The combined lifestyle intervention CooL in times of COVID-19: a descriptive case series study

Abstract Background The main objective of this nationwide study was to investigate changes over time of participants after eight months of participation in the Combined Lifestyle Intervention CooL (Coaching on Lifestyle) regarding health perceptions, self-mastery, dietary intake, physical activity, alcohol use, smoking, sleep, stress management and anthropometry. Since the study took place when the COVID-19 pandemic emerged, we were able to address changes over time while participants were exposed to pandemic-related restrictions and uncertainties. Methods Data were collected from November 2018 until October 2021 at different locations across the Netherlands from 1824 participating adults, meeting the Combined Lifestyle Intervention inclusion criteria. We collected a broad set of data on anthropometrics, behaviours and health perceptions. Results The results indicate that the COVID-19 pandemic impacted negatively on changes in self-mastery, perceived fitness and stress, but not on anthropometric outcomes, diet, sleep or social support. Overall, the outcomes show improvements in health perceptions, behaviours and weight after eight months compared to baseline. The largest effect sizes were found on weight, waist circumference, perceived health and the awareness around diet (i.e. attentiveness for diet, amount of food and consuming food). Conclusion Participating in CooL appeared to protect against engaging in unhealthy behaviour during the pandemic, despite a decreased sense of self-mastery and increased stress. The results support the lifestyle coaching approach that small changes in multiple behaviours can synergistically contribute to better (perceived) health and health-related outcomes.