DISCUSSION
Based on BMI, more than half of the enrolled athletes (59.5%) gained
weight during the lockdown from March to July 2020. Weight, height, BMI,
weight percentile, and weight-for-height Z score increased significantly
during that period. Weight gain among athletes can greatly affect their
performance. For many athletes across various sport disciplines there is
a direct causal connection between success and low body weight
[10] .
Contrary to the coach instructions, almost two thirds of the enrolled
athletes didn’t perform any home exercises. With further analysis
significantly more of those athletes who were not complaint to the home
exercise program gained weight during the pandemic lockdown. This result
comes in agreement with Zeigler and associates [11]
who reported lack of exercise as a risk factor for weight gain during
the COVID pandemic self-quarantine periods.
Lack of exercise and its related overweight problems can gravely impact
the immune system of those athletes. It has been mentioned that although
moderate-levels of exercise can boost overall immunity
[12], intensive and prolonged physical exertion has
been linked with an ‘open-window’ of impaired immunity up to 72 hours
after the exercise [13] . Nevertheless,
Campbell and Turner, [14] challenged the latter
theory and reinforced that it is a misconception to label any form of
acute exercise as immunosuppressive, and, instead, they stated that
exercise most likely improves immune competency across the lifespan.
Another hit to the immune system can come from the extra weight. In
addition to metabolic and cardiovascular obesity-related diseases,
recent evidence suggested that obesity might affect immune system
function [15] . From another perspective obesity was
linked to severity of COVID 19 infection among children in Canada
[16] and USA [17] . It is thus
clear that exercise is essential for boosting the immune system which is
greatly needed during pandemics not to mention the benefits of weight
control in this domain.
The mean sleep hours per day during the lockdown were 11.1 which is
within the appropriate sleeping hours of this age group as stated by the
American Academy of Sleep Medicine [18] . Although
sleeping hours were significantly higher among athletes who gained
weight and all of them had CHQS above 41, which reflected their
disturbed sleep pattern; the higher CHQS among the athletes who gained
weight didn’t reach statistical significance. The previous findings are
supported by the report of Jarrin and associates
[19] regarding the relation between disturbed sleep and weight
gain.
All participants reported screen time ranging between 4-10 hours/day and
played video games with an average time of 3.2 hours daily. Although
both screen time and its important element, which is video gaming, were
found increased among athletes who gained weight, these results didn’t
reach statistical significance. Goncalves and
collaborators, [20] reported that screen time is related to
obesity among children yet video gaming role is still inconclusive with
a promising role of exergame play as a tool for weight reduction
[21] .
Only 10 (27%) of our enrolled athletes had tics during the lockdown, 5
(13.5%) reported feeling unhealthy during the lockdown, and 9 (24.3%)
lost a family member during this particular period. Although these
points represent psychosocial stress and are among the non-chemical
stressors affecting childhood obesity [22] , this
wasn’t the case among our studied young athletes.
Although the participants’ mothers had a relatively high depression
score it correlated negatively with the increased BMI of the athletes.
On the other hand, the high anxiety score of mothers correlated
positively with the athletes increase in BMI. Although
Marshall and associates [23] reported that maternal
depression influences children’s weight and may increase risk of
obesity, Vehmeijer and associates [24] confirmed the
current study findings and reported that maternal anxiety was associated
with higher children BMI with no associations observed for maternal
depression.
The athletes mean QoL Score filled in March 2020 worsened significantly
compared to that of July 2020. The previous finding can be easily
interpreted in view of a latest publication by Ghosh and
collaborators, [25] . The latter authors reported that being
quarantined in homes and institutions may impose greater psychological
burden on children than the physical sufferings caused by the virus.
School closure, lack of outdoor activity, aberrant dietary and sleeping
habits are likely to disrupt children’s usual lifestyle and can
potentially promote monotony, distress, impatience, annoyance and varied
neuropsychiatric manifestations. Additionally, in the current study a
significant negative correlation was found between the increase in BMI
and the change of QoL from March to July 2020. QoL worsening with the
increase in BMI is due to the fact that children and adolescents with
obesity frequently report an impaired health-related quality of life
[26] , which can be defined as ‘the impact of health
or disease on physical, mental, and social well-being from the patient’s
point of view’ [27] .
In conclusion, the recent COVID 19 pandemic lockdown had both physical
and psychological effects on Egyptian young athletes with plausible
interrelations correlating them. Additionally, maternal psychological
status during these extreme measures has their reflections on the
children. Since athletes‘ performance is vulnerable to such effects,
they should be aware of the need for weight control when outdoors
physical activity is necessarily restricted by pandemic control and
preventive measures. Compliance to home exercising schedules with less
screen time and video gaming can be of crucial importance to them during
these extenuating circumstances. It is prudent to say that following all
these previous measures can have a positive effect on the athletes QoL.