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You might be onto something if you suspect your mental and physical health declined during the COVID-19 lockdown earlier this year.
Stay-at-home orders appear to have had an overall bad effect on people's health around the world, a global survey shows.
People reported that they gained weight during the lockdown, were less active, suffered from poor sleep, and experienced increased stress and anxiety, said lead author Emily Flanagan, a postdoctoral researcher at the Pennington Biomedical Research Center in Baton Rouge, La.
Flanagan worries that these health changes will affect people's lives long after COVID-19 has been brought to heel as an infectious disease threat.
"There's research to show that even short-term changes in health -- short-term weight gain or short-term physical inactivity -- have long-lasting repercussions, more so than when you lose weight or start exercising again or start eating better," she said. "These, unfortunately, will have long-lasting impacts beyond the stay-at-home orders and beyond the COVID pandemic."
France and Germany both locked down this week in the face of a second wave of COVID-19 infections spreading across Europe, raising expectations that parts or all of the United States will have to follow suit this winter.
Dr. Reshmi Srinath, director of the Mount Sinai Weight and Metabolism Management Program in New York City, said this is a "powerful study" that confirms what clinicians have seen in patients who are being followed for diabetes and weight gain.
"Stress, anxiety, excess snacking and less activity all are contributing to weight gain and uncontrolled glucose [blood sugar] levels in patients with diabetes," said Srinath, who was not involved with the new research.
For this study, Flanagan's team surveyed more than 7,700 people through an advertising link on Facebook. Most respondents were in the United States, with half from Louisiana, but people from more than 50 other countries also filled out the detailed online questionnaire.
Interestingly, one solid piece of good news did emerge from the lockdown. While people were stuck at home, they tended to eat more healthy foods than usual, Flanagan said.
"The main driver of that healthy eating score was actually people not eating out as much," she said. "Because of that, we saw less fried food consumption, less takeout, less fast-food -- so overall, healthy eating scores increased."
Regardless of healthier eating, more than one-quarter of respondents (27%) said they still gained weight. People who were already obese reported weight gain more often than people who were overweight or at normal weight, the results showed. By contrast, about 17% of respondents said they'd lost weight.
Although diets improved overall, people still reported eating more snacks, desserts and sugar-sweetened beverages. For example, about 26% reported an increase in healthy snacking, but 44% reported an increase in unhealthy snacking.
A decline in physical activity probably also played a big part in weight gain, the study authors noted.
People spent more time as couch potatoes during the lockdown, with increases in television viewing, video gaming and screen time. Flanagan said they were less likely to engage in any physical activity or intense exercise.
Srinath said, "Weight gain is directly tied to caloric intake and expenditure. Even though we might be eating less food outside the home and possibly making better food choices, there is more time for snacking when you are stuck at home. We also forget how much activity we get just from going to work, being outside the home."
Mental health also took a blow during the lockdown, with overall anxiety increasing. About 20% reported symptoms of anxiety during the stay-at-home orders, compared to 14% prior to the pandemic, the researchers found.
"Unfortunately, we saw major declines in overall mental health through increases in anxiety," Flanagan said. "The majority of the people who took our survey reported they were not only concerned for their overall health and safety with the virus, but also concerned for their loved ones and family friends."
"Overall, sleep patterns were shifted forward an hour. People were going to bed about an hour later and waking up an hour later," Flanagan said. "With that, their sleep quality declined. People reported they were waking up in the middle of the night with fear of the virus."
The researchers found little difference in the way people around the world responded to lockdown orders, with no serious country-to-country variations.
"This is a global pandemic. It shows we're all responding in similar ways with these shutdowns and how our daily behaviors are changing," Flanagan said.
But your body weight prior to the pandemic did appear to influence how lockdown affected you, the researchers noted.
"We saw those individuals with obesity were actually the hardest hit by the stay-at-home orders with respect to their mental health decline, but on the other hand, we saw their eating behaviors improved the most," Flanagan said. "That was because when you looked at their pre-pandemic eating behaviors, they had the lowest scores. With those stay-at-home orders, everyone increased, but those with obesity increased more. They had a lower diet quality going into the shutdown, and with the stay-at-home orders their diet improved more so than those with normal weight and overweight."
If lockdowns occur again, Flanagan and her colleagues suggest doctors increase mental health screenings and stay in touch with patients through remote visits to help remind them to eat healthy and stay active.
"Health providers are able to focus in on these things at their visits to try to mitigate these going forward," Flanagan said.
The report was published online recently in the journal Obesity.
Srinath encouraged people concerned about their health during lockdown to stay in frequent contact with their doctor, and to try to:
- Find ways to mimic your old routine and create structure to your day.
- Add at least 20 minutes of walking or some form of movement into every day.
- Limit the amount of processed foods and high sugar-/high calorie-containing snacks in the home.
"This can help curb snacking on the wrong foods," Srinath said.
SOURCES: Emily Flanagan, PhD, postdoctoral researcher, Pennington Biomedical Research Center, Baton Rouge, La.; Reshmi Srinath, MD, director, Mount Sinai Weight and Metabolism Management Program, New York City; Obesity, Oct. 11, 2020, online
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