The Impact of the COVID-19 Pandemic Environment on Cardiometabolic Health

PROJECT SUMMARY RELEVANCE: The COVID-19 pandemic upended life in the United States through social distancing policies, such as remote work mandates, to halt the spread of the SARS-CoV-2 coronavirus. Weight gain and changes in physical activity, dietary intake, and other health behaviors related to cardio-metabolic conditions were reported during and immediately following the acute lockdown period. Two years after the acute lockdown period, nearly one-third of Americans continue to work remotely and understanding whether these early cardio- metabolic health changes persisted will have important implications for cardio-metabolic health in the decades to come. OBJECTIVES: To quantify the magnitude, modifying characteristics, and mechanisms associated with cardio-metabolic health changes in US adults >1 year after the post-acute lockdown period. DESIGN: We build on a high-quality community-based cohort study of ~140,000 adults, the American Cancer Society Cancer Prevention Study 3 (CPS-3). CPS-3 participants provided detailed health behavior, weight status, medical history, and socioeconomic data at triennial surveys since enrollment (2013). The 2021-22 survey supplements standard modules with information specifically designed to measure individual experiences of the pandemic environment such as changes to work and caregiving responsibilities. We will use geocodes to link individual data with measures of the severity of the local pandemic environment, measured by local policy restrictions, mobility reductions, and epidemiologic risks. We will examine the overall impact of the pandemic environment on weight status and cardio-metabolic health behaviors (dietary intake, physical activity, sedentary time, sleep patterns, tobacco use, and alcohol use). In AIM 1A, we will evaluate the impact of the pandemic environment on changes in weight status and cardio-metabolic health behaviors. In Aim 1B, we will identify population characteristics that modify the pandemic's impact on changes in cardio-metabolic health. In AIM 2, we will evaluate potential mechanisms linking the pandemic environment and weight status, with special emphasis on remote work policies. IMPACT: This national investigation with prospectively collected ata before and during the pandemic will provide insight into the cardio-metabolic health sequelae of the COVID-19 pandemic. As we move into the post-pandemic recovery phase, findings may inform policy decisions regarding continuation of remote work, as well as future priority areas and priority populations for cardio-metabolic health promotion.