The Coronavirus illness 2019 (COVID‐19) pandemic has the potential to trigger appreciable morbidity and mortality, affecting the folks and well being care techniques globally.1 Many of the international locations adopted restrictive measures resembling closing cultural occasions, prohibiting social occasions, residence confinement, and lockdown to stop illness transmission and to include the COVID-19 outbreak.2 To forestall the unfold of COVID-19, academic establishments have been closed, and on-line schooling was carried out. Though these restrictive measures decreased the COVID-19 unfold, it might additionally result in well being threat behaviors3 and will impression the scholar’s bodily exercise, dietary sample, sleeping hours, social habits, and psychological well being.4,5 These health-related components might have an effect on the traditional physique weight upkeep of faculty college students.6
The Kingdom of Saudi Arabia (KSA) introduced a sequence of restrictions because of the growing variety of COVID-19 circumstances. The lockdown started on 23 March and ended on 21 June 2020 to restrict the unfold of COVID-19. In the course of the lockdown, folks may exit of their homes for obligatory purchasing 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 diminished 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 may very well 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 threat components on the earth for cardiovascular ailments are sedentary existence and bodily inactivity. Cardiorespiratory health may very well be achieved by bettering bodily exercise, and wholesome life-style practices.10
Proof indicated that elevated BMI standing is extremely associated to creating extreme problems of COVID-19.11,12 The modifications in physique weight, both weight problems or underweight are confirmed to be essential health-related threat 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 normally influences on the particular person and environmental ranges. Meals insecurity has been related to weight achieve and the danger of weight problems.14–16
Way of life elements resembling bodily inactivity, sedentary life-style practices, and dietary habits are the principle 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 embody dietary consumption patterns, frequency of meals, and skipping breakfast.18 Moreover, lockdown insurance policies disrupted the scholar’s habits and existence.19
A research on the course of the affiliation between physique fatness and self-reported display 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 time.21 Different research additionally indicated that the frequency of meal consumption contributed to the event of weight problems.22,23 One other research outcome 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 might need worsened because of the COVID-19 lockdown in Saudi Arabia which is alarming the danger components and growing 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 might need resulted in life-style modifications. This has been related to behavioral modifications, dietary modifications, and BMI.29 College college students have been notably inclined to experiencing psychological well being issues evaluating with the overall inhabitants.30 Due to this fact, we performed this research to check the speculation, during which the first purpose of the research was to find out the modifications in BMI standing, bodily exercise, and life-style of the scholars together with food plan, sleep, and psychological well being of the college college students earlier than and throughout the COVID‐19 lockdown. The secondary purpose 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 performed 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 research was performed based on 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 research earlier than knowledge assortment and ensured confidentiality, no threat, anonymity, and voluntary participation.
Examine Setting and Individuals
The research was carried out at Al-Ahsa which is the most important governorate within the jap province of Saudi Arabia. There are numerous academic organizations obtainable. There, 21,870 college students have been learning on the graduate programs in numerous disciplines resembling 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 overall undergraduate college students, the estimated pattern dimension was 642 with a 95% confidence degree and 80% energy. The scholars of graduate applications 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 device 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 resembling age in years, gender, degree of research, marital standing, household kind, and time spent in social media per day throughout the preliminary level of knowledge assortment.
The physique weight and top of the scholars have been measured in faculty throughout the first level of an interview earlier than lockdown. College students have been requested to put on gentle garments. From which measurements, BMI was calculated. In the course of the lockdown, college students have been requested to examine their weight of their residence two instances within the early morning with their gentle garments on the second level of knowledge 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 throughout the lockdown. This questionnaire has 4 domains resembling reasonable and vigorous exercise at work, journey to and from locations, reasonable and vigorous leisure actions, and sedentary habits. In that, the work area was excluded, as a result of, all research contributors have been college students who don’t interact in any reasonable or vigorous work actions. The device included many bodily exercise elements, such because the frequency and length of vigorous or reasonable depth together with a query relating to 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 per week.
Way of life Questionnaire
The approach to life questionnaire together with elements resembling food plan, sleep, and psychological well being of the college college students, was used earlier than and throughout 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 research 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 record of 140 meals objects was included within the questionnaire with closed-ended questions, the place consumption frequency decisions have been acknowledged as the next: by no means or lower than a month, as soon as per 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 objects. PSQI37 was used to evaluate sleep high quality earlier than and throughout the lockdown. The device incorporates 7 elements, encompassing 19 questions of self-evaluation, consisting of subjective sleep high quality, sleep latency, sleep length, sleep effectivity, sleep disturbances, sleeping remedy, and daytime dysfunction. The rating for every element can vary from zero indicating no problem to 3 indicating extreme problem. The sum of the seven elements offers the overall 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 commonest scales used to evaluate the stress degree of various inhabitants teams, consists of 10 objects, together with six detrimental and 4 constructive. The dimensions measures despair, anxiousness, and notion of poor well being, in addition to decreased satisfaction with self, job, and life usually, 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 obtained the next rating, which indicated the upper perceived stress. Whole scores vary from 0 to 40, during 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 device was examined (r = 0.968) utilizing Cronbach’s alpha after acquiring validity.
The research 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 Info of the College students
Table 1 shows the essential sociodemographic data of scholars, which included age in years, gender, yr of research, marital standing, household kind, and supply of well being data. A complete variety of 628 college students within the bachelor program responded to the survey, during 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 faculty degree. 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. Many of the college students 311 (49.5%) belonged to a easy household. Relating to 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 every day.
Desk 1 Baseline Info of the College students. (n=628)
Anthropometric Knowledge 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. Relating to BMI, underweight decreased from 13.1% to 11.6%, and weight problems decreased from 7.4% to six.4% throughout the lockdown. Nonetheless, the traditional 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 burden achieve and weight reduction teams (Table 2).
Desk 2 Comparability of Weight Modifications 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 every 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 throughout the lockdown, which was additionally vital (p=0.0001). The GPAQ ≥600 MET-min/week was advisable by 327 (52.1%) earlier than lockdown and 301 (47.9%) throughout the lockdown, proved statistical significance (p<0.05) (Table 3). Many of the college students (68%) who maintained the identical weight advisable GPAQ ≥600 MET-min/week throughout 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 device elements together with food plan, sleep, and psychological well being of the college college students, earlier than and throughout 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 throughout 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 throughout the lockdown. Furthermore, the overall 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 Modifications and Baseline Info of the College students Throughout Lockdown. (n=628)
The first function of this potential research 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 research (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 research was performed amongst Polish ladies,39 of which most girls gained weight, whereas few of them diminished weight throughout the research 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 research on diet behaviors in Polish adults earlier than and through COVID-19 lockdown, during which two-thirds of the contributors proved vital physique weight modifications, amongst them, half of the Polish adults have been chubby throughout the lockdown.40 This was supported by the BMI standing of the scholars which was related to the burden achieve of contributors. These college students with greater 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 scholar’s bodily actions have been diminished throughout the lockdown interval.42–46 Within the current research, the imply and SD of sedentary time (minutes) used every 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 throughout the lockdown, which was additionally vital (p=0.0001). The research was achieved amongst UK adults on the weight problems, consuming habits, and bodily exercise throughout COVID-19 lockdown, which ends up have been predictive of larger overeating and decrease bodily exercise in lockdown.47
One other research aimed to evaluate modifications in weight problems and exercise patterns amongst youths throughout the pandemic lockdown in China. This research outcomes proved that there have been vital modifications, together with the decreased frequency of partaking in lively transport, reasonable or vigorous and high-intensity home tasks, bodily exercise throughout leisure time, strolling throughout leisure time, and there was elevated sedentary, sleeping, and display time.48 An Italian survey was performed to evaluate the impression of the pandemic on consuming habits and life-style modifications throughout COVID-19 lockdown, which indicated that weight achieve was noticed amongst half of the inhabitants and there was a slight improve in bodily exercise.49 Nonetheless, within the present research in Saudi, most college students 436 (69.4%) have been hung out 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 prone 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 throughout the lockdown, and better adherence to meat, dairy, and quick meals.50 An observational retrospective research was achieved in northern Italy ensuing that there was a big affiliation between elevated weight achieve and never consuming wholesome meals and people with weight problems considerably gained weight one month after the start of the quarantine.51
About the remaining and sleep sample in a pandemic,42 a web-based survey was performed to evaluate the impression of lockdown on the sleep-wake sample, meal timings, and digital media publicity time of the Indian inhabitants throughout the lockdown. The evaluation evidenced that the sleep onset and wakeup time and meal-time was considerably delayed throughout the lockdown, which was extremely pronounced in youthful contributors.52 Within the present research, 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 research positioned in Verona, Italy, performed to find out the results 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 time additionally elevated per day (p < 0.001).25,53 On this analysis, relating to 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 every day.
This research derives strengths within the excessive energy of the pattern and honest illustration of scholars from completely different schools. This research aimed to affiliate BMI with bodily exercise and life-style on the faculty degree. Although it’s pandemic, we may capable of accumulate the information. The device was validated by consultants and reliability was examined via a pilot research. The findings are obtained via sound evaluation by utilizing the software program. Nonetheless, the research 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 research, which could impression the findings of affiliation. There may very well be recall bias whereas amassing life-style elements. Additionally, the design of the analysis didn’t allow causal inferences within the outcomes. Sooner or later, the research may very well be concerned post-graduate college students to evaluate their BMI modifications in such sort of pandemic lockdown.
Although half of the scholars keep 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 diminished weight could also be attributed by diminished consumption of quick and fried meals throughout 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 cut back weight problems prevalence. Therefore, well being consciousness resembling weight upkeep, lively bodily actions, a wholesome life-style together with a balanced food plan, ample sound sleep, lively and stress-free psychological standing have to 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 lengthen their appreciation to the Deanship of Scientific Analysis at King Faisal College, Al-Ahsa, Kingdom of Saudi Arabia for its monetary help via Nasher observe close to the analysis grant quantity 206130.
The authors report no conflicts of curiosity on this work.
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