Two Decades of Diabetes Prevention Efforts: A Call to Innovate and Revitalize Our Approach to Lifestyle Change.

The impact of global diabetes prevention efforts has been modest despite the promise of landmark diabetes prevention trials nearly twenty years ago. While national and regional initiatives show potential, challenges remain to adapt large-scale strategies in the real-world that fits individuals and their communities. Additionally, the sedentary lifestyle changes during the COVID-19 pandemic and guidelines that now call for earlier screening (e.g., US Preventative Task Force) will increase the pool of eligible adults worldwide. Thus, a more adaptable, person-centered approach that expands the current toolkit is urgently needed to innovate and revitalize our approach to diabetes prevention. This review identifies key priorities to optimize the population-level delivery of diabetes prevention based on a consensus-based evaluation of the current evidence among experts in global translational programs; key priorities identified include (1) participant eligibility, (2) intervention intensity, (3) delivery components, (4) behavioral economics, (5) technology, and (6) the role of pharmacotherapy. We offer a conceptual framework for a broader, person-centered approach to better address an individual's risk, readiness, barriers, and digital competency.

Assessment of Mediterranean Diet Adherence and Lifestyle Change during COVID-19 National Lockdown in Tunisian Adult Population.

The Mediterranean diet (MD) is a plant-based diet associated with a reduction in the risk of developing COVID-19 comorbidities. Lockdown instigation during the COVID-19 pandemic has affected eating habits and lifestyles, highlighting the need to analyze the healthiness of new consumption patterns. We conducted a survey to assess lifestyle change in Tunisian adults and their MD adherence. A total of 1082 respondents completed a self-administered online survey designed to assess their food and lifestyle habits. Poor overall adherence to MD was observed (mean MEDAS score 6.6, SD 1.07) in a preponderance of the mid-MD adherent subgroup (71.2% of the participants). Location, age, profession, and household welfare proxy were the main determinants of high MD adherence. When adjusting for sociodemographic variables, location and income remained statistically significant. Positive health outcomes were noticed in respondents with high MEDAS scores. Most importantly, binary logistic regression showed that risk of COVID-19 infection decreased as MEDAS score increased for unvaccinated obese participants (OR = 0.63; confidence interval (CI) 0.4-0.98; p = 0.045). Regarding lifestyle changes, confinement had contributed to an overall reduction in cigarette consumption, sleeping hours, and physical activity. Long-term consequences of these changes on health outcomes must be further explored.

Outbreak of COVID-19-Related Myopia Progression in Adults: A Preliminary Study.

Purpose: The COVID-19 pandemic has necessitated specific public health measures, resulting in the alteration of lifestyles, such as increased digital screen time and fewer outdoor activities. Such conditions have increased the progression of myopia in children. However, no investigation of myopia progression in early adulthood has been conducted during this period. Consequently, this study aimed to evaluate the outbreak of COVID-19-related myopia progression among adults at an optometry clinic during the COVID-19 pandemic. Materials and Methods: This was a retrospective cohort study in which participants aged 18-25 years who first visited (baseline) the optometry clinic between June 2019 and March 2020 were recruited for follow-up from November 2021 to March 2022. Spherical equivalent refraction (SER), uncorrected distance visual acuity (UCDVA), and binocular cross cylinder (BCC) were recorded at baseline and a follow-up visit. Using questionnaires, a survey was conducted to assess the lifestyle changes that transpired during the COVID-19 pandemic. Results: In total, 37 participants with a mean age of 22.5±1.4 years were enrolled, of which 89.2% were female. Following the outbreak of the COVID-19 pandemic, most participants self-reported increased daily use of digital devices (89.2%), online education (86.5%), and spending more time at home (94.6%), which increased by approximately 7.6±3.2 hours, 5.9±1.7 hours, and 13.2±7.5 hours, respectively. There were statistically significant differences between SER and BCC at baseline and after approximately 2 years of the COVID-19 pandemic (p < 0.05). The mean two-year myopia progression was -0.59±0.67 D (Maximum = 0.00 D, Minimum = -3.38 D). Conclusion: This study revealed that myopia could progress during adulthood among those who have lived under public health measures intended to address the COVID-19 pandemic.

Sudden Cardiac Death Risk Perception and Its Relation to Personal Lifestyle Among Female University Students During the COVID-19 Pandemic.

Introduction Risk perception is the key component of many health behavior changes. This study identified the deliberative sudden cardiac death (SCD) risk perception among young females during the coronavirus disease 2019 (COVID-19) pandemic and its implication on their willingness to lifestyle change in the Riyadh region, Saudi Arabia. This cross­sectional study using self­administered online questionnaires was conducted to reach a total of 797 female university students in Riyadh, Saudi Arabia. Results Eighty-six percent of participants showed moderate SCD risk perception, with a mean score of 20.4±4.4. Ninety-six percent of participants had ≥1 established SCD risk factor. A family history of cardiovascular disease and SCD was the most commonly reported risk factor (75.5%), followed by physical inactivity (75.4%). Nearly 60% of participants showed a high willingness to change personal lifestyle behaviors, however, the presence of risk factors did not significantly enhance their willingness tochange in order to control these risk factors. Conclusions This study identifies the deliberative SCD risk perception among young Saudi women and raises the need for preventive health care programs that enhance healthy behaviors among students at high risk, to minimize cardiovascular diseases and fatalities.

The patient-centered diabetes management during the COVID-19 pandemic.

Since December 2019, in the fight against the coronavirus disease 2019 (COVID-19) pandemic, we observed that glycemic control in people with diabetes is easily affected by lifestyle changes. To maintain a good health condition, a patient-centered approach with mental support and close monitoring is required. For these, telemedicine and online continuous glucose monitoring (CGM), are effective systems. Therefore, based on our experience during the two-year period, we reviewed the literature for appropriate actions required for the management of diabetes to prevent COVID-19 infection and avoid unfavorable outcomes in COVID-19 cases. Once infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there is a high risk of a poor prognosis in patients with diabetes. Glucocorticoid therapy in severe COVID-19 cases leads to further hyperglycemia. Since good glycemic control has been shown to improve outcomes, strict glycemic control using CGM is recommended. Using CGM data, insulin can be adequately titrated without causing hypoglycemia, and remote data monitoring can reduce the risk of infection for health care professionals, by reducing the frequency of patient contact. Among patients with COVID-19, some are found to have newly-diagnosed diabetes at admission. Those newly diagnosed patients present with a higher risk of poor prognosis compared to those with pre-existing diabetes. Therefore, glycemic status should be evaluated in all patients with COVID-19 admitted to hospitals.

Associations between Lifestyle Changes and Adherence to COVID-19 Restrictions in Older Adults with Hypertension.

COVID-19 has changed people's routines and imposed new ways of living. This study investigated variations in lifestyles (namely, physical activity, diet, alcohol consumption, and cigarette smoking) between the prepandemic and the pandemic period in a sample of older adults with hypertension. Moreover, it investigated predictors of adherence to government restrictions during the first lockdown period, evidencing the role of relevant sociodemographic indicators and lifestyle changes. A sample of 105 older Italian adults (M_age = 70 years; SD = 5.83) with hypertension was enrolled from a previous longitudinal study and interviewed on the phone between May and August 2020. Updated information about sociodemographic indicators and lifestyle changes was collected. Adherence to restrictions was explored through several questions regarding compliance with home confinement, facemask use, and the observance of social distancing. Results evidenced that only 33% of the respondents abided by all the national restrictions. During the first pandemic peak, considerable changes in lifestyles occurred, particularly regarding physical activity, which diminished in 70% of the sample. Women, unemployed/retired people, and individuals who decreased their amount of physical activity reported higher adherence to rules. Maintaining a healthy lifestyle over time is essential for disease prevention. Therefore, it is essential to continue to inform the population about the importance of a healthy lifestyle, and it is necessary to provide guidelines to maintain and promote it even during housebound periods.

ASSESSING BARRIERS TO ADOPTION OF SUSTAINABLE PERSONAL HYGIENE BEHAVIOUR AND LIFESTYLE CHANGE IN COMMUNITIES IN RAWALPINDI DURING COVID-19 PANDEMIC

Objective: To assess the current habits of personal hygiene practices, to determine the role of demographic characteristics in personal hygiene practices and to identify barriers to sustainable behavioral change during COVID-19 pandemic in general communities of Rawalpindi. Study Design: A cross sectional mixed method study. Place and Duration of Study: Different communities of Rawalpindi city, from Aug 2020 to Apr 2021. Methodology: Non-probability consecutive sampling was used. Both qualitative and quantitative data (sample size;n=400) was collected for understanding of the barriers in sustainability of modified behaviour during and after COVID-19. Results: Out of 400 respondents, 43% were in the age group of 15-30 years while 30% were between 31-45 years. More than half 65% of them were males and 35% females. About 98% of the respondents practice frequent hand washing, 87% uses hand sanitizers, 75% wear masks, 67% practice social distancing and 95% cover their mouth during coughing and sneezing. The educational and occupational status of the respondents was significantly associated with personal hygiene and lifestyle change behaviour. About 391 respondents 391 (97%) were used to practice hand washing, 350 (87.3%) hand sanitizer 301 (75%) wear masks outside home. About 269 (67%) practice social distancing and 382 (95%) cover their mouth while coughing/sneezing. Conclusion: Sustainable behaviour change for positive health and reduced transmission of communicable diseases is possible, if the nature of human beings and the cultural and religious beliefs that define them are taken into account.

Remission of type 2 diabetes depends on prompt comprehensive lifestyle changes upon diagnosis: How can this "Road to Damascus" experience be supported?

Theoretically, a new diagnosis of type 2 diabetes mellitus (T2DM) requires a dramatic change in an individual's way of life. Weight loss and physical activity can lead to remission of diabetes, which has been associated with a lower risk of developing complications. Today, the importance of a healthy lifestyle is further highlighted by data showing that obesity and diabetes increase the risk of severe complications from coronavirus disease 2019. However, remission rarely occurs in reality, probably due to the inability of people with T2DM to adhere to the intensive lifestyle interventions that are necessary. The complexity of contributing factors may explain why making these changes is so challenging and underscore the fact that there is no magical solution for T2DM. Instead, hard work from both patients and health care providers is needed for the conversion to be achieved. This article calls for more research on the underlying reasons why adhering to a healthy way of life is so difficult for people with diabetes and obesity. Clearly defining these barriers would facilitate the planning of effective policies to promote the adoption of appropriate lifestyle changes early in the course of the disease.

Healing addiction with EMDR therapy: A trauma-focused guide

Unhealed trauma causes distress in the body. When the nature of the distress overrides a person's existing system for coping, or the trauma is not processed, survivors may numb themselves or seek a more pleasurable experience to escape. Such behavior is a completely natural response to unprocessed trauma. This tendency we have as human beings to dissociate, or sever from the present moment when the moment becomes unpleasant or painful, is amplified for survivors when chemicals or other reinforcing behaviors are introduced. Such chemicals and behaviors can accelerate the potency of dissociation. Eye movement desensitization and reprocessing (EMDR) therapy is a complete system of psychotherapy that can facilitate this process. This innovative book offers an investigation into therapies which can assist therapists to assess trauma and how it impacts the mind-body. It provides a clear guide to therapists in changing the way healing addiction is imagined. The book continues to challenge the existing paradigms for treating addiction and related issues. Despite the longstanding existence of professional treatment in North America, recidivism is high. People are still dying at alarming rates, not just from the opioid crisis that dominates news headlines, but also from the impact of alcohol, cocaine, nicotine, and other maladaptive behaviors. Moreover, the social isolation and collective trauma caused by the COVID-19 pandemic added fuel to an already raging fire, revealing massive cracks in a system for care that is barely functional. In assessment, no single drug, substance, or behavior is the culprit the real issue is the untreated trauma that lurks underneath, causing people to seek out the relief of these substances in the first place. EMDR therapy is a complete psychotherapy that facilitates the shifts that are required in an individual to achieve meaningful lifestyle change. Recovery, healing, and wellness require lifestyle change. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

COVID-19-Related Lifestyle Changes among Community-Dwelling Older Adult Day-Care Users: A Qualitative Study.

In Japan, the community-based comprehensive care system is an important initiative. The purpose of this study was to understand COVID-19-related lifestyle changes experienced by older adults who lived in communities and used day-care services. Using a qualitative inductive research method, semi-structured interviews were conducted with 13 older adults who used day-care services in Kyoto City, which assessed lifestyle changes before and after the spread of COVID-19 during March-April 2021. The extracted lifestyle change codes were classified into six categories and 16 subcategories. The data revealed that older adults felt socially isolated and experienced multiple changes in their lives, including limited leisure activities, changes in roles, decreased interpersonal interaction with family and acquaintances, poor diet and sleep quality, and reduced attention to personal appearance and grooming. The findings suggest that during COVID-19, older adults had difficulty adapting to the various changes in their lives and showed a decline in physical and mental functioning. Thus, it is important for day-care facilities to create sustainable spaces in response to the various care needs of community-dwelling older adults whose lifestyles have changed as a result of the COVID-19 situation.

Using the transtheoretical model of behaviour change to analyse the impact of stopping exercise: a reflection.

This article is an analytical reflection of the personal health journey of a first-year nursing student that was undertaken as part of a first-year unit of study. Focusing on social, physical and psychological aspects of health, it explores the impact of the cessation of exercise on her emotional and physical health and wellbeing. This is relevant to current practice as a result of COVID-19, which reduced opportunities for exercise for many people, whether because of self-isolation and lockdown restrictions on leisure facilities or increased workload and caring responsibilities, all of which affect health and wellbeing. The article is presented in the first person, reflecting the personal analysis it captures.

Reach, engagement and effectiveness of in-person and online lifestyle change programs to prevent diabetes.

BACKGROUND: COVID-19 has accelerated interest in and need for online delivery of healthcare. We examined the reach, engagement and effectiveness of online delivery of lifestyle change programs (LCP) modelled after the Diabetes Prevention Program (DPP) in a multistate, real-world setting. METHODS: Longitudinal, non-randomized study comparing online and in-person LCP in a large multistate sample delivered over 1 year. Sample included at-risk adults (n = 26,743) referred to online (n = 9) and in-person (n = 11) CDC-recognized LCP from a multi-state registry (California, Florida and Colorado) between 2015 and 2018. The main outcome was effectiveness (proportion achieving > 5% weight loss) at one-year. Our secondary outcomes included reach (proportion enrolled among referred) and engagement (proportion ≥ 9 sessions by week 26). We used logistic regression modelling to assess the association between participant- and setting -level characteristics with meaningful weight loss. RESULTS: Online LCP effectiveness was lower, with 23% of online participants achieving > 5% weight loss, compared with 35% of in-person participants (p < 0.001). More adults referred to online programs enrolled (56% vs 51%, p < 0.001), but fewer engaged at 6-months (attendance at ≥9 sessions 46% vs 66%, p < 0.001) compared to in-person participants. CONCLUSIONS: Compared to adults referred to in-person LCP, those referred to online LCP were more likely to enroll and less likely to engage. Online participants achieved modest meaningful weight loss. Online delivery of LCP is an attractive strategy to deliver and scale DPP, particularly with social distancing measures currently in place. However, it is unclear how to optimize delivery models for maximal impact given trade-offs in reach and effectiveness.

The Unintended Consequences of the Pandemic: The New Normal for College Students in South Korea and Taiwan.

This study attempts to compare the impacts of the coronavirus (COVID-19) pandemic on college students' lifestyles and mental health conditions in South Korea and Taiwan. As the COVID-19 outbreak has spread across the globe, it has brought significant changes to college campuses worldwide. College students have been heavily affected by the closure, as online learning has become increasingly common in higher education institutions. Using data collected from college students in South Korea and Taiwan in the spring of 2020, this study examines the effects of pandemic-related lifestyle changes on mental health conditions for college students in the two countries. The results were 3-fold. First, compared to college students in Taiwan, college students in South Korea reported greater decreases in time spent traveling, being with friends, eating at restaurants, and engaging in part-time employment, and greater increases in online shopping and ordering food for delivery. Second, college students in South Korea reported a higher level of worry, a greater possibility of contact with a person with COVID-19, and a lower level of happiness than did college students in Taiwan. Third, our findings indicate that social activities, including spending time with friends, were positively correlated with mental health conditions in South Korea and Taiwan. Comparing Korean and Taiwanese students' lifestyle changes and mental health conditions amid the pandemic, the study argues that the decrease in socialization and interaction under these new circumstances may be a significant factor that explains an increase in mental health issues in Korean college students compared to Taiwanese students, given the increase in confirmed COVID-19 cases in South Korea and the corresponding greater use of online teaching platforms there than in Taiwan.

Lifestyle changes and their impact on glycemic control and weight control in patients with diabetes during the coronavirus disease 2019 pandemic in Japan.

AIMS/INTRODUCTION: This study aimed to reveal lifestyle changes and their impact on glycemic control and weight control in patients with diabetes during the coronavirus disease 2019 (COVID-19) pandemic in Japan. MATERIALS AND METHODS: We retrospectively analyzed 1,402 outpatients with diabetes at a clinic in Osaka, Japan, who responded to an interview sheet regarding lifestyle changes during the COVID-19 pandemic between 28 March and 30 May 2020. The association of lifestyle changes with hemoglobin A1c (HbA1c) and weight changes from February to May 2020 was investigated using the linear regression model. We also investigated the association with clinically important change of HbA1c (by ≥0.3%) and bodyweight (by ≥3%), using the cumulative link model. RESULTS: Leisure time and other outside physical activities were decreased in one-quarter of patients during the COVID-19 pandemic, whereas the amount of meals and snacks was decreased and increased in approximately 10%, respectively. The change in leisure time physical activities was inversely associated with HbA1c and weight changes, whereas the quantitative change of meals with the decline in eating out and that of snacks were positively associated with HbA1c and weight changes (all P < 0.05). The quantitative change of meals without the decline in eating out was also positively associated with weight change (P = 0.012). The cumulative link model for clinically important HbA1c and weight change showed broadly similar associations, except for that between snacks and bodyweight (P = 0.15). CONCLUSIONS: A considerable number of outpatients with diabetes experienced lifestyle changes during the COVID-19 pandemic. The lifestyle changes were associated with HbA1c and weight changes.

Dominate others, hurt self: Social dominance orientation predicts depression during the COVID-19 pandemic.

The ongoing coronavirus pandemic threatens physical and psychological health. We examined whether social dominance orientation (SDO), a preference for inequality among social groups, contributes to mental health during the pandemic. In particular, we predicted that people high in SDO would experience higher levels of depression than others low in SDO. Our results (N = 2008) showed that SDO was positively associated with depression. In addition, participants' perceived lifestyle changes moderated the association between SDO and depression. We also discuss the theoretical and practical implications of the current work.