During the first lockdown people were a good 40
percent less active, as shown by an international study led by Goethe University
Frankfurt. Psychological well-being sank as well; the portion of people at potential
risk for depression tripled. The authors fear long-term consequences and urge
that this be taken into account going forward.
scientists from 14 countries warn of a hidden “pandemic within the pandemic“ in
two current publications. On the one hand, physical activity levels have gone
down significantly, on the other hand, psychological well-being has suffered.
“Governments and those responsible for health systems should take our findings
seriously," emphasizes the author team, headed by Dr Jan Wilke from the
Institute for Sport Sciences at Goethe University Frankfurt.
About 15,000 people in participating
countries answered standardised questionaires as part of an international
survey. In April/May 2020, they reported physical activity levels (13,500
participants) as well as their mental and physical well-being (15,000
participants) before and during the pandemic-related restrictions.
Older individuals especially affected
“The results show drastic reductions in
physical activity and well-being," says Wilke. More than two thirds of those
questioned were unable to maintain their usual level of activity. Moderate exercise
decreased by an average of 41 percent according to self-reported data - this
includes anything that increases heart rate and breathing, such as brisk
walking, running, cycling or even strenuous gardening.
The proportion of vigorous exercise during
which people sweat and clearly run out of breath fell by a similar amount (42
percent). The effects were somewhat higher among professional athletes and
particularly active people, as well as comparatively young and old people. The
decline in activity was particularly noticeable among people over 70 years of
age, who were 56 to 67 percent less active than before. "We know that
physical inactivity, especially in older people, can lead to changes that are
difficult to reverse after only two weeks - for example, in body fat percentage
or insulin sensitivity," warn the study authors.
Exercise helps prevents disease and reduces mortality
The WHO recommends at least 150 minutes of
moderate or 75 minutes of intensive physical activity per week - 81 percent of
the study participants achieved this before the pandemic, but only 63 percent
during the lockdowns. Yet sufficient exercise can reduce mortality by up to 39
per cent, as a 2015 study showed. Data suggests that too little exercise plays
a role in about one in ten premature deaths, because physical activity reduces
the likelihood of, for example, high blood pressure, metabolic disorders such
as type 2 diabetes, and cancer.
Exercise is known to activate the immune
system because it promotes blood circulation and activates lymphocytes and
messenger substances (cytokines) that are important for immune defence. Studies
show that physically active people are less susceptible to influenza, rhino and
herpes viruses and respiratory infections in general. So it may be that
exercise also offers protection against severe COVID-19 by reducing risk
factors such as obesity. Physical health and exercise also reduce the risk of
mental health problems such as depression and anxiety disorders.
Mental well-being drastically reduced
In another part of the study, the team of
authors asked about mental well-being during the pandemic restrictions. 73
percent of the study participants stated that their well-being had
deteriorated. The perceived quality of life as measured by the WHO well-being
Index, which measures mood, relaxation, activity, rest and interest, dropped on
average from 68 percent before the pandemic to 52 percent during the first
Above all, people felt less "active
and full of energy" and led a life less "filled with interesting
things". The proportion of very low scores indicating a possible risk of depression
tripled from 15 to 45 percent. "These effects were stronger among women
and younger people, " the study says. "More attention should be paid
to the needs of women in particular, as they are significantly more
Nonetheless, 14 to 20 percent of the
respondents also stated that their health had improved - the authors see more
family time, greater work autonomy, fewer business trips or a changed
perception of health as possible reasons. "But a large part of the
population may still be suffering from barely visible health effects of the
pandemic," the team of authors warns.
This could also translate into rising
health costs: According to US data, the annual expenditure for inactive or
insufficiently active people increases by 1200 and 600 euros respectively -
this would add up to two to four million euros after one year just for the 3104
people from the survey who did not exercise enough during the lockdown.
The results of these first multinational
studies are likely to be relevant for an estimated four billion people
worldwide who were affected by the restrictions of the first coronavirus wave
in the spring of 2020. However, the data was predominantly collected through
electronic media, so populations without internet were not included. Also, no
differentiation was made according to factors such as living environment,
education and social status. In addition, the data is based on
self-assessments, not measurements, which may distort retrospective perceptions
in particular. "Nevertheless, our results show that the issues of physical
activity and well-being belong on the policy agenda," Wilke emphasises.
"Governmental and health-related
decison-makers need to develop strategies to mitigate the loss of physical
activity," write the authors. They suggest better public education,
creating exercise opportunities with a low likelihood of infection, or offering
effective home exercise programmes. Among numerous other health facets, this
would have a particularly positive effect on mental well-being.
Negative effects similar to those observed
in these studies should be avoided at all costs in future pandemics.
"Unfortunately, physical activity and exercise do not have a strong lobby
and are usually neglected in public discourse," says Wilke. "Yet they
can greatly help us to better cope with the pandemic."
Jan Wilke et al. A Pandemic within the Pandemic? Physical Activity Levels Substantially
Decreased in Countries Affected by COVID-19. Int. J. Environ. Res. Public
Health, Vol. 18, 5 (2021), https://www.mdpi.com/1660-4601/18/5/2235/htm#B11-ijerph-18-02235
Jan Wilke et al., Drastic Reductions in Mental Well-Being Observed Globally During the
COVID-19 Pandemic: Results from the ASAP Survey. Front. Med. 8:578959
Dr Jan Wilke
Institute für Sport Sciences
Goethe University Frankfurt
Tel. +49 (69) 798-24588,
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