Have Lifestyle Habits and Psychological Well-Being Changed among Adolescents and Medical Students Due to COVID-19 Lockdown in Croatia?
Tóm tắt
Objective: To investigate dietary habits, sleep and psychological well-being of adolescents and medical students during COVID-19 lockdown in Split, Croatia. Methods: We surveyed 1326 students during 2018 and 2019, and compared their responses with 531 students enrolled in May 2020. Perceived stress, quality of life (QoL), happiness, anxiety, and optimism were assessed as proxies of psychological well-being, using general linear modelling. Results: We found no substantial differences in dietary pattern between pre-lockdown and lockdown periods, including the overall Mediterranean diet (MD) adherence. However, the MD pattern changed, showing increased adherence to the MD pyramid for fruit, legumes, fish, and sweets, while cereals, nuts, and dairy intake decreased during COVID-19 lockdown. A third of students reported weight loss during lockdown, 19% reported weight gain, while physical activity remained rather stable. The most prominent change was feeling refreshed after a night’s sleep, reported by 31.5% of students during lockdown vs. 8.5% before; median length of sleep duration increased by 1.5 h. Lockdown significantly affected QoL, happiness, optimism (all p < 0.001), and perceived stress in students (p = 0.005). MD adherence was positively correlated with QoL and study time, and negatively with TV and mobile phone use in pre-lockdown period (all p < 0.001). Interestingly, higher MD adherence was correlated with less perceived hardship and greater happiness and QoL during lockdown. Conclusion: These insights provide valuable information for tailored interventions aimed at maintaining healthy lifestyle in young population. Given the numerous beneficial effects associated with MD adherence, modification of lifestyle through application of lifestyle medicine deserves a priority approach.
Từ khóa
Tài liệu tham khảo
Rabi, F.A., Al Zoubi, M.S., Kasasbeh, G.A., Salameh, D.M., and Al-Nasser, A.D. (2020). SARS-CoV-2 and Coronavirus Disease 2019: What We Know So Far. Pathogens, 9.
Blavatnik School of Government UoO (2020, October 22). Relationship between Number of COVID-19 Cases and Government Response. Available online: https://covidtracker.bsg.ox.ac.uk/stringency-scatter.
Bokan, 2020, Adherence to epidemiological measures and related knowledge and attitudes during the coronavirus 2019 epidemic in Croatia: A cross-sectional study, Croat. Med. J., 61, 508, 10.3325/cmj.2020.61.508
Nicola, 2020, The socio-economic implications of the coronavirus pandemic (COVID-19): A review, Int. J. Surg., 78, 185, 10.1016/j.ijsu.2020.04.018
Kriaucioniene, V., Bagdonaviciene, L., Rodriguez-Perez, C., and Petkeviciene, J. (2020). Associations between Changes in Health Behaviours and Body Weight during the COVID-19 Quarantine in Lithuania: The Lithuanian COVIDiet Study. Nutrients, 12.
Gualtieri, 2020, Eating habits and lifestyle changes during COVID-19 lockdown: An Italian survey, J. Transl. Med., 18, 229, 10.1186/s12967-020-02399-5
Dogas, 2020, The effect of COVID-19 lockdown on lifestyle and mood in Croatian general population: A cross-sectional study, Croat. Med. J., 61, 309, 10.3325/cmj.2020.61.309
Calcaterra, 2020, Special Attention to Diet and Physical Activity in Children and Adolescents With Obesity During the Coronavirus Disease-2019 Pandemic, Front. Pediatr., 8, 407, 10.3389/fped.2020.00407
Brooks, 2020, The psychological impact of quarantine and how to reduce it: Rapid review of the evidence, Lancet, 395, 912, 10.1016/S0140-6736(20)30460-8
Burke, T., Berry, A., Taylor, L.K., Stafford, O., Murphy, E., Shevlin, M., McHugh, L., and Carr, A. (2020). Increased Psychological Distress during COVID-19 and Quarantine in Ireland: A National Survey. J. Clin. Med., 9.
Pfefferbaum, 2020, Mental Health and the Covid-19 Pandemic, N. Engl. J. Med., 383, 510, 10.1056/NEJMp2008017
Miedema, 2015, Association of Fruit and Vegetable Consumption During Early Adulthood With the Prevalence of Coronary Artery Calcium After 20 Years of Follow-Up: The Coronary Artery Risk Development in Young Adults (CARDIA) Study, Circulation, 132, 1990, 10.1161/CIRCULATIONAHA.114.012562
Hershner, 2014, Causes and consequences of sleepiness among college students, Nat. Sci. Sleep, 6, 73, 10.2147/NSS.S62907
Schlarb, 2017, Sleep problems in university students an intervention, Neuropsychiatr. Dis. Treat., 13, 1989, 10.2147/NDT.S142067
Sogari, G., Velez-Argumedo, C., Gomez, M.I., and Mora, C. (2018). College Students and Eating Habits: A Study Using an Ecological Model for Healthy Behavior. Nutrients, 10.
Aucejo, 2020, The impact of COVID-19 on student experiences and expectations: Evidence from a survey, J. Public Econ., 191, 104271, 10.1016/j.jpubeco.2020.104271
Bracale, 2020, Changes in food choice following restrictive measures due to Covid-19, Nutr. Metab. Cardiovasc. Dis., 30, 1423, 10.1016/j.numecd.2020.05.027
Husain, 2020, Does COVID-19 change dietary habits and lifestyle behaviours in Kuwait: A community-based cross-sectional study, Environ. Health Prev. Med., 25, 61, 10.1186/s12199-020-00901-5
Ruiz-Roso, M.B., de Carvalho Padilha, P., Mantilla-Escalante, D.C., Ulloa, N., Brun, P., Acevedo-Correa, D., Peres, W.A.F., Martorell, M., Aires, M.T., and Cardoso, L.D.O. (2020). Covid-19 Confinement and Changes of Adolescent’s Dietary Trends in Italy, Spain, Chile, Colombia and Brazil. Nutrients, 12.
Glabska, D., Skolmowska, D., and Guzek, D. (2020). Population-Based Study of the Changes in the Food Choice Determinants of Secondary School Students: Polish Adolescents’ COVID-19 Experience (PLACE-19) Study. Nutrients, 12.
Pigaiani, Y., Zoccante, L., Zocca, A., Arzenton, A., Menegolli, M., Fadel, S., Ruggeri, M., and Colizzi, M. (2020). Adolescent Lifestyle Behaviors, Coping Strategies and Subjective Wellbeing during the COVID-19 Pandemic: An Online Student Survey. Healthcare, 8.
Gallo, L.A., Gallo, T.F., Young, S.L., Moritz, K.M., and Akison, L.K. (2020). The Impact of Isolation Measures Due to COVID-19 on Energy Intake and Physical Activity Levels in Australian University Students. Nutrients, 12.
Duong, T.V., Pham, K.M., Do, B.N., Kim, G.B., Dam, H.T.B., Le, V.T., Nguyen, T.T.P., Nguyen, H.T., Nguyen, T.T., and Le, T.T. (2020). Digital Healthy Diet Literacy and Self-Perceived Eating Behavior Change during COVID-19 Pandemic among Undergraduate Nursing and Medical Students: A Rapid Online Survey. Int. J. Environ. Res. Public Health, 17.
Monteagudo, C., Mariscal-Arcas, M., Rivas, A., Lorenzo-Tovar, M.L., Tur, J.A., and Olea-Serrano, F. (2015). Proposal of a Mediterranean Diet Serving Score. PLoS ONE, 10.
Kolcic, 2016, Mediterranean diet in the southern Croatia does it still exist?, Croat. Med. J., 57, 415, 10.3325/cmj.2016.57.415
Relja, A., Miljkovic, A., Gelemanovic, A., Boskovic, M., Hayward, C., Polasek, O., and Kolčić, I. (2017). Nut Consumption and Cardiovascular Risk Factors: A Cross-Sectional Study in a Mediterranean Population. Nutrients, 9.
Vecek, N.N., Mucalo, L., Dragun, R., Milicevic, T., Pribisalic, A., Patarcic, I., Hayward, C., Polašek, O., and Kolčić, I. (2020). The Association between Salt Taste Perception, Mediterranean Diet and Metabolic Syndrome: A Cross-Sectional Study. Nutrients, 12.
Marendić, M., Polić, N., Matek, H., Oršulić, L., Polašek, O., and Kolčić, I. (2021). Mediterranean Diet Assessment Challenges: Validation of the Croatian Version of the 14-item Mediterranean Diet Serving Score (MDSS) Questionnaire. PLoS ONE, under review.
Berry, 2011, Mediterranean diet pyramid today. Science and cultural updates, Public Health Nutr., 14, 2274, 10.1017/S1368980011002515
Kim, 2017, The relationship between perceived stress scale and carotid intima-media thickness using ultrasonography in university students, Korean J. Clin. Lab. Sci., 49, 308, 10.15324/kjcls.2017.49.3.308
Gornicka, M., Drywien, M.E., Zielinska, M.A., and Hamulka, J. (2020). Dietary and Lifestyle Changes During COVID-19 and the Subsequent Lockdowns among Polish Adults: A Cross-Sectional Online Survey PLifeCOVID-19 Study. Nutrients, 12.
Romero-Blanco, C., Rodriguez-Almagro, J., Onieva-Zafra, M.D., Parra-Fernandez, M.L., Prado-Laguna, M.D.C., and Hernandez-Martinez, A. (2020). Sleep Pattern Changes in Nursing Students during the COVID-19 Lockdown. Int. J. Environ. Res. Public Health, 17.
Cellini, N., Canale, N., Mioni, G., and Costa, S. (2020). Changes in sleep pattern, sense of time and digital media use during COVID-19 lockdown in Italy. J. Sleep Res., e13074.
Cappuccio, 2017, Sleep and Cardio-Metabolic Disease, Curr. Cardiol. Rep., 19, 110, 10.1007/s11886-017-0916-0
Song, C., Zhang, R., Liao, J., Fu, R., Wang, C., Liu, Q., Song, W., Wang, H., and Dou, K. (2020). Sleep quality and risk of coronary heart disease-a prospective cohort study from the English longitudinal study of ageing. Aging (Albany NY), 12.
Lund, 2010, Sleep patterns and predictors of disturbed sleep in a large population of college students, J. Adolesc. Health, 46, 124, 10.1016/j.jadohealth.2009.06.016
Pilcher, 1997, How sleep deprivation affects psychological variables related to college students’ cognitive performance, J. Am. Coll. Health, 46, 121, 10.1080/07448489709595597
Wolfson, 2007, Middle school start times: The importance of a good night’s sleep for young adolescents, Behav. Sleep Med., 5, 194, 10.1080/15402000701263809
Adam, 2007, Sleep timing and quantity in ecological and family context: A nationally representative time-diary study, J. Fam. Psychol., 21, 4, 10.1037/0893-3200.21.1.4
Dexter, 2003, Sleep, sleepiness and school start times: A preliminary study, WMJ, 102, 44
Owens, 2010, Impact of delaying school start time on adolescent sleep, mood, and behavior, Arch. Pediatr. Adolesc. Med., 164, 608, 10.1001/archpediatrics.2010.96
Sidor, A., and Rzymski, P. (2020). Dietary Choices and Habits during COVID-19 Lockdown: Experience from Poland. Nutrients, 12.
Bae, M., and Kim, H. (2020). Mini-Review on the Roles of Vitamin C, Vitamin D, and Selenium in the Immune System against COVID-19. Molecules, 25.
Food and Agriculture Organization of the United Nations (FAO) (2020, November 01). Maintaining a Healthy Diet during the COVID-19 Pandemic. Available online: https://doi.org/10.4060/ca8380en.
Richardson, D.P., and Lovegrove, J.A. (2020). Nutritional status of micronutrients as a possible and modifiable risk factor for COVID-19: A UK perspective. Br. J. Nutr., 1–7.
Perez-Cueto, F.J.A. (2019). An Umbrella Review of Systematic Reviews on Food Choice and Nutrition Published between 2017 and-2019. Nutrients, 11.
Kant, 2015, Within-person comparison of eating behaviors, time of eating, and dietary intake on days with and without breakfast: NHANES 2005-2010, Am. J. Clin. Nutr., 102, 661, 10.3945/ajcn.115.110262
Okada, 2019, The Association of Having a Late Dinner or Bedtime Snack and Skipping Breakfast with Overweight in Japanese Women, J. Obes., 2019, 2439571, 10.1155/2019/2439571
ALMughamis, N.S., AlAsfour, S., and Mehmood, S. (2020). Poor Eating Habits and Predictors of Weight Gain During the COVID-19 Quarantine Measures in Kuwait: A Cross Sectional Study. Res. Sq.
Gunes, 2019, Awareness of cardiovascular risk factors among university students in Turkey CORRIGENDUM, Prim. Health Care Res. Dev., 20, e148, 10.1017/S1463423619000823
D’Innocenzo, S., Biagi, C., and Lanari, M. (2019). Obesity and the Mediterranean Diet: A Review of Evidence of the Role and Sustainability of the Mediterranean Diet. Nutrients, 11.
Munoz, 2009, Adherence to the Mediterranean diet is associated with better mental and physical health, Br. J. Nutr., 101, 1821, 10.1017/S0007114508143598
Salvatore, 2019, Mediterranean diet and mental distress: “10,001 Dalmatians” study, Br. Food J., 121, 1314, 10.1108/BFJ-06-2018-0339
Rippe, 2018, Lifestyle Medicine: The Health Promoting Power of Daily Habits and Practices, Am. J. Lifestyle Med., 12, 499, 10.1177/1559827618785554
World Health Organization (WHO) (2020, November 02). Stay Physically Active during Self-Quarantine. Available online: https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/publications-and-technical-guidance/noncommunicable-diseases/stay-physically-active-during-self-quarantine.
Rose, 2017, A Systematic Review of Digital Interventions for Improving the Diet and Physical Activity Behaviors of Adolescents, J. Adolesc. Health, 61, 669, 10.1016/j.jadohealth.2017.05.024
Rodriguez-Perez, C., Molina-Montes, E., Verardo, V., Artacho, R., Garcia-Villanova, B., Guerra-Hernandez, E.J., and Ruiz-López, M.-D. (2020). Changes in Dietary Behaviours during the COVID-19 Outbreak Confinement in the Spanish COVIDiet Study. Nutrients, 12.
Ammar, A., Brach, M., Trabelsi, K., Chtourou, H., Boukhris, O., Masmoudi, L., Bouaziz, B., Bentlage, E., How, D., and Ahmed, M. (2020). Effects of COVID-19 Home Confinement on Eating Behaviour and Physical Activity: Results of the ECLB-COVID19 International Online Survey. Nutrients, 12.
Pellegrini, M., Ponzo, V., Rosato, R., Scumaci, E., Goitre, I., Benso, A., Belcastro, S., Crespi, C., De Michieli, F., and Ghigo, E. (2020). Changes in Weight and Nutritional Habits in Adults with Obesity during the “Lockdown” Period Caused by the COVID-19 Virus Emergency. Nutrients, 12.
Bann, D., Villadsen, A., Maddock, J., Hughes, A., Ploubidis, G., Silverwood, R., and Patalay, P. (2020). Changes in the behavioural determinants of health during the coronavirus (COVID-19) pandemic: Gender, socioeconomic and ethnic inequalities in 5 British cohort studies. medRxiv.
Bann, 2019, Adolescents’ physical activity: Cross-national comparisons of levels, distributions and disparities across 52 countries, Int. J. Behav. Nutr. Phys. Act., 16, 141, 10.1186/s12966-019-0897-z
Chen, 2020, Returning Chinese school-aged children and adolescents to physical activity in the wake of COVID-19: Actions and precautions, J. Sport Health Sci., 9, 322, 10.1016/j.jshs.2020.04.003
Mediouni, 2020, COVID-19: How the quarantine could lead to the depreobesity, Obes. Med., 19, 100255, 10.1016/j.obmed.2020.100255
Fegert, 2020, Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: A narrative review to highlight clinical and research needs in the acute phase and the long return to normality, Child Adolesc. Psychiatry Ment. Health, 14, 20, 10.1186/s13034-020-00329-3
2008, Comparison of web-based versus paper-and-pencil self-administered questionnaire: Effects on health indicators in Dutch adolescents, Health Serv. Res., 43, 1708, 10.1111/j.1475-6773.2008.00860.x
Sherry, 2007, Accuracy of adolescent self-report of height and weight in assessing overweight status: A literature review, Arch Pediatr. Adolesc. Med., 161, 1154, 10.1001/archpedi.161.12.1154