Exchanging screen for non-screen sitting time or physical activity might attenuate depression and anxiety: a cross-sectional isotemporal analysis during early pandemics in South America

Objectives To examine the theoretical substitutions of screen exposure, non-screen sitting time, moderate and vigorous physical activity with depressive and anxiety symptoms in South American adults during the COVID-19 pandemic. Design A cross-sectional study during the first months of the COVID-19 pandemic with data from 1981 adults from Chile, Argentina, and Brazil. Methods Depressive and anxiety symptoms were assessed using the Beck Depression and Anxiety Inventories. Participants also reported physical activity, sitting time, screen exposure, sociodemographic, and tobacco use data. Isotemporal substitution models (ISM) were created using multivariable linear regression methods. Results Vigorous physical activity, moderate physical activity, and screen exposure were independently associated with depression and anxiety symptoms. In adjusted ISM, replacing 10 min/day of either screen exposure or non-screen sitting time with any intensity of physical activity was associated with lower levels of depressive symptoms. Improvements in anxiety symptoms were found when reallocating either screen exposure or non-screen sitting time to moderate physical activity. Furthermore, replacing 10 min/day of screen exposure with non-screen sitting time was beneficially associated with anxiety (B = − 0.033;95% CI = − 0.059, − 0.006) and depression (B = − 0.026;95% CI = -0.050, − 0.002). Conclusion Replacement of screen exposure with any intensity of physical activity or non-screen sitting time could improve mental health symptoms. Strategies aiming to reduce depressive and anxiety symptoms highlight physical activity promotion. However, future interventions should explore specific sedentary behaviors as some will relate positively while others negatively.

Changes in movement behaviors and back pain during the first wave of the COVID-19 pandemic in Brazil.

BACKGROUND: Quarantine periods change routines and behaviors with potential impact on different health outcomes. OBJECTIVE: To determine the association between changes in physical activity and sedentary behaviors with changes in back pain during the COVID-19 pandemic quarantine among Brazilian adults. METHODS: This was a nationwide survey through online questionnaires using data from 43,062 adults (≥ 18 years of age). Information on back pain was assessed using questions about episodes of back pain and worsening symptoms during the quarantine. The pattern of movement behaviors adopted before and during the pandemic were considered for physical inactivity (< 150 min/week of activity), high TV-viewing (≥ 4 h/d), and high computer/tablet use (≥ 4 h/d). Covariates included sex, age group, academic achievement, skin color, working status during the quarantine, and adherence to the quarantine. Logistic regression models were used for statistical analyses (weighted for national representativity). RESULTS: Becoming inactive (OR=1.76, 95% CI: 1.32, 2.37), with high TV-viewing (OR=1.35, 95% CI: 1.14, 1.61) and high computer/tablet use (OR=1.39, 95% CI: 1.11, 1.73) during the pandemic were associated with a higher incidence of back pain. The incidence of physical inactivity was also associated with increased back pain (OR=2.71, 95%CI: 1.64, 4.48). CONCLUSIONS: We conclude that increased physical inactivity and sedentary behaviors due to the COVID-19 pandemic quarantine are associated with the incidence and worsening symptoms of back pain among Brazilian adults.

The association between physical activity and mental health during the first year of the COVID-19 pandemic: a systematic review.

INTRODUCTION: The Coronavirus disease-19 (COVID-19) pandemic affected countries worldwide and has changed peoples' lives. A reduction in physical activity and increased mental health problems were observed, mainly in the first year of the COVID-19 pandemic. Thus, this systematic review aims to examine the association between physical activity and mental health during the first year of the COVID-19 pandemic. METHODS: In July 2021, a search was applied to PubMed, Scopus, and Web of Science. Eligibility criteria included cross-sectional, prospective, and longitudinal study designs and studies published in English; outcomes included physical activity and mental health (e.g., depressive symptoms, anxiety, positive and negative effects, well-being). RESULTS: Thirty-one studies were included in this review. Overall, the studies suggested that higher physical activity is associated with higher well-being, quality of life as well as lower depressive symptoms, anxiety, and stress, independently of age. There was no consensus for the optimal physical activity level for mitigating negative mental symptoms, neither for the frequency nor for the type of physical activity. Women were more vulnerable to mental health changes and men were more susceptive to physical activity changes. CONCLUSION: Physical activity has been a good and effective choice to mitigate the negative effects of the COVID-19 pandemic on mental health during the first year of the COVID-19 pandemic. Public health policies should alert for possibilities to increase physical activity during the stay-at-home order in many countries worldwide.

Incidence of physical inactivity and excessive screen time during the first wave of the COVID-19 pandemic in Brazil: what are the most affected population groups?

PURPOSE: Our aim was to verify the incidence of physical inactivity and excessive screen time during the first wave of the COVID-19 pandemic among Brazilian adults, as well as to identify subgroups that are more affected by the quarantine actions. METHODS: The data of 39,693 Brazilian adults were collected through an online questionnaire between April 24th and May 24th, 2020. Information about physical activity (weekly frequency and daily duration), TV viewing, and computer/tablet use (daily duration) before and during the pandemic period were reported. The correlates adopted were sex, age group, highest academic achievement, skin color, per capita income, country macro region, working status during the quarantine, and adherence to the quarantine. Logistic regression models were used. RESULTS: The incidence of physical inactivity (<150 min/week), high TV viewing (≥4 h/d), and computer/tablet use (≥4 h/d), were, respectively, 70.4%, 31.4%, and 37.9% during the COVID-19 pandemic. The younger age group showed higher incidences of physical inactivity (78%) and high computer/tablet use (59%), while middle-age adults (30-59 years) showed a higher incidence of TV viewing (34%). People who adhered to stricter measures of quarantine presented a higher incidence of excessive screen time. CONCLUSION: High incidences of physical inactivity and excessive screen time were identified in specific population subgroups during the first wave of the COVID-19 pandemic in Brazil.

Moderate to vigorous physical activity and sedentary behavior changes in self-isolating adults during the COVID-19 pandemic in Brazil: a cross-sectional survey exploring correlates.

Background: The COVID-19 pandemic imposed major changes on daily-life routine worldwide. To the best of our knowledge, no study quantified the changes on moderate to vigorous physical activity (MVPA) and sedentary behaviors (SB) and its correlates in Brazilians. This study aimed to (i) evaluate the changes (pre versus during pandemic) in time spent in MVPA and SB in self-isolating Brazilians during the COVID-19 pandemic, and (ii) to explore correlates. Methods: A cross-sectional, retrospective, self-report online web survey, evaluating the time spent in MVPA and SB pre and during the COVID-19 pandemic in self-isolating people in Brazil. Sociodemographic, behavioral, and clinical measures, and time in self-isolation were also obtained. Changes in MVPA and SB and their correlates were explored using generalized estimating equations (GEE). Models were adjusted for covariates. Results: A total of 877 participants (72.7% women, 53.7% young adults [18-34 years]) were included. Overall, participants reported a 59.7% reduction (95% CI 35.6-82.2) in time spent on MVPA during the pandemic, equivalent to 64.28 (95% CI 36.06-83.33) minutes per day. Time spent in SB increased 42.0% (95% CI 31.7-52.5), corresponding to an increase of 152.3 (95% CI 111.9-192.7) minutes per day. Greater reductions in MVPA and increases in SB were seen in younger adults, those not married, those employed, and those with a self-reported previous diagnosis of a mental disorder. Conclusions: People in self-isolation significantly reduced MVPA levels and increased SB. Public health strategies are needed to mitigate the impact of self-isolation on MVPA and SB. Supplementary Information: The online version contains supplementary material available at 10.1007/s11332-021-00788-x.

Physical Activity Is Associated With Improved Eating Habits During the COVID-19 Pandemic.

The aim of this study was to analyze the association between physical activity and eating habits during the COVID-19 pandemic among Brazilian adults. A sample of 1,929 participants answered an online survey, however 1,874 were included in the analysis. The impact of the COVID-19 pandemic on eating habits was assessed inquiring about participants' intake of fruits, vegetables, fried foods, and sweets during the pandemic. Physical activity was assessed by asking participants about their weekly frequency, intensity and number of minutes/hours engaging in structured physical activities per week. Participants were then stratified into categories based on moderate-to-vigorous intensity (0-30; 31-90; 91-150; 151-300; and >300 min/week) and into active (≥150 min) or inactive (<150 min). Increased sweets consumption was the most commonly reported change to eating habits (42.5%), followed by an increase in the consumption of vegetables (26.6%), fruits (25.9%), and fried foods (17.9%). Physical activity practice was related to lower consumption of fried foods (OR = 0.60; p < 0.001) and sweets (OR = 0.53; p < 0.001). A cluster analysis revealed subjects with higher the level of physical activity was more likely to follow a healthy diet (p < 0.001). Thus, physical activity was positively associated with healthier eating habits. Health authorities must recommend regular physical as a strategy to improve overall health during the COVID-19 pandemic. Future studies should address the physical activity interventions to improve health status during a pandemic.

Associations of sedentary behaviours and incidence of unhealthy diet during the COVID-19 quarantine in Brazil.

OBJECTIVE: Our aim was to analyse the association of change patterns on TV-viewing and computer/tablet use and incidence of elevated consumption of ultra-processed food consumption and lower consumption of fruits and vegetables during the COVID-19 pandemic. DESIGN: Data of 39 208 Brazilian adults from a Behaviour Web Survey were used. Unhealthy nutrition habits were eating fruits or vegetables for <5 d/week and ultra-processed food (sugary foods, snacks, ready-to-eat frozen foods and embedded foods) for ≥5 d/week. For incidence indicators, we only considered participants without unhealthy behaviour before the quarantine. We created four categories of change in TV-viewing and computer/tablet use, considering a cut-off point of 4 h/d for each behaviour (1 - consistently low, 2 - become low during the quarantine, 3 - become high during the quarantine or 4 - consistently high). Analyses were adjusted for sex, age group, highest academic achievement, per capita income, working status during the quarantine, skin colour and adherence to the quarantine. SETTING: Brazil. PARTICIPANTS: Brazilian adults (nationally representative). RESULTS: Logistic regression models revealed that high TV-viewing and computer/tablet use incidence were associated with higher odds for elevated frequency of ultra-processed food consumption (TV-viewing: OR 1·70; 95 % CI 1·37, 2·12; computer/tablet: OR 1·73; 95 % CI 1·31, 2·27) and low consumption of fruit and vegetables (TV-viewing: OR 1·70; 95 % CI 1·29, 2·23; computer/tablet: OR 1·53; 95 % CI 1·08, 2·17) incidence. Consistent high computer/tablet use also presented higher odds for incidence of elevated frequency of ultra-processed food consumption. CONCLUSIONS: Participants with incidence of sedentary behaviours were also more likely to present incidence of unhealthy diet during the COVID-19 pandemic quarantine.

The mediation role of sleep quality in the association between the incidence of unhealthy movement behaviors during the COVID-19 quarantine and mental health.

BACKGROUND: Our aim was to investigate the mediating role of worsening sleep quality in the association of the incidence of physical inactivity, high TV-viewing, and high computer/tablet use with loneliness, sadness, and anxiety. METHODS: Data of 45,161 Brazilian adults from a nationwide behavior survey, conducted between April 24th and May 24th (2020), were used. Participants reported physical inactivity (PI; <150 min/week), high TV-viewing (TV; ≥4 h/day), and high computer/tablet use (PC; ≥4 h/day) before and during COVID-19 quarantine (exposures). For incidence indicators, we only considered participants without the risk behavior before quarantine. Changes in sleep quality during the quarantine period (maintained/got better or worsened) were treated as a mediator. Elevated frequencies of feelings of loneliness, sadness (feel sad, crestfallen, or depressed), and anxiety (feel worried, anxious, or nervous) during the pandemic period were the study outcomes. Analyses were adjusted for sex, age group, highest academic achievement, working status during quarantine, skin color, previous diagnosis of depression, and adherence to quarantine. Mediation models were created using the Karlson Holm Breen method. RESULTS: The incidence of PI, high TV, and high PC use were associated with loneliness, sadness, and anxiety feelings. Worsening sleep quality partly mediated the association of the incidence of PI, high TV, and high PC use with loneliness (PI:30.9%; TV:19.6%; PC: 30.5%), sadness (PI:29.8%; TV:29.3%; PC: 39.1%), and anxiety (PI:21.9%; TV:30.0%; PC:38.5%). CONCLUSION: The association of the incidence of physical inactivity and sedentary behaviors with mental health indicators is partly mediated by worsening sleep quality during the COVID-19 pandemic quarantine.

Physical inactivity and elevated TV-viewing reported changes during the COVID-19 pandemic are associated with mental health: A survey with 43,995 Brazilian adults.

OBJECTIVE: To analyze the associations of physical activity and TV-viewing reported changes during the COVID-19 pandemic quarantine with mental health among Brazilian adults with and without depression. METHODS: Data of 43,995 Brazilian adults from a cross-sectional, nationwide behavior research were used. Participants reported the frequency on loneliness, sadness (feel sad, crestfallen or depressed) and anxiety (feel worried, anxious or nervous) feelings during the pandemic period. Frequency and duration of physical activity as well as duration of TV-viewing before and during the pandemic period were also reported. We created four categories of reported changes in physical activity (1-consistently active, 2-become active, 3-become inactive or 4-consistently inactive) and TV-viewing (1-consistently high, 2-become low, 3-become high or 4-consistently high). Participants also reported previous diagnoses of depression [yes (PD) or no (nPD). Logistic regression models separating people with and without depression were created. RESULTS: Compared to consistently active participants, to become inactive during the pandemic was associated with a higher odds for loneliness [nPD:OR:1.32 (95%CI,1.02-1.70); PD:2.22 (1.21-4.06)], sadness [nPD:1.34 (1.01-1.77); PD:2.88 (1.54-5.36)], and anxiety [nPD:1.71 (1.30-2.25); PD:2.55 (1.20-5.42)]. Also, people with depression and consistently physically inactive presented higher odds for loneliness and sadness. Compared to consistently low TV-viewing, participants that become with high TV-viewing showed higher odds for loneliness [nPD:1.59 (1.37-1.86)], sadness [nPD:1.68 (1.44-1.96); PD:1.61 (1.21 to 2.15)] and anxiety [nPD:1.73 (1.48-2.02); PD:1.58 (1.12-2.23)]. CONCLUSIONS: Reported increases in physical inactivity and TV-viewing during the COVID-19 pandemic were associated with poorer mental health indicators. People with depression and consistently physically inactivity were more likely to present loneliness and sadness.

Changes in the clustering of unhealthy movement behaviors during the COVID-19 quarantine and the association with mental health indicators among Brazilian adults.

Our aim was to analyze the prevalence of unhealthy movement behavior clusters before and during the COVID-19 pandemic, as well as to investigate whether changes in the number of unhealthy behaviors during the COVID-19 pandemic quarantine were associated with mental health indicators. Data of 38,353 Brazilian adults from a nationwide behavior research were used. For movement behaviors, participants reported the frequency and duration of physical activity and daily time on TV viewing and computer/tablet use before and during the pandemic period. Participants also reported the frequency of loneliness, sadness (feeling sad, crestfallen, or depressed), and anxiety feelings (feeling worried, anxious, or nervous) during the pandemic period. Sex, age group, highest academic achievement, working status during quarantine, country region, and time adhering to the quarantine were used as correlates. We used descriptive statistics and logistic regression models for the data analysis. The prevalence of all movement behavior clusters increased during the COVID-19 pandemic. The cluster of all three unhealthy movement behaviors increased from 4.6% (95% confidence interval [CI]: 3.9-5.4) to 26.2% (95% CI: 24.8-27.7). Younger adults, people with higher academic achievement, not working or working at home, and those with higher time in quarantine presented higher clustering. People that increased one and two or three unhealthy movement behaviors were, respectively, more likely to present loneliness (odds ratio [OR] = 1.41 [95% CI: 1.21-1.65] and OR = 1.71 [95% CI: 1.42-2.07]), sadness (OR = 1.25 [95% CI: 1.06-1.48] and OR = 1.73 [95% CI: 1.42-2.10]), and anxiety (OR = 1.34 [95% CI: 1.13-1.57] and OR = 1.78 [95% CI: 1.46-2.17]) during the COVID-19 quarantine. Clustering of unhealthy movement behaviors substantially increased and was associated with poorer mental health during the COVID-19 pandemic.