The COVID-19 epidemic has become a pandemic and a global health threat. Within a year of the outbreak, COVID-19 infected over 120 million persons worldwide, with more than 2,671,764 confirmed deaths [1]. In Israel, according to the last update of the Israel Ministry of Health (March 17, 2021, 08:49 AM) [2], a total of 823,314 had tested positive, and 6051 deaths occurred [2]. The sudden and rapid spread of the COVID-19 pandemic has shattered the normality of daily life worldwide, and will surely have a long-term impact. On March 15th, 2020, a lockdown was imposed throughout the country. The entire K-12 education system and many jobs transitioned to online. Public places, restaurants, gyms, theaters, community centers, parks, and businesses were shut down to ensure social distancing, limit the movement of the population, and mitigate the effect of the pandemic. People could leave their home only if they were required as essential workers or needed to carry out necessary activities such as purchasing medicines or food. Although this strategy was reported to be efficient for containing the COVID-19 outbreak, the quarantine was also reported as being associated with harmful implications to society.
Lockdown is usually a debilitating experience. The loss of freedom, financial cost, uncertainty over disease status, separation from loved ones, boredom, frustration, and inadequate information may create dramatic harmful effects [3]. Negative outcomes, such as suicide [4], the generation of substantial anger [5], as well as an increase in violence and aggressiveness within the family [6], are just a few examples that have been recorded. Results of a review [3] of 24 articles concerning the short- and the long-term impact of quarantine on psychological well-being, demonstrated that prolonged self-isolation has a negative impact on psychological responses, promoting post-traumatic stress symptoms, confusion, and anger. In addition, quarantine might lead to physical inactivity, which should be of major concern as a great deal of evidence has shown that lack of physical activity (PA) contributes to adverse health changes, such as affecting the immune system [7,8,9], depression [10], obesity [11], and sleeping problems [12]. Therefore, the potential benefits of a mandatory mass lockdown need to be weighed carefully against the possible psychological costs [3].
Within several months into the pandemic, a myriad of research had already been conducted in many countries regarding its implications on various aspects related to health and lifestyle. Meyer et al. [13], for example, conducted a cross-sectional study with 3052 US adults from all 50 states. Participants self-reported pre- and post-COVID-19 levels of moderate and vigorous PA, mental health and social aspects. Findings showed that PA was lower post-COVID among participants reporting being previously active, but largely unchanged among previously inactive participants. Lack of PA was associated with worsening mental health. Rhodes et al. [14] examined weekly moderate to vigorous physical activity (MVPA) frequency and duration of pre and post COVID-19 restrictions among 1055 Canadian participants aged 18+ years, and related psychosocial and environmental factors. Their findings revealed that participants had decreased weekly MVPA. Maher et al. [15] reported similar results among college students. They found that total minutes of PA were positively associated with positive affect before and during COVID-19 stay-at-home orders. Werneck et al. [16] focused their research on the association between depression and changes in PA and diet behaviors among 41,923 Brazilian adults. Their findings showed participants with a previous diagnosis of depression were at risk for incidence of unhealthy diet behaviors. Wang et al. [17] explored how COVID-19 affected the health-related quality of life (QoL) among 2289 Chinese adults who had been isolated at home for an average of 77 days. More than 50% of the respondents reported that their time engaged in daily PA decreased. During home isolation, 75.2% of the adults rated their sleep quality as very good, and 65% reported that they were satisfied with their QoL.
In Israel, research has also been conducted regarding the relationship between PA and health behavior during the period of The COVID-19 pandemic [e.g., 18, 19, 20]. For example, Dor-Haim and his colleagues [18] surveyed 1202 trainees who exercised on a regular basis. They found that 70% trained less during the pandemic period, and 55% gained weight with an average increase of 1.2 kg. However, those who exhibited a higher physical activity level gained less weight. The Israeli Center for Disease Control [19] conducted a telephone survey with a representative sample of 2580 Israeli participants aged 21+ to examine the changes that have taken place in the use of medical services, and in their mental state, healthy behaviors, and nutrition. In addition, it checked citizens’ compliance with government guidelines from the onset of the plague to the quarantine following the second wave of the plague. They reported that 56.8% of the respondents regularly engaged in physical activity before the Corona plague. Of all those who reported regular physical activity, 65.7% reported that their habits had changed since the Corona pandemic. Of the respondents who reported a change in physical activity habits, 62.1% reported a decrease in the frequency or duration of their activity, and 46.7% reported a decrease in intensity. As for weight control, 28.6% of respondents reported gaining weight since the onset of the Corona plague and 24.1% reported eating more. Lastly, Zach et al. [20] examined the differences between Israeli adults in the age group 70+ and two other age groups (45–59 and 60–69) concerning their healthy and active lifestyle. They surveyed 1202 people and found that in adults at 70+, the physical activity level, physical activity before and during the lockdown, emotions, sleeping hours, and weight change were similar to the other adult groups that were examined (45–59 and 60–69). However, in the older adults groups (70+ and 60–69), resilience and depression symptoms were lower than in the youngest age group.
Considering the findings that emerged from these studies, the Chinese [17] study showed that the majority of the participants reported life satisfaction despite a long duration of isolation; the Brazilian study [16] focused on the association between PA, unhealthy diet behaviors, and depression; the Canadian study [14] focused on PA behavior change; and, the study conducted in the US [13] measured psychological, social, and PA behavior changes pre and post the COVID-19. Differences in the research goals of these studies might be related to cultural differences among the countries. We were interested in finding out similarities as well as the uniqueness of the Israeli population related to other populations that were reviewed.
Israel is a sunny country with some of the characteristics of a Mediterranean lifestyle, such as strong community life and cultural traditions [21, 22]. Greater community resilience – social, economic, infrastructural, and institutional, in addition to higher sunlight exposure, were associated with lower factors of mental health hazards [23]. The first lockdown’s forced isolation and lower exposure to community life and to sunlight were both expected to be risk factors for a decrease in mental health aspects for Israelis – probably more than in other populations. Hence, the present study aimed to examine health behavior changes among Israeli participants. Specifically, we wanted to examine changes in the PA levels during the first lockdown imposed on the Israeli population during the COVID-19 pandemic, and to determine their relationships with weight control and psychological health.