Changes in the clustering of unhealthy movement behaviors during the COVID-19 quarantine and the association with mental health indicators among Brazilian adults

Werneck, André O; Silva, Danilo R; Malta, Deborah C; Souza-Júnior, Paulo R B; Azevedo, Luiz O; Barros, Marilisa B A; Szwarcwald, Célia L

Our aim was to analyze the prevalence of unhealthy movement behavior clusters before and during the COVID-19 pandemic, as well as to investigate whether changes in the number of unhealthy behaviors during the COVID-19 pandemic quarantine were associated with mental health indicators. Data of 38,353 Brazilian adults from a nationwide behavior research were used. For movement behaviors, participants reported the frequency and duration of physical activity and daily time on TV viewing and computer/tablet use before and during the pandemic period. Participants also reported the frequency of loneliness, sadness (feeling sad, crestfallen, or depressed), and anxiety feelings (feeling worried, anxious, or nervous) during the pandemic period. Sex, age group, highest academic achievement, working status during quarantine, country region, and time adhering to the quarantine were used as correlates. We used descriptive statistics and logistic regression models for the data analysis. The prevalence of all movement behavior clusters increased during the COVID-19 pandemic. The cluster of all three unhealthy movement behaviors increased from 4.6% (95% confidence interval [CI]: 3.9–5.4) to 26.2% (95% CI: 24.8–27.7). Younger adults, people with higher academic achievement, not working or working at home, and those with higher time in quarantine presented higher clustering. People that increased one and two or three unhealthy movement behaviors were, respectively, more likely to present loneliness (odds ratio [OR] = 1.41 [95% CI: 1.21–1.65] and OR = 1.71 [95% CI: 1.42–2.07]), sadness (OR = 1.25 [95% CI: 1.06–1.48] and OR = 1.73 [95% CI: 1.42–2.10]), and anxiety (OR = 1.34 [95% CI: 1.13–1.57] and OR = 1.78 [95% CI: 1.46–2.17]) during the COVID-19 quarantine. Clustering of unhealthy movement behaviors substantially increased and was associated with poorer mental health during the COVID-19 pandemic.