Health behaviors and mental health before and during the COVID-19 pandemic: A longitudinal population-based survey

Abstract

Background: Health behaviors such as physical activity and a balanced diet are essential to promote and maintain health. Especially during a crisis, such as the COVID-19 pandemic, they have the potential to buffer against stress and protect mental health. Method: In a longitudinal study with four measurement points over 3 months during the COVID-19 pandemic, about 3,500 randomly selected participants representative of the German population reported their mental health (i.e., anxiety, depression, loneliness), screen time, snack consumption, and physical activity. Results: Symptoms of anxiety, depression, and loneliness were highest during the first month of the pandemic-related lockdown, particularly in women and people in poor health, and decreased over time. Screen time and snacking increased and physical activity decreased compared to pre-lockdown. Snacking and physical activity went back to pre-lockdown levels within 2 months; screen time increased further over time. Snack increase and physical activity decrease was stronger in women than men throughout the lockdown. Generally, more screen time, more snacking, and less physical activity were related to higher symptoms of anxiety, depression, and loneliness across all time points. Changes in health behaviors over time did not predict changes in mental health symptoms. Conclusions: Mental health and health behaviors worsened as an immediate response to stress but mostly returned to pre-crisis levels within 2 to 3 months. Engaging in healthier behaviors is associated with better mental health. This study provides important descriptions of (unintended) side effects of a national crisis and contributes to our understanding of how to preserve mental health.

COVID-19 Stress and Food Intake: Protective and Risk Factors for Stress-Related Palatable Food Intake in U.S. Adults

“…For example, one study found that individuals with higher health and diet literacy were more likely to increase healthy eating during the pandemic [ 60 ], while another reported that pro-healthy changes to diet were associated with older age and increased consumption of home cooking [ 58 ]. Another key element in dietary changes during the pandemic appears to be the role of snacking between meals [ 61 , 62 , 63 ]. While our survey did not assess whether snacking increased during the COVID-19 pandemic, the high proportion of participants reporting increased intake of snack foods and desserts suggests that intake outside of regular mealtimes could have increased in this sample as well.…”

Longitudinal changes in physical activity during and after the first national lockdown due to the COVID-19 pandemic in England

“…This study is the first to examine the heterogeneity in longitudinal changes in physical activity during the COVID-19 pandemic. Building on recent longitudinal studies, which reported a general decline in physical activity at the start of the pandemic, [10][11][12][13][14][15]25 our analyses identified six unique classes of growth trajectories of physical activity. Three of these classes were stable, showing little change over time, including the inactive (11.6%), the fairly active (22.2%) and the highly active (28.6%).…”

“…These differing trajectories may explain the inconsistent findings to date from longitudinal studies testing whether physical activity returned to pre-lockdown levels with the easing of restrictions in the UK. 10,11,14,15 This study further examined sociodemographic and health-related predictors of physical activity growth trajectories. When comparing the three stable classes (inactive, fairly active, and highly active; LC1-3), we found no gender, ethnic, or urban/rural differences between them.…”

“…Studies examining longer-term impacts on physical activity have provided mixed findings on whether physical activity returned to pre-lockdown levels with the initial easing of restrictions in the UK in May 2020. 10,11,14,15 To our knowledge, no studies have investigated changes in physical activity after further easing of restrictions in the UK in July 2020, meaning the longer term impact of lockdown measures on physical activity remains unclear. We do not know whether short-term disruptions to physical activity lead to long-term behavioural changes that could have adverse effects on health.…”

“…Being female, younger, single, a parent, and from an ethnic minority group as well as having poor health, lower education and income, and no access to outside space have been associated with lower physical activity during lockdown. 11,12,15,20,21 However, findings have been inconsistent, and many studies have only examined physical activity at one point early in the pandemic. It therefore remains unclear whether similar factors are associated with trajectories of physical activity throughout lockdown and the easing of restrictions.…”