The long-term perils of pandemic weight gain
If there’s one thing that’s been thick on the ground during the coronavirus pandemic, it’s health and fitness advice. Since the very beginning of the global outbreak, the bank of lockdown-friendly exercise programs has built up, like lactic acid in the legs on an uphill run.
On the face of it, it’s never been easier (or cheaper) to exercise at home. In reality, finding motivation has likely never been harder.
“It’s been one of the biggest things for me,” says exercise physiologist Andy King, research fellow at the Mackillop Institute for Health Research. “That no matter where you are on that regular physical activity spectrum, it has been really hard to exercise when dealing with this pandemic.”
With the social element of exercise all but lost, even some of the fittest of us have struggled to keep up the habit.
Add in the burden of increased stress, disturbed sleep, emotional eating and a lack of natural sunlight, and we face a perfect storm of factors that compromise our physical and psychological health.
Early research indicates the pandemic has had a huge impact on weight and wellbeing, and that home isolation increases cardiovascular risk.
While it’s too early to know how hard the hammer will fall, experts are worried that restrictions aimed at controlling the rate of infection will worsen the obesity epidemic.
Dr King shares their concerns. In May 2020, with much of the world still in lockdown, he teamed up with three Mackillop colleagues to publish an article in the journal Sports Medicine.
Titled, The Challenge of Maintaining Metabolic Health During a Global Pandemic, the paper provided evidence-based advice on maintaining good health through the crisis.
“On top of the very real risk that this virus has posed, I think the overall situation changed the desire and the capability of many people to engage in slightly healthier practices, and that can be dangerous,” Dr King says.
“For people already on the verge of metabolic disorders, it could be just the tipping point that takes them over the edge.”
Routine and rhythm
One of the issues outlined in Dr King’s paper is the effect that indoor isolation can have on sunlight exposure, and how this might impact our circadian biology.
Our bodies are programmed to run on internal clocks that tell us the best time to eat, sleep and be physically active.
In the absence of regular exposure to natural light, the body clock appears to drift, affecting a range of things including mood and appetite. The simple act of partaking in a regular late-night snack – especially so-called “comfort foods” – can compromise the body’s natural rhythm.
“One of the things we were worried about with the COVID-19 situation initially was that the lack of daylight exposure, especially in the Australian winter, could disturb this rhythm and routine, because we know this can have many metabolic consequences,” says Dr King, whose research explores exercise metabolism and nutrient interactions.
These disruptions can undo our body’s efforts to improve metabolism and combat disease, leading to fatigue and weight gain and further harming our circadian biology. For those with pre-existing conditions, or who live a predominantly sedentary lifestyle, this vicious cycle can have severe health consequences.
“It becomes a circular loop relationship between all of these factors: your sleep is affected, you’re eating more or at the wrong time, you’re moving less and that affects sleep as well, and at the same time you’re stressed … before you know it, you can end up in this state of being socially jet-lagged,” Dr King says.
“Looking ahead, our main worry is people who already have some of those cardio-metabolic risk factors, because for them, the likelihood is that within a short amount of time, their health could suffer dramatically. And rescuing that down the track could be very difficult.”
The magic trio: exercise, nutrition and sleep
Dr King’s paper offers readers a range of lifestyle strategies to stave off the worst of the health risks.
He and his co-authors Louise Burke, Shona Halson and John Hawley present evidence around three primary health drivers – exercise, nutrition and sleep –explaining how they help to “offset the deleterious effects of inactivity and excess food intake”.
Getting back on the horse can be difficult, and those whose positive habits have fallen away might find it hard to re-establish a rhythm.
“Once we get into cycle of disruption, it can take a lot of effort to break back out of it again,” says Dr King, who has worked with professional athletes in cycling, triathlon, rugby and other sports.
“Habits are hard to break, and it can be anxiety-provoking to change your current situation, especially if you’ve created something within which you feel safe.”
If this sounds like you, Dr King has some tips to get you back on track.
1) Find joy in movement
It wasn’t long ago that the official guidelines for physical activity recommended exercise should consist of “continuous bouts lasting a minimum of ten minutes”.
But in recent years, an established body of research (and widespread public interest) has touted the benefits of high-intensity interval training (HIIT), where bursts of intense activity are interspersed with rest periods.
Dr King and his co-authors point to evidence suggesting HIIT can “provoke physiological adaptations that are similar, or even superior, to traditional endurance exercise training in healthy individuals, as well as those with lifestyle-induced cardio-metabolic disorders”.
Best of all, HIIT doesn’t require gym equipment, and seven minutes may be all you need.
For some, however, bursts of intense exercise may not be attractive or even suitable. In this case, Dr King suggests “exercise snacking”, which involves breaking up physical activity into several shorter bouts spread throughout the day.
It might be something as simple as standing up from your desk to stretch, or getting some fresh air and sunlight with a short walk around the block.
“The place to start is increasing that incidental type of exercise, because it doesn’t take much to get off your chair, walk up your stairs and come back down again,” he says.
“Almost any type of movement will make you feel good, and in some cases, a few short bouts a few times a day could be enough, particularly for those who are very sedentary.
“If all of a sudden you add 10 or 20 minutes of exercise into your day, over time that can build, hopefully for long enough for you to form a regular exercise habit and find some joy in it.”
2) Think about when you eat, not what you eat
It’s no secret that some of us have packed on the pounds during the pandemic. It’s also common knowledge that fad dieting simply doesn’t work.
Whether it’s the raw food diet, paleo, ketogenic or vegan, restrictive eating regimens generally don’t succeed in the long term.
“There are hundreds and hundreds of them, and exactly why so few people make any of these diets work is complex,” Dr King says.
“I think the key thing in a lot of our current research is moving away from trying to suddenly change people’s food choices, because a lot of it comes down to personality and behaviour.”
One method that is gaining traction is time-restricted eating (TRE), which involves only consuming food or drink within a specific time-window of 10 or 11 hours during the day.
Dr King’s paper recommends TRE as a practical strategy for curbing energy intake (during self-isolation and in normal circumstances) because of its simplicity.
“It’s gathered a huge amount of momentum in the last 10 years or so, and it’s very simple, because it’s just about ensuring you’re only eating in a nine or 10-hour window, and that’s often best between 10am and 7pm.”
As well as weight loss, research on time-restricted eating has revealed a range of positive health outcomes. It can regulate circadian rhythm, reduce the risk of chronic disease and lead to improved sleep and increased energy levels.
3) Get a good night’s shuteye
For some, sleep was one of the first things to suffer when the pandemic took hold.
The lifestyle changes that came as a result of home confinement, as well as the stresses of the global health crisis, meant people simply weren’t getting enough shuteye.
“Once sleep’s become disrupted, we know that that has metabolic consequences on its own,” he says. “But it can also affect other things like the timing and composition of what we eat, and that feeds back into doing less activity, and then that all comes full circle and disrupts our sleep.”
This is why a healthy routine and rhythm is so crucial, Dr King adds. He suggests that the key to good sleep begins the minute you wake up.
“Almost everything in our sleep-wake cycle is driven by lifestyle choices,” he says. “If you’re waking and going to sleep at a different time every day and night, or eating at different times, that’s going to have a knock-on effect.”
Increased exposure to daylight is useful, especially in the morning, so open up those shutters and blinds and get out there if you can. Dimming lights and minimising exposure to blue light from phones and tablets in the evening is crucial. And regular eating times and daily exercise can also be a huge help.
“These daily rhythms form the foundation of good health … they help us to form the types of habits that lead to healthier practices,” Dr King says.
“With any of these things — sleep or exercise or nutrition — it takes something to drive adherence. It can be hard, especially when there are so many other things going on, but in the end, I think it’s mainly about buy-in, simplifying choices and unlocking the potential inside all of us.”
Dr Andy King is a postdoctoral research fellow at ACU’s Mackillop Institute for Health Research. With a keen interest in exercise and nutrient interactions and athletic performance, Andy joined the institute in 2019 after supporting the Australian Institute of Sport in a research capacity.
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