ABSTRACT
ObjectivesTo assess physical activity levels in post-bariatric patients who adhered or not to social distancing measures due to the Covid-19 pandemic. Our secondary aim was to compare physical activity estimates between objectively measured and self-reported physical activity level. MethodsIn this descriptive, cross-sectional study, we assessed physical activity level using accelerometers and a validated questionnaire in 33 post-bariatric patients who reported to be adherent (n=15) or not (n=18) to social distancing measures. ResultsPatients adherent to social distancing measures spent more time in sedentary behavior (1.1 hours/day [95%CI: 0.1, 2.2]; p=0.045) and less time in moderate-to-vigorous physical activity (-12.2 min/day [95%CI: -23.8, -0.6]; p=0.040) compared to non-adherent ones. No difference was observed for light-intensity physical activity. Bland-Altman analysis comparing objective and subjective physical activity estimates showed a bias for time spent in sedentary behavior and moderate-to-vigorous physical activity of 2.8 hours/day and 8.5 min/day, respectively. ConclusionPost-bariatric patients who were adherent to social distancing measures due to the Covid-19 outbreak were more inactive and sedentary than non-adherent ones. Additionally, questionnaire data widely underestimated sedentary behavior. Strategies to increase or at least sustain physical activity levels in post-bariatric patients exposed to social distancing measures are necessary during the Covid-19 pandemic. O_LSTWhat is already known about this subject?C_LSTO_LIReduced physical activity is associated with poor health-related outcomes in patient undergoing bariatric surgery. C_LIO_LIThe impact of the social distancing measures due to Covid-19 pandemic on objectively-measured physical activity in this condition remains unknown. C_LI O_LSTWhat are the new findings in your manuscript?C_LSTO_LIAdherence to social distancing due to Covid-19 pandemic was associated with decreased objectively measured physical activity and increased sedentary behavior in patients who had undergone bariatric surgery. C_LIO_LIQuestionnaire data widely underestimated sedentary behavior when compared to accelerometry data. C_LI O_LSTHow might your results change the direction of research or the focus of clinical practice?C_LSTO_LIGiven the increased burden of cardiovascular diseases related to inactivity and sedentary behavior, strategies to increase physical activity in post-bariatric patients are clinically relevant during the Covid-19 pandemic. C_LIO_LIThe use of validated accelerometers is recommended to screen and track physical activity during the pandemic. C_LI
ABSTRACT
Background/ObjectivesThis was an out-of-hospital screening of health status and lifestyle during the Covid-19 pandemic in post-operative bariatric patients from Sao Paulo, Brazil, prevented from face-to-face health care. Subjects/MethodsIn this cross-sectional study, 66 patients were remotely (via phone call) and in-person (by home visit) assessed for health status and lifestyle habits. Results: Mean age was 47.4 years. Patients were obese grade I (30.0%), II (22.0%), and III (30.0%), and 94.2% had above reference waist circumference values. Sixty-four percent displayed high blood pressure, whereas 24% showed CRP levels above normal range. Nineteen percent of patients reported irregular use of nutritional supplementation and 6.0% reported binge eating habits. Thirty-three exhibited symptoms of depression. Mild-to-moderate and moderate-to-severe anxiety symptoms were reported by 27.4% and 11.3% of the patients; 4.5% exhibited suicidal ideation and were referred to a specialist for healthcare. Of relevance, inactive patients (59.6%) had poorer global mental and physical health scores as compared to active peers (both p<0.05). Conclusion: This out-of-hospital screening revealed that the absence of face-to-face health care due to the Covid-19 pandemic is associated with suboptimal status of physical and mental health as well as lifestyle inadequacies among patients who have recently undergone bariatric surgery. Key pointsO_LIWe performed an out-of-hospital screening in post-operative bariatric patients prevented from face-to-face health care during the Covid-19 pandemic. C_LIO_LISixty-five percent displayed high blood pressure, whereas 24% showed C-reactive protein levels above normal range. C_LIO_LIAbout one third showed mild to severe symptoms of depression, whereas [~]40% showed mild to severe anxiety symptoms. C_LIO_LIInactive patients (59.6%) had poorer global mental and physical health scores as compared to active peers. C_LIO_LIThree patients exhibited suicidal ideation and were referred to a specialist for healthcare. C_LIO_LIDuring the Covid-19 pandemic, there are a considerable number of post-bariatric patients in need of direct health care. C_LI
