Introduction: During the Covid-19 pandemic the Dutch government implemented its so-called 'intelligent lockdown' in which people were urged to stay at home. This life changing event may have caused changes in lifestyle-behavior. Methods: Life-style related changes were studied among a random representative sample of adults in the Netherlands using an online survey (22-27 May 2020). Differences in COVID-19-related lifestyle changes between Complementary and Alternative Medicine (CAM) users and non-CAM users were determined. The survey included a modified version of the I-CAM-Q and 26 questions on lifestyle-related-measures and changes since the COVID-19-outbreak. Results: 1004 respondents were included in the study, aged between 18 and 88 years (50.7% females). Changes to a healthier lifestyle were observed in 19.3% of the population, mainly due to a change in diet habits, physical activity and relaxation, of whom 56.2% reported to be motivated to maintain this in a post-COVID-19 era. Fewer respondents (12.3%) changed into an unhealthier lifestyle. Multivariable logistic regression analyses revealed that changing into a healthier lifestyle was positively significantly associated with the variables 'Worried/Anxious getting COVID-19′ (OR:1.56, 95% C.I. 1.26-1.93), 'CAM use' (OR:2.04, 95% C.I. 1.38-3.02) and 'stress in relation to financial situation' (OR:1.89, 95% C.I. 1.30-2.74). 'Age' (OR18-25:1.00, OR25-40:0.55, 95% C.I. 0.31-0.96, OR40-55:0.50 95% C.I. 0.28-0.87 OR55+:0.1095% C.I. 0.10-0.33), 'stress in relation to health' (OR:2.52, 95% C.I. 1.64-3.86) and 'stress in relation to the balance work and home' (OR:1.69, 95% C.I. 1.11-2.57) were found predicting the change into a more unhealthy direction. Conclusion: These findings suggest that the coronavirus crisis results in a healthier-lifestyle in one part and, to a lesser extent, in an unhealthier-lifestyle in another part of the Dutch population. Further studies are warranted to see whether this behavioral change is maintained over time, and how different lifestyle factors can affect the susceptibility for and the course of COVID-19. Keywords: COVID-19, Life-style, CAM, Integrative Medicine
Lifestyle changes during the first wave of the COVID-19 pandemic: a cross-sectional survey in the Netherlands