Americans are stuck in unhealthy pandemic habits. Here's how to reboot
The early days of lockdown restrictions had a profound effect on people's daily lives. Alcohol sales skyrocketed, physical activity dropped off sharply, and "comfort eating" led to weight gain, too.
So, what's happened since March of 2020? After two years of pandemic life, many of these effects persist. The strategies we used to adapt and cope have cemented into habits for many of us. And this is not a surprise to scientists who study behavior change.
"We know when a shock arises and forces a change in our behavior for an extended period of time, there tend to be carryover effects because we're sticky in our behaviors," says Katy Milkman of the University of Pennsylvania, and author of the book How To Change. In other words, our pandemic habits may be hard to break.
Take, for example, alcohol consumption. During the first week of stay-at-home restrictions in March 2020, Nielsen tracked a 54% increase in national sales of alcohol. This came as bars and restaurants closed. A study from Rand documented a 41% increase in heavy drinking among women in the months that followed. (Heavy drinking was defined as four or more drinks for women within a few hours.)
"Of concern is the fact that increases in drinking are linked to stress and coping," says Dr. Aaron White of the National Institute on Alcohol Abuse and Alcoholism. He points to a study that found a 50% increase in the number of people who said they drank to cope in the months right after COVID began compared to before the pandemic.
After a spike in sales in the spring of 2020, alcohol sales dipped.
But the most recent data from Nielsen show sales of beer, wine and spirits at the start of 2022 remain higher than they were in 2019. That trend is also reflected yearly: In 2019, spirit sales totaled about $16.3 billion, compared with $21 billion in 2021. Bottom line: Alcohol sales have remained higher than they were before the pandemic, even after adjusted for inflation.
Changes in physical activity have followed a similar pattern. Scientists at UC San Francisco analyzed data from a wellness smartphone app, Argus, which tracks daily step counts among users in countries around the globe. One month after stay-at-home restrictions were initiated in the spring of 2020, people took about 27% fewer steps a day, on average. That's 1,432 fewer steps.
And what's happened since? "The first decrease in activity was really the most drastic," explains study author Geoff Tison, a cardiologist at UCSF who continues to track the smartphone data. In the U.S., physical activity picked up during spring and summer months (both in 2020 and 2021), when cases retreated and there was more daylight, but declined again amid fall and winter surges, including the Omicron surge this winter. Movement trends do vary widely, though. While on the average people moved less, there were some people who used their time during the pandemic to get very fit.
"I don't think it's surprising," Tison says. Physical activity levels are gradually increasing, he says, but have not rebounded to pre-pandemic levels. "Folks are creatures of habit and it's been almost two years. I think it is possible that people are just less used to being active," he says.
This trend may be even more pronounced for older Americans — a University of Michigan study found that 40% of people 65 and older reported less movement amid the pandemic.
And, in the trifecta of bad pandemic habits, remember the early pandemic baking frenzy? Yes, there is evidence of weight gain, too. When researchers at UCSF analyzed data from volunteers who reported their weight during the early months of the pandemic using a Bluetooth-connected smart scale, they recorded an average 1.5 pounds of weight gain per month.
"This is an important lesson for all of us," says study author Dr. Gregory Marcus, of UCSF. It was all too easy to overeat as many of us stayed home more, and the combined effects of weight gain, stress, alcohol and less movement can take its toll on heart health.
"Chronic disease prevention has taken a major hit nationally," says Michael Honigberg, a cardiologist at Massachusetts General Hospital.
He points to a study that documents a rise in blood pressure during the first year of the pandemic. The study included about 500,000 people from all 50 states who were enrolled in an employer-sponsored wellness program operated by Quest Diagnostics.
"Blood pressure went up, on average, by over two points, over two millimeters of mercury," Honigberg says. That's a small change for an individual patient, but at a population level, this level of blood pressure rise can translate into increased risk, especially if the trend continues.
"One thing I worry a lot about is whether this might translate into higher rates of heart attack, stroke, and other such complications across the population in the years to come," Honigberg says. On top of this, he says more people missed preventive care amid the pandemic, everything from delayed cholesterol checks to cancer screenings, which has led to cancer being diagnosed at later stages.
So, if it's time for a collective reboot, to reset pandemic habits, is anyone listening? Marcus says he's optimistic. "In speaking with my patients, [some] people have started to leverage some of the flexibility that comes with remote work, for example, to build in physical activity into their normal daily routines," Though not everyone has that flexibility, "We can all change for the better," Marcus says.
Here are four tips to get started:
Make an appointment with yourself.
"I often advise my patients to calendarize their workouts or their physical activity to make sure it's something they know they're actually going to do," Marcus says. Just as you wouldn't skip a work meeting or doctor's appointment, putting time on your calendar to walk, run or go to the gym, can help you stick with it.
Set bite-sized goals.
If you want to run a marathon, you've got to start with a mile. You want to focus on something you can make progress on each day. "When we have bite-sized goals, we're more likely to achieve them, says Katy Milkman. This is true, whether you're trying to change exercise or eating habits, or if you're trying to save money. Saving $150 a month is the same as saving $5 a day, but when we focus on the smaller, daily goal, it feels better. The goals don't seem enormous or impossible.
Make it fun.
You know you want to watch that new streaming show your friends are talking about? Try this: Hold off on watching until you're at the gym. Then, you could be achieving your workout goal and enjoying yourself at the same time. Or, if you've been wanting to reconnect with a friend, ask them to join you for a walk. You'll combine rekindling a friendship with getting in your steps. "If you don't enjoy the pursuit of the goal, you won't persist," Milkman says.
Bet on yourself.
There's a body of science to back up the idea that we're more likely to achieve our goals if we have to give up something if we don't stick to our plan. "There's wonderful research on cigarette smokers who want to quit, and having a way to put money on the line they'll have to forfeit if they don't achieve their goals within six months improves success rates by 30 percent," says Milkman. You can do this on a website, such as STIKK, or just make a bet with a friend or partner. Milkman says this can be hugely motivating.
And it's almost spring. "My research on the 'fresh start' effect has actually shown that there are moments in our lives that feel like new beginnings, and they include the start of spring," Milkman says. So capitalize on this change in season – with better weather and longer days. The research shows the "fresh start" mentality can give us the extra nudge to get started – and follow through.
Copyright 2022 NPR. To see more, visit https://www.npr.org.