Lifestyle Behavior Changes and Associated Risk Factors During the COVID-19 Pandemic: Results from the Canadian COVIDiet Online Cohort Study

Abstract

Background The COVID-19 pandemic and related lockdowns have impacted lifestyle behaviors, including eating habits and physical activity; yet, few studies have identified the emerging patterns of such changes and associated risk factors. Objective This study aims to identify the patterns of weight and lifestyle behavior changes, and the potential risk factors, resulting from the pandemic in Canadian adults. Methods Analyses were conducted on 1609 adults (18-89 years old; n=1450, 90.1%, women; n=1316, 81.8%, White) of the Canadian COVIDiet study baseline data (May-December 2020). Self-reported current and prepandemic weight, physical activity, smoking status, perceived eating habits, alcohol intake, and sleep quality were collected through online questionnaires. Based on these 6 indicator variables, latent class analysis (LCA) was used to identify lifestyle behavior change patterns. Associations with potential risk factors, including age, gender, ethnicity, education, income, chronic diseases, body image perception, and changes in the stress level, living situation, and work arrangement, were examined with logistic regressions. Results Participants’ mean BMI was 26.1 (SD 6.3) kg/m2. Of the 1609 participants, 980 (60.9%) had a bachelor’s degree or above. Since the pandemic, 563 (35%) had decreased income and 788 (49%) changed their work arrangement. Most participants reported unchanged weight, sleep quality, physical activity level, and smoking and alcohol consumption, yet 708 (44%) reported a perceived decrease in eating habit quality. From LCA, 2 classes of lifestyle behavior change emerged: healthy and less healthy (probability: 0.605 and 0.395, respectively; Bayesian information criterion [BIC]=15574, entropy=4.8). The healthy lifestyle behavior change group more frequently reported unchanged weight, sleep quality, smoking and alcohol intake, unchanged/improved eating habits, and increased physical activity. The less healthy lifestyle behavior change group reported significant weight gain, deteriorated eating habits and sleep quality, unchanged/increased alcohol intake and smoking, and decreased physical activity. Among risk factors, body image dissatisfaction (odds ratio [OR] 8.8, 95% CI 5.3-14.7), depression (OR 1.8, 95% CI 1.3-2.5), increased stress level (OR 3.4, 95% CI 2.0-5.8), and gender minority identity (OR 5.5, 95% CI 1.3-22.3) were associated with adopting less healthy behaviors in adjusted models. Conclusions The COVID-19 pandemic has appeared to have influenced lifestyle behaviors unfavorably in some but favorably in others. Body image perception, change in stress level, and gender identity are factors associated with behavior change patterns; whether these will sustain over time remains to be studied. Findings provide insights into developing strategies for supporting adults with poorer mental well-being in the postpandemic context and promoting healthful behaviors during future disease outbreaks. Trial Registration ClinicalTrials.gov NCT04407533; https://clinicaltrials.gov/ct2/show/NCT04407533

Imaginarios de la actividad física y la salud en estudiantes universitarios durante la pandemia del Co-vid-19 (Imaginaries of physical activity and health in university students during the Covid-19 pandemic)

“…Se encontró, que el imaginario social está dado por la montaña rusa de emociones y sentimientos que generó un descontrol emocional y esto la incertidumbre, el desempleo, el duelo por la pérdida de familiares, y el consumo de sustancias psicoactivas; lo que puso en evidencia unos niveles altos de estrés, depresión y baja autoestima (Morales-Beltrán et al, 2022). Es importante mencionar que el periodo de aislamiento se relacionó con el imaginario social de sensaciones negativas que generan miedo e incertidumbre, y que determinan un trastorno en común que es el llamado "síndrome de la cabaña" (Castillo, 2021); pero por otro lado de sensaciones positivas como el autocuidado, la capacidad de organizar un ahorro, el hecho de hacer un cambio en la rutina que permita tener nuevas experiencias de conocimiento y aprendizaje, la mejora de ciertos hábitos como el aumento de los niveles de actividad física para tener un fitness cardiorrespiratorio óptimo y el replanteamiento de una mejor alimentación (Tessier et al, 2023). Lo anterior, se hace evidente en ese proceso de aceptación de la problemática que se vivió en cada núcleo familiar y en la necesidad de volver a la interacción social después del aislamiento para fortalecer las relaciones interpersonales y acabar con el conflicto social de discutir con las personas con las que se convivía todo el tiempo.…”

“…El aumento de la actividad física diaria desencadena una serie de beneficios para la salud tanto física como mental (Ruegsegger & Booth, 2018). Sin embargo, debido a la pandemia por el Covid-19, surgió una emergencia sanitaria (Gómez-González, Chávez-Díaz, & Sierra-Macías, 2020) y con esto una nueva realidad laboral, económica y social, que disminuyó notablemente los tiempos de desplazamiento y de movimiento físico, lo que llevó a una reducción en los niveles de actividad física (Musa, Dergaa, Bachiller, & Saad, 2023) y un aumento en los factores de riesgo cardiovascular, así como los trastornos mentales como el insomnio, la ansiedad y la depresión (Caroppo et al, 2021) (Heidari-Beni, Bemanalizadeh, Heshmat, Qorbani, & Kelishadi, 2022) (Tessier et al, 2023). Se comprende que esta pandemia comprometió la estabilidad emocional en la población a nivel mundial, sumándose a los factores que impactan la salud mental de las personas (Morales-Beltrán et al, 2022).…”

May the Force be with you during the quarantine: A cross-sectional study on the perception of health locus of control, sports engagement and emotional eating of individuals who exercised regularly

“…However, adverse modifications in their dietary patterns were observed. According to latent class analysis, the group with a less healthy lifestyle reported that their body weight increased, their eating habits worsened, and their physical activity decreased [63]. Unhealthy eating habits have been associated with depression, body image dissatisfaction, and increased stress levels.…”

Impact of socioeconomic factors on lifestyle changes among employees of public higher education institutions in ELSA-Brasil during COVID-19 pandemic

“…However, there are no studies that indicate the factors associated with such changes during this period in Brazil. In other parts of the globe, studies have indicated an association between unhealthy behaviors and racial/ethnic minority groups, younger individuals, lower education, and gender 11 , 12 , 13 .…”