Article Text
Abstract
Background Existing research reports significant changes in lifestyle and behavioral habits during the COVID-19 pandemic, particularly in the context of first-ever large-scale global lockdowns. Yet, results are largely heterogeneous across populations and settings, motivating a better understanding of factors and contexts that can help safeguard well-being during health emergencies. This study examined self-reported changes in lifestyle and behavioral habits in Lebanon during the first countrywide COVID-19 lockdown, with the aim of contextualizing these changes in relation to mental health and outbreak- and lockdown-related factors.
Methods A cross-sectional web survey (May-June 2020) assessed changes in smoking, alcohol consumption, diet, eating habits, physical activity, sleep, social media use, and self-rated health. We examined the relationship of these changes with depressive (Patient Health Questionnaire (PHQ-9) and anxiety (Generalized Anxiety Disorder (GAD-7)) symptoms, outbreak-related worries, and lockdown-related factors (extent of adherence to lockdown and daily life difficulties experienced during lockdown) using logistic regressions models adjusted for sociodemographic indicators.
Results Among 494 participants with complete data (mean age 36.2±11.3, 70.4% women), the most prevalent changes were increased time spent on social media (63.2%), decreased physical activity (53.4%), increased eating (35.8%), and lower sleep satisfaction (34.6%). Least reported changes were for smoking (9.9%), alcohol consumption (11.7%), and self-rated health (15.2%). Higher depressive and anxiety symptoms were related to worsening of all lifestyle and health behaviors. Participants with higher outbreak-related worries had less healthy diet (OR=1.13,95% CI=1.00,1.27), poorer self-rated health (OR=0.87,95% CI= 0.75,1.02), and increased time spent on social media (OR=1.20,95% CI=1.06,1.35). Higher levels of daily life difficulties during the lockdown were related to worsening in smoking (OR=1.16,95% CI=1.02,1.31), physical activity (OR=1.19,95% CI=1.07,1.32), healthy eating (OR=1.18,95% CI=1.08,1.30), time spent on social media (OR=1.17,95% CI=1.07,1.29), sleep (OR=1.22,95% CI=1.11,1.35), and self-rated health (OR=1.24,95% CI=1.11,1.39). Higher adherence to lockdown was significantly associated with positive changes (lower alcohol consumption, healthier diet, and better self-rated health) but was also associated with increased social media time and lower sleep satisfaction.
Conclusion In this Lebanese sample, we found considerable negative changes in lifestyle and health behaviors during the first COVID-19 lockdown, particularly in social media use, physical activity, eating habits, and sleep. Results indicate important clustering of negative changes with higher mental health and lockdown-related daily life difficulties, suggesting an intricate and widespread impact on health and well-being. Higher lockdown adherence was associated with positive changes, highlighting a potentially important role for active engagement in lessening the burden of response measures.