Help Patients Avoid the Quarantine 15

Weight loss is frequently a popular topic in the United States, with 73.6% of the population over the age of 20 years overweight and 42.5% obese.¹

However, the coronavirus disease 2019 (COVID-19) pandemic appears to be accelerating this. A quick search on Instagram reveals 59,600 results for the hashtag “#quarantine15.” Many of these results display people either sharing that they have gained weight during the pandemic or how they have managed to stave off the weight or even lose weight. Weight gain during the pandemic is not just a vanity concern on social media but is increasingly becoming a health concern that could lead to long-term health consequences for adults and children alike.

Survey results released by biotechnology company Gelesis in December 2020 showed that 71 million Americans had gained weight during the pandemic, and 63% had found it more difficult to maintain healthy lifestyle habits.² The 71 million figure is extrapolated from an online survey among 1012 adults in the United States from October 26, 2020, to November 3, 2020. 2 Nonetheless, this shows that a significant number of Americans may be struggling to maintain a healthy weight during the pandemic. The disruption of daily lives, food insecurity, physical restrictions, and stress all play a role in gaining weight. Many people are also increasing their unhealthy snacking habits.

According to the results of an online cross-sectional survey between April 2020 and June 2020, participants reported increased consumption of salty snacks (37.4%) and sweets (43.8%),³ which can contribute to weight gain.

Children are not immune to the pandemic weight gain. Prior to the pandemic, more than 20% of children ages 6 years and older were obese.1 Evidence is starting to show that limited access to healthy food and places to be physically active can increase a child’s risk for obesity.⁴

Here are some tips to maintain a healthy weight:

Avoid boredom snacking: Snack mindfully. That means avoiding snacking while watching television or simply out of boredom. This can quickly increase calorie intake.

Choose healthy snacks. Any snacks between meals should also be nutrient-dense. Avoid foods that are devoid of nutritional value. For example, a piece of whole fruit or raw vegetables with a side of hummus provide macro and micronutrients that make an individual feel full.

Control portion sizes. Individuals who are given larger portions tend to eat more.5 The results of one study showed that increasing portions by 75% increased food intake by a mean 27% and energy intake by 25%.⁵ Adults can practice making appropriate portions by checking out MyPlate.gov and adhering to the recommended portion sizes. They should also be aware of the portions they are giving to children.

Drink plenty of water. Drinking more water has myriad direct and indirect benefits. Drinking water instead of sweetened beverages can reduce overall caloric intake, but it also can help improve alertness, cognition, metabolism, and workouts; remove waste from the body; and suppress the appetite.⁶ Individuals should drink between 8 and 16 glasses of water each day, though amount should also be dictated by thirst and the color of urine. If the urine appears dark or concentrated, that indicates dehydration. Healthy urine is colorless or light yellow.

Eat nutrient-dense foods. Meals should be full of nutritious foods. It may sound obvious, but many foods are overly processed and stripped of nutrients. This leads to calorie-laden food with little nutritional value. Ideally, the food should be a rich source of healthy macronutrients (healthy fats and sources of carbohydrates and high-quality protein) and micronutrients (minerals and vitamins), as well as lower in calories. Foods that are high in calories but low in nutritional value, such as candies, chips, and sweetened beverages, lead to weight gain and can increase the risk of cardiovascular disease and metabolic disorders. Foods that are high in fiber and protein provide vital nutrients but also help ward off hunger. Avoid both regular and sugar-free soda, as it is a huge culprit behind weight gain.

Get enough sleep. Studies have shown that insufficient sleep can increase hunger and lead to weight gain. How much sleep should people get?⁷ Newborn should sleep 14 to 17 hours a day, babies who are 12 months of age should sleep 10 hours at night and nap for 4 hours each day, two-year-olds should sleep 11 to 12 hours at night and have 1-to-2-hour afternoon nap each day, children age 3 to 5 years should sleep 10 to 13 hours a day, those 6 to 13 years of age should sleep between 9 and 11 hours each night, teenagers age 14 to 17 should sleep between 8 and 10 hours each night, and adults should get 7 to 9 hours’ worth of shut eye each night.

Increase fiber intake. Fiber has many benefits, including helping with bowel regularity and a feeling of fullness. It can help lower cholesterol and stabilize blood sugar. Additionally, foods that are naturally high in fiber generally are healthier and offer other nutritional benefits. For example, fruits and vegetables are great sources of fiber but also are lower in calories and have antioxidants, minerals, and vitamins. Legumes are high in fiber and are also great sources of protein. Nuts and seeds are high in fiber, healthy fatty acids, minerals, protein, and vitamins.

Reduce stress. When individuals are stressed, it can lead to a rise in hormone levels that can cause craving fatty or sugary food and overeating. There are many ways to reduce stress, including asking for help, creating a relaxing nighttime routine, eating healthy, exercising, finding time for leisure, meditating, practicing yoga, prioritizing quality sleep, setting personal boundaries, spending time with family and friends, and taking a break from negative news.

Stay active. Both children and adults need to be physically active and should be active every day. Before the pandemic, 80% of Americans were not getting enough physical activity.⁸ Humans are meant to be active, and there is extensive research on the negative health consequences of being sedentary. Physical activity has myriad benefits, including reducing the risk of death from heart disease, heart-related events, high blood pressure and cholesterol, type 2 diabetes, and various cancers, and reducing anxiety, dementia, and depression. Physical activity also improves cognition and sleep. How much exercise is suggested? Children ages 3 to 5 years should be active throughout the day, while those who are 6 to 17 years should get at least 60 minutes of moderate to intense exercise each day.⁸ Adults should get 150 to 300 minutes of moderate exercise or 75 to 150 minutes of vigorous exercise each week.⁸

Try an evidence-based diet or weight loss strategy. Avoid crash diets and dangerous trends. It is important that a diet be well-balanced and realistic for the long term. Crash diets tend to fail and lead to rebound weight gain, and there is no need to lose weight quickly. The key is to create a healthy lifestyle. One good plan to follow is the Mediterranean diet, which focuses on regularly consuming beans, flavorful herbs and spices, fruits, legumes, nuts, olive oil, vegetables, and whole grains; fish and seafood at least a couple of times a week; cheese, eggs, poultry, and yogurt in moderation; and red meats and sweets sparingly.⁹ Other diets may lead to more or faster weight loss, but many are lacking in nutrients and not sustainable. Individuals who are interested in intermittent fasting or low-carbohydrate diets should consult a health care professional for guidance to see if these methods are appropriate or safe for them and how to incorporate these into a healthy, well-rounded diet.

REFERENCES

1. CDC. Obesity and overweight. Updated January 11, 2021. Accessed February 18, 2021. https://www.cdc.gov/nchs/fastats/obesity-overweight.htm
2. New survey finds 71 million Americans have gained weight throughout the pandemic [news release]. Boston, MA; December 22, 2020: Gelesis. Accessed February 17, 2021. gelesis.com. https://www.gelesis.com/2020/12/22/new-survey-finds-71-million-americans-have-gained-weight-throughout-the-pandemic/
3. Bin Zarah A, Enriquez-Marulanda J, Andrade JM. Relationship between dietary habits, food attitudes and food security status among adults living within the United States three months post-mandated quarantine: a cross-sectional study. Nutrients. 2020;12(11):3468. doi:10.3390/nu12113468
4. State of Childhood Obesity. Impact‌ ‌of‌ ‌the‌ ‌COVID-19 pandemic‌ ‌on‌ ‌childhood‌ ‌obesity‌‌. Accessed February 18, 2021. https://stateofchildhoodobesity.org/stories/impact-of-the-pandemic-on-childhood-obesity/
5. Zuraikat FM, Roe LS, Sanchez CE, Rolls BJ. Comparing the portion size effect in women with and without extended training in portion control: a follow-up to the Portion-Control Strategies Trial. Appetite. 2018;123:334-342. doi:10.1016/j.appet.2018.01.012
6. Johns Hopkins University. Yes, drinking more water may help you lose weight. The Hub. January 15, 2020. Accessed February 19, 2021. https://hub.jhu.edu/at-work/2020/01/15/focus-on-wellness-drinking-more-water/
7. Olson EJ. How many hours of sleep are enough for good health? Mayo Clinic. June 6, 2019. Accessed February 18, 2021. https://www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/how-many-hours-of-sleep-are-enough/faq-20057898
8. Piercy KL, Troiano RP, Ballard RM, et al. The Physical Activity Guidelines for Americans. JAMA.2018;320(19):2020–2028. doi:10.1001/jama.2018.14854
9. Mediterranean diet. U.S. News & World Report. Accessed February 19, 2021. https://health.usnews.com/best-diet/mediterranean-diet