Lifestyle changes during the first and second waves of the COVID-19 pandemic in medical college students: are there gender-related differences?

Main Article Content

Francesca Coppi
Milena Nasi
Silvia Sabatini
Pierantonio Bellini
Luigi Generali
Daniela Mecugni
Alberto Farinetti
Ugo Consolo
Anna Vittoria Mattioli

Keywords

lifestyle, gender, COVID 19, Students, young, anxiety

Abstract

Background and aims. The COVID-19 pandemic has seriously affected young people. The present study aims to explore the effects of COVID-19 on lifestyle in 500 undergraduate students both during the acute phase of the pandemic (so-called "first wave") and during the second spread of infections (so-called "second wave"). Gender differences were also explored. 


Methods and results. During the first wave we found weight gain in 48.6% of subjects, a switch to an unhealthy diet (43%), and an increase in the amount of food introduced (35%). Interestingly, women showed higher intake of food in order to cope, while men privileged higher wine consumption as a coping mechanism. We observed a sharp reduction in physical activity, increased sedentary behaviours and deterioration in sleep quality. Stress correlates with eating to cope (r=0.86; p<0.001); drinking to cope (r=0.83; p<0.001). Contrary to expectations, the second wave led to a situation similar to the first. We have detected a further deterioration in quality of sleep (67% vs 77%; p<0.01) and also a reduction in sleeping time (68.6% vs 77.7; p<0.01).


Conclusions. The long pandemic has led to unhealthy lifestyle changes in the student population of our municipality in Northern Italy. There are gender differences in lifestyle modifications developed during the pandemic that suggest a different response to stress. Moreover, the persistence of pandemic-related stress due to the “second wave” has severely affected the lifestyle habits of undergraduate student.

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References

1. Government of Italy Decree-Law Number 6 23 February 2020. Available online: https://www.gazzettaufficiale.it/eli/id/2020/02/23/20G00020/sg
2. Government of Italy Decree of the President of the Council of Ministers 9 March 2020. Available online: https://www.gazzettaufficiale.it/eli/id/2020/03/09/20A01558/sg
3. Government of Italy Decree of the President of the Council of Ministers 13 October 2020 http://www.salute.gov.it/portale/nuovocoronavirus/dettaglioNotizieNuovoCoronavirus.jsp?lingua=italiano&id=5119
4. Esteves CS, Oliveira CR, Argimon IIL. Social Distancing: Prevalence of Depressive, Anxiety, and Stress Symptoms Among Brazilian Students During the COVID-19 Pandemic. Frontiers in Public Health 2021; 8: 923
5. Pandya A, Lodha P. Mental health consequences of COVID-19 pandemic among college students and coping approaches adapted by higher education institutions: A scoping review. SSM Ment Health. 2022 Dec;2:100122. doi: 10.1016/j.ssmmh.2022.100122. Epub 2022 May 29.
6. Wilson OWA, Holland KE, Elliott LD, Duffey M, Bopp M. The Impact of the COVID-19 Pandemic on US College Students' Physical Activity and Mental Health. J Phys Act Health. 2021 Feb 18:1-7. doi: 10.1123/jpah.2020-0325. Epub ahead of print. PMID: 33601332.
7. Parmet WE, Sinha MS. Covid-19 — The Law and Limits of Quarantine. N Engl J Med 2020 DOI: 10.1056/NEJMp2004211
8. Emara HE, Alhindi AA, Orebi HA, Kabbash IA, Elghazally NM. COVID-19 Pandemic: Knowledge, Attitude And Perception Of Medical Students Towards The Novel Coronavirus Disease. Disaster Med Public Health Prep. 2021 Jun 7:1-23. doi: 10.1017/dmp.2021.169.
9. Gratz KL, Mann AJD, Tull MT. Suicidal ideation among university students during the COVID-19 pandemic: Identifying at-risk subgroups. Psychiatry Res. 2021 May 27;302:114034. doi: 10.1016/j.psychres.2021.114034.
10. Ahammed B, Jahan N, Seddeque A, et al. Exploring the association between mental health and subjective sleep quality during the COVID-19 pandemic among Bangladeshi university students. Heliyon. 2021 May 16;7(5):e07082. doi: 10.1016/j.heliyon.2021.e07082.
11. Genovese C, La Fauci V, Di Pietro A, et al. COVID-19: opinions and behavior of Italian general population during the first epidemic phase. Acta Biomed [Internet]. 2022 Jul. 1 [cited 2022 Sep. 15];93(3):e2022262.
12. Steffen J, Schlichtiger J, Brunner S, Huber BC. Health promoting behaviour of medical versus non-medical students during COVID-19 pandemic: results from the COLA cross-sectional study. J Transl Med. 2021 Jun 4;19(1):242. doi: 10.1186/s12967-021-02899-y.
13. Nixon E, Trickey A, Christensen H, et al. Contacts and behaviours of university students during the COVID-19 pandemic at the start of the 2020/2021 academic year. Sci Rep. 2021 Jun 3;11(1):11728. doi: 10.1038/s41598-021-91156-9.
14. Marelli S, Castelnuovo A, Somma A, et al. Impact of COVID-19 lockdown on sleep quality in university students and administration staff. J Neurol. 2021 Jan;268(1):8-15. doi: 10.1007/s00415-020-10056-6. Epub 2020 Jul 11.
15. Ali I. COVID-19: Are We Ready for the Second Wave? Disaster Med Public Health Prep. 2020 May 7:1-3. doi: 10.1017/dmp.2020.149. Epub ahead of print
16. Manti S, Licari A. How to obtain informed consent for research. Breathe (Sheffield, England). 14(2), 145-15 (2018). doi:10.1183/20734735.001918
17. Mattioli AV, Nasi M, Cocchi C, Farinetti A. COVID 19 outbreak: impact of the quarantine-induced stress on cardiovascular disease risk burden. Future Cardiol 2020, 16(6), pp. 539–542 Doi: 10.2217/fca-2020-0055
18. Mattioli AV, Sciomer S, Maffei S, Gallina S. Lifestyle and Stress Management in Women During COVID-19 Pandemic: Impact on Cardiovascular Risk Burden. Am J Lifestyle Med 2021 15(3), pp. 356–359. doi: 10.1177/155982762098101
19. Weingarten HP Elston D. Food cravings in a college population. Appetite. 1991 Dec;17(3):167-75. doi: 10.1016/0195-6663(91)90019-o.
20. Torres SJ, Nowson CA. Relationship between stress, eating behavior, and obesity. Nutrition. 2007;23(11- 12):887-894. https://doi. org/10.1016/j.nut.2007.08.008
21. Bucciarelli V, Nasi M, Bianco F, et al. Depression pandemic and cardiovascular risk in the COVID-19 era and long COVID syndrome: Gender makes a difference. Trends Cardiovasc Med. 2022 Jan;32(1):12-17. doi: 10.1016/j.tcm.2021.09.009
22. Mattioli AV, Pinti M, Farinetti A, Nasi M. Obesity risk during collective quarantine for the COVID-19 epidemic. Obes Med. 2020 Dec;20: 100263. doi: 10.1016/j.obmed.2020.100263. Epub 2020 Jun 9
23. Sharma N, Vaish H. Impact of COVID - 19 on mental health and physical load on women professionals: an online cross-sectional survey. Health Care Women Int. 2020 Nov-Dec;41(11-12):1255-1272. doi: 10.1080/07399332.2020.1825441.
24. Kaufman-Shriqui V, Kaufman-Shriqui V, Navarro DA, Raz O, Boaz M. Dietary changes and anxiety during the coronavirus pandemic: a multinational survey. Eur J Clin Nutr. 2022 Jan;76(1):84-92. doi: 10.1038/s41430-021-00897-3.
25. Impact of covid-19 on the global coffee sector: the demand side. International Coffee Organization. Coffee Break Series, 1; april 2020 Available at http://www.ico.org/
26. Bracale R, Vaccaro CM. Changes in food choice following restrictive measures due to Covid-19. Nutr Metab Cardiovasc Dis. 2020 Aug 28;30(9):1423-1426. doi: 10.1016/j.numecd.2020.05.027. Epub 2020 May 30.
27. Begdache L, Sadeghzadeh S, Derose G, Abrams C. Diet, Exercise, Lifestyle, and Mental Distress among Young and Mature Men and Women: A Repeated Cross-Sectional Study. Nutrients. 2020 Dec 23;13(1):24. doi: 10.3390/nu13010024.
28. Hughes RN, Hancock NJ. Effects of acute caffeine on anxiety-related behavior in rats chronically exposed to the drug, with some evidence of possible withdrawal- reversal. Behav. Brain Res 2017. 321, 87–98. doi: 10.1016/j.bbr.2016.12.019
29. Mattioli AV. Effects of caffeine and coffee consumption on cardiovascular disease and risk factors. Future Cardiol. 2007;3(2):203-12. doi: 10.2217/14796678.3.2.203
30. Mattioli AV, Farinetti A, Miloro C, Pedrazzi P, Mattioli G. Influence of coffee and caffeine consumption on atrial fibrillation in hypertensive patients. Nutr Metab Cardiovasc Dis, 2011, 21(6), pp. 412–417
31. Truzzi ML, Ballerini Puviani M, Tripodi A et al. Mediterranean Diet as a model of sustainable, resilient and healthy diet. Progress in Nutrition. 2020; 22, 2, 388-394. https://doi.org/10.23751/pn.v22i2.8632.
32. Russo GL, Siani A, Fogliano V, et al. The Mediterranean diet from past to future: Key concepts from the second "Ancel Keys" International Seminar. Nutr Metab Cardiovasc Dis. 2021 Jan 2:S0939-4753(20)30546-9. doi: 10.1016/j.numecd.2020.12.020.
33. Thomas JJ, Moring J, Bowen A, Rings JA, Emerson T, Lindt A. The influence of stress and coping on diabetes self-care activities among college students. J Am Coll Health. 2021 Jun 16:1-6. doi: 10.1080/07448481.2021.1928142.
34. López-Sánchez GF, Sánchez-Castillo S, López-Bueno R, et al. Comparison of physical activity levels in Spanish people with diabetes with and without cataracts. Eur J Public Health. 2020 Dec 11;30(6):1201-1205. doi: 10.1093/eurpub/ckaa104.
35. Mattioli AV, Toni S, Coppi F, Farinetti A. Practical tips for prevention of cardiovascular disease in women after quarantine for COVID-19 disease. Acta Biomed. 2020 Jul 22;91(4):e2020127. doi: 10.23750/abm.v91i4.10284.
36. Filho A, Miranda T, de Paula C, et al. COVID-19 and quarantine: expanding understanding of how to stay physically active at home. Front. Psychol 2020; 11:566032. doi: 10.3389/fpsyg.2020.566032;
37. López-Bueno R, Calatayud J, Casaña J, et al. COVID-19 confinement and health risk behaviors in Spain. Front. Psychol. 2020; 11:1426. doi: 10.3389/fpsyg.2020.01426.
38. López-Bueno R, Calatayud J, Ezzatvar Y, et al. Association between current physical activity and current perceived anxiety and mood in the initial phase of COVID-19 confinement. Front. Psychiatry 2020; 11:729. doi: 10.3389/fpsyt.2020.00729
39. Qin Z, Shi L, Xue Y, et al. Prevalence and Risk Factors Associated With Self-reported Psychological Distress Among Children and Adolescents During the COVID-19 Pandemic in China. JAMA Netw Open. 2021 Jan 4;4(1):e2035487. doi: 10.1001/jamanetworkopen.2020.35487.
40. Zis P, Artemiadis A, Bargiotas P, Nteveros A, Hadjigeorgiou GM. Medical Studies during the COVID-19 Pandemic: The Impact of Digital Learning on Medical Students' Burnout and Mental Health. Int J Environ Res Public Health. 2021 Jan 5;18(1):349. doi: 10.3390/ijerph18010349.
41. Maher JP, Doerksen SE, Elavsky S, et al. A daily analysis of physical activity and satisfaction with life in emerging adults. Health Psychol. 2013; 32:647–56. doi: 10.1037/a0 030129
42. Paolisso P, Bergamaschi L, Saturi G, et al. Secondary Prevention Medical Therapy and Outcomes in Patients With Myocardial Infarction With Non-Obstructive Coronary Artery Disease. Front Pharmacol. 2020 Jan 31;10:1606. doi: 10.3389/fphar.2019.01606.
43. Nasi M, Patrizi G, Pizzi C, et al. The role of physical activity in individuals with cardiovascular risk factors: An opinion paper from Italian Society of Cardiology-Emilia Romagna-Marche and SIC-Sport. J Cardiovasc Med 2019; 20(10):631-639. doi: 10.2459/JCM.0000000000000855
44. Augner C. Associations of subjective sleep quality with depression score, anxiety,physical symptoms and sleep onset latency in young students. Cent. Eur. J. Publ. Health 2011; 19 (2), 115–117.
45. 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, 1129–1154 .
46. Kobayashi I, Boarts JM, Delahanty DL. Polysomnographically measured sleep abnormalities in PTSD: a meta-analytic review. Psychophysiology 2007; 44, 660–669. https://doi.org/10.1111/j.1469-8986.2007.537.x.
47. Wright KP, Linton SK, Withrow D, et al. Sleep in university students prior to and during COVID-19 stay at-home orders. Curr. Biol. 2020; 30 (14), R797–R798.
48. Connolly N, Abdalla ME. Impact of COVID-19 on medical education in different income countries: a scoping review of the literature. Med Educ Online. 2022 Dec;27(1):2040192. doi: 10.1080/10872981.2022.2040192.