Factors Associated with Body Weight Gain among Korean Adults during the COVID-19 Pandemic

Weightism in Asia: A Narrative Review and Implications for Practice

Weightism, also known as weight-related discrimination, is pervasive and believed to be one of the socially accepted types of discrimination in Asia. Weightism is pervasive, impactful, and has significant repercussions on individuals grappling with excess weight. Despite being a major risk factor for obesity, excess weight is not well documented in the Asian literature. This narrative review explores compelling evidence indicating that weightism adversely affects both physical and psychological well-being across various aspects of life. Research findings suggest that weightism be deemed socially unacceptable in Asia to mitigate the obesity epidemic and enhance overall well-being. Consequently, several recommendations for reducing weight stigma in Asian culture are proposed to support a healthier future.

Synergistic effects of COVID-19 pandemic and sedentary lifestyles on obesity rates among South Korean adults

Since March 2020, South Korea has implemented social distancing measures to reduce the spread of the coronavirus disease (COVID-19). These policies resulted in significant changes in the lifestyle of Korean adults, including spending more time indoors and experiencing increased sedentary time during the pandemic. This study aimed to investigate the combined influence of sedentary lifestyle and the COVID-19 pandemic on obesity rates among adults residing in South Korea. Data were obtained from the 2018-2020 Korea National Health and Nutrition Examination Survey (KNHANES). Multiple logistic regression was used to analyze the synergistic effects of a sedentary lifestyle and COVID-19 on obesity. The prevalence of sedentary lifestyles among the participants increased from 30.4% pre-COVID-19 to 36.6% during the pandemic. Furthermore, the obesity rates were raised independently by COVID-19 (OR: 1.16, 95% CI 1.04-1.30) and by a sedentary lifestyle (OR = 1.17, 95% CI 1.04-1.31). A synergistic effect of a sedentary lifestyle and COVID-19 on obesity was identified (OR: 1.57, 95% CI 1.30-1.85). COVID-19 and a sedentary lifestyle significantly increased the risk of obesity in South Korean adults. Moreover, the combined synergistic effects of these risk factors were too substantial to be disregarded by merely summing their individual effects on obesity.

Association of weight changes with SARS-CoV-2 infection and severe COVID-19 outcomes: A nationwide retrospective cohort study

BACKGROUND

Obesity is a risk factor for COVID-19. However, it is unknown whether weight changes can alter this risk. We investigated the association of weight changes with SARS-CoV-2 infection and acute severe COVID-19 outcomes occurring within two months of the infection.

METHODS

We used 6.3 million nationwide cohort. The body weight was classified as follows: (1) underweight, body mass index (BMI) < 18.5 kg/m2; (2) normal, BMI 18.5-22.9 kg/m2; (3) overweight, BMI 23-24.9 kg/m2; (4) obese, BMI≥ 25 kg/m2. Weight changes were defined by comparing the classification of body weight during the health screening period I and II. The outcomes were SARS-CoV-2 infection and severe COVID-19 outcomes within two months after the infection. The association was evaluated using multivariable-adjusted logistic regression. The following covariates were adjusted: age, sex, household income, cigarette smoking, alcohol consumption, physical activity, hypertension, diabetes mellitus, dyslipidemia, Charlson comorbidity index score, and dose of all COVID-19 vaccinations prior to SARS-CoV-2 infection.

RESULTS

Of the 2119,460 study participants, 184,204 were infected with SARS-CoV-2. Weight gain showed a higher risk of SARS-CoV-2 infection in underweight to normal and normal to overweight groups. Conversely, weight loss showed a lower risk of SARS-CoV-2 infection in normal to underweight, overweight to underweight, overweight to normal, obese to normal, and obese to overweight groups. In addition, weight gain revealed a higher risk of severe COVID-19 outcomes, whereas weight loss showed a lower risk of severe COVID-19 outcomes.

CONCLUSION

This study found that weight loss and gain are associated with a lower and higher risk of both SARS-CoV-2 infection and severe COVID-19 outcomes, respectively. Healthy weight management may be beneficial against the risk of COVID-19.

Association between Lifestyle Factors and Weight Gain among University Students in Japan during COVID-19 Mild Lockdown: A Quantitative Study

We aimed to investigate the lifestyle factors influencing weight gain among university students in Japan during the mild lockdown imposed due to the novel coronavirus disease pandemic. In this cross-sectional study, we conducted a questionnaire survey of students who underwent health examinations at Nagasaki University in 2021. Students reporting a weight gain of ≥3 kg were included in the weight gain group; the remaining students were included in the non-weight-gain group. Fisher's exact test and binary logistic regression were performed to determine the association between weight gain and each lifestyle factor. We included 3059 respondents (response rate: 45.7%), and 9.5% of them reported a weight gain of ≥3 kg. The following factors were associated with weight gain (odds ratio (95% confidence interval), p value based on Fisher's exact test): dining out for four times or more/week (2.16 (1.40, 3.32), p = 8.7 × 10-4) and gaming time of ≥4 h/day (2.26 (1.45, 3.47), p = 2.4 × 10-4). Binary logistic regression among the four highest odds ratios revealed that after adjusting for other factors, frequent dining out and prolonged gaming time were significantly associated with weight gain in students during the mild lockdown.

Sodium intake trend and current intake level by meal provision place among the citizens of Seoul

BACKGROUND/OBJECTIVES

The diversity of meal provision places has increased in recent years and sodium intake can vary depending on where meals are eaten, particularly in large cities. In this study, an analysis of the recent trends in sodium intake was performed and a comparison of sodium intake level according to meal provision place among citizens of Seoul was performed.

SUBJECTS/METHODS

Data from a 24-h recall dietary intake survey from the 2010-2019 Korea National Health and Nutrition Examination Survey (KNHANES) were used in order to determine the trends in sodium intake among citizens of Seoul, aged 3-74 years old. (n = 11,811). The trend of daily sodium intake was presented in absolute amount and proportion compared to the chronic disease risk reduction intake (CDRR) for each selected characteristic. A comparison of sodium intake level according to meal provision place by sex and age groups as a total amount per meal (mg), density per meal (mg/1,000 kcal), and proportion of the daily sodium intake was performed using the 2016-2019 KNHANES.

RESULTS

Sodium intake levels showed a downward trend from 2010-2019. The highest level of sodium intake was observed for subjects aged 30-49, and the level for males aged 30-49 was 202.8% higher than the CDRR. Results of the analysis of sodium intake per meal according to meal provision place showed that the highest sodium intake was in the order of restaurant meal (RM) > institutional foodservice (IF) > home meal (HM) > convenience food (CF). A higher sodium density (mg/1,000 kcal) was observed for IF compared with RM in most adults. Adults aged over 50 years old consumed more than half of the daily sodium in HM.

CONCLUSION

Significant variation in the level of sodium intake was observed according to sex and age groups, therefore, different approaches and nutrition policies based on meal provision place are needed.

Lifestyle and Dietary Patterns during the COVID-19 Lockdown in Bahrain: A Web-Based Cross-Sectional Study

Lifestyle factors such as dietary habits, perceived weight, sleep, and physical activity worsened during the COVID-19 pandemic. Through this study, we aimed to understand the impact of COVID-19 on these lifestyle factors in Bahrain. A cross-sectional study was conducted among 1005 adult Bahrainis. Data were collected online using a structured and validated questionnaire for the assessment of eating habits, physical activity, and lifestyle during the COVID-19 pandemic. Participants were snowballed through those who agreed to answer the online questionnaire. There was a higher consumption of fast food, and a higher dependence on takeaways during the COVID-19 pandemic. About 63.5% of the participants consumed >4 meals per day, compared to 36.5% before the COVID-19. About 30% reported consumption of sugar sweetened beverages from two to three times a day. Weight loss was predominantly observed in persons exercising 1-3 times a week. The consumption of sugar-sweetened beverages was also high, with about 19% reporting drinking sweet beverages once every day, 10.6% from two to three times a day, and 40.4% from one to four times a week. A higher proportion of the participants reported poor sleep quality during the pandemic (31.2%) compared to before (12.2%), and 39.7% of the participants reported feeling lazy. Screen time use also doubled during the pandemic, with participants spending more than five hours per day on screens for entertainment, which went from 22.4% before to 51.9% during the pandemic. The lifestyle and dietary habits changed drastically for our study participants during the pandemic. The increased reliance on processed fast food instead of healthier options is a challenge to be tackled in any future pandemic situation. Future research needs to focus on strategies to promote healthier lifestyle modifications during situations such as the COVID-19 pandemic.

Awareness of and practice toward cancer prevention recommendations: results of the Korean National Cancer Prevention Awareness and Practice Survey in 2021

OBJECTIVES

This study reports data regarding the awareness and practice of cancer prevention among Koreans in 2021 and behavioral changes during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

We collected Cancer Prevention Awareness and Practice Survey data through face-to-face interview surveys using a structured questionnaire completed by 4,000 randomly selected men and women aged between 20 years and 74 years in 17 provinces. We examined the awareness and practice of 10 cancer prevention recommendations and evaluated their associations with potential risk factors through multiple logistic regression analysis adjusted for age, gender, residence, marital status, education, and income.

RESULTS

Eighty percent of participants knew that cancer is preventable, while 45% practiced cancer prevention. Cancer prevention practice tended to be more common among older participants (adjusted odds ratio [aOR], 1.39 per 10-year increment; 95% confidence interval [CI], 1.29 to 1.49) and less common among rural inhabitants (aOR, 0.66; 95% CI, 0.51 to 0.86) than among urban residents and among single people (aOR, 0.55; 95% CI, 0.45 to 0.66) than among married people. Practices were the highest for avoiding burned or charred foods (87.6%) and lowest for vaccination against human papillomavirus (14.5%). Refusal to follow recommendations was most common for avoiding alcohol consumption (7.9%). The most difficult recommendations to follow were (1) regular exercise (57.7%); (2) maintaining a healthy body weight (46.1%); and (3) avoiding alcohol (40.1%). The most significant COVID-19-related changes were less exercise (32.5%) and increased body weight (25.6%).

CONCLUSIONS

The awareness of cancer prevention was high, but the practice was low. Recommendations targeting awareness and practice need to be further promoted.

Association between obesity and COVID-19

Background: Since December 2019, most countries have struggled with the novel coronavirus, severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). During the coronavirus disease-2019 (COVID-19) pandemic, weight gain became prevalent because the preventive measures against the spread of SARS-CoV-2 infection resulted in decreased physical activity and increased consumption of unhealthy food among the general public.Current Concepts: Several mechanisms have been proposed for the association between obesity and COVID-19. SARS-CoV-2 infection aggravates inflammation and hypoxia in obese people, which can lead to severe COVID-19 disease. COVID-19 affects the immune system, resulting in various complications. Several cytokines, including interleukin-6, are integral to the progression of COVID-19. Thus, COVID-19-associated inflammation and immune dysfunction predispose patients to the complications of obesity, such as cardiovascular diseases and diabetes mellitus.Discussion and Conclusion: Obese patients are commonly prescribed antidiabetic agents, blood pressure lowering medications, and lipid-lowering medications such as statins. The routine intake of these drugs is a protective factor against all-cause mortality. During the COVID-19 pandemic, preventive measures, such as minimizing team sports and closing public exercise facilities, might have contributed to the weight gain in obese individuals. Thus, an active lifestyle with regular home exercise and a healthy diet should be advised for obese patients.