Status of Weight Change, Lifestyle Behaviors, Depression, Anxiety, and Diabetes Mellitus in a Cohort with Obesity during the COVID-19 Lockdown: Turk-Com Study Group.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic led to a lockdown period. Confinement periods have been related to unhealthy lifestyle behaviors. Our study aimed to determine weight change, changes in eating and exercise habits, the presence of depression and anxiety, and diabetes mellitus (DM) status in a cohort of patients with obesity. METHODS: The study was undertaken in nine centers of Collaborative Obesity Management (COM) of the European Association for the Study of Obesity (EASO) in Turkey. An e-survey about weight change, eating habits, physical activity status, DM status, depression, and anxiety was completed by patients. The International Physical Activity Questionnaire (IPAQ) score was used to determine physical activity in terms of metabolic equivalents (METs). A healthy nutrition coefficient was calculated from the different categories of food consumption. The Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7) Questionnaire  were used for determining depression and anxiety, respectively. RESULTS: Four hundred twenty-two patients (age 45 ± 12.7 years, W/M = 350/72) were included. The healthy nutrition coefficient before the pandemic was 38.9 ± 6.2 and decreased to 38.1 ± 6.4 during the pandemic (p < 0.001). Two hundred twenty-nine (54.8%) patients gained weight, 54 (12.9%) were weight neutral, and 135 (32.3%) lost weight. Patients in the weight loss group had higher MET scores and higher healthy nutrition coefficients compared with the weight gain and weight-neutral groups (p < 0.001). The PHQ and GAD scores were not different between the groups. Percent weight loss was related to healthy nutrition coefficient (CI: 0.884 [0.821-0.951], p = 0.001) and MET categories (CI: 0.408 [0.222-0.748], p = 0.004). One hundred seventy patients had DM. Considering glycemic control, only 12 (8.4%) had fasting blood glucose <100 mg/dL and 36 (25.2%) had postprandial BG <160 mg/dL. When patients with and without DM were compared in terms of dietary compliance, MET category, weight loss status, PHQ-9 scores, and GAD-7 scores, only MET categories were different; 29 (11.7%) of patients in the nondiabetic group were in the highly active group compared with 5 (2.9%) in the diabetic group. CONCLUSION: The COVID-19 lockdown resulted in weight gain in about half of our patients, which was related to changes in physical activity and eating habits. Patients with DM who had moderate glycemic control were similar to the general population in terms of weight loss but were less active.

Regulation of waste and waste management in Turkey.

Industrial and technological developments have increased rapidly throughout the world including Turkey. Furthermore, the population of Turkey is also increasing and the ever-increasing consumption creates larger amounts of waste materials and adversely affects the environment and human health. The development of a waste management and disposal system has become necessary in all countries of the world. As part of the process of seeking entry to the European Union, Turkey continues to prepare the necessary legislation to satisfy European Union regulations for the disposal of solid waste, packaging waste, biodegradable waste and medical waste materials within the framework of the strategy. An integrated waste management system is necessary for each town in Turkey that is suitable for the different contents and increasing amounts of waste produced. In the present study, Turkey's geographical regions were examined in terms of population and the total amount of solid waste generated in each province to produce detailed data for the Turkish Ministry of Environment and Forestry. As a result of this study, it is understood that Turkey has drawn up a 'road map' which will be followed by the 2008-2012 Waste Management Action Plan. To achieve this, the Ministry of the Environment and Forestry, Turkey and the municipalities must fulfill the tasks that have been allocated to them. Turkey will attain the European Union standards for waste management if these tasks lead to the achievement of the targets within the action plan.