Pandemics and subsequent lifestyle restrictions such as ‘lockdowns’ may have unintended consequences, including alterations in body weight. This systematic review assesses the impact of pandemic confinement on body weight and identifies contributory factors. A comprehensive literature search was performed in seven electronic databases and in gray sources from their inception until July 1st 2020 with an update in PubMed and Scopus on February 1st 2021. In total, 2,361 unique records were retrieved, of which 41 studies were identified eligible: 1 case control study, 14 cohort and 26 cross-sectional studies (469, 362 total participants). The participants ranged in age from 6–86 years. The proportion of female participants ranged from 37% to 100%. Pandemic confinements were associated with weight gain in 7.2%–72.4% of participants and weight loss in 11.1%–32.0% of participants. Weight gain ranged from 0.6 (±1.3) to 3.0 (±2.4) kg, and weight loss ranged from 2.0 (±1.4) to 2.9 (±1.5) kg. Weight gain occurred predominantly in participants who were already overweight or obese. Associated factors included increased consumption of unhealthy food with changes in physical activity and altered sleep patterns. Weight loss during the pandemic was observed in individuals with previous low weight, and those who ate less and were more physically active before lock down. Maintaining a stable weight was more difficult in populations with reduced income, particularly in individuals with lower educational attainment. The findings of this systematic review highlight the short-term effects of pandemic confinements.

Background Multimorbidity, defined as having two or more chronic diseases, has a major impact on public health and Sustainable Development Goals (SDG). This study aims to assess the prevalence of medication adherence and associated factors among patients with multimorbidity. Methods A questionnaire-based, cross-sectional survey was conducted by a trained interviewer across patients with multimorbidity attending outpatient clinics in two tertiary referral hospitals in the United Arab Emirates (UAE). Demographic and social variables and the outcome (self-reported adherence to long-term medication) were measured using the General Medication Adherence Scale (GMAS). Multiple logistic regression was used to assess medication adherence and associated factors. Results From a total of 630 participants included in this study, the estimated prevalence of high medication adherence is 78.57% (±1.63478) with a 95% confidence interval (CI) [75.19, 81.61]. The odds of high medication adherence increased with age. The odds of high medication adherence for patients aged 66 years and older than those aged 19–35 years is adjusted odds ratio (AOR) = 3.880, with a 95% CI [1.124, 13.390]. Patients with income more than 50,000 had the odds, AOR = 5.169 with a 95% CI [1.282, 20.843], compared to those earning less than 10,000 Dirhams (AED). Patients aged 36–65 with health insurance coverage had higher medication adherence than groups on the other end. The number of current medications is significantly (p-value = 0.027) associated with high medication adherence with the odds of high medication adherence, AOR = 4.529 with a 95% CI [1.184, 17.326], the highest for those currently taking four medications. Conclusion This study highlights younger population having multimorbidity in the context of an increasing life expectancy and suboptimal therapeutic outcomes. Furthermore, the study highlights multimorbidity is associated with low medication adherence and out-of-pocket payment, and non-availability of insurance is a major hindrance to medication adherence.

Pandemics and subsequent lifestyle restrictions such as lockdowns may have unintended consequences including alterations in body weight. Understanding the impact and the mechanisms affecting body weight is paramount for planning effective public health measures for both now and future lockdown-type situations. This systematic review assesses and the impact of pandemic confinement on body weight and to identifies contributory factors. A comprehensive literature search was performed in seven electronic databases and in gray sources from their inception until 1st July 2020 with an update in PubMed and Scopus on 1st February 2021. In total, 2,361 unique records were retrieved, of which 41 studies were identified eligible: 1 case-control study, 14 cohort and 26 cross-sectional studies (469362 total participants). Weight gain occurred predominantly in participants who were already overweight or obese. Associated factors included increased consumption of unhealthy food with decreased intake of healthy fresh fruits and vegetables, changes in physical activity, and altered sleep patterns. Weight loss during the pandemic was observed in individuals with previous low weight, and those who ate less and were more physically active before lock down. Associated factors included increased intake of fruits and vegetables, drinking more water and consuming no alcohol. Maintaining a stable weight was more difficult in populations with reduced income particularly in individuals with lower educational attainment. The findings of this systematic review highlight the short-term effects of pandemic confinements. Learning from the lockdown experience is fundamental if we are to prepare for the next wave; a holistic, reactive, tailored response is needed involving multiple providers.

The Islamic month of Ramadan is marked by fasting, when Muslims refrain from eating and drinking from dawn to sunset, which has an impact on their dietary habits. The study aimed to assess Nigerian Muslims’ dietary modifications during Ramadan and their related changes in body weight and health status. A web-based cross-sectional study was conducted among Nigerian adult Muslims. The survey assessed sociodemographic, dietary habits, eating behaviors, food choices, perceived weight changes, and health status. The logistic regression model was used to assess the predictors of weight change and perceived health status. There were 770 participants, 62.9% of whom were women, ranging in age from 18 to 60 years with a mean age of 27.7 ± 6.4 years. Fruits, palm dates, homemade foods, milk products, and vegetables were more frequently consumed. There were fewer energy drinks, pastries, salty snacks, and carbonated or sugared drinks consumed during Ramadan than before. Over half (54.6%, 95% CI: 51.0–58.9%) of the respondents lost weight during Ramadan, 37.0% (95% CI: 17.4–38.6%) maintained their weight and 8.4% (95% CI: 6.6–10.6%) gained weight during the month. Nearly all (97.3%, 95% CI: 95.8–98.3%) reported having good health during Ramadan, and 2.7% (95% CI: 1.7–4.1%) reported having a poorer health state during Ramadan. There was a significant weight loss and healthy dietary change associated with Ramadan fasting in Nigeria. Public health measures must be in place to impart such positive health behaviors so that such healthy habits continue throughout the year.

BackgroundOf around 2 billion Muslims worldwide, approximately 1.5 billion observe Ramadan fasting (RF) month. Those that observe RF have diverse cultural, ethnic, social, and economic backgrounds and are distributed over a wide geographical area. Sleep is known to be significantly altered during the month of Ramadan, which has a profound impact on human health. Moreover, sleep is closely connected to dietary and lifestyle behaviors.MethodsThis cross-sectional study collected data using a structured, self-administered electronic questionnaire that was translated into 13 languages and disseminated to Muslim populations across 27 countries. The questionnaire assessed dietary and lifestyle factors as independent variables, and three sleep parameters (quality, duration, and disturbance) as dependent variables. We performed structural equation modeling (SEM) to examine how dietary and lifestyle factors affected these sleep parameters.ResultsIn total, 24,541 adults were enrolled in this study. SEM analysis revealed that during RF, optimum sleep duration (7–9 h) was significantly associated with sufficient physical activity (PA) and consuming plant-based proteins. In addition, smoking was significantly associated with greater sleep disturbance and lower sleep quality. Participants that consumed vegetables, fruits, dates, and plant-based proteins reported better sleep quality. Infrequent consumption of delivered food and infrequent screen time were also associated with better sleep quality. Conflicting results were found regarding the impact of dining at home versus dining out on the three sleep parameters.ConclusionIncreasing the intake of fruits, vegetables, and plant-based proteins are important factors that could help improve healthy sleep for those observing RF. In addition, regular PA and avoiding smoking may contribute to improving sleep during RF.