The COVID-19 lockdown as an opportunity to change lifestyle and body weight in people with overweight/obesity and diabetes: Results from the national French COVIDIAB cohort

Abstract

Background and aims: To analyze lifestyle habits and weight evolution during the COVID-19 pandemic-associated lockdown, in diabetes and overweight/obesity patients (body mass index (BMI) [25e29.9] and !30 kg/m 2 , respectively). Methods and results: We collected information on participants' characteristics and behavior regarding lifestyle before and during the lockdown, through the CoviDIAB web application, which is available freely for people with diabetes in France. We stratified the cohort according to BMI (!25 kg/m 2 vs < 25 kg/m 2 ) and examined the determinants of weight loss (WL), WL > 1 kg vs no-WL) in participants with a BMI !25 kg/m 2 , in both univariate and multivariate analyses.Of the 5280 participants (mean age, 52.5 years; men, 49%; diabetes, 100% by design), 69.5% were overweight or obese (mean BMI, 28.6 kg/m 2 (6.1)). During the lockdown, patients often quit or decreased smoking; overweight/obese participants increased alcohol consumption less frequently as compared with normal BMI patients. In addition, overweight/obese patients were more likely to improve other healthy behaviors on a larger scale than patients with normal BMI: increased intake of fruits and vegetables, reduction of snacks intake, and reduction of total dietary intake. WL was observed in 18.9% of people with a BMI !25 kg/m 2 , whereas 28.6% of them gained weight. Lifestyle favorable changes characterized patients with WL. Conclusions: A significant proportion of overweight/obese patients with diabetes seized the opportunity of lockdown to improve their lifestyle and to lose weight. Identifying those people may help clinicians to personalize practical advice in the case of a recurrent lockdown.

COVID-19 pandemic impact on people with diabetes: results from a large representative sample of Italian older adults

“…First, our results on increasing exercise among people with diabetes in a higher proportion than healthy individuals are consistent with previous findings [23] , [41] . A possible explanation is that individuals with diabetes, aware of their vulnerability, likely try to protect themselves [42] .…”

“…We observed unstable BMI trends among people with diabetes, who experienced both weight loss and gain [11] . Reduced alcohol consumption is in line with other analyses [23] and could be explained with an effort towards better nutrition. In accordance with existing literature [22] , results for psychiatric symptoms were inconclusive.…”

“…As a specific vulnerable group targeted by health promotion and prevention interventions [50] , they demonstrated a surprising resilience. The main lesson is that people with diabetes are less stables but not systematically prone to worsen lifestyles when external conditions theoretically complicate their efforts: they can also seize the opportunity to maintain and even improve their health [23] .…”

“…Thus far, there are no unequivocal results regarding the impact on people with diabetes, representing a specific vulnerable group in terms of attention paid to health behaviours, disease follow-up and compliance with treatments. Since hyperglicemia was the second most common comorbidity for COVID-19, after hypertension, and its management deeply relies on lifestyles and routine care [20] , [21] , assessing these aspects is crucial, especially with available evidence referring to non-representative hospital-recruited samples and forbidding results generalisation [22] , [23] , [24] .…”

Lifestyles Under Lockdown: A Scoping Review of International Studies on Type 2 Diabetes Self-Management Behaviors During COVID-19

“…For alcohol, Binhardi et al (39) and Ghosh et al (45) reported that modal responses were no alcohol consumption or no change in alcohol consumption, respectively. Hansel et al (47) and Sacre et al (36) reported no change in alcohol consumption. For smoking, Utli et al (60) and Ghosh et al (45) reported no smoking as the modal response.…”