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      Effect of lockdown for COVID-19 on self-reported body weight gain in a sample of obese patients Translated title: Efecto del confinamiento por COVID-19 sobre la ganancia de peso corporal autorreportada en una muestra de pacientes obesos

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          Abstract

          Abstract Objective: the COVID-19 pandemic, by restricting population mobility, may exacerbate the risk factors for weight gain associated with physical inactivity and increased consumption of calorie-dense foods. The aim of this cross-sectional study was to evaluate the risk factors related to self-reported body weight gain among obese subjects. Methods: the study involved a population of 284 adult obese subjects. After a 7-week confinement period starting on March 17, a telephone interview (May 4 through 7) was conducted. In this phone call, self-reported body weight gain and a number of factors were recorded. In order to obtain the baseline data of this population, biochemical and anthropometric parameters were collected from electronic medical records. Results: mean age was 60.4 ± 10.8 years (range: 23-71) and mean body mass index (BMI) was 35.4 ± 4.7 kg/m2 (range: 30.6-41.2). Gender distribution was 211 females (74.3 %) and 73 males (25.7 %). Self-reported body weight gain was 1.62 ± 0.2 kg. Among patients who reported doing a lot of exercise self-reported body weight gain was lower (1.62 ± 0.2 vs 1.12 ± 0.3 kg; p = 0.02). Regarding eating habits, patients recognized snacking in 17 % of the sample. Patients who reported snacking had higher self-reported body weight gains (2.60 ± 0.36 vs 1.30 ± 0.17 kg; p = 0.001). The remaining variables did not influence self-reported body weight gain. In the multiple regression analysis with self-reported body weight gain as dependent variable, adjusted for age, sex, and physical activity, the snaking habit remained a risk factor: beta = 1.21 (95 % CI: 1.11-2.13; p = 0.01). Conclusions: the lockdown decreed during SARS-CoV-2 pandemic has produced an increase in self-reported body weight among obese subjects, which was related to the habit of taking snacks.

          Translated abstract

          Resumen Objetivo: la pandemia de COVID-19, al restringir la movilidad de la población, podría exacerbar los factores de riesgo del aumento de peso asociados a la inactividad física y un mayor consumo de alimentos ricos en calorías. El objetivo de este estudio transversal fue evaluar los factores de riesgo relacionados con el aumento de peso corporal autoinformado entre sujetos obesos. Métodos: el estudio incluyó una muestra de 284 sujetos obesos adultos. Después de un período de reclusión de 7 semanas a partir del 17 de marzo, se realizó una entrevista telefónica (del 4 al 7 de mayo). En esta llamada telefónica se registraron el aumento de peso corporal autoinformado y diferentes factores asociados. Para obtener los datos basales de esta población, se registraron parámetros bioquímicos y antropométricos a partir de la historia clínica electrónica. Resultados: la edad media fue de 60,4 ± 10,8 años (rango: 23-71) y el índice de masa corporal (IMC) medio de 35,4 ± 4,7 kg /m2 (rango: 30,6-41,2). La distribución por géneros fue de 211 mujeres (74,3 %) y 73 hombres (25,7 %). El aumento de peso corporal autoinformado fue de 1,62 ± 0,2 kg. Los pacientes que reconocieron que hacían mucho ejercicio informaron de que la ganancia de peso corporal había sido menor (1,62 ± 0,2 vs 1,12 ± 0,3 kg; p = 0,02). En cuanto a los hábitos alimentarios, los pacientes reconocieron practicar el picoteo en el 17 % de la muestra. Los pacientes que reconocieron picar entre horas presentaron una mayor ganancia de peso corporal autoinformada (2,60 ± 0,36 vs 1,30 ± 0,17 kg; p = 0,001). Las demás variables no influyeron en el aumento de peso corporal autoinformado. En el análisis de regresión múltiple, con la ganancia de peso corporal autoinformada como variable dependiente y ajuste de edad, sexo y actividad física, el hábito del picoteo permaneció como factor de riesgo: beta = 1,21 (IC 95 %: 1,11-2,13; p = 0,01). Conclusiones: el encierro decretado durante la pandemia por el SARS-CoV-2 ha producido un aumento del peso corporal autoinformado en los sujetos obesos y este se ha relacionado con el hábito de picar entre horas.

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          Obesity in patients younger than 60 years is a risk factor for Covid-19 hospital admission

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            Effects of COVID‐19 Lockdown on Lifestyle Behaviors in Children with Obesity Living in Verona, Italy: A Longitudinal Study

            Abstract Objective To test the hypothesis that youths with obesity, when removed from structured school activities and confined to their homes during the COVID‐19 pandemic, will display unfavorable trends in lifestyle behaviors. Methods The sample included 41 children and adolescents with obesity participating in a longitudinal observational study located in Verona, Italy. Lifestyle information including diet, activity, and sleep behaviors were collected at baseline and three weeks into the national lockdown during which home confinement was mandatory. Changes in outcomes over the two study time points were evaluated for significance using paired t‐tests. Results There were no changes in reported vegetable intake; fruit intake increased (p=0.055) during the lockdown. By contrast, potato chip, red meat, and sugary drink intakes increased significantly during the lockdown (p‐value range, 0.005 to <0.001). Time spent in sports activities decreased (X±SD) by 2.30±4.60 hours/week (p=0.003) and sleep time increased by 0.65±1.29 hours/day (p=0.003). Screen time increased by 4.85±2.40 hours/day (p<0.001). Conclusions Recognizing these adverse collateral effects of the COVID‐19 pandemic lockdown is critical in avoiding depreciation of weight control efforts among youths afflicted with excess adiposity. Depending on duration, these untoward lockdown effects may have a lasting impact on a child’s or adolescent’s adult adiposity level.
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              COVID 19 and the Patient with Obesity – The Editors Speak Out

              The pandemic of COVID‐19 is bringing public health to the forefront for all members of The Obesity Society. COVID‐19 emerged in Wuhan, China, in December 2019 and is thought to be a betacoronavirus related to the SARS virus (1). The manifestations of the COVID‐19 infection run the spectrum from asymptomatic disease to severe acute respiratory infection. Lacking herd immunity and in the absence of effective vaccines or antiviral therapies, countries around the world are witnessing an unprecedented strain on health systems and disruption of economies as we start to understand the biology and mode of transmission of COVID‐19. At issue is that while most people with COVID‐19 develop no symptoms or have only mild illness, the evidence from China indicates that approximately 14% develop severe disease that requires hospitalization and oxygen support, while 5% require admission to an intensive care unit (ICU) (1). For those 5%, acute respiratory distress syndrome (ARDS), sepsis and septic shock, and multiorgan failure, including acute kidney injury and cardiac injury, can all occur (2). Older age and comorbid disease have been reported as risk factors for death while the present European experience seems to indicate more and more severe cases among younger age groups (3, 4). The prevalence of diabetes was 20% and of hypertension 30% in the first cases analyzed for risk factors for severe disease (3, 4). Persons with obesity around the world are already at high risk for severe complications of COVID‐19, by virtue of the increased risk of the chronic diseases that obesity drives. While China does not have the high incidence of obesity as that in the US when obesity is defined by BMI, China has been experiencing an epidemic of type 2 diabetes, with prevalence rates similar to the US (5). The reason for this is that individuals of Asian descent have a propensity for ectopic and visceral fat storage, while those of European descent are storing more of the excess fat in subcutaneous depots, with a lesser lipotoxic profile. The Chinese experience needs to inform the health system response in other countries around the world. Yes, Americans have higher BMI than those from China—the prevalence of obesity in the US was 42.4% in 2017‐2018—but Americans also have a high burden of class III obesity, with 9.2% of the population with BMI > 40 kg/m2 (6). This has serious implications for our health care system. Persons with severe obesity who become ill and require intensive care (5% of infections) present challenges in patient management—more bariatric hospital beds, more challenging intubations, more difficult to obtain an imaging diagnosis (there are weight limits on imaging machines), more difficult to position and transport by nursing staff. And like pregnant patients in ICUs, they may not do well when prone. Special beds and positioning/transport equipment are available mostly in specialized bariatric surgery units but may not be widely available elsewhere in hospitals. We are likely to see a collision of the two public health epidemics in the US with obesity and COVID‐19 interacting to further strain our health system. The impact of COVID‐19 will also be felt outside of the ICU. There is a psychological toll of the viral pandemic. Persons with obesity who are self‐isolating and avoiding social contact are already stigmatized and already experiencing higher rates of depression. Social isolation is at the heart of obesity stigma. More than ever, our health care providers need to fight obesity bias. Finally, we have learned much from influenza in patients with obesity and there will almost certainly be parallels to COVID‐19. The Centers for Disease Control and Prevention considers those with BMI ≥ 40 kg/m2 as being at risk for flu complications (7). During the 2009 H1N1 pandemic, obesity was recognized as an independent risk factor for complications from influenza (8). Thus, it is likely that obesity shall be an independent risk factor for COVID‐19. Of great concern also is the fact that persons with obesity have diminished protection from influenza immunization with a study showing that adult recipients of IIV3 with obesity have two times greater incidence of influenza and/or influenza like illness despite being vaccinated (9). The COVID‐19 pandemic is challenging the world in unprecedented ways. We at Obesity have been sounding the alarm about the obesity epidemic and now must take up the cause for our patients with obesity in the face of this dual pandemic threat.
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                Author and article information

                Journal
                nh
                Nutrición Hospitalaria
                Nutr. Hosp.
                Grupo Arán (Madrid, Madrid, Spain )
                0212-1611
                1699-5198
                December 2020
                : 37
                : 6
                : 1232-1237
                Affiliations
                [1] Valladolid Castilla y León orgnameUniversidad de Valladolid orgdiv1School of Medicine orgdiv2Endocrinology and Nutrition Research Center Spain
                Article
                S0212-16112020000800021 S0212-1611(20)03700600021
                10.20960/nh.03307
                33155477
                dc79834a-cdb5-4b08-8d50-113a0e32e84b

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 08 September 2020
                : 17 August 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 21, Pages: 6
                Product

                SciELO Spain

                Categories
                Original Papers

                Confinamiento,Obesidad,COVID-19,Snacking,Picoteo,Lockdown,Obesity
                Confinamiento, Obesidad, COVID-19, Snacking, Picoteo, Lockdown, Obesity

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