The Coronavirus illness 2019 (COVID‐19) pandemic has the potential to trigger appreciable morbidity and mortality, affecting the folks and well being care programs globally.1 A lot of the international locations adopted restrictive measures corresponding to closing cultural occasions, prohibiting social occasions, residence confinement, and lockdown to forestall illness transmission and to include the COVID-19 outbreak.2 To forestall the unfold of COVID-19, instructional establishments have been closed, and on-line schooling was applied. Though these restrictive measures decreased the COVID-19 unfold, it might additionally result in well being danger behaviors3 and will influence the scholar’s bodily exercise, dietary sample, sleeping hours, social habits, and psychological well being.4,5 These health-related components could have an effect on the conventional physique weight upkeep of school college students.6
The Kingdom of Saudi Arabia (KSA) introduced a sequence of restrictions as a result of rising variety of COVID-19 circumstances. The lockdown started on 23 March and ended on 21 June 2020 to restrict the unfold of COVID-19. Through the lockdown, folks may exit of their homes for obligatory procuring from 6 am to 7 pm within the partial lockdown interval and 6 am to three pm in elevated timing of lockdown interval. Bodily exercise7 has been lowered for college students due to lockdown actions; this might alter their BMI. One of many frequent major contributors to the weight problems or chubby epidemic is bodily inactivity, which might be promoted or delayed by numerous environmental components.8
Globally, the prevalence of weight problems has risen, reaching pandemic ranges. It requires strategies that mix particular person interventions with environmental and societal modifications to lower weight problems prevalence.9 The main danger components on this planet for cardiovascular illnesses are sedentary life and bodily inactivity. Cardiorespiratory health might be achieved by enhancing bodily exercise, and wholesome life-style practices.10
Proof indicated that elevated BMI standing is extremely associated to creating extreme issues of COVID-19.11,12 The modifications in physique weight, both weight problems or underweight are confirmed to be necessary health-related danger components for numerous pathologies, together with COVID-19.13 Analysis proved that each weight problems and meals insecurity are frequent public well being issues that often influences on the particular person and environmental ranges. Meals insecurity has been related to weight acquire and the danger of weight problems.14–16
Way of life elements corresponding to bodily inactivity, sedentary life-style practices, and dietary habits are the primary components influencing the upkeep of BMI and contributing to weight problems amongst adolescents and younger adults, which was evidenced from a number of analysis research.17 The important thing components contributing to weight problems amongst faculty college students are dietary habits, which embrace dietary consumption patterns, frequency of meals, and skipping breakfast.18 Moreover, lockdown insurance policies disrupted the scholar’s habits and life.19
A examine on the route of the affiliation between physique fatness and self-reported display screen time in Dutch adolescents resulted in that point spent watching tv predicted modifications in physique mass index. Pc utilization time was considerably predicted to extend skinfolds in girls and boys and BMI in women alone.20 Physique fatness didn’t predict any variation in display screen time.21 Different research additionally indicated that the frequency of meal consumption contributed to the event of weight problems.22,23 One other examine end result revealed that half of Brits (47%) had placed on weight since their nation began in lockdown. Regardless of the severity and well being penalties of the COVID-19 outbreak is instigating wider conversations across the nation’s well being in addition to the significance of a balanced life-style.24–27
The shortage of weight administration actions and unhealthy dietary practices have been extra frequent amongst college students and it may need worsened as a result of COVID-19 lockdown in Saudi Arabia which is alarming the danger components and rising weight problems price.28 Evidences confirmed that the poor sleep high quality amongst college students was very excessive in COVID-19 lockdown and that altered sleep may need resulted in life-style modifications. This has been related to behavioral modifications, dietary modifications, and BMI.29 College college students have been notably vulnerable to experiencing psychological well being issues evaluating with the overall inhabitants.30 Due to this fact, we carried out this examine to check the speculation, by which the first goal of the examine was to find out the modifications in BMI standing, bodily exercise, and life-style of the scholars together with weight-reduction plan, sleep, and psychological well being of the college college students earlier than and in the course of the COVID‐19 lockdown. The secondary goal was to affiliate the baseline data of the scholars and parameters with the modified standing of BMI.
Supplies and Strategies
A potential cohort analysis design with a survey strategy was carried out among the many college college students at two factors, as soon as in earlier than lockdown (March 2020) and one other as soon as throughout lockdown (June 2020), of the pandemic. The examine was carried out in accordance with the rules of Helsinki and ethically accepted by the Analysis Ethics Committee, Deanship of Scientific Analysis at King Faisal College (HAPO-05-HS-003). Knowledgeable consent was obtained from all topics concerned within the examine earlier than knowledge assortment and ensured confidentiality, no danger, anonymity, and voluntary participation.
Examine Setting and Contributors
The examine was carried out at Al-Ahsa which is the biggest governorate within the japanese province of Saudi Arabia. There are various instructional organizations obtainable. There, 21,870 college students have been learning on the graduate programs in numerous disciplines corresponding to medical, well being, science, and humanities. The calculation of pattern dimension was decided by utilizing the open-source epidemiologic statistics from the web site of public well being. From the full undergraduate college students, the estimated pattern dimension was 642 with a 95% confidence stage and 80% energy. The scholars of graduate packages have been chosen from their registration numbers by utilizing a easy random approach with the help of computerized era software program. Nonetheless, lastly, from these chosen contributors, 628 college students responded to the information assortment.
The structured software included baseline data of the scholars, anthropometric knowledge, world bodily exercise questionnaire (GPAQ), dietary recall, Pittsburgh sleep high quality index (PSQI), and perceived stress scale (PSP).
Participated college students have been interviewed for baseline data corresponding to age in years, gender, stage of examine, marital standing, household sort, and time spent in social media per day in the course of the preliminary level of information assortment.
The physique weight and peak of the scholars have been measured in faculty in the course of the first level of an interview earlier than lockdown. College students have been requested to put on mild garments. From which measurements, BMI was calculated. Through the lockdown, college students have been requested to examine their weight of their residence two instances within the early morning with their mild garments on the second level of information assortment. BMI was calculated by utilizing the imply weight of two measures acknowledged by them. The BMI classifications31 as per Nationwide Institute of Well being (NIH) and the World Well being Group (WHO) suggestions have been used. From the BMI calculated at two factors of time, the modifications have been decided to have elevated or decreased BMI. If there have been no modifications, it was thought-about as steady BMI.32
Bodily Exercise Questionnaire
The GPAQ33 developed by the World Well being Group (WHO) was used to evaluate the apply of bodily exercise34 of the scholars in each factors as earlier than and in the course of the lockdown. This questionnaire has 4 domains corresponding to reasonable and vigorous exercise at work, journey to and from locations, reasonable and vigorous leisure actions, and sedentary conduct. In that, the work area was excluded, as a result of, all examine contributors have been college students who don’t have interaction in any reasonable or vigorous work actions. The software included many bodily exercise elements, such because the frequency and length of vigorous or reasonable depth together with a query concerning the variety of hours spent in sedentary actions per day. METs (Metabolic Equivalents) are generally used to precise the depth of bodily actions and it was used for the evaluation of GPAQ knowledge. The rating is assessed as an equal mixture of reasonably and vigorously intense bodily exercise, and college students who achieved a minimal of 600 MET minutes for every week.
Way of life Questionnaire
The approach to life questionnaire together with elements corresponding to weight-reduction plan, sleep, and psychological well being of the college college students, was used earlier than and in the course of the COVID‐19 lockdown. The dietary evaluation was carried out with meals frequency questionnaire35 developed by the Saudi Meals and Drug Administration (SFDA), on this examine for each time factors; Initially, via direct face-to-face interview, the information was obtained. Nonetheless, throughout COVID-19, it was obtained via telecommunication interviews.36 A complete listing of 140 meals gadgets was included within the questionnaire with closed-ended questions, the place consumption frequency selections have been acknowledged as the next: by no means or lower than a month, as soon as every week, two to 4 instances per week, 5 to 6 instances per week, as soon as a day, two to 3 instances per day, 4 to 5 instances per day, greater than 5 instances per day. Open-ended questions have been included within the questionnaire to gather details about unlisted meals gadgets. PSQI37 was used to evaluate sleep high quality earlier than and in the course of the lockdown. The software incorporates 7 elements, encompassing 19 questions of self-evaluation, consisting of subjective sleep high quality, sleep latency, sleep length, sleep effectivity, sleep disturbances, sleeping medicine, and daytime dysfunction. The rating for every element can vary from zero indicating no issue to 3 indicating extreme issue. The sum of the seven elements offers the full PSQI rating between zero and 21 factors. The scholars who scored larger than 5 thought-about poor sleepers whereas these with a PSQI rating equal to or lower than 5 thought-about good sleepers. The PSS38 is without doubt one of the most typical scales used to evaluate the stress stage of various inhabitants teams, consists of 10 gadgets, together with six destructive and 4 optimistic. The size measures despair, anxiousness, and notion of poor well being, in addition to decreased satisfaction with self, job, and life basically, that are completely different psychosocial measures. Every merchandise is rated on a 5-point scale from by no means scored zero to fairly often scored 4. The scholars bought a better rating, which indicated the upper perceived stress. Complete scores vary from 0 to 40, by which 0–13 indicating low stress, 14–26 indicating reasonable stress, and 27–40 corresponding extreme stress. The questionnaire was piloted amongst 12 college students, they usually have been excluded from the evaluation. The reliability of the software was examined (r = 0.968) utilizing Cronbach’s alpha after acquiring validity.
The examine was analyzed by utilizing the Statistical Package deal for Social Sciences (SPSS), model 21.0, Armonk, New York: Worldwide Enterprise Machines (IBM) Company. The normality of every quantitative variable was examined earlier than evaluation. The numbers and percentages have been tabulated within the type of a frequency distribution by utilizing descriptive evaluation for categorical variables. Outcomes have been introduced as imply ± SD for steady variables with 95% confidence interval. The BMI earlier than and through lockdown was in contrast utilizing the “t” check. Chi-square evaluation was used to check the affiliation between baseline data and BMI amongst college students. The outcomes on the extent of p < 0.05 have been mounted for statistical significance.
Baseline Data of the College students
Table 1 shows the essential sociodemographic data of scholars, which included age in years, gender, yr of examine, marital standing, household sort, and supply of well being data. A complete variety of 628 college students within the bachelor program responded to the survey, by which 445 (70.9%) have been females, 194 (30.9%) have been the primary yr and 188 (29.9%) have been the second yr of school stage. Amongst them, 228 (36.3%) have been within the age of 18–19 years. The imply age rating was 20.45 ± 1.93 years. The outcomes additionally confirmed that 437 (69.6%) and 191 (30.4%) of the scholars have been single and married, respectively. A lot of the college students 311 (49.5%) belonged to a easy household. Concerning the time spent on social media, 292 (46.5%) of them used 1 to 2 hours and 167 (26.6%) of them used 5 or greater than 5 hours day by day.
Desk 1 Baseline Data of the College students. (n=628)
Anthropometric Information of the College students
The body weight of the scholars confirmed that 32% elevated their weight, 22% misplaced their weight, and roughly half of the contributors (46%) maintained the identical weight throughout COVID-19 lockdown when evaluating to earlier than lockdown. Concerning BMI, underweight decreased from 13.1% to 11.6%, and weight problems decreased from 7.4% to six.4% in the course of the lockdown. Nonetheless, the conventional BMI price elevated from 53.5% to 55.1%, and chubby elevated from 26% to 26.9% (Figure 1). There was statistical vital (P<0.001) affiliation discovered between modifications in parameters earlier than and through lockdown with the load acquire and weight reduction teams (Table 2).
Desk 2 Comparability of Weight Adjustments and Parameters Earlier than and Throughout Lockdown
Determine 1 BMI of the scholars earlier than and through COVID-19 lockdown.
Bodily Exercise of the College students
The imply and commonplace deviation (SD) of sedentary time (minutes) used day by day by the scholars have been 448.7± 73.6 and 517.8 ± 83.03 earlier than and through lockdown respectively, which was vital (p=0.0001). GPAQ rating (MET-min/week) was 1116.5 ± 125.3 earlier than lockdown and 1149.2 ± 120.08 in the course of the lockdown, which was additionally vital (p=0.0001). The GPAQ ≥600 MET-min/week was really useful by 327 (52.1%) earlier than lockdown and 301 (47.9%) in the course of the lockdown, proved statistical significance (p<0.05) (Table 3). A lot of the college students (68%) who maintained the identical weight really useful GPAQ ≥600 MET-min/week in the course of the lockdown.
Desk 3 Comparability of Bodily Exercise of the College students Earlier than and Throughout Lockdown. (n=628)
Way of life of the College students
The approach to life software elements together with weight-reduction plan, sleep, and psychological well being of the college college students, earlier than and in the course of the COVID‐19 lockdown outcomes have been proven in Table 4. Within the dietary recall evaluation, 569 (90.6%) and 341 (54.3%) college students have been taken quick meals consumption earlier than and through lockdown respectively. Equally, 547 (87.1%) and 321 (51.1%) have been taken fried meals consumption earlier than and through lockdown respectively. The PSQI scores considerably (p = 0.001) decreased from 6.8 ± 3.1 to five.9 ± 2.8 throughout lockdown when evaluating with earlier than lockdown (Table 4). Roughly, 188 (29.9%) college students felt that sleep high quality was good earlier than lockdown, and 126 (20.1%) college students felt the identical in the course of the lockdown. The PSS-10 rating revealed that there was a statistically (p = 0.003) decreased from 21.6 ± 5.8 to 17.4 ± 6.7 in the course of the lockdown. Furthermore, the full sleeping time elevated from 6.6 ± 2.3 hours per day to eight.3 ± 2.7 hours per day, which was additionally proved statistically vital (p = 0.001). The chi-square check proved that there was a big affiliation between the BMI throughout lockdown with the extent of scholars (p < 0.05) and time spent on social media per day (p < 0.0001) (Table 5).
Desk 4 Comparability of Way of life of the College students Earlier than and Throughout Lockdown. (n=628)
Desk 5 Affiliation of Weight Adjustments and Baseline Data of the College students Throughout Lockdown. (n=628)
The first objective of this potential examine was to evaluate the modifications in physique weight, BMI, bodily exercise, and life-style and their affiliation with COVID-19 lockdown among the many college college students of Saudi Arabia. Out of 628 college students, 29.1% have been boys and 70.9% have been women. Eventhough, many of the college students have been women, there was no vital affiliation discovered between BMI and gender variations. Amongst them, the imply rating of age with SD was 20.45 ± 1.93 and many of the contributors on this examine (69.6%) have been single. The frequency of chubby elevated from 16.6% to 17.8%, and weight problems was elevated from 10.2% to 11.3%. An analogous cross-sectional examine was carried out amongst Polish ladies,39 of which most girls gained weight, whereas few of them lowered weight in the course of the examine interval of the COVID-19 pandemic. The chi-square check proved that there was a big affiliation between BMI (weight modifications) throughout lockdown with the extent of scholars (p < 0.05) and time spent on social media per day (p < 0.0001). A examine on diet behaviors in Polish adults earlier than and through COVID-19 lockdown, by which two-thirds of the contributors proved vital physique weight modifications, amongst them, half of the Polish adults have been chubby in the course of the lockdown.40 This was supported by the BMI standing of the scholars which was related to the load acquire of contributors. These college students with increased BMI gained extra weight, which was usually in comparison with these college students who had regular BMI.41
Many sorts of researches indicated that faculty pupil’s bodily actions have been lowered in the course of the lockdown interval.42–46 Within the current examine, the imply and SD of sedentary time (minutes) used day by day by the scholars have been 448.7± 73.6 and 517.8 ± 83.03 earlier than and through lockdown respectively, which was vital (p=0.0001). GPAQ rating (MET-min/week) was 1116.5 ± 125.3 earlier than lockdown and 1149.2 ± 120.08 in the course of the lockdown, which was additionally vital (p=0.0001). The examine was achieved amongst UK adults on the weight problems, consuming conduct, and bodily exercise throughout COVID-19 lockdown, which ends have been predictive of larger overeating and decrease bodily exercise in lockdown.47
One other examine aimed to evaluate modifications in weight problems and exercise patterns amongst youths in the course of the pandemic lockdown in China. This examine outcomes proved that there have been vital modifications, together with the decreased frequency of participating in lively transport, reasonable or vigorous and high-intensity house responsibilities, bodily exercise throughout leisure time, strolling throughout leisure time, and there was elevated sedentary, sleeping, and display screen time.48 An Italian survey was carried out to evaluate the influence of the pandemic on consuming habits and life-style modifications throughout COVID-19 lockdown, which indicated that weight acquire was noticed amongst half of the inhabitants and there was a slight enhance in bodily exercise.49 Nonetheless, within the present examine in Saudi, most college students 436 (69.4%) have been frolicked in sitting at one place for an extended interval. And 24.5% have been eaten snacks between meals all day and 23% have been most well-liked to eat junk meals for meals all the time and 31.4% have been more likely to eat quick meals and fried meals for meals generally. Another research additionally witnessed that there was an affiliation between the BMI with much less frequent consumption of excellent nutrient meals like greens, fruits, and legumes in the course of the lockdown, and better adherence to meat, dairy, and quick meals.50 An observational retrospective examine was achieved in northern Italy ensuing that there was a big affiliation between elevated weight acquire and never consuming wholesome meals and people with weight problems considerably gained weight one month after the start of the quarantine.51
About the remainder and sleep sample in a pandemic,42 a web based survey was carried out to evaluate the influence of lockdown on the sleep-wake sample, meal timings, and digital media publicity time of the Indian inhabitants in the course of the lockdown. The evaluation evidenced that the sleep onset and wakeup time and meal-time was considerably delayed in the course of the lockdown, which was extremely pronounced in youthful contributors.52 Within the present examine, the PSQI scores decreased considerably (p = 0.001) from 6.8 ± 3.1 to five.9 ± 2.8 throughout lockdown when evaluating with earlier than lockdown.
A longitudinal observational examine situated in Verona, Italy, carried out to find out the consequences of COVID-19 lockdown on life-style behaviors in kids with weight problems proved that the time spent in sports activities actions decreased in kids (p = 0.003), and sleep time elevated (p = 0.003) and the watching of display screen time additionally elevated per day (p < 0.001).25,53 On this analysis, concerning the time spent on social media, 292 (46.5%) of them used 1 to 2 hours and 167 (26.6%) of them used 5 or greater than 5 hours day by day.
This examine derives strengths within the excessive energy of the pattern and honest illustration of scholars from completely different faculties. This examine aimed to affiliate BMI with bodily exercise and life-style on the faculty stage. Although it’s pandemic, we may capable of accumulate the information. The software was validated by specialists and reliability was examined via a pilot examine. The findings are obtained via sound evaluation by utilizing the software program. Nonetheless, the examine has some limitations. The anthropometric measurements at a second level of time have been assessed by the scholars. There have been extra females than males who participated within the examine, which could influence the findings of affiliation. There might be recall bias whereas accumulating life-style elements. Additionally, the design of the analysis didn’t allow causal inferences within the outcomes. Sooner or later, the examine might be concerned post-graduate college students to evaluate their BMI modifications in such type of pandemic lockdown.
Although half of the scholars preserve the identical BMI in lockdown, the scholars elevated BMI which was related to bodily and life-style components. Curiously, among the many college students who lowered weight could also be attributed by lowered consumption of quick and fried meals in the course of the COVID-19 lockdown. Poor bodily exercise was reported by many college students and most of them utilizing a sedentary life-style. It’s an alarming report for us to take measures to scale back weight problems prevalence. Therefore, well being consciousness corresponding to weight upkeep, lively bodily actions, a wholesome life-style together with a balanced weight-reduction plan, enough sound sleep, lively and stress-free psychological standing should be created among the many college students, which assist in creating and implementing insurance policies sooner or later.
BMI, physique mass index; COVID-19, corona virus illness; GPAQ, world bodily exercise questionnaire; KSA, Kingdom of Saudi Arabia; METs, Metabolic Equivalents; NIH, nationwide institute of well being; PSQI, Pittsburgh sleep high quality index; PSS, perceived stress scale; SD, commonplace deviation; WHO, World Well being Group.
The authors prolong their appreciation to the Deanship of Scientific Analysis at King Faisal College, Al-Ahsa, Kingdom of Saudi Arabia for its monetary assist via Nasher monitor as regards to the analysis grant quantity 206130.
The authors report no conflicts of curiosity on this work.
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