PaLS Study: How Has the COVID-19 Pandemic Influenced Physical Activity and Nutrition? Observations a Year after the Outbreak of the Pandemic
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design and Selection of Study Subjects
2.2. Construction of the Questionnaire
2.2.1. IPAQ-SF and Dietary Habits
2.2.2. Self-Assessment Question
2.3. Data Analysis
3. Results
3.1. Sociodemographic Characteristics and BMI Index
3.2. Results from International Physical Activity Questionnaire—Short Form
3.3. Dietary Habits Results
3.4. Results of Self-Opinion Questions
3.4.1. Results of Self-Opinion Question on Physical Activity
3.4.2. Results of Self-Opinion Question on Dietary Habits
3.5. Correlations
3.6. Summary of Differences in Results between Medical and Non-Medical Students
4. Discussion
5. Conclusions
6. Limitations
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Regulation of the Minister of Health 1 of 20 March 2020 on the Declaration of an Epidemic in the Territory of the Republic of Poland. Available online: https://dziennikustaw.gov.pl/D2020000049101.pdf (accessed on 2 August 2021).
- Chu, D.K.; Akl, E.A.; Duda, S.; Solo, K.; Yaacoub, S.; Schunemann, H.J. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: A systematic review and meta-analysis. Lancet 2020, 395, 1973–1987. [Google Scholar] [CrossRef]
- Khanna, R.C.; Cicinelli, M.V.; Gilbert, S.S.; Honavar, S.G.; Murthy, G.V. COVID-19 pandemic: Lessons learned and future directions. Indian J. Ophthalmol. 2020, 68, 703–710. [Google Scholar] [CrossRef]
- Mattioli, A.V.; Sciomer, S.; Cocchi, C.; Maffei, S.; Gallina, S. Quarantine during COVID-19 outbreak: Changes in diet and physical activity increase the risk of cardiovascular disease. Nutr. Metab. Cardiovasc. Dis. 2020, 30, 1409–1417. [Google Scholar] [CrossRef]
- King, A.J.; Burke, L.M.; Halson, S.L.; Hawley, J.A. The Challenge of Maintaining Metabolic Health During a Global Pandemic. Sports Med. 2020, 50, 1233–1241. [Google Scholar] [CrossRef]
- Hossain, M.M.; Sultana, A.; Purohit, N. Mental health outcomes of quarantine and isolation for infection prevention: A systematic umbrella review of the global evidence. Epidemiol. Health 2020, 42, e2020038. [Google Scholar] [CrossRef]
- Magdalena Górnicka, M.E.D.; Zielinska, M.A.; Hamułka, J. Dietary and lifestyle changes during COVID-19 and the subsequent lockdowns among polish adults: A cross-sectional online survey PLifeCOVID-19 study. Nutrients 2020, 12, 2324. [Google Scholar] [CrossRef] [PubMed]
- Gjaka, M.; Feka, K.; Bianco, A.; Tishukaj, F.; Giustino, V.; Parroco, A.M.; Palma, A.; Battaglia, G. The Effect of COVID-19 Lockdown Measures on Physical Activity Levels and Sedentary Behaviour in a Relatively Young Population Living in Kosovo. J. Clin. Med. 2021, 10, 763. [Google Scholar] [CrossRef]
- Ammar, A.; Brach, M.; Trabelsi, K.; Chtourou, H.; Boukhris, O.; Masmoudi, L.; Bouaziz, B.; Bentlage, E.; How, D.; Ahmed, M.; et al. Efects of COVID-19 Home Confinement on Eating Behaviour and Physical Activity: Results of the ECLB-COVID19 International Online Survey. Nutrients 2020, 12, 1583. [Google Scholar] [CrossRef]
- Opez-Valenciano, A.; Suarez-Iglesias, D.; Sanchez-Lastra, M.A.; Ayan, C. Impact of COVID-19 pandemic on university students’ physical activity levels: An early systematic review. Front. Psychol. 2020, 11, 624567. [Google Scholar] [CrossRef]
- Luciano, F.; Cenacchi, V.; Vegro, V.; Pavei, G. COVID-19 lockdown: Physical activity, sedentary behaviour and sleep in Italian medicine students. Eur. J. Sport Sci. 2020, 6, 1–10. [Google Scholar] [CrossRef] [PubMed]
- Błaszczyk-Bębenek, E.; Jagielski, P.; Bolesławska, I.; Jagielska, A.; Nitsch-Osuch, A.; Kawalec, P. Nutrition Behaviors in Polish Adults before and during COVID-19 Lockdown. Nutrients 2020, 12, 3084. [Google Scholar] [CrossRef] [PubMed]
- Robinson, E.; Boyland, E.; Chisholm, A.; Harrold, J.; Maloney, N.G.; Marty, L.; Mead, B.R.; Noonan, R.; Hardman, C.A. Obesity, eating behavior and physical activity during COVID-19 lockdown: A study of UK adults. Appetite 2021, 156, 104853. [Google Scholar] [CrossRef]
- Barrington, W.E.; Beresford, S.A.; McGregor, B.A.; White, E. Perceived stress and eating behaviors by sex, obesity status, and stress vulnerability: Findings from the vitamins and lifestyle (VITAL) study. J. Acad. Nutr. Diet. 2014, 114, 1791–1799. [Google Scholar] [CrossRef] [Green Version]
- Cotter, E.W.; Kelly, N.R. Stress-related eating, mindfulness, and obesity. Health Psychol. 2018, 37, 516–525. [Google Scholar] [CrossRef]
- Antonopoulou, M.M.; Maria, M.; Serdari, A.; Bonotis, K.; Vasios, G.; Pavlidou, E.; Trifonos, C. Evaluating Mediterranean diet adherence in university student populations: Does this dietary pattern affect students’ academic performance and mental health? Int. J. Health Plann. Manag. 2020, 35, 5–21. [Google Scholar] [CrossRef] [PubMed]
- Suliga, E.; Ciesla, E.; Michel, S.; Kaducakova, H.; Martin, T.; Sliwinski, G.; Braun, A.; Izova, M.; Lehotska, M.; Koziel, D.; et al. Diet Quality Compared to the Nutritional Knowledge of Polish, German, and Slovakian University Students-Preliminary Research. Int. J. Environ. Res. Public Health 2020, 17, 9062. [Google Scholar] [CrossRef]
- Morinaka, T.; Wozniewicz, M.; Jeszka, J.; Bajerska, J.; Nowaczyk, P.; Sone, Y. Westernization of dietary patterns among young Japanese and Polish females—A comparison study. Ann. Agric. Environ. Med. 2013, 20, 122–130. [Google Scholar]
- Likus, W.; Milka, D.; Bajor, G.; Jachacz-Lopata, M.; Dorzak, B. Dietary habits and physical activity in students from the Medical University of Silesia in Poland. Rocz. Panstw. Zakl. Hig. 2013, 64, 317–324. [Google Scholar]
- Aceijas, C.W.; Waldhäusl, S.; Lambert, N.; Cassar, S.; Bello-Corassa, R. Determinants of health-related lifestyles among university students. Perspect. Public Health 2017, 137, 227–236. [Google Scholar] [CrossRef] [PubMed]
- Grasdalsmoen, M.; Eriksen, H.R.; Lonning, K.J.; Sivertsen, B. Physical exercise and body-mass index in young adults: A national survey of Norwegian university students. BMC Public Health 2019, 19, 1354. [Google Scholar] [CrossRef]
- Budzynski-Seymour, E.C.; Conway, R.; Wade, M.; Lucas, A.; Jones, M.; Mann, S.; Steele, J. Physical activity, mental and personal well-being, social isolation, and perceptions of academic attainment and employability in university students: The scottish and british active students surveys. J. Phys. Act. Health 2020, 17, 610–620. [Google Scholar] [CrossRef]
- Warburton, D.E.R.; Bredin, S.S.D. Health benefits of physical activity: A systematic review of current systematic reviews. Curr. Opin. Cardiol. 2017, 32, 541–556. [Google Scholar] [CrossRef] [PubMed]
- Galbete, C.; Schwingshackl, L.; Schwedhelm, C.; Boeing, H.; Schulze, M.B. Evaluating Mediterranean diet and risk of chronic disease in cohort studies: An umbrella review of meta-analyses. Eur. J. Epidemiol. 2018, 33, 909–931. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Fiona Bull, J.W.; Baltag, V.; Bucagu, M.; Butchart, A.; Chowdhary, N.; Guthold, R.; Hämäläinen, R.-M.; Ilbawi, A.; Khan, W.; Lee, L.; et al. WHO Guidelines on Physical Activity and Sedentary Behaviour. 2020. Available online: https://www.who.int/publications/i/item/9789240015128 (accessed on 2 August 2021).
- Tabish, S.A. Lifestyle diseases: Consequences, characteristics, causes and control. J. Cardiol. Curr. Res. 2017, 9, 000326. [Google Scholar]
- Schlesinger, S.; Neuenschwander, M.; Ballon, A.; Nöthlings, U.; Barbaresko, J. Adherence to healthy lifestyles and incidence of diabetes and mortality among individuals with diabetes: A systematic review and meta-analysis of prospective studies. J. Epidemiol. Community Health 2020, 74, 481–487. [Google Scholar] [CrossRef]
- Nyberg, S.T.; Singh-Manoux, A.; Pentti, J.; Madsen, I.E.H.; Sabia, S.; Alfredsson, L.; Bjorner, J.B.; Borritz, M.; Burr, H.; Goldberg, M.; et al. Association of healthy lifestyle with years lived without major chronic diseases. JAMA Intern. Med. 2020, 180, 760–768. [Google Scholar] [CrossRef] [Green Version]
- Hamer, M.K.; Kivimäki, M.; Gale, C.R.; Batty, G.D. Lifestyle risk factors, inflammatory mechanisms, and COVID-19 hospitalization: A community-based cohort study of 387,109 adults in UK. Brain Behav. Immun. 2020, 87, 184–187. [Google Scholar] [CrossRef]
- Finkelstein, E.A.; Khavjou, O.A.; Thompson, H.; Trogdon, J.G.; Pan, L.; Sherry, B.; Dietz, W. Obesity and severe obesity forecasts through 2030. Am. J. Prev. Med. 2012, 42, 563–570. [Google Scholar] [CrossRef]
- Nina Roth, C.K.; Afezolli, M.; Casals Alis, J.M.; Basilisian, M.; Bagyrova, B.; Wagner, F.; Kolomiets, N.; van Havere, R.J.L.; Filipovic-Hadziomeragic, A.; Jusupovic, F.; et al. Food Based Dietary Guidelines in the WHO European Region, in WHO Regional Office for Europe; World Health Organization: Geneva, Switzerland, 2003; p. 5. [Google Scholar]
- Zatonska, K.; Psikus, P.; Basiak-Rasala, A.; Stepnicka, Z.; Gawel-Dabrowska, D.; Wolyniec, M.; Gibka, J.; Szuba, A.; Poltyn-Zaradna, K. Obesity and chosen non-communicable diseases in pure Poland cohort study. Int. J. Environ. Res. Public Health 2021, 18, 2701. [Google Scholar] [CrossRef]
- Guthold, R.; Stevens, G.A.; Riley, L.M.; Bull, F.C. Worldwide trends in insufficient physical activity from 2001 to 2016: A pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet Glob. Health 2018, 6, e1077–e1086. [Google Scholar] [CrossRef] [Green Version]
- Lee, P.H.; Macfarlane, D.J.; Lam, T.H.; Stewart, S.M. Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF): A systematic review. Int. J. Behav. Nutr. Phys. Act. 2011, 8, 115. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- National Center for Nutritional Education- Healthy Eating Recommendations. Available online: https://ncez.pzh.gov.pl/abc-zywienia/talerz-zdrowego-zywienia/ (accessed on 3 August 2021).
- IPAQ Scoring Protocole. Available online: https://sites.google.com/site/theipaq/scoring-protocol (accessed on 3 August 2021).
- Byrne, N.M.; Hills, A.P.; Hunter, G.R.; Weinsier, R.L.; Schutz, Y. Metabolic equivalent: One size does not fit all. J. Appl. Physiol. 2005, 99, 1112–1119. [Google Scholar] [CrossRef] [Green Version]
- Kokko, S.; Martin, L.; Geidne, S.; Van Hoye, A.; Lane, A.; Meganck, J.; Scheerder, J.; Seghers, J. Does sports club participation contribute to physical activity among children and adolescents? A comparison across six European countries. Scand. J. Public Health 2019, 47, 851–858. [Google Scholar] [CrossRef] [PubMed]
- He, F.J.; Nowson, C.A.; Lucas, M.; MacGregor, G.A. Increased consumption of fruit and vegetables is related to a reduced risk of coronary heart disease: Meta-analysis of cohort studies. J. Hum. Hipertens. 2007, 21, 717–728. [Google Scholar] [CrossRef] [Green Version]
- Crowe, F.L.R.; Roddam, A.W.; Key, T.J.; Appleby, P.N.; Overvad, K.; Jakobsen, M.U.; Tjonneland, A.; Hansen, L.; Boeing, H.; Weikert, C.; et al. Fruit and vegetable intake and mortality from ischaemic heart disease: Results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study. Eur. Heart J. 2011, 32, 1235–1243. [Google Scholar] [CrossRef] [Green Version]
- Butler, M.J.; Barrientos, R.M. The impact of nutrition on COVID-19 susceptibility and long-term consequences. Brain Behav. Immun. 2020, 87, 53–54. [Google Scholar] [CrossRef] [PubMed]
- Kłosiewicz-Latoszek, L.; Szostak, W.B.; Podolec, P.; Kopeć, G.; Pająk, A.; Kozek, E.; Naruszewicz, M.; Stańczyk, J.; Opala, G.; Windak, A.; et al. Epidemiology and prevention Polish Forum for Prevention Guidelines on Diet. Pol. Heart J. 2008, 66, 812–814. [Google Scholar]
- Perk, J.; De Backer, G.; Gohlke, H.; Graham, I.; Reiner, Z.; Verschuren, M.; Albus, C.; Benlian, P.; Boysen, G.; Cifkova, R.; et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur. Heart J. 2012, 33, 1635–1701. [Google Scholar]
- McGuire, S.; U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2010, 7th ed.; U.S. Government Printing Office: Washington, DC, USA, 2011; Volume 2, pp. 293–294.
- Stelmach-Mardas, M.; Kleiser, C.; Uzhova, I.; Penalvo, J.L.; La Torre, G.; Palys, W.; Lojko, D.; Nimptsch, K.; Suwalska, A.; Linseisen, J.; et al. Seasonality of food groups and total energy intake: A systematic review and meta-analysis. Eur. J. Clin. Nutr. 2016, 70, 700–708. [Google Scholar] [CrossRef]
- Rosi, A.; Paolella, G.; Biasini, B.; Scazzina, F. Dietary habits of adolescents living in North America, Europe or Oceania: A review on fruit, vegetable and legume consumption, sodium intake, and adherence to the Mediterranean Diet. Nutr. Metab. Cardiovasc. Dis. 2019, 29, 544–560. [Google Scholar] [CrossRef]
- Sidor, A.; Rzymski, P. Dietary choices and habits during COVID-19 lockdown: Experience from Poland. Nutrients 2020, 12, 1657. [Google Scholar] [CrossRef]
- Hill, J.O.; Wyatt, H.R.; Peters, J.C. Energy balance and obesity. Circulation 2012, 126, 126–132. [Google Scholar] [CrossRef]
- Oyeyemi, A.L.; Muhammed, S.; Oyeyemi, A.Y.; Adegoke, B.O. Patterns of objectively assessed physical activity and sedentary time: Are Nigerian health professional students complying with public health guidelines? PLoS ONE 2017, 12, e0190124. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kwan, M.Y.; Cairney, J.; Faulkner, G.E.; Pullenayegum, E.E. Physical activity and other health-risk behaviors during the transition into early adulthood: A longitudinal cohort study. Am. J. Prev. Med. 2012, 42, 14–20. [Google Scholar] [CrossRef]
- Chen, P.; Mao, L.; Nassis, G.P.; Harmer, P.; Ainsworth, B.E.; Li, F. Coronavirus disease (COVID-19): The need to maintain regular physical activity while taking precautions. J. Sport Health Sci. 2020, 9, 103–104. [Google Scholar] [CrossRef]
- Office, C.S. Higher Education in the 2020/2021 Academic Year (Preliminary Results). 2021. Available online: https://stat.gov.pl/obszary-tematyczne/edukacja/edukacja/szkolnictwo-wyzsze-w-roku-akademickim-20202021-wyniki-wstepne,8,7.html (accessed on 2 August 2021).
- Burzynska, J.; Bartosiewicz, A.; Rekas, M. The social life of COVID-19: Early insights from social media monitoring data collected in Poland. Health Inform. J. 2020, 26, 3056–3065. [Google Scholar] [CrossRef]
Variables | Number | % | |
---|---|---|---|
Sample | Participants Female Male Did not specify gender | 1323 1021 297 5 | 100 77.17 22.45 0.38 |
BMI category | Underweight (BMI < 18.5 kg/m2) Normal weight (BMI 18.5–25 kg/m2) Overweight (BMI 25–30 kg/m2) Obese (BMI ≤ 30 kg/m2) | 154 927 188 54 | 11.64 70.07 14.21 4.08 |
University | MUS NMUS | 630 693 | 47.62 52.38 |
Year of study | 1st 2nd 3rd 4th 5th 6th | 442 241 207 207 177 49 | 33.4 18.22 15.65 15.65 13.38 3.7 |
Type of Activity | Females | Males | Total | |
---|---|---|---|---|
VPA | Days/week Min/week MET/week | 1.81 ± 1.75 71.06 ± 101.59 565.19 ± 812.7 | 2.06 ± 1.88 112.48 ± 161.63 899.85 ± 1293.07 | 1.87 ± 1.78 80.49 ± 119.11 640.6 ± 952.86 |
MPA | Days/week Min/week MET/week | 2.14 ± 1.81 72.53 ± 93.44 290.12 ± 373.77 | 2.31 ± 2.01 106.99 ± 162.67 427.97 ± 650.7 | 2.18 ± 1.86 80.3 ± 113.73 321.18 ± 454.92 |
Walking | Days/week Min/week MET/week | 4.07 ± 2.15 157.79 ± 174.39 520.72 ± 575.46 | 4.08 ± 2.17 180.16 ± 215.02 594.52 ± 709.58 | 4.07 ± x 162.83 ± 184.56 537.35 ± 609.05 |
All PA | Days/week Min/week MET/week | 8.02 ± 4.33 300.97 ± 276.03 1376.03 ± 1376.03 | 8.44 ± 4.81 399.63 ± 447.47 1922.35 ± 2221.36 | 8.11 ± 4.44 323.20 ± 325.33 1499.14 ± 1579.21 |
Sitting time | Min/week | 559.2 ± 196.2 | 561 ± 191.4 | 559.2 ± 194.4 |
Group of Students | Low | Moderate | High |
---|---|---|---|
Males: MUS | 18 (17.65%) | 54 (52.94%) | 30 (29.41%) |
Males: NMUS | 58 (29.74%) | 78 (40.00%) | 59 (30.26%) |
Females: MUS | 161 (32.59%) | 226 (45.75%) | 107 (21.66%) |
Females: NMUS | 123 (23.34%) | 280 (53.13%) | 124 (23.53%) |
Did not specify gender | 0 (0%) | 4 (80%) | 1 (20%) |
Total | 360 (27.21%) | 642 (48.53%) | 324 (24.26%) |
Once a Week or Less Often (%) | 2–3 Times Per Week (%) | Majority of Days within a Week (%) | Everyday (%) | |
---|---|---|---|---|
Consuming more meals per day than before the pandemic (including snacking): | 42.86 | 26.98 | 22.68 | 7.48 |
Consuming less than 3 servings of wholegrain products daily (less than 90 g/day): | 40.8 | 27.7 | 22.4 | 9.2 |
Consuming less than 400 g vegetables and fruits: | 34.0 | 30.5 | 22.7 | 12.8 |
Consuming less than 2 glasses of unsweetened milk or other dairy products daily: | 38.9 | 24.8 | 19.7 | 16.7 |
Consuming products containing processed meat, such as sausages, ham, frankfurters, etc.: | 43.5 | 27.7 | 19.1 | 9.8 |
Replacing meat with protein-rich plant products such as nuts and legumes: beans, chickpeas, soy, lentils, fava beans, peas: | 51.9 | 21.5 | 15.4 | 11.2 |
Consuming products that are sources of animal fats or trans fatty acids present in products, such as pastries, candy bars, salty snacks, and fast-food products: | 31.6 | 36.9 | 22.1 | 9.5 |
Consuming products that are sources of unsaturated fatty acids, such as canola oil, olive oil, or fish: | 20.1 | 38.0 | 29.2 | 12.7 |
Drinking sweetened beverages or fruit juices instead of water: | 20.1 | 38.0 | 29.2 | 12.7 |
Adding salt to meals: | 41.5 | 24.3 | 20.0 | 14.3 |
Consuming meals while looking at the screen of a TV, computer, or other device: | 9.6 | 17.0 | 34.2 | 39.2 |
Paying attention to labels of chosen products during shopping, taking into account ingredients, amount of calories, etc. | 36.5 | 20.4 | 23.0 | 20.1 |
Type of Variable | Higher BMI | Studying at MU | Lower Score in PA Self-Opinion Question |
---|---|---|---|
Lower level of PA | p = 0.017 | - | p < 0.001; r = 0.4; Rho = 0.435 |
Higher level of PA | - | p = 0.014 | - |
Consumption of more meals before pandemic per day | p < 0.001 | - | - |
Higher consumption of animal fats or trans fatty acids | p = 0.003 | - | - |
More frequent replacement of water with sweetened beverages or fruit juices | p = 0.014 | - | - |
More frequent attention paid to labels of products and their caloric intake | - | p < 0.001; OR = 1.784; 95%Cl = 1.432–2.222 | - |
Less frequent consumption of processed meat products | - | p < 0.001; OR = 0.544; 95%Cl = 0.426–0.695 | - |
Less frequent consumption of animal fats and trans fatty acid sources | - | p = 0.007; OR = 0.727; 95%Cl = 0.575–0.919 | - |
More frequent replacements of animal protein sources with plant-based equivalents | - | p < 0.001; OR = 1.736; 95%Cl = 1.357–2.221 | - |
Less frequent drinking of sweetened beverages or fruit juices instead of water | - | p < 0.001; OR = 0.331; 95%Cl = 0.24–0.455 | - |
Less frequent consumption of less than 400 g vegetables and fruits per day | - | p = 0.019; OR = 0.763; 95%Cl = 0.608–0.957 | - |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Jodczyk, A.M.; Gruba, G.; Sikora, Z.; Kasiak, P.S.; Gębarowska, J.; Adamczyk, N.; Mamcarz, A.; Śliż, D. PaLS Study: How Has the COVID-19 Pandemic Influenced Physical Activity and Nutrition? Observations a Year after the Outbreak of the Pandemic. Int. J. Environ. Res. Public Health 2021, 18, 9632. https://doi.org/10.3390/ijerph18189632
Jodczyk AM, Gruba G, Sikora Z, Kasiak PS, Gębarowska J, Adamczyk N, Mamcarz A, Śliż D. PaLS Study: How Has the COVID-19 Pandemic Influenced Physical Activity and Nutrition? Observations a Year after the Outbreak of the Pandemic. International Journal of Environmental Research and Public Health. 2021; 18(18):9632. https://doi.org/10.3390/ijerph18189632
Chicago/Turabian StyleJodczyk, Alicja Monika, Grzegorz Gruba, Zuzanna Sikora, Przemysław Seweryn Kasiak, Joanna Gębarowska, Natalia Adamczyk, Artur Mamcarz, and Daniel Śliż. 2021. "PaLS Study: How Has the COVID-19 Pandemic Influenced Physical Activity and Nutrition? Observations a Year after the Outbreak of the Pandemic" International Journal of Environmental Research and Public Health 18, no. 18: 9632. https://doi.org/10.3390/ijerph18189632