Nationwide lockdowns during SARS-CoV-2 (COVID-19) can compromise mental health and psychological wellbeing and limit opportunities for physical activity (PA), particularly in clinical populations, such as people with rheumatoid arthritis (RA), who are considered at risk for COVID-19 complications. This study aimed to investigate associations between PA and sedentary time (ST) with indicators of mental health and wellbeing in RA during COVID-19 lockdown, and examine the moderation effects of self-isolating. 345 RA patients completed an online questionnaire measuring PA (NIH-AARP Diet and Health Study Questionnaire), ST (International Physical Activity Questionnaire-Short Form), pain (McGill Pain Questionnaire and Visual Analogue Scale), fatigue (Multidimensional Fatigue Inventory), depressive and anxious symptoms (Hospital Anxiety and Depression Scale), and vitality (Subjective Vitality Scale) during the United Kingdom COVID-19 lockdown. Associations between PA and ST with mental health and wellbeing were examined using hierarchical multiple linear regressions. Light PA (LPA) was significantly negatively associated with mental fatigue (β = − .11), depressive symptoms (β = − .14), and positively with vitality (β = .13). Walking was negatively related to physical fatigue (β = − .11) and depressive symptoms (β = − .12) and positively with vitality (β = .15). Exercise was negatively associated with physical (β = − .19) and general (β = − .12) fatigue and depressive symptoms (β = − .09). ST was positively associated with physical fatigue (β = .19). Moderation analyses showed that LPA was related to lower mental fatigue and better vitality in people not self-isolating, and walking with lower physical fatigue in people self-isolating. These findings show the importance of encouraging PA for people with RA during a lockdown period for mental health and wellbeing.

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BACKGROUND Risk factors for obesity prevalence can help target treatment, but less is known about risk factors for obesity incidence which may be distinct and more pertinent for preventing excessive weight gain. OBJECTIVE To explore factors associated with child/adolescent BMI and childhood obesity incidence over 5 years in Malaysia including parental cardiometabolic risk, socio-demographic and baseline child BMI. METHODS Longitudinal data on 1768 children (aged 6-14 years) and parents were drawn from a Malaysian cohort and followed up after 5 years. Multilevel models estimated associations between parent cardiometabolic risk factors (overweight/obesity, central obesity, hypertension, hyperglycaemia), socio-demographics (ethnicity, employment, education) and child BMI z-score at follow-up, adjusting for baseline and potential confounders. Associations with five-year child obesity incidence were explored using logistic multilevel models. RESULTS Obesity prevalence was stable (16-17%) and average annual obesity incidence ranged from 2.2% for 6-10 years (childhood) to 1.2% for 11-14 years (adolescence). Higher baseline BMI z-score was associated with a higher follow-up BMI z score in childhood (0.60; 95% CI: 0.55, 0.65) and adolescence (0.76; 95% CI: 0.70, 0.82). Associations were smaller with maternal overweight/obesity and childhood BMI (overweight: 0.16; 95% CI: -0.03, 0.36, obesity: 0.41; 95% CI: 0.20, 0.61), and paternal overweight/obesity and adolescent BMI (overweight: 0.22; 95% CI: 0.01, 0.43, obesity: 0.16; 95% CI: -0.10, 0.41). Five-year obesity incidence in adolescence was associated with parental obesity (paternal OR= 4.37; maternal OR= 3.38). There were no marked associations with parental hypertension/hyperglycaemia or socio-demographics. CONCLUSIONS Parental overweight/obesity was prospectively associated with higher child BMI and obesity incidence, but the largest follow-up BMIs were among children with a higher baseline BMI. Early childhood, rather than parent cardiometabolic risk, maybe a better target for obesity prevention.

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