Social support across contexts: In times of crisis and in interventions

Study 1. As an active ingredient in lifestyle interventions, social support is shown to be effective for promoting positive health outcomes. However, many interventions do not directly assess social support, leaving its impact in these contexts ambiguous. The Diabetes Prevention Program is one of the most well supported lifestyle interventions, and specifically targets decreased weight and increased physical activity. The DPP intervention has many opportunities for the exchange of social resources, but these social aspects remain unassessed. The present study assesses the relationship between perceived social support and the Diabetes Prevention Program outcomes of weight and physical activity. Results demonstrate a significant negative relationship between intraindividual change in social support and intraindividual changes in weight across the trajectory of the intervention. Additionally, this relationship was significantly mediated by intraindividual changes in self-efficacy. However, these relationships were not supported for physical activity. This study contributes to the literature investigating the role of social support in lifestyle interventions, and is the first to do so within the Diabetes Prevention Program. Study 2. The COVID-19 pandemic resulted in drastic restrictions limiting in-person social connection, but also drove adoption and progression in digital communication. Social support can act as a buffer for stress during such times of crisis. However, when social distancing was required, many adapted much of their social interaction into a digital context. There is minimal work understanding how digital social support differs from in-person social support, particularly during a time when in-person social support is already displaced. The present study investigates the relationship between strictness of distancing and perceived digital social support, perceived general social support, and higher perceived loneliness. In a randomized controlled trial (RCT), the present study also assessed the effectiveness of a brief video-based social support intervention for increasing perceived digital social support, increasing perceived general social support, and decreasing perceived stress. Higher strictness of distancing was related to lower perceived digital social support, perceived general social support, and perceived loneliness. Additionally, the intervention group had significantly greater increases in perceived digital social support than controls, but no significant difference in change for general social support or perceived stress. The present study demonstrates the unique context that COVID-19 created for social interaction, and provides initial evidence in support of a brief and low-resource intervention for increasing perceptions of digital social support. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

The Influence of Nutrition and Physical Activity on Exercise Performance after Mild COVID-19 Infection in Endurance Athletes-CESAR Study.

COVID-19 and imposed restrictions are linked with numerous health consequences, especially among endurance athletes (EA). Unfavorable changes in physical activity and nutrition may affect later sports and competition performance. The aims of this study were: (1) to assess the impact of COVID-19 infection and pandemic restrictions on the nutrition and physical activity of EAs and (2) to compare them with the results of cardiopulmonary exercise testing (CPET). In total, 49 EAs (nmale = 43, nfemale = 6, mean age = 39.9 ± 7.8 year., height = 178.4 ± 6.8 cm, weight = 76.3 ± 10.4 kg; BMI = 24.0 ± 2.6 kg·m−2) underwent pre- and post-COVID-19 CPET and fulfilled the dietary and physical activity survey. COVID-19 infection significantly deteriorated CPET performance. There was a reduction in oxygen uptake and in heart rate post-COVID-19 (both p < 0.001). Consuming processed meat and replacing meat with plant-based protein affected blood lactate concentration (p = 0.035). Fat-free mass was linked with consuming unsaturated fatty acids (p = 0.031). Adding salt to meals influenced maximal speed/power (p = 0.024) and breathing frequency (p = 0.033). Dietary and Fitness Practitioners and Medical Professionals should be aware of possible COVID-19 infection and pandemic consequences among EA. The results of this study are a helpful guideline to properly adjust the treatment, nutrition, and training of EA.

Social support across contexts: In times of crisis and in interventions

Study 1. As an active ingredient in lifestyle interventions, social support is shown to be effective for promoting positive health outcomes. However, many interventions do not directly assess social support, leaving its impact in these contexts ambiguous. The Diabetes Prevention Program is one of the most well supported lifestyle interventions, and specifically targets decreased weight and increased physical activity. The DPP intervention has many opportunities for the exchange of social resources, but these social aspects remain unassessed. The present study assesses the relationship between perceived social support and the Diabetes Prevention Program outcomes of weight and physical activity. Results demonstrate a significant negative relationship between intraindividual change in social support and intraindividual changes in weight across the trajectory of the intervention. Additionally, this relationship was significantly mediated by intraindividual changes in self-efficacy. However, these relationships were not supported for physical activity. This study contributes to the literature investigating the role of social support in lifestyle interventions, and is the first to do so within the Diabetes Prevention Program. Study 2. The COVID-19 pandemic resulted in drastic restrictions limiting in-person social connection, but also drove adoption and progression in digital communication. Social support can act as a buffer for stress during such times of crisis. However, when social distancing was required, many adapted much of their social interaction into a digital context. There is minimal work understanding how digital social support differs from in-person social support, particularly during a time when in-person social support is already displaced. The present study investigates the relationship between strictness of distancing and perceived digital social support, perceived general social support, and higher perceived loneliness. In a randomized controlled trial (RCT), the present study also assessed the effectiveness of a brief video-based social support intervention for increasing perceived digital social support, increasing perceived general social support, and decreasing perceived stress. Higher strictness of distancing was related to lower perceived digital social support, perceived general social support, and perceived loneliness. Additionally, the intervention group had significantly greater increases in perceived digital social support than controls, but no significant difference in change for general social support or perceived stress. The present study demonstrates the unique context that COVID-19 created for social interaction, and provides initial evidence in support of a brief and low-resource intervention for increasing perceptions of digital social support. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Risk Factors and Lifestyle Interventions.

There are many nonmodifiable and modifiable risk factors for type 2 diabetes. Nonmodifiable risk factors include age, genetics, epigenetics, and social determinants of health (including education level, socioeconomic status, and noise and arsenic exposure). Modifiable risk factors include obesity, the microbiome, diet, cigarette smoking, sleep duration, sleep quality, and sedentary behavior. Major lifestyle interventions to prevent and treat diabetes relate to these risk factors. Weight loss is the lifestyle intervention with the largest benefit for both preventing and treating diabetes. Exercise, even without weight loss, significantly reduces the incidence of type 2 diabetes.

Increasing Efficacy of Covid-19 Vaccines by Lifestyle Interventions.

COVID-19 caused a serious threat to the world population as it spread worldwide rapidly. Existing medicines and vaccines could not cure and control this deadly disease. In this regard, several vaccines have been proposed and designed to control this infection's spread effectively. Along with these vaccines, the general population should adopt specific lifestyle interventions to strengthen their immune system and combat deadly viruses. We used Google Scholar and PubMed databases to find the related information using key terms such as 'COVID-19', 'COVID-19 AND Vaccine efficacy', 'Lifestyle intervention AND COVID-19', and "Lifestyle intervention AND Vaccines," etc. Only articles that discussed the interactions between lifestyle intervention and the efficacy of COVID-19 vaccines were selected for this study. Several previous clinical trials and scientific observations with influenza, polio, and other viral vaccines have demonstrated that vaccine response varies across individuals for antibody titer, independent of vaccine antigenicity. This different vaccine response observed among individuals is attributed to several factors such as dietary and nutritional habits, physical activity, stress and sleep deprivation, deficiency of micronutrients (minerals, vitamins), gut microbiota composition, immunosenescence, smoking, and drinking habits. Although there is not much information about COVID-19 vaccine efficacy and lifestyle interventions, experience with other vaccines can undoubtedly be used to suggest lifestyle interventions to improve COVID-19 vaccine efficacy. These lifestyle interventions may boost antibody responses against COVID-19 vaccines, leading to higher protection from the disease, especially among elderly and immunocompromised people. In conclusion, the present review attempts to understand the role of various nutritional and psychological factors that lead to poor vaccine response and suggests specific nutritional and psychological interventions that can enhance vaccine efficacy and improve immune response against COVID-19 vaccines.

Primary Care at the Intersection of Lifestyle Interventions and Unhealthy Substance Use.

Primary care physicians are well-positioned to integrate lifestyle interventions into the management of patients with unhealthy substance use, who may also have mental and physical chronic health comorbidities. However, the COVID-19 pandemic exacerbated the U.S.'s poor state of health, revealing that its current approach to chronic disease management is neither effective nor sustainable. Today's full spectrum comprehensive care model requires an expanded toolkit. Lifestyle interventions broaden current treatment approaches and may enhance Addiction Medicine care. Primary care providers have the potential to have the greatest impact on unhealthy substance use care because they are experts in chronic disease management and their frontline accessibility minimizes healthcare barriers. Individuals with unhealthy substance use are at an increased risk of chronic physical conditions. Incorporating lifestyle interventions with unhealthy substance use care at every level of medicine, from medical school through practice, normalizes both as part of the standard care of medicine and will drive evidence-based best practices to support patients through prevention, treatment, and reversal of chronic diseases.

Social prescribing during the COVID-19 pandemic: a qualitative study of service providers' and clients' experiences.

BACKGROUND: COVID-19 public health restrictions, such as social distancing and self-isolation, have been particularly challenging for vulnerable people with health conditions and/or complex social needs. Link worker social prescribing is widespread in the UK and elsewhere and is regarded as having the potential to provide support to vulnerable people during the pandemic. This qualitative study explores accounts of how an existing social prescribing service adapted to meet clients' needs in the first wave of the pandemic, and of how clients experienced these changes. METHODS: Data were collected in a deprived urban area of North East England via remote interviews with clients (n = 44), link workers (n = 5) and service provider managerial staff (n = 8) from May-September 2020. Thematic data analysis was conducted. RESULTS: The research found that service providers quickly adapted to remote intervention delivery aiming to serve existing clients and other vulnerable groups. Service providers experienced improved access to some existing clients via telephone in the first months of remote delivery and in some cases were able to engage clients who had previously not attended appointments at GP surgeries. However, link workers also experienced challenges in building rapport with clients, engaging clients with the aims of the intervention and providing a service to digitally excluded people. Limited link worker capacity meant clients experienced variable contact with link workers with only some experiencing consistent support that was highly valued for helping to manage their conditions and mental wellbeing. Limited access to linked services also adversely affected clients. Clients living in less affluent circumstances and/or with worse health were more likely to experience negative impacts on their long-term condition. Some found their health and progress with social prescribing was 'on hold' or 'going backwards', which sometimes negatively affected their health. CONCLUSIONS: Social prescribing offered valued support to some during the pandemic, but remote support sometimes had limited impact for clients and findings highlight the vulnerability of social prescribing's success when linked services are disrupted. Findings also show the need for more to be done in the upscaling of social prescribing to provide support to digitally excluded populations.

Self-Perceived Physical Activity and Adherence to the Mediterranean Diet in Healthy Adolescents during COVID-19: Findings from the DIMENU Pilot Study.

The global pandemic coronavirus disease (COVID-19) resulted in restrictions which forced adolescents to stay at home and influenced their food habits and lifestyles with potential negative health impact. This study aims to investigate the self-reported physical activity (PA) and eating habits related to the consumption of Mediterranean foods in a sample of adolescents during the COVID-19 lockdown enrolled into the DIMENU study. A web survey was launched for 91 adolescents (aged 15-17 years) to assess their adherence to the Mediterranean Diet using the KIDMED test and lifestyle habits using a questionnaire designed following recommendations by Italian National Institute of Health (ISS score). Our results indicate that most of the sample declared no changes in eating habits and PA without sex differences. After dividing the sample into active and sedentary groups based on the self-perceived PA, we found that KIDMED and ISS scores were significantly higher (p = 0.0028 and p = 0.0001, respectively) in active adolescents. Moreover, KIDMED was positively correlated with ISS only in active adolescents (r = 0.311, p = 0.0185). In conclusion, our data underline the impact of the PA on the Mediterranean diet adherence in adolescents during the lockdown, suggesting the usefulness of promoting wellness programs directed towards inactive individuals to increase their awareness on the importance of healthy lifestyles.

Impact of the COVID-19 pandemic on statistical design and analysis plans for multidomain intervention clinical trials: Experience from World-Wide FINGERS.

INTRODUCTION: The coronavirus disease-19 (COVID-19) pandemic presents challenges to the conduct of randomized clinical trials of lifestyle interventions. METHODS: World-Wide FINGERS is an international network of clinical trials to assess the impact of multidomain lifestyle intervention on cognitive decline in at-risk adults. Individual trials are tailoring successful approaches from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) to local cultures and environments. The network convened a forum for researchers to discuss statistical design and analysis issues they faced during the pandemic. We report on experiences of three trials that, at various stages of conduct, altered designs and analysis plans to navigate these issues. We provide recommendations for future trials to consider as they develop and launch behavioral intervention trials. RESULTS: The pandemic led researchers to change recruitment plans, interrupt timelines for assessments and intervention delivery, and move to remote intervention and assessment protocols. The necessity of these changes add emphasis to the importance, in study design and analysis, of intention to treat approaches, flexibility, within-site stratification, interim power projections, and sensitivity analyses. DISCUSSION: Robust approaches to study design and analysis are critical to negotiate issues related to the intervention. The world-wide network of similarly oriented clinical trials will allow us to evaluate the effectiveness of responses to the pandemic across cultures, local environments, and phases of the pandemic.

Mental health during the COVID-19 pandemic and beyond: The importance of the vagus nerve for biopsychosocial resilience.

The COVID-19 pandemic has led to widespread increases in mental health problems, including anxiety and depression. The development of these and other psychiatric disorders may be related to changes in immune, endocrine, autonomic, cognitive, and affective processes induced by a SARS-CoV-2 infection. Interestingly, many of these same changes can be triggered by psychosocial stressors such as social isolation and rejection, which have become increasingly common due to public policies aimed at reducing the spread of SARS-CoV-2. The present review aims to shed light on these issues by describing how viral infections and stress affect mental health. First, we describe the multi-level mechanisms linking viral infection and life stress exposure with risk for psychopathology. Then, we summarize how resilience can be enhanced by targeting vagus nerve function by, for example, applying transcutaneous vagus nerve stimulation and targeting lifestyle factors, such as exercise. With these biopsychosocial insights in mind, researchers and healthcare professionals will be better equipped to reduce risk for psychopathology and increase resilience during this challenging pandemic period and beyond.