COVID-19, healthy habits and emotional wellbeing

For the first time in decades, people have had to fundamentally adjust how they go about their day-to-day lives due to the coronavirus-related lockdown and social distancing restrictions.
 
The way people work, socialise, parent, sleep, exercise, eat, and spend money have all been significantly affected by COVID-19. And, for some, the mental health impact of the upheaval of these routines has been pronounced.
 
Results from two separate studies, in which researchers examined the associations between emotional distress and changes in selected health behaviours since the onset of COVID-19 in Australia, are indicative of the challenges faced in trying to maintain wellbeing during a significant lifestyle shift.
 
The CSIRO’s wellbeing survey of the Total Wellbeing Diet database of almost 4000 community members, uncovered that almost half (41%) of Australians are set to emerge from lockdown with their emotional wellbeing affected.
 
The results suggest exercise (66%) and diet (36%) have worsened during lockdown, with two in five respondents indicating they have gained weight during the same period, 61% reporting an increase in junk food consumption, and 63% an increase in snacking.
 
In terms of the negative impact of the lockdown experience, exercise and social events rated the highest, with 90% of respondents rating the impact on social events as negative while 66.3% said it had a negative effect on exercise.
 
Alcohol consumption has also increased, according to a CQUniversity study published in the International Journal of Environmental Research and Public Health. More than 26% of the almost 1500 surveyed participants reported an increase in alcohol consumption, and 6.9% are smoking more.
 
In the same survey, 48.9% of respondents indicated they had been less active than before the pandemic, and 40.7% reported poorer sleep quality.
 
Lead researcher Dr Robert Stanton from CQUniversity highlighted that these changes in health behaviours significantly affect wellbeing.
 
‘The biggest message from this study is that the reported negative changes in health behaviour, such as reduced physical activity, poorer sleep quality, and increased smoking and alcohol intake, are all associated with increased depression, anxiety and distress,’ he said.
 
The study found significantly higher scores in one or more psychological distress states for females, single people, those in lower socioeconomic areas, or with a chronic illness.
 
Australians are also feeling concerned about how long it will take for life to return to ‘normal’, CSIRO behavioural scientist and author of the wellbeing report Dr Emily Brindal said.

‘Our analysis found that the COVID-19 outbreak has negatively impacted respondents’ health and wellbeing,’ she said.
 
‘Increased concern about finances and the certainty of the future also featured strongly, as restrictions ease and respondents adjust to a new normal.’
 
Dr Cathy Andronis is Chair of the RACGP Specific Interests Psychological Medicine network. She said the study findings reflect the strong association with mental health and unhealthy lifestyle behaviours, particularly around exercise and eating patterns.
 
‘People commonly turn to food for comfort during difficult times and in the absence of healthy distractions, unhealthy distractions can be luring alternatives,’ she told newsGP.
 
However, Dr Andronis says there is a silver lining in that a lot of these less-than-ideal behaviours can be temporary during situations such as a pandemic.
 
‘As long as the change is short term and unusual, we tend to revert to more usual patterns in life, including returning to our regular eating and exercise habits,’ she said.

‘So, those people who eat well are highly likely to lose the extra kilograms from “social isolation” times as they resume normal life, with the timing depending on how quickly they are able to re-establish healthy lifestyle habits including regular meals, exercise and safe alcohol consumption.’
 
The CQUniversity study also identifies the need for ongoing evaluation of the impact of lifestyle changes associated with the pandemic.
 
‘It is our recommendation that effective health promotion strategies … be used to reduce the acute and chronic increases in psychological distress during these unprecedented times,’ Dr Stanton said.
 
‘It will also be necessary to conduct ongoing evaluation of the impact of lockdown rules and social distancing on health behaviours to inform targeted health promotion strategies.’

Dr Cathy Andronis believes it is important for GPs and other healthcare professionals to discuss healthy lifestyle choices with their patients.

One of the health promotion strategies to eventuate from the research is thatthe CSIRO’s Total Wellbeing Diet online program now includes positive psychology tools, with a focus on boosting wellbeing and mood.

‘The survey findings indicate a clear need for something to give Australians a mood boost as they emerge from lockdown and adapt to the new normal,’ Dr Brindal said.

Dr Andronis also notes the ever-present importance of GPs and other healthcare professionals in monitoring healthy lifestyle choices for their patients.
 
‘We need to be proactive and discuss lifestyle and preventive health issues opportunistically,’ she said.
 
‘The GP has an important role in promoting a return to good health by asking about lifestyle issues including diet and exercise, examining vital signs including weight and offering advice, psychoeducation and using motivational interviewing techniques to encourage healthier living.
 
‘Encouraging people to start socialising and exercising while maintaining safe physical distancing and hand hygiene is the best way for them to integrate back into a healthy lifestyle with others.
 
‘We can therefore get back sooner to eating to live rather than living to eat.’
 
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diet exercise lifestyle behaviour lockdown mental health