Evaluation of socioecological factors on health behaviors and weight change during major life event: A cross‐sectional study using data collected during the COVID‐19 pandemic

Author:

Chui Tsz Kiu1ORCID,Cedillo Yenni E.1ORCID,El Zein Assil2,Pavela Gregory3,Caldwell Ann E.4,Peters John C.4,Friedman James E.1,DebRoy Swati5,Oslund Jennifer L.6,Das Sai Krupa7,Roberts Susan B.8,Hill James O.1ORCID,Sayer R. Drew2ORCID

Affiliation:

1. Department of Nutrition Sciences University of Alabama at Birmingham Birmingham Alabama USA

2. Department of Family and Community Medicine University of Alabama at Birmingham Birmingham Alabama USA

3. Department of Health Behavior University of Alabama at Birmingham Birmingham Alabama USA

4. Division of Endocrinology Metabolism & Diabetes University of Colorado Anschutz Medical Campus Aurora Colorado USA

5. Certara Drug Development Services Certara Princeton New Jersey USA

6. Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy Tufts University Boston Massachusetts USA

7. Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University Boston Massachusetts USA

8. Geisel School of Medicine Dartmouth College Hanover New Hampshire USA

Abstract

AbstractBackgroundSocioecological factors are associated with key health behaviors that are critical for weight management, and major life events may disrupt engagement in these behaviors. However, the influence of socioecological factors on health behaviors in the midst of major life events is not clear and is difficult to study due to the random and sporadic nature of their occurrence. The COVID‐19 pandemic provided a unique opportunity to study a major life event and its impacts on diet, physical activity, and body weight.ObjectiveThis cross‐sectional study aimed to investigate associations between socioecological factors (environmental, interpersonal, and individual) and self‐reported weight change during a major life event using data collected during the COVID‐19 pandemic, and whether the associations were mediated through self‐reported changes in eating and physical activity behaviors.MethodsParticipants self‐reported socioecological factors, weight change, and changes in eating behaviors (EB) and physical activity (PA) via online questionnaires between December 2020 and October 2021. Changes in EB and PA were measured using scales with higher scores reflecting more positive changes during the COVID‐19 pandemic.ResultsParticipants (n = 1283) were mostly female (84.9%) with age 52.1 ± 14.1 years (mean ± SD) and BMI of 32.9 ± 8.2 kg/m2. Stronger healthy eater and exercise identities (individual factors) were associated with higher EB scores (EBS) and PA scores (PAS), respectively (p's < 0.00001). Less discouragement for healthy eating by family/friends (interpersonal factor) was associated with higher EBS (p = 0.002). Higher EBS and PAS were associated with weight loss. The indirect effect of healthy eater identity (−0.72; 95% CI: −0.90, −0.55) and discouragement for diet (0.07; 95% CI: 0.03, 0.12) on weight change through EBS were significant, as was the indirect effect of exercise identity (−0.25; 95% CI: −0.35, −0.15) on weight change through PAS.ConclusionsStronger identities and less discouragement from family/friends may support health promoting behaviors and weight loss during a major life event, as well as identify additional behavioral targets for lifestyle interventions.Clinical Trial RegistrationIWCR was registered at ClinicalTrials.gov (NCT04907396).

Funder

Agricultural Research Service

National Institute of Diabetes and Digestive and Kidney Diseases

Publisher

Wiley

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