Changes in physical activity and sedentary behavior during the first COVID-19 pandemic- restrictions in Germany

Background The COVID-19 pandemic restrictions posed challenges to maintaining healthy lifestyles and physical
well-being. During the frst mobility restrictions from March to mid-July 2020, the German population was advised
to stay home, except for work, exercise, and essential shopping. Our objective was to comprehensively assess
the impact of these restrictions on changes in physical activity and sedentary behavior to identify the most afected
groups.
Methods Between April 30, 2020, and May 12, 2020, we distributed a COVID-19-specifc questionnaire to partici‑
pants of the German National Cohort (NAKO). This questionnaire gathered information about participants’ physical
activity and sedentary behavior currently compared to the time before the restrictions. We integrated this new data
with existing information on anxiety, depressive symptoms, and physical activity. The analyses focused on sociodemo‑
graphic factors, social relationships, physical health, and working conditions.
Results Out of 152,421 respondents, a signifcant proportion reported altered physical activity and sedentary
behavioral patterns due to COVID-19 restrictions. Over a third of the participants initially meeting the WHO’s physical
activity recommendation could no longer meet the guidelines during the restrictions. Participants reported substan‑
tial declines in sports activities (mean change (M)= -0.38; 95% CI: -.390; -.378; range from -2 to+2) and reduced active
transportation (M= -0.12; 95% CI: -.126; -.117). However, they also increased recreational physical activities (M=0.12;
95% CI: .117; .126) while engaging in more sedentary behavior (M=0.24; 95% CI: .240; .247) compared to prerestriction levels. Multivariable linear and log-binomial regression models indicated that younger adults were more
afected by the restrictions than older adults. The shift to remote work, self-rated health, and depressive symptoms
were the factors most strongly associated with changes in all physical activity domains, including sedentary behavior,
and the likelihood to continue following the physical activity guidelines