Main Article Content
lockdown, COVID-19, fitness, health, lifestyle, chronic disease, health promotion
The COVID-19 lockdown imposed radical changes in the lifestyles of the population through isolation measures, with considerable health, social, psychological and economic consequences. Lockdown measures may have exacerbated negative population behaviors regarding exercise and nutrition, with risk of weight gain and obesity, collectively predisposing to increased cardiometabolic risk and mortality. At particular risk of deleterious consequences were patients such as those affected by chronic non communicable diseases (CNCD).
The benefits of regular exercise are evident at several levels of CNCD prevention, however, from a public health standpoint, it is important to consider they are also related to improved stress management, work/academic performance, and reduced illegal behavior, isolation and depression. Therefore, during enforced isolation, a primary goal for all individuals is to maintain energy balance.
During lockdown, several lifestyle interventions were posted online, with the internet playing a major role in exercise and fitness promotion. Among these one must recognize the ambitious “#StayHomeStayFit” project by the University of Milan, providing useful general information and trustworthy advice regarding nutrition, physical activity, and psychological support, for the general population in a time of need. Data showed a total of 21224 views on various social media and webpages during the reference period, with a mean time of 4’ 17’’ spent per page/video.
Given the health risks associated with population physical inactivity and unhealthy lifestyle, policymakers should evaluate the benefits of projects such as #StayHomeStayFit and consider how to maximize population perception and reach. After all, additional COVID-19 lockdowns might be implemented in the future.
2. Velavan TP, Meyer CG. The COVID-19 epidemic. Trop Med Int Health 2020; 25:278-280.
3. https://coronavirus.jhu.edu/map.html Accessed 27 Jul 2020.
4. Gazzetta Ufficiale https://www.gazzettaufficiale.it/eli/id/2020/03/08/20A01522/sg Accessed 28 Jul 2020.
5. Gazzetta Ufficiale https://www.gazzettaufficiale.it/eli/id/2020/03/09/20A01558/sg Accessed 28 Jul 2020.
6. Pasquarella C, Veronesi L, Napoli C, et al. What about behaviours in swimming pools? Results of an Italian multicentre study Microchem J 2014; 112: 190–195.
7. Liguori G, Castaldi S, Signorelli C, et al. [Hygienic risks in swimming pool: knowledge and behaviours of consumers of three structures in Crema, Parma and Naples]. Ann Ig. 2007; 19:325-335.
8. Garcia S, Albaghdadi MS, Meraj PM, et al. Reduction in ST-Segment Elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic. J Am Coll Cardiol 2020; 75:2871-2872.
9. Andersson C, Gerds T, Fosbøl E, et al. Incidence of New-Onset and Worsening Heart Failure Before and After the COVID-19 Epidemic Lockdown in Denmark: A Nationwide Cohort Study. Circ Heart Fail. 2020; 13(6):72-74.
10. Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: A web-based cross-sectional survey. Psychiatry Res. 2020; 288:112954.
11. Sønderskov KM, Dinesen PT, Santini ZI, Østergaard SD. The depressive state of Denmark during the COVID-19 pandemic. Acta Neuropsychiatr. 2020; 32(4):226-228.
12. Wang C. Drinking alone: COVID-19, lockdown, and alcohol-related harm. Lancet Gastroenterol Hepatol. 2020;5(7):625.
13. Narasimha VL, Shukla L, Mukherjee D, et al. Complicated Alcohol Withdrawal-An Unintended Consequence of COVID-19 Lockdown. Alcohol Alcohol. 2020;55(4):350-353.
14. Pan R, Wan X, Tan Y, Xu L, Ho CS, Ho RC. Immediate psychological responses and associated factors during the initial stage of the 2019 Coronavirus Disease (COVID-19) epidemic among the general population in China. Int. J. Environ. Res. Public Health 2020; 17:1729.
15. Liang L, Ren H, Cao R, et al. The effect of COVID-19 on youth mental health. Psychiatr. Q. 2020; 1-12.
16. Moccia L, Janiri D, Pepe M, et al. Affective temperament, attachment style, and the psychological impact of the COVID-19 outbreak: An early report on the Italian general population. Brain Behav. Immun. 2020; 87:75–79;
17. Zhang SX, Wang Y, Rauch A, Wei F. Unprecedented disruption of lives and work: Health, distress and life satisfaction of working adults in China one month into the COVID-19 outbreak. Psychiatry Res. 2020;288:112958.
18. Blume C, Schmidt MH, Cajochen C. Effects of the COVID-19 lockdown on human sleep and rest-activity rhythms. Curr Biol. 2020;30(14):795-797.
19. Thomson, B. The COVID-19 pandemic: A global natural experiment. Circulation 2020; 142(1):14-16.
20. Di Renzo L, Gualtieri P, Pivari F, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med 2020; 18:299.
21. Qin F, Song Y, Nassis GP, et al. Physical Activity, Screen Time, and Emotional Well-Being during the 2019 Novel Coronavirus Outbreak in China. Int J Environ Res Public Health. 2020; 17(14):5170.
22. Balanzá–Martínez V, Atienza–Carbonell B, Kapczinski F, Boni RBD. Lifestyle behaviours during the COVID-19—Time to connect. Acta Psychiatr. Scand. 2020; 141(5):399-400.
23. Pellegrini M, Ponzo V, Rosato R, et al. Changes in Weight and Nutritional Habits in Adults with Obesity during the "Lockdown" Period Caused by the COVID-19 Virus Emergency. Nutrients 2020;12(7):2016.
24. Ghosal S, Arora B, Dutta K, Ghosh A, Sinha B, Misra A. Increase in the risk of type 2 diabetes during lockdown for the COVID19 pandemic in India: A cohort analysis. Diabetes Metab Syndr. 2020;14(5):949-952.
25. Moynihan AB, van Tilburg WAP, Igou ER, Wisman A, Donnelly AE, Mulcaire JB. Eaten up by boredom: consuming food to escape awareness of the bored self. Front Psychol. 2015;6:369.
26. Evers C, Dingemans A, Junghans AF, Boevé A. Feeling bad or feeling good, does emotion affect your consumption of food? A meta-analysis of the experimental evidence. Rev Neurosci Biobehav 2018; 92:195-208.
27. Rodríguez-Martín BC, Meule A. Food craving: new contributions on its assessment, moderators, and consequences. Front Psychol 2015; 6:21.
28. Ma Y, Ratnasabapathy R, Gardiner J. Carbohydrate craving: not everything is sweet. Curr Opin Clin Nutr Metab Care. 2017; 20:261–265.
29. Muscogiuri G, Pugliese G, Barrea L, Savastano S, Colao A. Obesity: the “Achilles heel” for COVID-19? Metabolism. 2020; 108:154251.
30. https://www.businessinsider.nl/countries-on-lockdown-coronavirus-italy-2020-3?international=true&r=US Accessed 29 Jul 2020.
31. Fitbit. The impact of coronavirus on global activity. https://blog.fitbit.com/covid-19-global-activity/. Accessed 29 Jul 2020.
32. Homer AR, Owen N, Dunstan DW. Too much sitting and dysglycemia: Mechanistic links and implications for obesity. Curr Opin Endocr Metab Res. 2019; 4:42–49.
33. Hamburg NM, McMackin CJ, Huang AL, et al. Physical inactivity rapidly induces insulin resistance and microvascular dysfunction in healthy volunteers. Arterioscler Thromb Vasc Biol. 200; 27(12):2650-6.
34. Organization WH. Global recommendations on physical activity for health. Geneva2010.
35. Joyner, M J, Green, D, J Exercise protects the cardiovascular system: effects beyond traditional risk factors. The Journal of physiology 2009;587(23):5551-5558.
36. Spring, B, Ockene, J, K, Gidding, S, S, Mozaffarian, D, Moore, S, Rosal, M, C, et al. Better population health through behavior change in adults: a call to action. Circulation 2013;128(19):2169-2176.
37. Artinian, N, Fletcher, G, F, Mozaffarian, D, Kris-Etherton, P, Van Horn, L, Lichtenstein, A, H, et al. Interventions to promote physical activity and dietary lifestyle changes for cardiovascular risk factor reduction in adults: a scientific statement from the American Heart Association. Circulation 2010;122(4):406-441.
38. Lucini D, Cesana G, Vigo C, Malacarne M, Pagani M. Reducing weight in an internal medicine outpatient clinic using a lifestyle medicine approach: a proof of concept. European Journal of internal Medicine, 2015 Nov;26(9):680-4. doi: 10.1016/j.ejim.2015.05.020. Epub 2015 Jun 12.
39. Milani, R, V, Lavie, C, J Health care 2020: reengineering health care delivery to combat chronic disease. The American journal of medicine 2015;128(4):337-343.
40. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128•9 million children, adolescents, and adults. NCD Risk Factor Collaboration (NCD-RisC).Lancet. 2017 Dec 16; 390(10113):2627-2642.
41. (superherofitnesstv https://www.youtube.com/channel/UConrMq-4C_ykPGueZ1qczlg accessed 28 Jul 2020.
42. blogilates https://www.youtube.com/user/blogilates/featured accessed 27 Jul 2020.
43. FitnessBlender https://www.youtube.com/user/FitnessBlender accessed 27 Jul 2020.
44. BeFit https://www.youtube.com/channel/UCD0nBMLdq_KbIK9u-mzpNkA accessed 27 Jul 2020.
45. Strong Nation https://www.youtube.com/channel/UCD0nBMLdq_KbIK9u-mzpNkA accessed 27 Jul 2020; Yoga with Adriene.
46. https://www.youtube.com/user/yogawithadriene accessed 27 Jul 2020.
47. Pilates con Giorgia https://www.youtube.com/channel/UCUnk9yY51-gHcp7urV1GVwA accessed 27 Jul 2020.
48. (Cyberobic App by McFit gyms https://www.cyberobics.com/it/ accessed 27 Jul 2020.
49. Revolution by Virgin Active gyms https://www.virginactive.it/revolution accessed 27 Jul 2020.
50. Weburn https://joinweburn.com/en/ accessed 27 Jul 2020.
51. Keep Fit! Play at Home Project by CSI https://www.youtube.com/playlist?list=PL6d3zsX40iS6500uwrv3PXWLznYV4zT_E accessed 29 Jul 2020.
52. Italian Ministry of Health http://www.salute.gov.it/portale/nuovocoronavirus/dettaglioNotizieNuovoCoronavirus.jsp?lingua=italiano&menu=notizie&p=dalministero&id=4421 Accessed 27 Jul 2020.
53. Hammami A., Harrabi B., Mohr M., Krustrup P. Physical activity and coronavirus disease 2019 (COVID-19): Specific recommendations for home-based physical training. Manag. Sport Leis. 2020 doi: 10.1080/23750472.2020.1757494.
54. Lau H, Khosrawipour V, Kocbach P, Mikolajczyk A, Schubert J, Bania J, Khosrawipour T. The positive impact of lockdown in Wuhan on containing the COVID-19 outbreak in China., J Travel Med. 2020 May 18; 27(3).
55. (Chen P, Mao L, Nassis GP, Harmer P, Ainsworth BE. Coronavirus disease (COVID-19):, Li FJ Sport Health Sci. The need to maintain regular physical activity while taking precautions 2020 Mar; 9(2):103-104.
56. King AJ, Burke LM, Halson SL, Hawley JA. The Challenge of Maintaining Metabolic Health During a Global Pandemic. Sports Med. 2020;50(7):1233-1241.
57. Cattolica per lo Sport by Università Cattolica del Sacro Cuore https://www.unicatt.it/sport-tecnico-sportiva-lo-sport-e-l-esercizio-fisico-dopo-il-lockdown-come-ripartire accessed 27 Jul 2020; Fitness UniPG by the University of Perugia https://www.coronavirus.unipg.it/fitness-unipg accessed 27 Jul 2020.
58. https://www.unimi.it/it/studiare/vivere-luniversita/stayhomestayfit-i-consigli-degli-esperti accessed 27 Jul 2020.