How Will Our Bodies Change from Being Inside for Months?

According to multiple ads I’ve seen, we are in this thing together. “Together we will prevail,” the ads say. You lay there – alone, in a shirt stained with who can say what – and think: nothing. What is there to think? If you were going to have an interesting thought, you would’ve had it weeks ago. Better to wreck yourself with caffeine and awful snacks, is my take, which diverges somewhat from the advice in our latest Giz Asks – an investigation into what exactly this quarantine might be doing to our bodies, and how we might mitigate some of those effects.

Mark Tremblay

Professor of Medicine at the University of Ottawa and Senior Scientist at the CHEO Research Institute, whose research focuses on sedentary physiology, among other things

Two months indoors, or four months indoors, isn’t a long time in the course of a lifetime. If you’re a typically sedentary person who spends two months training for a 5k run, and then go back to your old ways afterwards, the time you spent training isn’t going to dramatically lower your risk of getting diseases in the future. It all depends on what your baseline is, and your propensity towards certain kinds of issues.

So can we say this lockdown is going to have a serious effect on chronic disease? Probably not, at least based on the timeline we currently have. But things are trending in the wrong direction. We are almost certainly facing a small acceleration in the kind of chronic disease development associated with a sedentary lifestyle. And there’s the possibility that some of these negative habits will outlast the virus – whether that’s going to bed later, engaging in less physical activity or spending more time looking at screens.

There are people who will use this as an opportunity to positively transform their life, because they now have some time available. But on a population level, I think you’re going to find increasing evidence published in the literature that questions the balance between disease prevention and health promotion. By being very cautious in order to prevent virus-contraction, are we reducing the overall health of the population? Beyond the adverse effects of staying indoors, alcohol sales are up 30 per cent to 40 per cent in Canada, which leads to increases in domestic abuse and many other negative outcomes.

Neville Owen

Senior Principal Research Fellow and Professor of Health Sciences at Swinburne University, whose research focuses on the negative health consequences of physical inactivity and sedentary behaviour

Diet and exercise are the two big-ticket issues that come to mind here. The worst-case  – and not uncommon – scenario is that we sit for most of our waking hours. Throw into this mix snacking on junk food, keeping up with work and family demands, being click-baited and otherwise distracted, and the reality is that sometimes we just don’t get around to being outdoors and physically active.

For us as individuals, maintaining good health is about meeting the challenge of sticking to the simple, tried and true things we know we need – having a routine of regular exercising and eating good quality food.

Too much sitting and too little exercise create a toxic mix that impacts and adversely on our metabolic health. Sugar and ultra-processed carbohydrates – especially those industrially-fabricated food-like substances that find their way into packaged, convenient, pre-prepared foods – travel far too quickly from our digestive tracts to our bloodstreams. Sugary drinks, carbonated beverages and (counter-intuitively for some) fruit juices, are major culprits; they are unnecessary and to be avoided.

Consuming sugary drinks and ultra-processed foods results in an excessively-rapid energy uptake, which leads to spikes in our blood glucose and an increased demand for insulin from our pancreas. And, this influences our general level of systemic inflammation, with adverse long-term consequences for most of our bodily organs, including our arteries, hearts, livers, kidneys and brains.

Furthermore, it is well known that years and years of poor diet quality, associated weight gain and physical inactivity can result in the pancreas no longer being able to do its main job well-enough: controlling our blood sugar levels. This, together with a reduced capacity of our muscles – which shrink in size and become much less efficient through inactivity – to metabolise blood glucose as a fuel, provides a double-whammy of risk for developing type 2 diabetes and heart disease.

So, what we can do to make a difference for our health is not always easy, but it is obvious these days. Put simply, we need to sit less and move more, and follow the clear consensus on what makes a healthy diet. Complex carbohydrates, as close as possible to the form in which they come from nature, are a key element of how we can better manage our metabolic health and avoid developing these diseases as we age.

I have five core behavioural and biological messages about what we can do to stay healthy during the Covid-19 lockdown and isolation: 1) sit less and move more; 2) do a minimum of 30 minutes of recreational physical activity or exercise every day (this can be accumulated across the day); 3) avoid sugary and ultra-processed foods and drinks; 4) find foods consistent with a mainly plant-based/Mediterranean eating pattern; 5) sit down to plates of food that are varied and colourful.

It’s important that we see this all in perspective: health and well-being in these unprecedented times is not just about ourselves as individuals. Of equal if not greater importance are the broader public-health and civic dimensions of life. We all have to do our best to be kind to ourselves as well as prudent in our selection of healthy choices. And, we also have to do our best to be socially responsible, personally considerate, helpful and friendly to other people. We need not only to look after ourselves as best we can, but also to look out for others and to have them look out for us.

Linda Pescatello

Distinguished Professor of Kinesiology and Developer and Instructor of the Exercise Prescription Online Graduate Certificate Program

It doesn’t matter if you’re inside or outside if you’re not practising healthy lifestyle behaviours. If you’re living unhealthily already, the lockdown might just expedite those tendencies, because you’re locked indoors with not a lot of things to do. Things could change substantially, even if you were living a relatively healthy life beforehand. You watch a lot more TV; you become less physically active; you eat more; you may drink more; you may watch the news too much, and get very stressed. All you have to do is turn on the radio or TV for acknowledgement that this is a very difficult time for people. But as long as you’re adhering to the public health recommendations of the CDC, and staying mindful of your health and safety, I think this is actually an opportunity to become as active – or more active – than you’ve ever been before. If you develop the right mindset, and can get outside, and the weather cooperates, then this might be a time where you can become more active and avoid being inside.

Obviously, gyms have been shut down, and exercise equipment is selling out, so we have to try to be creative. The good news is things are starting to open up, but we also have to be careful of people not abiding by the rules, especially if a person happens to be somewhat more at risk for contracting the virus.

Arch Mainous

Professor of Health Services Research, Management and Policy at the University of Florida

There is plenty of evidence to indicate that a sedentary lifestyle is associated with a variety of health risks. It isn’t just obesity as an outcome. In fact, even when people keep their weight at a healthy level, a sedentary lifestyle still increases their risk for both diabetes as well as cardiovascular disease. So if we are wondering what will happen to our bodies during a lockdown, I think that we need to look at what we are doing during that lockdown to guess at potential changes. If we don’t get any exercise during several months of staying at home it is highly likely that we will add fat, decrease our cardio-respiratory fitness, and decrease our lean muscle mass. Those changes don’t have to happen but everyone will have to be pretty proactive in making time for exercise and even being creative about how to exercise. With gyms closed, doing things at home like push-ups, jumping rope and things like callisthenics are options that may not be the usual go-to exercises, but they should work until you can get back out into a normal routine.

Ulf Ekelund

Professor, Physical Activity and Health, Norwegian School of Sport Sciences, Oslo, whose research focuses on the role of physical activity and sedentary behavior for preventing non-communicable diseases, among other things

Despite some creative examples of being physically active during the lockdown recently highlighted on social media, e.g. running a marathon in the flat or in the backyard, for most people being indoors is associated with reduced levels of physical activity. Data from commercial activity trackers comparing activity levels globally during the same week in March 2019 with that in March 2020 suggested a 7 per cent to 38 per cent decline in daily number of steps taken . While these data should be interpreted cautiously and cannot be generalised to the entire population, they indicate declining levels of physical activity due to social distancing measures put in place in almost every country.

Physical activity according to the physical activity guidelines recommended by the World Health Organization and many national health authorities states that adults should accumulate 150 to 300 minutes of moderate-intensity physical activity per week (such as brisk walking). Following these guidelines has acute and long-term health effects. Acutely, physical activity reduces blood pressure, improves the body’s ability to metabolise glucose and fats, reduces stress and improves general well-being. These effects usually last for 24 to 48 hours following an exercise session. Being sedentary and inside your home for long periods of time have the opposite effects with deteriorating metabolism, higher stress levels and higher blood pressure.

The long-term effects of physical activity include lower risk of premature mortality, and lower risk of developing cardio-vascular diseases, type 2 diabetes and many types of cancer. Regular physical activity also improves mental health, reduces the risk of falls and improves bone health. The latter is especially important for older individuals.

The effect of the lockdown on future public health is difficult to predict. However, one could speculate that for those individuals who currently are physically inactive, the detrimental effects on health may be worse than in those who are regularly physically active. Most countries are now slowly opening up, providing an exceptional opportunity for politicians to positively influence public health by facilitating a safe cycling and walking infrastructure and abandon motorised transport. If adopted, this will have multiple benefits – acute and long-term health effects for the individual, for the society and for the climate.

Jennifer Heisz

Associate Professor of Kinesiology and Associate Director of the Physical Activity Centre of Excellence at McMaster University

The pandemic is expected to amplify psychological distress, which can quickly deteriorate into mental illness, even in people without a prior diagnosis. In any given year, one in five people experience a mental illness. This year those numbers could climb much higher.

My team of researchers and I have shown that six weeks of chronic psychological stress can lead to symptoms of depression. We are well beyond that point in this pandemic and will likely see a surge in stress-induced mental illness that will only worsen as the pandemic continues and its timeline remains fluid and uncertain.

One of the most effective interventions to prevent stress-induced mental illness is exercise. However, physical distancing has created unique barriers to being physically active including abrupt closure of gyms and recreational facilities, coupled with limited access to public parks and trails.

With the closure of daycares and schools, parents face the added challenge of providing childcare during work hours, making it even more difficult to be sufficiently active for the maintenance of good health.

Thirty minutes of aerobic exercise three times weekly can boost mood, reduce psychological distress and decrease symptoms of depression and anxiety relative to those who are sedentary, though most people find it difficult to get recommended levels of activity under normal circumstances.

Anne McTiernan

Research Professor, Epidemiology, University of Washington

This all depends. In some areas, people are able to get outside for exercise and other essential activities. For people who are able to take the opportunity to exercise outdoors, they will benefit from sustained or even increased fitness. But even people who can’t get outside, it’s possible to keep moving and maintain fitness and health. There are many online fitness videos, podcasts and class available, many for free, that people can take advantage of. Or just keeping moving by taking stairs inside the house or apartment building, and doing strength exercises using the body’s own weight (like squats, lunges, push-ups).

One risk of staying at home more could be repetitive movement problems, like sitting at a computer, tablet or smartphone device. This can result in pain and even injuries. The best way to avoid this is to stand up and move around at least every hour.

Another risk of being inside more than usual is the lack of sunlight resulting in low vitamin D. Most people can keep their vitamin D levels in a healthy range with just a multivitamin.

Jill N. Barnes

Assistant Professor, Kinesiology, University of Wisconsin-Madison

After being inside for months, many people are going to experience detraining. This happens when we reduce our physical activity or exercise. Detraining results in a loss of muscle mass and strength, a decrease in fitness, and a decline in cardiovascular and metabolic function. Many of us are no longer commuting to work or school, running errands or attending social events and this means we are moving less. Overall, we have less physical activity, fewer steps, more screen time and an increase in the hours spent sitting compared to our “normal” routine. When this happens for a few days, there may not be a noticeable difference in how the body looks or feels, but now that we have been operating in this mode for months, these subtle changes have added up!

An increase in sitting or sedentary time is linked to an increased risk of cardio-metabolic diseases. Even if a person is performing regular exercise (current recommendations are at least 150 minutes/week of aerobic exercise at a moderate intensity), this does not necessarily offset the negative consequences of increased sitting time. The good news is that there is evidence that breaking up sitting time with “movement breaks” can minimise the negative effects. Research has shown that when prolonged periods of sitting are broken up by light activity (such as slow walking), the reduction in cardiovascular and metabolic function and blood vessel health was prevented. This means that for every hour of sitting or sedentary time one should move around for 5-10 minutes. This could be as simple as cleaning, doing housework, climbing stairs or dancing. These short movement breaks will add up throughout the day! In addition, if it possible and safe, a walk outside or in nature a few times per week can do wonders for the body and mind and help minimise the effects of sitting inside for too long.

Featured illustration: Elena Scotti (Photos: Getty Images, Shutterstock)