What a year it has been so far! As a public health professional – and on a personal level someone who has passion about my own health and wellness – I thought I would share one of the many things on my mind during this pandemic. I have been very interested in eating habits and staying active while in quarantine, and what that may mean for our waistlines and overall health. We keep hearing that those with underlying conditions are more at risk for COVID-19 complications, so I want to keep myself healthy for that reason as well. Since good health for all is part of my job, I want to share my thoughts and findings with Unconditionally Her readers. I wrote another article which will be read by my colleagues and peers who are academicians and who appreciate research and science, and decided the information was great to share with all. So bear with me through some of the more scientific lingo, which really IS quite interesting and has great information for all of us. I also took on some informal research of my own and asked those in my circles some specific questions about how they were dealing with the pandemic and included those responses at the end. I enjoyed hearing from others and hope you will, too!
So what happens when the messages received by public health and medical professionals lean more towards hunkering down and staying home than towards getting out and about with an active lifestyle? When it’s due to a global pandemic, it certainly creates a change in mindset and can seem very contradictory to advice we have been given for years. What we are now being asked to do is a 360° from what health experts have encouraged us to do for years and were still encouraging just six short months ago. And while we are being encouraged to stay within the four walls of home as often as possible, what kind of foods are we eating while staring at those same walls for months on end? And what about that “active lifestyle”? It is the perfect set-up for compounding the problems this country already is experiencing with obesity and individuals who are overweight or have obesity.
For months, most gyms, fitness clubs, and similar venues were closed during stay-at-home orders, and trips to grocery stores often meant coming home with whatever happened to be on the shelves as people were often in a state of panic and picking up whatever was there for the picking. Immediately placing people in quarantine requires a dramatic change in lifestyle for most. The psychosocial aspects are tremendous and significant enough to be a separate topic itself. What about the physical impact of the pandemic specific to healthy weight and the food and activity levels brought about by the pandemic? It is certain that there will be research on this topic, and we will soon learn a lot more. For now, we can start with what we do know.
Being at a healthy weight and free from chronic disease is important at any time, but especially in the era of COVID-19. According to the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS) data brief, the prevalence of obesity in the United States was 42.4% in 2017~2018. We have all heard from public health and medical professionals repeatedly that it isn’t just older adults who are at risk of COVID-related complications and premature death, but those with underlying health conditions, including overweight and obesity. Preliminary research published in The Lancet found that as the pandemic hit the Johns Hopkins Hospital in late March, 2020, younger patients began to be admitted to their intensive care unit (ICU), many of whom were obese. An informal survey of colleagues directing ICUs at other hospitals around the country yielded similar findings and the Lancet study noted several news editorials identifying noting obesity as an underappreciated risk factor for COVID-19. With weight being a risk factor for several chronic diseases and conditions – and the United States having obesity rates upwards of 42% – it is wise to manage weight as best we can to reduce risk of developing chronic disease and for overall good health, especially during the COVID-19 pandemic.
A study published July 1 in the Journal of the American Medical Association (JAMA) examined the number of deaths reported in the U.S. in March and April of this year, when the pandemic first began, as compared with preceding years. The study found large increases in excess deaths from underlying causes such as diabetes, heart disease and Alzheimer’s disease in Massachusetts, Michigan, New Jersey, New York and Pennsylvania. These states had the most COVID-19 deaths in March and April. The largest increases were in New York City, which experienced the biggest increases, including a 398% rise in heart disease deaths and a 356% increase in diabetes-related deaths, each which have obesity and overweight as risk factors. There are also issues with mental health and substance abuse that are beyond the scope of this article, but equally important to consider.
Is there any good news with all of this? Well, yes and no. We do not yet have published research on the fitness and activity levels during the pandemic, however, there are several unscientific polls and studies that give a picture of this. According to Ebay sales data, sales of dumbbells went up by 1,980% in March and April of this year compared to 2019 and weight plate sales increased by 1,355%.  Despite the surge in purchases of fitness equipment, many have found it difficult to maintain the same level of activity pre-quarantine. A survey of 2,000 Americans was done by the protein powder company Naked Nutrition, with assistance from OnePoll, with the survey results published in national, international and regional media outlets including the New York Post, International Business Times, Fox News, People magazine, and others. The survey found that of 2,000 Americans who routinely exercised, 65 percent were taking time off to “let themselves go a bit” and half had given up on their 2020 summer fitness goals.  (Sadlier, 2020)The study also found that 64 percent, had tried an in-home exercise routine, with the most popular activities being outdoor walks, exercise apps, health/exercise websites, online live stream classes and pre-taped workout videos. Respondents indicated dumbbells (48 percent) and yoga mats (45 percent) were the top isolation exercise equipment choices, with stationary bikes (41 percent), and ankle weights (38%) trailing behind. Responses indicated 54% purchased some kind of workout equipment. The survey also looked at eating habits and found that 50% of respondents have increased their consumption of refined carbohydrates such as pastries, white bread and pasta, though 54% percent still made an effort to eat vegetables, and 46% increasing the amount of protein they consume. Respondents reporting an average weight gain of 5 pounds during quarantine.
While the Naked Nutrition survey had respondents reporting an average weight gain of 5 pounds during quarantine, there has not yet been a larger and more formal national study of how COVID-19 has impacted the nation’s weight. There are a lot of anecdotal reports including those from a Yale University School of Medicine physician who has seen 10, 20, and even up to 30-pound weight gains during quarantine. There have also been some anecdotal reports of weight loss according to Yale. There have been several non-scientific polls from multiple fitness, weight loss and other organizations that show mixed results. Overall, it appears that there is some “good” along with some “not-so-good” in regards to eating and physical activity habits and weight during the ongoing pandemic, though we need more time for scientific research to catch up and complete a large-scale assessment of the impact the pandemic has had in these areas.
Let’s make this personal.
Wondering what people say about their eating and activity habits throughout the pandemic? I asked a few people in my circles about their food and activity habits to see what they had to say. It isn’t all bad news! Take a look at the responses to our questions below.
Here’s what I asked:
Has your food intake changed during the COVID-19 quarantine (quantity as well as type of foods)? Please explain if so, and indicate why you think this is so. Did you have any foods that you ate that you usually do not eat? Found new favorites?
Has your physical activity level changed during the quarantine? Please explain, if so.
Have you gained weight, lost weight, or stayed the same during the ongoing pandemic? Before the pandemic, were you at what you consider a healthy weight, or over-/underweight?
Do you believe that you experienced any “stress eating” during the quarantine so far?
Do you have anything else interesting that you would like to share?
“Prior to COVID-19, I tried to devote more time to an exercise regime and being active. When COVID hit, I began walking with a neighbor in the evenings for an hour to unwind and to take a break from the routine of dealing with a loved one who was in the hospital. I began to enjoy that time and continued it after returning to Murfreesboro. I am more active now than I was before COVID. As a person of color this is vitally important as we know that COVID disproportionately impacts communities of color primarily due to underlying chronic health conditions It is important that all of us – especially people of color – keep ourselves as healthy as possible. The social aspect of a fitness routine can also be so important to staying engaged. There are plenty of ways to stay engaged with others who support your fitness routine and can keep you motivated such as online fitness classes w friends. Social support is an important factor in good health.”
“I’ve been stress eating Oreos, my coffee intake has increased from 1 cup a day to about 3 cups a day. I’ve eaten fewer salads during remote working, and I started going to the gym and then stopped when we had that COVID scare and am too afraid to go back. We have started doing more delivery food since we can’t go out AND we are so tired of cooking at home. We still do our meal kit delivery service for 3 suppers a week so at least those are healthy and portion controlled. But major yes on the stress eating AND boredom eating. I don’t like being stuck at home.”
“My activity level has changed during the quarantine. And, it has definitely made my mood more depressive. Before COVID, I was active in the gym with a personal trainer for at least two days and on my own the other two. Since that time, I feel more blah and definitely out of shape. I have purchased equipment, but find I am not as motivated and I feel it. The lack of physical and certainly affected my mental health more than I ever thought it would. I was at a good weight before and am not heavier or lighter, but definitely feel more out of shape. I hate it!
“More times than I can imagine am I stress eating. I am not a typical cocktail girl, but find when I am with friends, I will take a “nip-of-gin” more than before. I started out being more healthy, but find with the limitations of quarantine, I just do the best I can. I also try more recipes, which should be good, but I find I just find reasons to eat.”
“From a mental health perspective, I am more stressed and feel a sense of dread. I am SO not a “Negative Nelly” and perhaps that is not just COVID. But the world as it is today, my mental stress is getting to me more than the physical stress of not being physical. I just want my life as I knew it back. I so took it for granted. Now I am trying just to navigate a new normal when we can’t even see what the new normal is. My most frustration is trying to stay positive and find hope and kindness in a world that is so angry and bitter.”
“Our eating habits have certainly changed. We used to eat out 2-3 times a week. Now it’s takeout maybe once a week, and then it’s dictated by either which food truck happens to be in our neighborhood or which local business we want to support rather than health or nutrition. Also, we’ve been planning all of our home-cooked meals a week in advance and not “impulse shopping” at the grocery since we do curb-side pick-up now. I don’t really feel like the quantity of food has increased, except for an increase in home-baked sweets that I make with my 8-year old daughter.
“Until the heat got unbearable, our family had been very intentional about going on at least 1 family walk/bike ride every day. However, I don’t think that has been enough physical activity to offset the unintentional (or “built-in”) activity I was getting just by going into work, walking to classes, doing the shopping, etc. I don’t know that stress eating has increased, but frequency of wine in the evenings has increased.”
“Particularly during the month of our stay at home order, my family definitely ate more fast food and take-out food than we had before. With both adults and three young children at home all day every day, it was common for us to go out late afternoon or early evening to pick up drinks, snacks, or even meals from drive throughs and then just drive around town to break the monotony of the day. That had not been a part of our routine prior to COVID. Now, we still do that a lot on weekends. Even though the community has opened back up, we continue to avoid public gathering spots like park playgrounds, so fast food take-out is our way to get the kids out of the house. I never expected to be a mom who fed her kids McDonalds multiple times a week.”
“My food intake has changed dramatically! Our family used to eat out or get take-out 5+ times per week before the pandemic. We always tried to make healthy choices, but restaurant meals tend to be larger, fattier and more calorie dense than home-cooked meals. Since we are no longer running to sports and other activities and do not feel that dining out is worth the risk right now, I have been cooking all our meals for months. I feel like our nutrient intake has definitely improved (and we’ve saved lots of money!). I am in control of what I’m preparing and it’s been really nice to be able to do that for my family. At work, I usually eat microwave meals, but I’ve been eating lots of fresh foods at home since I have more time and access to my own pantry/fridge at lunchtime.”
“My activity level has stayed about the same. I used to exercise at the YMCA, but during the pandemic, I’ve been running outside. I have a very routine running schedule that gives me a sense of structure during the week. It’s a nice way to get out of the house and enjoy being outside by myself! My weight was healthy before the pandemic and I have stayed the same. So much is out of my control right now, but my personal choices are mine and that gives me a sense of having control over something.”
“I have definitely had some moments of stress eating. I try to not get stuck in those moments and recognize them as a temporary response that shouldn’t become the norm. It’s probably really important that people don’t compare their pandemic experience with others. This is a major shift in the way we live life and we should give ourselves some grace as we figure out how to cope. “
Stay healthy, friends! The first step is awareness. I hope this article has given some food for thought (pardon the pun) on how to get and stay healthy even during an unprecedented pandemic so we each have long, healthy, and enjoyable lives.
 Kass, D. A. ( 1 ), Cingolani, O. ( 1 ), & Duggal, P. ( 2 ). (n.d.). Obesity could shift severe COVID-19 disease to younger ages. The Lancet, 395(10236), 1544–1545. https://doi.org/10.1016/S0140-6736(20)31024-2
 Woolf SH, Chapman DA, Sabo RT, Weinberger DM, Hill L. Excess Deaths From COVID-19 and Other Causes, March-April 2020. JAMA. Published online July 01, 2020. doi:10.1001/jama.2020.11787
 Srikanth, Anagha. Americans are Gaining Weight and Buying More Fitness Equipment but are They Using it? The Hill. Changing America. Retrieved July 28, 2020, from https://thehill.com/changing-america/well-being/longevity/506100-americans-are-gaining-weight-and-buying-more-fitness.
 Sadlier, A. (2020, May 19). Nearly half of Americans worry they’ll never get their pre-quarantine body back. New York Post. Retrieved July 28, 2020, from https://nypost.com/2020/05/19/nearly-half-of-americans-worry-theyll-never-get-their-pre-quarantine-body-back/
 Katella, Kathy. Yale Medicine. Quarantine 15? What to Do About Weight Gain During the Pandemic. Retrieved July 28, 2020 from https://www.yalemedicine.org/stories/quarantine-15-weight-gain-pandemic/
*This article was written as part of an assignment in the Middle Tennessee State University’s graduate level course, NFS 6600/7600– Nutrition and Obesity, taught by Dr. Elizabeth Smith, RDN, LD.