence of overweight was 30.5% ‘before’ the COVID-19 pandemic, which increased to 34.9% ‘during’ the pandemic; that means 4.4% of the participants significantly gained weight after the pandemic inception. There was no significant role of socio-demographic (e.g., gender, age, current residence, occupation) or physical activity-related factors (e.g., unavailability of outdoor space, not performing regular physical exercise, exercising with a partner) in changing the BMI status after the pandemic inception. However, following a proper diet plan during the COVID-19 pandemic was observed to decrease BMI status significantly.

Conclusions

The present study suggests that a minor portion of the participants reported increasing their overweight status after the pandemic inception, whereas having a proper diet plan during the pandemic can significantly decrease BMI status. Therefore, the importance of the appropriate diet plan should be considered while implementing any policies.

Outdoor Activity in the Daytime, but Not the Nighttime, Predicts Better Mental Health Status During the COVID-19 Curfew in the United Arab Emirates

Background

The COVID-19 pandemic and the associated infection prevention and control measures had a negative impact on the mental health of many people. In the United Arab Emirates (UAE), infection control measures implemented after March 24th, 2020, placed necessary restrictions on people's freedom of movement.

Aim

This study aimed to assess the association between levels of daytime vs. nighttime outdoor activity and mental health among a sample of UAE residents during the lockdown period.

Method

An opportunity sample of 245 participants completed an online survey assessing levels of depression, somatic symptoms, daytime and nighttime activity levels.

Results

Multivariate logistic regression revealed that daytime activity, but not nighttime activity, was associated with a lower risk of clinically significant depressive and somatic symptomatology.

Conclusion

The association of better mental health with daytime not nighttime outdoor activity could be possibly attributed to vitamin D, but further studies are needed to confirm this speculation.