Health-related factors of the Iraqi adult population during the 2020 COVID-19 pandemic: physical activity, eating behavior, quality of life, general health, and mood states cross-talk.

BACKGROUND: The lockdown and social distancing caused by Coronavirus disease 2019 (COVID-19) may have changed Physical Activity Level (PAL), eating behavior, and health habits due to long-term confinement worldwide. OBJECTIVE: This study aimed to evaluate the PAL, eating behavior, Quality of Life (QoL), General Health (GH), and mood states during COVID-19 confinement in a large sample of Iraqi adults. METHODS: 3738 healthy adults (age 18-70 years) residing in Halabjeh, Iraq answered the online questionnaires including the short form of international physical activity, GH, three-factor eating (TFEQ-R18), and a short form of the profile of mood states (POMS-SF) questionnaires. Data analysis was done by Chi-square, and Spearman's correlation using SPSS statistical software at a significant level of (P < 0.05). RESULTS: The results showed unfavorable PAL, eating behavior, QoL, GH, and mood states in the total population. Low PAL was observed in 69.96% of the men and 75.99% of the women; only 3.60% of the men and 0.77% of the women had a high PAL. There was a significantly positive relationship between low PAL and the incidence of COVID-19 both in men and women (P = 0.801; r = 0.001; and P = 0.682; r = 0.011), respectively; While a significant negative relationship was observed between the moderate and high PAL and the incidence of COVID-19 in men (P = 0.011; r=-0.682 and P = 0.027, r=-0.589), and women (P = 0.001; r=-0.796 and P = 0.018, r=-0.623). No significant relationships were observed between PAL and eating behavior (men: P = 0.086; r = 0.256 and women: P = 0.365, r=-0.121); While, the results show significant positive relationships between PAL with QoL in men (P = 0.012; r = 0.623) and women (P = = 0.001; r = 0.837). based on the results, significant negative relationships between PAL with GH and mood state scores were observed in both men (P = 0.001; r=-0.837 and P = 0.001, r=-0.786) and women (P = 0.010; r=-0.652 and P = 0.001, r=-0.745), respectively. CONCLUSIONS: The Iraqi adult population showed low PAL, GH, QoL, and mood state during COVID-19 which might be due to the confinement. Also, the significant relationships between low PAL with GH, and mood state recommends physical activity as a valuable health optimizing factor during the COVID-19 pandemic.

Effect of Short-term Vitamin D Supplementation on the Alterations of Glycemic Variables in Response to Exhaustive Eccentric Exercise in Patients with Non-alcoholic Fatty Liver.

BACKGROUND: Exhaustive eccentric exercise (EEE), along with a positive role in weight loss and physiological adaptation, increases liver enzymes and disturbs glucose homeostasis. Many studies have been considered to neutralize the adverse effects of EEE, including vitamin D (Vit D) supplementation. The present study aimed to investigate the effect of short-term Vit D supplementation on the alteration of glycemic variables in response to EEE in patients with non-alcoholic fatty liver disease (NAFLD). METHODS: In this clinical trial, 22 overweight women with NAFLD were randomly assigned to control (C; n=11) and experimental (Exp; n=11) groups. C group received a lactose placebo daily with the same color, shape, and warmth percentage; Exp group received 2000 IU of Vit D daily for 6 weeks (42 days). Blood samples were taken to measure the liver enzymes, lipid profile, and Vit D levels alteration at four stages: Pre1(before the first EEE session), post 1 (after the first EEE session), pre 2 (before the second EEE session), and post 2 (after the second EEE session). Repeated measures ANOVA and independent t test were used to analyze the data using SPSS software (version 26) at a significance level of P < 0.05. RESULTS: The results show a significant increase in glucose, insulin, and homeostatic model assessment for insulin resistance (HOMA-IR) levels in both C and Exp groups following the EEE (comparing pre 1 and post 1). Also, after 6 weeks of Vit D supplementation, glucose, insulin, and HOMA-IR increased significantly in both C (P = 0.001, P = 0.001, and P = 0.001, respectively) and Exp (P = 0.001, P = 0.001, and P = 0.001, respectively) groups following EEE (comparison of pre 2 and post 2). However, these increases were significantly lower in Exp group compared with the C group (comparing post 2). CONCLUSION: Short-term Vit D supplementation downregulates the increased glucose, insulin, and insulin resistance induced by EEE in patients with NAFLD.

The Effect of Home-Based Aerobic Training and Vitamin D Supplementation on Fatigue and Quality of Life in Patients with Multiple Sclerosis During COVID-19 Outbreak Effets d’un entraînement aérobie à domicile et d’une supplémentation en vitamine D sur la fatigue et la qualité de vie de patientes atteintes de sclérose en plaques durant l'épidémie de COVID-19

Objectives. Multiple sclerosis (MS) is the most common neurological disease that causes disability in the nervous system, which reduces the Quality of Life (QoL). Studies have shown positive effects of therapeutic exercise with supplementation on motor- and cognitive function, fatigue, and QoL in individuals with MS. The purpose of this study was to investigate the effect of home-based Aerobic Training (AT) and Vitamin D (Vit D) supplementation on fatigue and QoL in patients with MS during the covid-19 outbreak. Equipment and methods. We recruited 40 females (20 - 40 years) with MS (EDSS: 3-5). The subjects were then randomly assigned to one of four groups: AT (n=9;50-75 percent, 20-40 minutes per day, three days per week), Vit D supplementation (Vit D;n=9;50,000 IU one day per week), AT plus Vit D supplementation (AT + Vit D;n=10), and sedentary control (C;n=10 placebo). The data were analyzed using paired t-test and one-way analysis of variance and Tukey's post hoc test using SPSS 26 at a significance level of P < 0.05. Results. After eight weeks of intervention, fatigue grade markedly reduced in the AT + Vit D, AT, and Vit D groups);However, fatigue increased in the control group. QoL increased significantly in AT+Vit D, AT, and Vit D compared to C. Also, the results show that the AT+Vit D had significantly higher QoL than AT and Vit D. These findings suggest that therapeutic AT and Vit D supplementation effectively reduces fatigue and improves the QoL in female MS patients.

The short-term effect of vitamin D supplementation on the response to muscle and liver damages indices by exhaustive aerobic exercise in untrained men: a quasi-experimental study.

BACKGROUND: Exercise-induced muscle damage typically caused by unaccustomed exercise results in pain, soreness, inflammation, and muscle and liver damages. Antioxidant supplementation might be a useful approach to reduce myocytes and hepatocytes damages. Therefore, the present study was conducted to investigate the effect of short-term vitamin D (Vit D) supplementation on the response to muscle and liver damages indices by Exhaustive Aerobic Exercise (EAE) in untrained men. METHODS: In this clinical trial, 24 untrained men were randomly divided into experimental (Exp; n = 12) and control (C; n = 12) groups. Exp received 2000 IU of Vit D daily for six weeks (42 days), while C daily received a lactose placebo with the same color, shape, and warmth percentage. Two bouts of EAE were performed on a treadmill before and after six weeks of supplementation. Anthropometric characteristics (Bodyweight (BW), height, Body Fat Percentage (BFP), Body Mass Index (BMI), waist to hip ratio (WHR)) were measured at the Pre 1 and Pre 2. Blood samples were taken to measure the Creatine Kinase (CK), Lactate Dehydrogenase (LDH), Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Gamma-Glutamyl Transferase (GGT), Alkaline Phosphatase (ALP), and Vit D levels at four stages: Pre 1 (before the first EE session), Post 1 (after the first EE session), Pre 2 (before the second EE session), and Post 2 (after the second EE session). The data were analyzed using repeated-measures ANOVA, Bonferroni's post hoc test, independent t test, and dependent t-test at the significant level of P < 0.05 using SPSS version 26. RESULTS: The results show significant differences between Exp and C in alterations of BW (P = 0.039), BMI (P = 0.025), BFP (P = 0.043), and WHR (P = 0.035). The results showed that EAE increased muscle and liver damage indices and Vit D (P < 0.05). Compared with C, the results of the independent t-test showed significantly lower ALT (P = 0.001; P = 0.001), AST (P = 0.011; P = 0.001), GGT (P = 0.018; P = 0.001), and ALP (P = 0.001; P = 0.001); while significantly higher Vit D (P = 0.001, P = 0.001) in the Exp in both Pre 2 and Post 2; receptivity. The independent t test showed significantly lower ALT (P = 0.001; P = 0.001), AST (P = 0.011; P = 0.001), GGT (P = 0.018; P = 0.001), and ALP (P = 0.001; P = 0.001) and considerably greater Vit D (P = 0.001, P = 0.001) in the Exp in both Pre 2 and Post 2 compared to C. The results of an independent t test showed that LDH and CK levels in the Exp were significantly lower than those in the Post 2 (P = 0.001). CONCLUSIONS: Short-term Vit D supplementation could prevent myocytes and hepatocytes damage induced by EAE.

Home-based aerobic training and vitamin D improve neurotrophins and inflammatory biomarkers in MS patients.

BACKGROUND: Lifestyle modifications (physical activity and diet) are among the most promising strategies in multiple sclerosis (MS) rehabilitation. This study aimed to investigate the effects of combined home-based AT and Vit D on the neurotrophins level and biomarker of inflammation in MS patients during COVID-19 outbreak. METHODS: In this randomized, single-blinded, placebo-controlled trial, 38 females with MS having EDSS: 3-5 (aged 20-40 years with body mass index [BMI] of 25-30 kg/m2) were randomly assigned into four groups: AT+Vit D (n = 10), AT (n = 9), Vit D (n = 9), and Control (C n = 10). The AT program consisted of 50-70% of HRMax, 25-40 min/day, three days/wk for eight weeks. Participants in the Vit D group consumed 50,000 IU of Vit D supplement capsules per week for eight weeks. The data were analyzed through paired t-test and one-way analysis of variance and Tukey's post hoc test at the signification level of P<0.05. RESULTS: AT+Vit D, AT, and Vit D compared to the control, increased BDNF and NGF, and downregulated CRP, TNF-a, IL-6, and IL-1ß in MS patients. Additionally, the AT+Vit D group showed significantly lower CRP, TNF-a, IL-6, and IL-1ß levels and significantly higher BDNF and NGF levels compared to the AT and Vit D groups. Also, the results of this study showed significant differences between AT and Vit D groups in the variable mentioned above. CONCLUSIONS: These findings suggest that AT+Vit D improves neurotrophin and inflammatory biomarker levels in female MS patients more effectively than AT or Vit D alone.

How to Exercise During Coronavirus Quarantine?

The COVID-19 pandemic caused stress and anxiety in many people that can be reduced by regular physical activity. Regular physical exercise is essential for health. In the absence of COVID-19 symptoms, no limitation in physical activity is recommended. However, parameters such as frequency, intensity, type, and time need to be considered to prescribe the program and obtain the best results. Consequently, the level of physical activity that should be done during the outbreak has always been one of the most important and common questions.