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Basterfield L, Galna B, Burn NL, Batten H, Weston M, Goffe L, Lawn M, Weston KL. Back to 'normal'? BMI, physical fitness and health-related quality of life of children from North East England before, during and after the COVID-19 lockdowns. J Sports Sci 2024:1-13. [PMID: 38819118 DOI: 10.1080/02640414.2024.2359259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 05/17/2024] [Indexed: 06/01/2024]
Abstract
We assessed whether changes in children's body mass index (BMI), physical fitness and health-related quality of life observed post-2020 United Kingdom COVID-19 lockdown remained 12 and 18 months later. Twenty-metre shuttle run test (20mSRT), handgrip strength, standing broad jump, sit-and-reach, height, body mass, and health-related quality of life (Kidscreen27 questionnaire) were measured in 90 children (8-9 years) during October 2019 ("T0"), November 2020 ("T1"), November 2021 ("T2") and June 2022 ("T3"). Mixed-effects models showed age- and sex-normalised BMI increased from T0 (mean: 0.71) to T1 (0.97), remaining elevated at T2 (0.95) and T3 (0.89). Decreases in 20mSRT performance were observed from T0 (22.0) to T1 (19.3), then increased at T2 (23.5) and T3 (28.3). Standing broad jump and handgrip strength increased over time. The proportion of children with overweight/obesity increased from T0 (32%) to T3 (48%). Health-related quality of life decreased for "Physical Wellbeing" yet increased for "Autonomy & Parents". Our findings highlight that lockdowns may have had lasting implications for children's health, and the urgent need to reduce overweight and obesity in North East England. Improving health and fitness behaviours to maximise long-term health outcomes and build resilience to future emergencies and disruptions to health behaviours is also paramount.
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Affiliation(s)
- Laura Basterfield
- Human Nutrition and Exercise Research Centre, Newcastle University, Newcastle upon Tyne, UK
- Medical School, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Brook Galna
- Human Nutrition and Exercise Research Centre, Newcastle University, Newcastle upon Tyne, UK
- Centre for Healthy Ageing and School of Allied Health (Exercise Science), Murdoch University, Murdoch, WA, Australia
| | - Naomi L Burn
- UniSA Online, University of South Australia, Adelaide, Australia
| | - Hannah Batten
- Human Nutrition and Exercise Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - Matthew Weston
- Institute for Sport, Physical Education and Health Science, Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
- Institute of Sport, Manchester Metropolitan University, Manchester, UK
| | - Louis Goffe
- Medical School, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- NIHR Health Determinants Research Collaboration, Gateshead Council, Gateshead, UK
| | - Matt Lawn
- Walkergate Community School, Newcastle upon Tyne, UK
| | - Kathryn L Weston
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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Biese KM, McGuine TA, Haraldsdottir K, Reardon C, Watson AM. The Influence of Race, Socioeconomic Status, and Physical Activity on the Mental Health Benefits of Sport Participation During COVID-19. Sports Health 2024; 16:195-203. [PMID: 38246900 PMCID: PMC10916784 DOI: 10.1177/19417381231223494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND The purpose of this study was to compare the benefits of sport participation with no sport participation during the COVID-19 pandemic and determine the moderating effects of race and ethnicity, socioeconomic status (SES), and physical activity (PA) on mental health in adolescent athletes. HYPOTHESIS Sport participation would be associated with greater improvements in mental health for athletes from racial and ethnic minority and lower SES groups compared with White and high SES groups. PA would mediate <30% of the mental health benefits of sport participation. STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 4. METHODS In May 2021, adolescent athletes completed an online survey (demographics, sport participation, measures of anxiety and depression, PA). Participants were classified as those who played sports (PLY) and those who did not (DNP). Mental health symptoms for the PLY and DNP groups were compared via analysis of variance models that controlled for demographic variables. Moderating analyses assessed the interaction of sport participation status by (1) race and ethnicity (White/non-White) and (2) SES (high/low) with mental health. Mediation analyses assessed the degree that PA scores explained the differences in anxiety and depression between the 2 groups. RESULTS Participants included 4874 adolescent athletes (52% female; age, 16.1 ± 1.3 years; PLY, 91%). Athletes who returned to sport from racial minority groups and low SES had greater decreases in anxiety (race and ethnicity: interaction estimate (b) = -1.18 ± 0.6, P = 0.04; SES, b = -1.23 ± 0.5, P = 0.02), and depression (race and ethnicity: b = -1.19 ± 0.6, P = 0.05; SES, b = -1.21 ± 0.6, P = 0.03) compared with White and high SES athletes, respectively. PA explained 24% of anxiety (P < 0.01) and 20% of depression scores (P < 0.01). CONCLUSION Athletes who identify as a racial or ethnic minority and from areas of lower household income experienced disproportionately greater negative mental health impacts from sport restrictions during COVID-19. CLINICAL RELEVANCE Improving access to sports in traditionally underserved areas may have significant mental health impact for adolescents.
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Affiliation(s)
- Kevin M Biese
- Department of Kinesiology, University of Wisconsin - Oshkosh, Oshkosh, Wisconsin
| | - Timothy A McGuine
- Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Kristin Haraldsdottir
- Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Claudia Reardon
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Andrew M Watson
- Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Messiah SE, Xie L, Kapti EG, Chandrasekhar A, Srikanth N, Hill K, Williams S, Reid A, Mathew MS, Barlow SE. Prevalence of the metabolic syndrome by household food insecurity status in the United States adolescent population, 2001-2020: a cross-sectional study. Am J Clin Nutr 2024; 119:354-361. [PMID: 38042411 DOI: 10.1016/j.ajcnut.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/27/2023] [Accepted: 11/27/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND Household food insecurity (FI) is a modifiable social determinant of health linked to chronic health outcomes. Little is known, however, about the prevalence of metabolic syndrome (MetS) in pediatric population-based studies by household FI status. OBJECTIVES The objective of the study was to estimate the prevalence of the MetS by household FI status over the past 2 decades. METHODS This cross-sectional study used data from the 2001-2020 National Health and Nutrition Examination Survey (NHANES). Participants were nonpregnant adolescents ages 12- 18 y in United States. The prevalence of MetS [elevated waist circumference and >2 of the following risk factors: elevated blood pressure, and fasting glucose, triglyceride, and/or low high-density lipoprotein (HDL) cholesterol concentrations] by FI status was evaluated using chi-square and logistic regression analyses. RESULTS The estimated prevalence of MetS was 2.66% [95% confidence interval (CI): 2.28%, 3.09%] in the final analytical sample (unweighted N = 12,932). A total of 3.39% (95% CI: 2.53%, 4.53%) of adolescents from FI households had MetS compared to 2.48% (95% CI: 2.11%, 2.9%) among adolescents with no household FI. Hispanic adolescents had the highest prevalence of MetS (3.73%, 95% CI: 3.05, 4.56) compared with adolescents who identified as non-Hispanic White (2.78%, 95% CI: 2.25, 3.43), non-Hispanic Black (1.58%, 95% CI: 1.19, 2.10). Adolescents with household FI (23.20%) were more likely to have MetS [odds ratio (OR): 1.38; 95% CI: 1.02, 1.88; I=0.039) compared with adolescents with no household FI, but in fully adjusted models this was not significant (OR: 1.13; 95% CI: 0.75, 1.72). CONCLUSIONS Using the most current NHANES data, the estimated prevalence of MetS in adolescents in United States was slightly higher among those from FI households. However, after adjusting for potential confounders, the relationship between household FI and MetS was nonsignificant, highlighting the complexity of factors contributing to MetS in this population. Hispanic adolescents share a disproportionate burden of MetS compared with their non-Hispanic counterparts.
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Affiliation(s)
- Sarah E Messiah
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health (UTHealth) Science Center at Houston, School of Public Health, Dallas, TX, United States; Center for Pediatric Population Health, UTHealth School of Public Health at Houston, Dallas, TX, United States; Department of Pediatrics, UTHealth Houston McGovern Medical School, Houston, TX, United States.
| | - Luyu Xie
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health (UTHealth) Science Center at Houston, School of Public Health, Dallas, TX, United States; Center for Pediatric Population Health, UTHealth School of Public Health at Houston, Dallas, TX, United States
| | - Eda Gozel Kapti
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health (UTHealth) Science Center at Houston, School of Public Health, Dallas, TX, United States; Center for Pediatric Population Health, UTHealth School of Public Health at Houston, Dallas, TX, United States
| | - Aparajita Chandrasekhar
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health (UTHealth) Science Center at Houston, School of Public Health, Dallas, TX, United States; Center for Pediatric Population Health, UTHealth School of Public Health at Houston, Dallas, TX, United States
| | | | - Kristina Hill
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health (UTHealth) Science Center at Houston, School of Public Health, Dallas, TX, United States; Center for Pediatric Population Health, UTHealth School of Public Health at Houston, Dallas, TX, United States; Children's Health System of Texas, Dallas, TX, United States
| | | | - Aleksei Reid
- Children's Health System of Texas, Dallas, TX, United States
| | - Mathew Sunil Mathew
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health (UTHealth) Science Center at Houston, School of Public Health, Dallas, TX, United States; Center for Pediatric Population Health, UTHealth School of Public Health at Houston, Dallas, TX, United States
| | - Sarah E Barlow
- Children's Health System of Texas, Dallas, TX, United States; Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States
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McQuillan K, Yoshida-Montezuma Y, Jambon M, Vanderloo LM, Gonzalez A, Anderson LN. Physical activity and unexpected weight change in Ontario children and youth during the COVID-19 pandemic: A cross-sectional analysis of the Ontario Parent Survey 2. PLoS One 2024; 19:e0292934. [PMID: 38300964 PMCID: PMC10833564 DOI: 10.1371/journal.pone.0292934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/01/2023] [Indexed: 02/03/2024] Open
Abstract
The objective of this study was to investigate the association between children's parent-reported physical activity levels and weight changes during the COVID-19 pandemic among children and youth in Ontario Canada. A cross-sectional online survey was conducted in parents of children 5-17 years living in Ontario from May to July 2021. Parents recalled their child's physical activity and weight change during the year prior to their completion of the survey. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using multinomial logistic regression for the association between physical activity and weight gain or loss, adjusted for child age and gender, parent ethnicity, current housing type, method of school delivery, and financial stability. Overall, 86.8% of children did not obtain 60 minutes of moderate-to-vigorous physical activity per day and 75.4% of parents were somewhat or very concerned about their child's physical activity levels. For all physical activity exposures (outdoor play, light physical activity, and moderate-to-vigorous physical activity), lower physical activity was consistently associated with increased odds of weight gain or loss. For example, the adjusted OR for the association between 0-1 days of moderate-to-vigorous physical activity versus 6-7 days and child weight gain was 5.81 (95% CI 4.47, 7.56). Parent concern about their child's physical activity was also strongly associated with child weight gain (OR 7.29; 95% CI 5.94, 8.94). No differences were observed between boys and girls. This study concludes that a high proportion of children in Ontario had low physical activity levels during the COVID-19 pandemic and that low physical activity was strongly associated with parent reports of both weight gain and loss among children.
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Affiliation(s)
- Kathryn McQuillan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Yulika Yoshida-Montezuma
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Marc Jambon
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, ON, Canada
| | - Leigh M. Vanderloo
- ParticipACTION, Toronto, Ontario, Canada
- School of Occupational Therapy, University of Western Ontario, London, Ontario, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Laura N. Anderson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
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Keane OA, Ourshalimian S, O'Guinn M, Ing M, Odegard M, Ignacio R, Kelley-Quon LI. Increases in pediatric cholecystectomy during the COVID-19 pandemic: An interrupted time series analysis. Surgery 2024; 175:304-310. [PMID: 38036396 DOI: 10.1016/j.surg.2023.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/05/2023] [Accepted: 10/24/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Historically, cholecystectomy is infrequently performed in children. Lifestyle changes, delays in healthcare access, and increases in childhood obesity occurred during the COVID-2019 pandemic. It is unclear whether these changes impacted pediatric gallbladder disease and the need for cholecystectomy. METHODS A retrospective study of children ≤18 years old undergoing cholecystectomy from January 1, 2016, to July 31, 2022, at a tertiary children's hospital was conducted. On March 19, 2020, a statewide mandatory coronavirus disease 2019 stay-at-home policy began. Differences in children undergoing cholecystectomy before and during the pandemic were identified using bivariate comparisons. An interrupted time series analysis identified differences in case volume trends. RESULTS Overall, 633 children were identified-293 pre-pandemic and 340 pandemic. A majority were female sex (76.3%) and Hispanic (67.5%), with a median age of 15 years (interquartile range: 13.0-16.0). Children who underwent cholecystectomy during the pandemic had significantly higher body mass index (28.4 versus 25.8, P = .002), and obesity (body mass index >30) was more common (45.3% versus 31.7%, P = .001). During the pandemic, significant increases in complicated biliary disease occurred-symptomatic cholelithiasis decreased (41.5% versus 61.8%, P < .001) and choledocholithiasis (17.9% versus 11.6%, P = .026), gallstone pancreatitis (17.4% versus 10.6%, P = .015), and chronic cholecystitis (4.7% versus 1.0%, P = .007) increased. The number of cholecystectomies performed per month increased during the pandemic, and on interrupted time series analysis, there was a significant increase in month-to-month case count during the pandemic (P = .003). CONCLUSION Cholecystectomy case volume significantly increased during the coronavirus disease 2019 pandemic, possibly secondary to increases in childhood obesity. Future studies are needed to determine whether this increased frequency of pediatric cholecystectomy is representative of broader shifts in pediatric health and healthcare use after coronavirus disease 2019.
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Affiliation(s)
- Olivia A Keane
- Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA.
| | | | - MaKayla O'Guinn
- Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA
| | - Madeleine Ing
- Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Marjorie Odegard
- Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA
| | - Romeo Ignacio
- Department of Pediatric Surgery, Rady Children's Hospital, University of California San Diego School of Medicine, San Diego, CA
| | - Lorraine I Kelley-Quon
- Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA; Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA; Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
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6
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Dou N, Deitch R, Kowalski AJ, Kuhn A, Lane H, Parker EA, Wang Y, Zafari Z, Black MM, Hager ER. Studying the impact of COVID-19 mitigation policies on childhood obesity, health behaviors, and disparities in an observational cohort: Protocol for the COVID-19 Family Study. Contemp Clin Trials 2024; 136:107408. [PMID: 38072192 PMCID: PMC10922699 DOI: 10.1016/j.cct.2023.107408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/13/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND COVID-19 pandemic control policies, including school closures, suspended extra-curricular activities, and social distancing, were introduced to prevent viral transmission, and disrupted children's daily routines, health behaviors, and wellness. This observational cohort study among 697 families with children or adolescents, based on the Family Stress Model, aims to: 1) evaluate pre- to during-pandemic changes in child health behaviors (diet, physical activity, sleep) and weight gain, 2) identify mechanisms explaining the changes, and 3) determine projected healthcare costs on weight gain and obesity. Each aim includes an examination by racial and ethnic, socioeconomic, and geographic disparities. METHODS The study employs a mixed methods design, recruiting children and their caregivers from two obesity prevention trials halted in 2020. Enrolled participants complete annual surveys to assess child health behaviors, family resources, routines, and demographics, and home environment in 2020-2022. Height and weight are measured annually in 2021-2022. Annual semi-structured interviews are conducted within a subsample to understand mechanisms of observed changes. Multilevel mixed models and mediation analyses are used to examine changes in child health behaviors and weight gain and mechanisms underlying the changes. Qualitative data are analyzed within and across time points and integrated with quantitative findings to further explain mechanisms. Markov models are used to determine healthcare costs for unhealthy child behaviors and weight gain. CONCLUSION Findings from this study will aid in understanding pandemic-related changes in child health behaviors and weight status and will provide insights for the implementation of future programs and policies to improve child and family wellness.
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Affiliation(s)
- Nan Dou
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, 615 N Wolfe St, MD 21205, USA.
| | - Rachel Deitch
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, 615 N Wolfe St, MD 21205, USA.
| | - Alysse J Kowalski
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, 615 N Wolfe St, MD 21205, USA.
| | - Ann Kuhn
- Department of Exercise and Nutrition Sciences, University at Buffalo, The State University of New York, 401 Kimball Tower, Buffalo, NY 14214, USA.
| | - Hannah Lane
- Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC 27701, USA.
| | - Elizabeth A Parker
- University of Maryland School of Medicine, Department of Physical Therapy and Rehabilitation Science, 100 Penn Street, Baltimore, MD 21201, USA.
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue, NW, Washington, DC 20052, USA.
| | - Zafar Zafari
- Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, 20 North Pine Street, Baltimore, MD 21201, USA.
| | - Maureen M Black
- University of Maryland School of Medicine, Department of Pediatrics, 737 West Lombard Street, Baltimore, MD 21201, USA; RTI International, Research Triangle Park, NC 27709, USA.
| | - Erin R Hager
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, 615 N Wolfe St, MD 21205, USA.
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Androja L, Bavčević T, Jurčev Savičević A, Bavčević D, Ninčević J, Buljan A, Nonković D, Rodrigues V, Karin Ž. Body Mass Index Trends before and during the COVID-19 Pandemic in Primary School Students in Split-Dalmatia County, Croatia: A Retrospective Study. Nutrients 2023; 16:50. [PMID: 38201879 PMCID: PMC10780733 DOI: 10.3390/nu16010050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Within the last decade, childhood obesity has become a serious problem, especially during the COVID-19 pandemic. This research paper aimed to examine whether body mass index (BMI) was higher during the pandemic (2020-2022) than in the pre-pandemic period (2012/2013-2019) using trends related to sex, urban-rural area, and physical activity (PA). This study included data from physical examinations of an entire population of primary school children from Split-Dalmatia County (Croatia) over a period of 10 years. There were 103,804 students from the first, fifth, and eighth grades who participated in the analysis. During the pandemic, the BMI of all the students increased, except for eighth-grade girls. Generations of eighth graders have had significantly different BMIs throughout the past decade. We found that first graders were overweight and obese in urban areas, while in rural areas, this problem was experienced by upper grades. Girls were more overweight and obese in the first and eighth grades, but boys experienced this more in the fifth grade. Reduced PA influenced an increase in BMI in both sexes, especially in girls. During the pandemic, this situation became worse. This study could be useful to experts for the creation of new policies for Split-Dalmatia County and surrounding regions that are similar economically and culturally.
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Affiliation(s)
- Luka Androja
- School of Medicine, University of Split, 21000 Split, Croatia; (L.A.)
- Department of Sports Management, Aspira University of Applied Sciences, 21000 Split, Croatia
| | - Tonči Bavčević
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia
| | - Anamarija Jurčev Savičević
- School of Medicine, University of Split, 21000 Split, Croatia; (L.A.)
- Teaching Institute for Public Health of Split-Dalmatia County, 21000 Split, Croatia
- Department of Health Studies, University of Split, 21000 Split, Croatia
| | - Damir Bavčević
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia
| | - Jasna Ninčević
- Teaching Institute for Public Health of Split-Dalmatia County, 21000 Split, Croatia
| | - Anita Buljan
- Teaching Institute for Public Health of Split-Dalmatia County, 21000 Split, Croatia
| | - Diana Nonković
- Teaching Institute for Public Health of Split-Dalmatia County, 21000 Split, Croatia
| | - Vitor Rodrigues
- Faculty of Medicine, University of Coimbra, 3030-222 Coimbra, Portugal
| | - Željka Karin
- School of Medicine, University of Split, 21000 Split, Croatia; (L.A.)
- Teaching Institute for Public Health of Split-Dalmatia County, 21000 Split, Croatia
- Department of Health Studies, University of Split, 21000 Split, Croatia
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8
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Qin G, Li H, Qin Y, Liu B. Is the COVID-19 epidemic affecting the body mass of Chinese teenagers? - A longitudinal follow-up study. Front Public Health 2023; 11:1269076. [PMID: 38074753 PMCID: PMC10701275 DOI: 10.3389/fpubh.2023.1269076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
Background After the spread and outbreak of COVID-19 worldwide, the learning, lifestyle, and health level of young individuals have been immensely impacted. With regard to the existing studies, the development trend of adolescents' body shape in the late COVID-19 period is not sufficiently analyzed, and relevant targeted investigation is lacking. This study aimed to explore the body mass index (BMI) changes of 6-14 years-old adolescents before and after the COVID-19 epidemic, and to provide a reference for promoting the continuous enhancement of adolescent health. Methods The BMI and related data pertaining to 93,046 individuals from 2019 to 2022 were collected by cluster sampling, and changes in the BMI Z score and detection rate of overweight and obese adolescents before and after the epidemic were analyzed. Furthermore, the trend of obesity rates among adolescents in Jinan from 2019 to 2022 was analyzed using a logistic regression analysis model. Results The one-way ANOVA models indicated that the BMI Z score of 6-14 years-old adolescents in 2020 significantly increased compared to 2019 (p < 0.01), and decreased in 2021 and 2022; in 2020, the obesity rate of adolescents exhibited a significant increase; however, the rate decreased after being controlled in 2021 and 2022. The normal-body size proportion continued to rise (p < 0.01), and adolescents of different age groups and genders exhibited similar development trends; the results of the logistic regression analysis indicate that there was a significant increase in obesity rates in 2020, adolescents of different age groups and genders exhibited similar development trends (p < 0.05). Conclusion This study demonstrated that the COVID-19 epidemic impacts the BMI and obesity detection rate of adolescents. Adolescents from different age groups and genders exhibited similar development trends.
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Affiliation(s)
- Guoyang Qin
- College of Physical Education, Shandong Normal University, Jinan, China
| | - Hui Li
- Physical Education Teaching and Research Group, Shandong Water Conservancy Vocational College, Rizhao, China
| | - Yong Qin
- Physical Education Teaching and Research Office, Lixia District Bureau of Education and Sports of Jinan City, Jinan, China
| | - Bin Liu
- Physical Education Teaching and Research Group, Jinan Licheng No.2 High School, Jinan, China
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Irschik S, Brandt JB, Eisenkölbl J. COVID-19 pandemic-related weight gain in the pediatric population declined after restrictions ended, except among obese patients. Front Public Health 2023; 11:1260269. [PMID: 37942242 PMCID: PMC10628554 DOI: 10.3389/fpubh.2023.1260269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/21/2023] [Indexed: 11/10/2023] Open
Abstract
Introduction Childhood obesity has become an important topic, not only of increasing relevance during the COVID-19 pandemic but specifically enhanced by it. Restrictions implemented to mitigate further outbreaks led to major constraints on daily physical activity, leading to a severe increase in body weight among children. This study highlights changes in BMI and weight development in children during and (in particular) after the COVID-19 restrictions in Austria, focusing on various socioeconomic factors. Methods Weight development throughout the pandemic and socioeconomic factors were evaluated by anonymous cross-sectional surveys filled out by parents at a pediatric practice. Results This study included 388 children. The rate of obesity increased by 88.5%, from 6.4 to 12.1%, throughout the pandemic, reaching a maximum of 15.2% during the restrictions. Overall, age-adapted BMI z-scores increased significantly by 0.22 during the restrictions and remained increased by 0.19 compared to pre-pandemic levels. With the exception of obese children, all children in the study population experienced significant weight loss after the restrictions were lifted. Obese children continued to gain weight without any sign of the onset of normalization. Socioeconomic factors, such as participation in regular activity in the form of organized sport or the availability of an outdoor area, were associated with relevant differences before the pandemic but had no protective effect against intra-pandemic weight gain. A higher level of parental education was the only factor associated with less weight gain in children during the early phase of the pandemic. Discussion Austrian COVID-19 restrictions have had concerning effects on pediatric BMI, with very little effect of socioeconomic background. After restrictions were loosened, measurable weight loss occurred, but the significant increase in children's BMI percentiles persisted. No weight loss was observed among children who were obese prior to the pandemic. There is a need for broad projects tackling childhood obesity, as obese children are the most vulnerable group with the strongest and most severe long-term effects.
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Affiliation(s)
| | - Jennifer B. Brandt
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
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Nimali Seneviratne S, Kumarihamy Karunathilake CN, Pallegama CM, Malintha Lahiru TG, Jayarajah U. Endocrine manifestations of COVID-19 in children: A scoping review. Best Pract Res Clin Endocrinol Metab 2023; 37:101792. [PMID: 37453832 PMCID: PMC10303324 DOI: 10.1016/j.beem.2023.101792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
In this review, we explore associations between SARS CoV-2 infection and the endocrine system and metabolism in children and adolescents. PubMed, Scopus and Google scholar databases were searched to identify published data on endocrine manifestations of COVID-19 in children up to 31 March 2023, including diabetes, obesity, puberty, thyroid disorders, adrenal disorders and pituitary disorders. Data on changes in disease pattern/ incidence, disease control, and other effects due to the COVID-19 pandemic, as well as effects of pre-existing endocrine conditions on severity of COVID-19 infection are presented, and practice points and research needs provided under each section.
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Affiliation(s)
| | | | | | | | - Umesh Jayarajah
- Postgraduate Institute of Medicine, University of Colombo, Sri Lanka; Department of Surgery, Faculty of Medicine, University of Colombo, Sri Lanka.
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11
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Lane TS, Sonderegger DL, Binns HJ, Kirk S, Christison AL, Novick M, Tucker J, King E, Wallace S, Brazendale K, Kharofa RY, Walka S, de Heer H‘D. Seasonal variability in body mass index change among children enrolled in the Pediatric Obesity Weight Evaluation Registry: A step in the right direction. Pediatr Obes 2023; 18:e13012. [PMID: 36811325 PMCID: PMC10150645 DOI: 10.1111/ijpo.13012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 01/09/2023] [Accepted: 01/25/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Research has shown children disproportionately gain excess weight over the summer months (vs. school months), with stronger effects for children with obesity. However, the question has not been investigated among children receiving care in paediatric weight management (PWM) programs. OBJECTIVE To test for seasonal variability in weight change among youth with obesity in PWM care enrolled in the Pediatric Obesity Weight Evaluation Registry (POWER). METHOD Longitudinal evaluation of a prospective cohort from 2014 to 2019 among youth in 31 PWM programs. Change in percentage of the 95th percentile for BMI (%BMIp95) was compared by quarter. RESULTS Participants (N = 6816) were primarily ages 6-11 (48%), female (54%), 40% non-Hispanic White, 26% Hispanic and 17% Black, and 73% had severe obesity. Children were enrolled on average 424.9 ± 401.5 days. Participants reduced their %BMIp95 every season, but compared with Quarter 3 (July-September), reductions were significantly greater in Q1 (Jan-March, b = -0.27, 95%CI -0.46, -0.09), Q2 (April-June, b = -0.21, CI -0.40, -0.03), and Q4 (October-December, b = -0.44, CI -0.63, -0.26). CONCLUSION AND RELEVANCE Across 31 clinics nationwide, children reduced their %BMIp95 every season, but reductions were significantly smaller during the summer quarter. While PWM successfully mitigated excess weight gain during every period, summer remains a high-priority time.
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Affiliation(s)
- Taylor S Lane
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ
| | - Derek L Sonderegger
- Department of Math and Statistics, Northern Arizona University, Flagstaff, AZ
| | - Helen J Binns
- Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University, Chicago, IL
| | - Shelley Kirk
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- The Heart Institute, Center for Better Health and Nutrition Cincinnati Children’s Hospital Medical Center Cincinnati, OH
| | - Amy L. Christison
- Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, IL
| | - Marsha Novick
- Department of Pediatrics and Family & Community Medicine, Healthy Weight Program for Children and Teens, Penn State Milton S. Hershey Children’s Hospital, Hershey, PA
| | - Jared Tucker
- Health Optimization Services, Helen DeVos Children’s Hospital, Grand Rapids, MI
- Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, MI
| | - Eileen King
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Stephenie Wallace
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
- Adolescent Medicine, Children’s Alabama, Birmingham, AL
| | - Keith Brazendale
- Department of Health Sciences, University of Central Florida, Orlando, FL
| | - Roohi Y. Kharofa
- The Heart Institute, Center for Better Health and Nutrition Cincinnati Children’s Hospital Medical Center Cincinnati, OH
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Sherry Walka
- Northern Arizona Healthcare Inspire Program, Northern Arizona Healthcare, Flagstaff, AZ
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12
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Song K, Yang J, Lee HS, Kim SJ, Lee M, Suh J, Kwon A, Kim HS, Chae HW. Changes in the Prevalences of Obesity, Abdominal Obesity, and Non-Alcoholic Fatty Liver Disease among Korean Children during the COVID-19 Outbreak. Yonsei Med J 2023; 64:269-277. [PMID: 36996898 PMCID: PMC10067793 DOI: 10.3349/ymj.2022.0540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/23/2023] [Accepted: 02/09/2023] [Indexed: 04/01/2023] Open
Abstract
PURPOSE We aimed to investigate the prevalences of obesity, abdominal obesity, and non-alcoholic fatty liver disease (NAFLD) among children and adolescents during the coronavirus disease 2019 (COVID-19) outbreak. MATERIALS AND METHODS This population-based study investigated the prevalences of obesity, abdominal obesity, and NAFLD among 1428 children and adolescents between 2018-2019 and 2020. We assessed the prevalences of obesity, abdominal obesity, and NAFLD according to body mass index, age, sex, and residential district. Logistic regression analyses were performed to determine the relationships among obesity, abdominal obesity, and NAFLD. RESULTS In the obese group, the prevalence of abdominal obesity increased from 75.55% to 92.68%, and that of NAFLD increased from 40.68% to 57.82%. In age-specific analysis, the prevalence of abdominal obesity increased from 8.25% to 14.11% among participants aged 10-12 years and from 11.70% to 19.88% among children aged 13-15 years. In residential district-specific analysis, the prevalence of both abdominal obesity and NAFLD increased from 6.96% to 15.74% in rural areas. In logistic regression analysis, the odds ratio of abdominal obesity for NAFLD was 11.82. CONCLUSION Our results demonstrated that the prevalences of abdominal obesity and NAFLD increased among obese Korean children and adolescents and in rural areas during the COVID-19 outbreak. Additionally, the prevalence of abdominal obesity increased among young children. These findings suggest the importance of closely monitoring abdominal obesity and NAFLD among children during COVID-19, focusing particularly on obese young children and individuals in rural areas.
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Affiliation(s)
- Kyungchul Song
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Juyeon Yang
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
| | - Su Jin Kim
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Myeongseob Lee
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Junghwan Suh
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ahreum Kwon
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ho-Seong Kim
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Wook Chae
- Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.
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13
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Bond DM, Seimon R, Schneuer FJ, Baur LA, Craig M, Alexander S, Garnett SP, Henderson J, Nassar N. Impact and recovery of the COVID-19 pandemic on weight status of children and adolescents. Clin Obes 2023; 13:e12579. [PMID: 36682362 PMCID: PMC10909548 DOI: 10.1111/cob.12579] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/27/2022] [Accepted: 01/08/2023] [Indexed: 01/24/2023]
Abstract
Recent evidence suggests the immediate effects of the COVID-19 lockdowns and restrictions have resulted in increased weight in children and adolescents. However, the longer-term effects have not been assessed. The aim of this study was to examine the impact and longer-term effects of the COVID-19 pandemic on BMI and weight status of children and adolescents. This study used routinely collected clinical data from the Sydney Children's Hospitals Network, comprising two socio-demographically diverse children's hospitals in New South Wales, Australia from 2018 to 2021. Of 245 836 individuals ≤18-years assessed, mean BMI percentile increased from 58.7 (SD 31.6) pre-COVID-19 to 59.8 (SD 31.7) (p < .05) post-restrictions and overweight/obesity increased by 5.5% (obesity alone 6.3%), predominantly in children <12-years and from lower socioeconomic backgrounds. The trend in BMI percentile was steady pre-COVID-19 (β = -0.03 [95% CI -0.07, 0.01]), peaked immediately following COVID-19 restrictions (β = 1.28 [95% CI 0.24, 2.32]) and returned to pre-pandemic levels over ensuing 21 months (β = -0.04 [95% CI -0.13, 0.04]). Routine anthropometric measurement facilitates ongoing monitoring and evaluation of the weight status of children and adolescents, helping to identify those at-risk. Despite initial BMI and weight increases among children and adolescents, longer-term follow-up highlighted a return to pre-pandemic rates, possibly attributed to state-wide policies aimed at reducing childhood obesity.
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Affiliation(s)
- Diana M. Bond
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Radhika Seimon
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Francisco J. Schneuer
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Louise A. Baur
- Weight Management ServicesThe Children's Hospital at WestmeadWestmeadNew South WalesAustralia
- Charles Perkins CentreThe University of SydneySydneyNew South WalesAustralia
| | - Maria Craig
- Charles Perkins CentreThe University of SydneySydneyNew South WalesAustralia
- Paediatric EndocrinologyThe Children's Hospital at WestmeadWestmeadNew South WalesAustralia
| | - Shirley Alexander
- CHISM and Weight Management Services, Auburn Clinical SchoolUniversity of Notre DameSydneyNew South WalesAustralia
| | - Sarah P. Garnett
- SCHN Human Research Ethics Committee, Institute of Endocrinology and Diabetes, Discipline of Child and Adolescent HealthUniversity of SydneySydneyNew South WalesAustralia
| | - Joanne Henderson
- Sydney Children's Hospitals NetworkThe Children's Hospital at WestmeadWestmeadNew South WalesAustralia
| | - Natasha Nassar
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
- Charles Perkins CentreThe University of SydneySydneyNew South WalesAustralia
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14
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ÓhAiseadha C, Quinn GA, Connolly R, Wilson A, Connolly M, Soon W, Hynds P. Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population Health and Health Inequalities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5223. [PMID: 37047846 PMCID: PMC10094123 DOI: 10.3390/ijerph20075223] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/05/2023] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
Since the start of the COVID-19 pandemic in early 2020, governments around the world have adopted an array of measures intended to control the transmission of the SARS-CoV-2 virus, using both pharmaceutical and non-pharmaceutical interventions (NPIs). NPIs are public health interventions that do not rely on vaccines or medicines and include policies such as lockdowns, stay-at-home orders, school closures, and travel restrictions. Although the intention was to slow viral transmission, emerging research indicates that these NPIs have also had unintended consequences for other aspects of public health. Hence, we conducted a narrative review of studies investigating these unintended consequences of NPIs, with a particular emphasis on mental health and on lifestyle risk factors for non-communicable diseases (NCD): physical activity (PA), overweight and obesity, alcohol consumption, and tobacco smoking. We reviewed the scientific literature using combinations of search terms such as 'COVID-19', 'pandemic', 'lockdowns', 'mental health', 'physical activity', and 'obesity'. NPIs were found to have considerable adverse consequences for mental health, physical activity, and overweight and obesity. The impacts on alcohol and tobacco consumption varied greatly within and between studies. The variability in consequences for different groups implies increased health inequalities by age, sex/gender, socioeconomic status, pre-existing lifestyle, and place of residence. In conclusion, a proper assessment of the use of NPIs in attempts to control the spread of the pandemic should be weighed against the potential adverse impacts on other aspects of public health. Our findings should also be of relevance for future pandemic preparedness and pandemic response teams.
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Affiliation(s)
- Coilín ÓhAiseadha
- Department of Public Health, Health Service Executive, D08 W2A8 Dublin, Ireland
| | - Gerry A. Quinn
- Centre for Molecular Biosciences, Ulster University, Coleraine BT52 1SA, UK
| | - Ronan Connolly
- Independent Scientist, D08 Dublin, Ireland
- Center for Environmental Research and Earth Sciences (CERES), Salem, MA 01970, USA
| | - Awwad Wilson
- National Drug Treatment Centre, Health Service Executive, D02 NY26 Dublin, Ireland
| | - Michael Connolly
- Independent Scientist, D08 Dublin, Ireland
- Center for Environmental Research and Earth Sciences (CERES), Salem, MA 01970, USA
| | - Willie Soon
- Center for Environmental Research and Earth Sciences (CERES), Salem, MA 01970, USA
- Institute of Earth Physics and Space Science (ELKH EPSS), H-9400 Sopron, Hungary
| | - Paul Hynds
- SpatioTemporal Environmental Epidemiology Research (STEER) Group, Environmental Sustainability & Health Institute, Technological University, D07 H6K8 Dublin, Ireland
- Irish Centre for Research in Applied Geoscience, University College Dublin, D02 FX65 Dublin, Ireland
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15
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Oh KE, Kim YJ, Oh YR, Kang E, Nam HK, Rhie YJ, Lee KH. Commentary on "The prevalence of diabetic peripheral neuropathy in youth with diabetes mellitus". Ann Pediatr Endocrinol Metab 2023; 28:275-282. [PMID: 37015773 PMCID: PMC10765022 DOI: 10.6065/apem.2244214.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/10/2022] [Accepted: 02/16/2023] [Indexed: 01/05/2024] Open
Abstract
Purpose This study aimed to investigate the impact of coronavirus disease 2019 (COVID-19) on type 2 diabetes mellitus (T2DM) in children and adolescents. Methods Children and adolescents diagnosed with T2DM who visited the Korea University Hospital in 2019 and 2020 were retrospectively analyzed, including changes in body mass index (BMI)-standard deviation score (SDS), glycated hemoglobin (HbA1c), diabetes complications, and diabetes management from 2019 to 2020. Results Patient mean age and disease duration were 15.48±2.15 and 2.56±1.51 years, respectively. Obese patients accounted for 70.6% of the study population. From 2019 to 2020, mean BMI-SDS (2.21±1.25 vs. 2.35±1.43, P =0.044), HbA1c level (6.5%±2.72% vs. 7.3%±3.70%, P <0.001), blood pressure (BP), total cholesterol, and non–high-density lipoprotein cholesterol level in all patients increased significantly. Obesity was an independent predictor of increased HbA1c (95% confidence interval, 1.071–50.384; P =0.042). HbA1c levels did not increase significantly in nonobese patients, whereas HbA1c (6.45%±2.30% vs. 7.20%±3.05%, P <0.001), BMI-SDS (2.88±0.75 vs. 3.08±0.98, P =0.045), diastolic BP (P =0.037), and total cholesterol values (P =0.019) increased in obese patients in 2020 compared to 2019. Conclusions During the COVID-19 outbreak, glycemic control and diabetic complications worsened in children and adolescents with T2DM, particularly in obese patients. Close monitoring for glycemic control and diabetic complications is necessary in children and adolescents with T2DM, especially those with obesity.
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Affiliation(s)
- Kyeong Eun Oh
- Department of Pediatrics, Woori Children’s Hospital, Seoul, Korea
| | - Yu Jin Kim
- Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Ye Rim Oh
- Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Eungu Kang
- Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Hyo-Kyoung Nam
- Department of Pediatrics, Korea University Kuro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Young-Jun Rhie
- Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Kee-Hyoung Lee
- Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
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16
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Pierce SL, Kompaniyets L, Freedman DS, Goodman AB, Blanck HM. Children's rates of BMI change during pre-pandemic and two COVID-19 pandemic periods, IQVIA Ambulatory Electronic Medical Record, January 2018 Through November 2021. Obesity (Silver Spring) 2023; 31:693-698. [PMID: 36350181 PMCID: PMC9877959 DOI: 10.1002/oby.23643] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Many US youth experienced accelerated weight gain during the early COVID-19 pandemic. Using an ambulatory electronic health record data set, the authors compared children's rates of BMI change in three periods: pre-pandemic (January 2018-February 2020), early pandemic (March-December 2020), and later pandemic (January-November 2021). METHODS This study used mixed-effects models to examine differences in rates of change in BMI, weight, and obesity prevalence among the three periods. Covariates included time as a continuous variable, a variable indicating in which period each BMI was taken, sex, age, and initial BMI category. RESULTS In a longitudinal cohort of 241,600 children aged 2 through 19 years with ≥4 BMI measurements, the monthly rates of BMI change (kilograms per meters squared) were 0.056 (95% CI: 0.056-0.057) in the pre-pandemic period, 0.104 (95% CI: 0.102-0.106) in the early pandemic, and 0.035 (95% CI: 0.033-0.036) in the later pandemic. The estimated prevalence of obesity in this cohort was 22.5% by November 2021. CONCLUSIONS In this large, geographically diverse cohort of US youth, accelerated rates of BMI change observed during 2020 were largely attenuated in 2021. Positive rates indicate continued weight gain rather than loss, albeit at a slower rate. Childhood obesity prevalence remained high, which raises concern about long-term consequences of excess weight and underscores the importance of healthy lifestyle interventions.
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Affiliation(s)
- Samantha Lange Pierce
- Division of Nutrition, Physical Activity, and ObesityNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaGAUSA
| | - Lyudmyla Kompaniyets
- Division of Nutrition, Physical Activity, and ObesityNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaGAUSA
| | - David S. Freedman
- Division of Nutrition, Physical Activity, and ObesityNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaGAUSA
| | - Alyson B. Goodman
- Division of Nutrition, Physical Activity, and ObesityNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaGAUSA
- U.S. Public Health Service Commissioned CorpsRockvilleMDUSA
| | - Heidi M. Blanck
- Division of Nutrition, Physical Activity, and ObesityNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaGAUSA
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17
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Koebnick C, Sidell MA, Li X, Resnicow K, Kunani P, Young DR, Woolford SJ. Disparities in weight changes during the COVID-19 pandemic-related lockdown in youths. Obesity (Silver Spring) 2023; 31:789-801. [PMID: 36350042 PMCID: PMC9877933 DOI: 10.1002/oby.23645] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 10/18/2022] [Accepted: 10/21/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This study evaluates whether changes in weight among school-aged youth in California due to the COVID-19 lockdown vary by social constructs of race/ethnicity and associated social factors. METHODS Including 160,472 youth aged 5 to 17 years enrolled at Kaiser Permanente Southern California, mixed effects models stratified by age group were fitted to estimate changes in distance from the median BMI-for-age from March 2020 to January 2021 (lockdown) compared with the same period before the pandemic. RESULTS Excess pandemic weight gain was higher among Black and Hispanic youth aged 5 to 17 years than among White and Asian youth; this difference was most pronounced in those aged 5 to 11 years. In youth aged 5 to 11 years, the distance from the median BMI-for-age increased by 1.72 kg/m2 (95% CI: 1.61-1.84) in Hispanic and 1.70 kg/m2 (95% CI: 1.47-1.94) in Black youth during the lockdown compared with 1.16 kg/m2 (95% CI: 1.02-1.29) in non-Hispanic White youth. The excess weight gain was also higher in youth with fewer neighborhood parks and those with state-subsidized health insurance. CONCLUSIONS The COVID-19 pandemic lockdown led to a gain of excess body weight, particularly for Black and Hispanic youth; this weight gain varied by social factors associated with race and ethnicity.
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Affiliation(s)
- Corinna Koebnick
- Department of Research & EvaluationKaiser Permanente Southern CaliforniaPasadenaCA
| | - Margo A. Sidell
- Department of Research & EvaluationKaiser Permanente Southern CaliforniaPasadenaCA
| | - Xia Li
- Department of Research & EvaluationKaiser Permanente Southern CaliforniaPasadenaCA
| | - Ken Resnicow
- School of Public HealthUniversity of Michigan Health Behavior and Health EducationAnn ArborMI
| | - Poornima Kunani
- Department of PediatricsKaiser Permanente Manhattan Beach Medical OfficeManhattan BeachCA
| | - Deborah R. Young
- Department of Research & EvaluationKaiser Permanente Southern CaliforniaPasadenaCA
| | - Susan J. Woolford
- Child Health Evaluation and Research Center, Department of PediatricsUniversity of MichiganAnn ArborMI
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18
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Dietz WH. The COVID-19 lockdown increased obesity disparities; will the increases in type 2 diabetes continue? Obesity (Silver Spring) 2023; 31:699-702. [PMID: 36447419 PMCID: PMC9877697 DOI: 10.1002/oby.23662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/15/2022] [Accepted: 11/20/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVE The aim of this study was to compare the prevalence of the increases in pediatric obesity during the COVID-19 lockdown with the annual increases in obesity in the National Health and Nutrition Examination Survey (NHANES). METHODS This study compared two reports of increases in the prevalence of obesity in youth during the COVID-19 lockdown with the annual rate of increase in obesity in NHANES. RESULTS When expressed as multiples, the changes in prevalence among elementary school children observed in two population-based surveys were 28 to 63 times greater than the annual changes in the prevalence of obesity observed in NHANES. Increases in Black and Hispanic youth were greater than those in White youth. The net impact of the COVID-19 lockdown increased the disparities in obesity among this age group. CONCLUSIONS The rapid increases in obesity are likely to persist and may be associated with an increase in the prevalence of severe obesity as these children age. Furthermore, the increased susceptibility to diabetes in Hispanic and Black children, as well as the reported increase in diabetes among 0- to 18-year-old individuals during the COVID-19 pandemic, may lead to an increased incidence of type 2 diabetes in minority youth with obesity.
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Affiliation(s)
- William H. Dietz
- Redstone Global Center for Prevention and Wellness, George Washington University School of Public Health, George Washington UniversityWashingtonDCUSA
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19
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Anderson LN, Yoshida-Montezuma Y, Dewart N, Jalil E, Khattar J, De Rubeis V, Carsley S, Griffith LE, Mbuagbaw L. Obesity and weight change during the COVID-19 pandemic in children and adults: A systematic review and meta-analysis. Obes Rev 2023; 24:e13550. [PMID: 36721999 DOI: 10.1111/obr.13550] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 11/01/2022] [Accepted: 12/16/2022] [Indexed: 02/02/2023]
Abstract
Many obesity risk factors have increased during the COVID-19 pandemic, including physical inactivity, poor diet, stress, and poverty. The aim of this systematic review was to evaluate the impact of the COVID-19 pandemic, as well as associated lockdowns or restrictions, on weight change in children and adults. We searched five databases from January 2020 to November 2021. We included only longitudinal studies with measures from before and during the pandemic that evaluated the change in weight, body mass index (BMI) (or BMI z-scores for children), waist circumference, or the prevalence of obesity. Random effects meta-analyses were conducted to obtain pooled estimates of the mean difference in outcomes. Subgroups were evaluated for age groups and diabetes or obesity at baseline. The risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale, and the certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. A total of 74 studies were included (3,213,776 total participants): 31 studies of children, 41 studies of adults, and 2 studies of children and adults. In children, the pooled mean difference was 1.65 kg (95% confidence interval [CI]: 0.40, 2.90; 9 studies) for weight and 0.13 (95% CI 0.10, 0.17; 20 studies) for BMI z-scores, and the prevalence of obesity increased by 2% (95% CI 1%, 3%; 12 studies). In adults, the pooled mean difference was 0.93 kg (95% CI 0.54, 1.33; 27 studies) for weight and 0.38 kg/m2 (95% CI 0.21, 0.55; 25 studies) for BMI, and the prevalence of obesity increased by 1% (95% CI 0%, 3%; 11 studies). In children and adults, the pooled mean difference for waist circumference was 1.03 cm (95% CI -0.08, 2.15; 4 studies). There was considerable heterogeneity observed for all outcomes in both children and adults, and the certainty of evidence assessed using GRADE was very low for all outcomes. During the first year of the COVID-19 pandemic, small but potentially clinically significant increases in weight gain, BMI, and increased prevalence of obesity in both children and adults were observed. Increases were greater in children, and targeted prevention interventions may be warranted.
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Affiliation(s)
- Laura N Anderson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Yulika Yoshida-Montezuma
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Nora Dewart
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ezza Jalil
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jayati Khattar
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Vanessa De Rubeis
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sarah Carsley
- Department of Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada.,McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, Ontario, Canada.,Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon.,Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
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20
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Dopke KM, Pattison KL, Schaefer EW, Fogel BN, Sekhar DL. Effects of COVID-19 pandemic on pediatric weight: A retrospective chart review. Prev Med Rep 2023; 31:102109. [PMID: 36619801 PMCID: PMC9806925 DOI: 10.1016/j.pmedr.2022.102109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 12/05/2022] [Accepted: 12/31/2022] [Indexed: 01/03/2023] Open
Abstract
The COVID-19 pandemic forced United States school closures in March 2020. Students moved to online learning, fostering a sedentary lifestyle. As the pandemic heightened population disparities, the impact on weight gain may also be unequally distributed. This study aimed to evaluate changes in body mass index (BMI) z-scores and weight percentiles of pediatric patients during the pandemic and associated demographics to identify those at risk for weight gain. Methods included a retrospective chart review of patients 5-18 years-old with a well-visit in the three years 2018, 2019 and 2020; first identified with a well-visit in August-September of 2020. BMI z-scores and weight percentiles were analyzed using a correlated errors regression model appropriate for longitudinal data. This longitudinal approach was used to model outcomes by patient demographics. Interaction terms with time were evaluated for each variable. Of 728 patients, mean age was 9.7 years (2018); 47 % female, 70 % white, and 23 % publicly insured. BMI z-score did not increase significantly from 2018-2019 versus 2019-2020. Weight percentile demonstrated a slight trajectory increase over these same time points. Publicly insured patients demonstrated significantly greater increase in BMI z-score versus privately insured patients (p = 0.009). Mean differences between groups increased from 0.26 in 2018 (95 % CI [0.07, 0.45]) to 0.42 in 2020 (95 % CI [0.23, 0.61]). Results were similar for weight percentile. Publicly insured pediatric patients experienced significant increase in BMI-z score and weight percentile, but over time this trajectory remained constant. The results support targeting at risk subgroups in addressing long-term impacts of the pandemic.
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Affiliation(s)
- Kelly M. Dopke
- Pediatrics, Penn State College of Medicine, Hershey, PA, United States,Corresponding author at: 90 Hope Drive, A145, Hershey, PA 17033, United States.
| | | | - Eric W. Schaefer
- Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Benjamin N. Fogel
- Pediatrics, Penn State College of Medicine, Hershey, PA, United States
| | - Deepa L. Sekhar
- Pediatrics, Penn State College of Medicine, Hershey, PA, United States
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21
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McGuine T, Biese K, Hetzel S, Schwarz A, Reardon C, Bell DR, Brooks A, Dickman J, Watson AM. A Multiyear Assessment of the Effect of Sport Participation on the Health of Adolescent Athletes During the COVID-19 Pandemic. J Athl Train 2023; 58:44-50. [PMID: 35380683 PMCID: PMC9913056 DOI: 10.4085/1062-6050-0679.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Sport cancellations early in the COVID-19 pandemic had a significant negative effect on the health of US adolescents. The effect of restarting sports during the pandemic has not been described. OBJECTIVE To identify the effect of sport participation on the health of adolescents before and during the COVID-19 pandemic. DESIGN Cross-sectional study. SETTING Sample recruited via social media. PATIENTS OR OTHER PARTICIPANTS Wisconsin adolescent athletes. MAIN OUTCOME MEASURE(S) Participants provided information regarding their age, sex, and sport(s) involvement and completed the Patient Health Questionnaire-9 Item to assess depression symptoms, the Hospital for Special Surgery Pediatric Functional Activity Brief Scale to measure physical activity, and the Pediatric Quality of Life Inventory 4.0 to measure quality of life (QoL). Data were collected in spring 2021 (Spring21; n = 1906, age = 16.0 ± 1.2 years, females = 48.8%), when interscholastic sports had fully resumed, and were compared with similar cohorts of adolescent athletes at 2 time points: (1) spring 2020 (Spring20; n = 3243, age = 16.2 ± 1.2 years, females = 57.9%) when sports were cancelled and (2) 2016-2018 (PreCOVID-19) before the pandemic (n = 5231, age = 15.7 ± 1.1 years, females = 65.0%). Comparisons were conducted via analysis-of-variance models and ordinal regressions with age and sex as covariates. RESULTS The prevalence of moderate to severe depression was lower in Spring21 than in Spring20 but higher than in PreCOVID-19 (PreCOVID-19 = 5.3%, Spring20 = 37.8%, Spring21 = 22.8%; P < .001). Physical activity scores (mean [95% CI]) were higher in Spring21 than in Spring20 but lower than in PreCOVID-19 (PreCOVID-19 = 23.1 [22.7, 23.5], Spring20 = 13.5 [13.3, 13.7], Spring21 = 21.9 [21.6, 22.2]). Similarly, QoL scores were higher in Spring21 than in Spring20 but lower than in PreCOVID-19 (PreCOVID-19 = 92.8 [92.5, 93.1], Spring20 = 80.7 [80.3, 81.1], Spring21 = 84.3 [83.8, 84.8]). CONCLUSIONS Although sports have restarted, clinicians should be aware that physical activity, mental health, and QoL are still significantly affected in adolescent athletes by the ongoing pandemic.
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Affiliation(s)
- Timothy McGuine
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison
| | | | - Scott Hetzel
- Clinical Science Center, University of Wisconsin-Madison
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22
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Azrak MÁ, Fasano MV, Avico AJ, Sala M, Casado C, Padula M, Kruger AL, Malpeli A, Andreoli MF. Prolonged body weight gain, lifestyle changes and health-related quality of life in children during the COVID-19 pandemic lockdown: A follow-up study. Eur J Clin Nutr 2022; 77:460-467. [PMID: 36510000 PMCID: PMC9744372 DOI: 10.1038/s41430-022-01252-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Further investigation is needed to define the impact of long-term pandemic lockdown in children. OBJECTIVES To examine changes in body mass index z-score (zBMI), lifestyle, Health-Related Quality of Life and proportion of overweight or obesity (OW/OB) in 6- to 9-year-old children in Argentina. METHODS Observational study with baseline measurements prior to lockdown and follow-up after eight months of strict restrictive measures (November 2020, first visit, n = 144) and after ten months of partial reopening (September 2021, second visit, n = 108). Anthropometric changes from baseline to first visit in lockdown group (LG) were compared with a historical control group (HCG, n = 134). Follow-up visits included anthropometric measures, lifestyle questionnaire and Pediatric Quality of Life Inventory. RESULTS Change in zBMI was higher in LG [median, IQR: 0.46 (-0.00; 0.83)] vs HCG [median, IQR: 0.02 (-0.31; 0.27)]; p < 0.001, particularly in children with pre-existing OW/OB. In LG, zBMI was higher at first and second visit vs baseline (p < 0.001) and in second visit vs first visit for boys (p = 0.037) but not for girls. The proportion of children with OW/OB increased from baseline (43.5%) to first (56.5%) and second visit (58.3%) (p = 0.029). Unlike girls, the proportion of boys with OW/OB increased from baseline to first and second visit (p = 0.045). Change in zBMI was higher in children with less healthy habits (p < 0.001). CONCLUSIONS Weight gain continued to increase in boys when lockdown measurements were eased, although sedentary behaviors decreased and quality of life improved, indicating that the effects of pandemic lockdown could be difficult to reverse.
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Affiliation(s)
- María Ángeles Azrak
- Instituto de Desarrollo e Investigaciones Pediátricas (IDIP) Prof. Dr. Fernando E. Viteri. HIAEP “Sor María Ludovica” de La Plata - CIC-PBA. La Plata, Buenos Aires, Argentina
| | - María Victoria Fasano
- Instituto de Desarrollo e Investigaciones Pediátricas (IDIP) Prof. Dr. Fernando E. Viteri. HIAEP “Sor María Ludovica” de La Plata - CIC-PBA. La Plata, Buenos Aires, Argentina ,grid.9499.d0000 0001 2097 3940Centro de Matemática de La Plata (CMaLP), Facultad de Ciencias Exactas, UNLP - CIC-PBA. La Plata, Buenos Aires, Argentina
| | - Ana Julia Avico
- Instituto de Desarrollo e Investigaciones Pediátricas (IDIP) Prof. Dr. Fernando E. Viteri. HIAEP “Sor María Ludovica” de La Plata - CIC-PBA. La Plata, Buenos Aires, Argentina
| | - Marisa Sala
- Instituto de Desarrollo e Investigaciones Pediátricas (IDIP) Prof. Dr. Fernando E. Viteri. HIAEP “Sor María Ludovica” de La Plata - CIC-PBA. La Plata, Buenos Aires, Argentina
| | - Carla Casado
- Instituto de Desarrollo e Investigaciones Pediátricas (IDIP) Prof. Dr. Fernando E. Viteri. HIAEP “Sor María Ludovica” de La Plata - CIC-PBA. La Plata, Buenos Aires, Argentina
| | - Marcela Padula
- Instituto de Desarrollo e Investigaciones Pediátricas (IDIP) Prof. Dr. Fernando E. Viteri. HIAEP “Sor María Ludovica” de La Plata - CIC-PBA. La Plata, Buenos Aires, Argentina
| | - Ana Luz Kruger
- Instituto de Desarrollo e Investigaciones Pediátricas (IDIP) Prof. Dr. Fernando E. Viteri. HIAEP “Sor María Ludovica” de La Plata - CIC-PBA. La Plata, Buenos Aires, Argentina ,grid.423606.50000 0001 1945 2152CONICET. La Plata, Buenos Aires, Argentina
| | - Agustina Malpeli
- Instituto de Desarrollo e Investigaciones Pediátricas (IDIP) Prof. Dr. Fernando E. Viteri. HIAEP “Sor María Ludovica” de La Plata - CIC-PBA. La Plata, Buenos Aires, Argentina
| | - María F. Andreoli
- Instituto de Desarrollo e Investigaciones Pediátricas (IDIP) Prof. Dr. Fernando E. Viteri. HIAEP “Sor María Ludovica” de La Plata - CIC-PBA. La Plata, Buenos Aires, Argentina ,grid.423606.50000 0001 1945 2152CONICET. La Plata, Buenos Aires, Argentina
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23
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Magge SN, Wolf RM, Pyle L, Brown EA, Benavides VC, Bianco ME, Chao LC, Cymbaluk A, Balikcioglu PG, Halpin K, Hsia DS, Huerta-Saenz L, Kim JJ, Kumar S, Levitt Katz LE, Marks BE, Neyman A, O'Sullivan KL, Pillai SS, Shah AS, Shoemaker AH, Siddiqui JAW, Srinivasan S, Thomas IH, Tryggestad JB, Yousif MF, Kelsey MM. The Coronavirus Disease 2019 Pandemic is Associated with a Substantial Rise in Frequency and Severity of Presentation of Youth-Onset Type 2 Diabetes. J Pediatr 2022; 251:51-59.e2. [PMID: 35985535 PMCID: PMC9383958 DOI: 10.1016/j.jpeds.2022.08.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/31/2022] [Accepted: 08/10/2022] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To evaluate the frequency and severity of new cases of youth-onset type 2 diabetes in the US during the first year of the pandemic compared with the mean of the previous 2 years. STUDY DESIGN Multicenter (n = 24 centers), hospital-based, retrospective chart review. Youth aged ≤21 years with newly diagnosed type 2 diabetes between March 2018 and February 2021, body mass index ≥85th percentile, and negative pancreatic autoantibodies were included. Demographic and clinical data, including case numbers and frequency of metabolic decompensation, were compared between groups. RESULTS A total of 3113 youth (mean [SD] 14.4 [2.4] years, 50.5% female, 40.4% Hispanic, 32.7% Black, 14.5% non-Hispanic White) were assessed. New cases of type 2 diabetes increased by 77.2% in the year during the pandemic (n = 1463) compared with the mean of the previous 2 years, 2019 (n = 886) and 2018 (n = 765). The likelihood of presenting with metabolic decompensation and severe diabetic ketoacidosis also increased significantly during the pandemic. CONCLUSIONS The burden of newly diagnosed youth-onset type 2 diabetes increased significantly during the coronavirus disease 2019 pandemic, resulting in enormous strain on pediatric diabetes health care providers, patients, and families. Whether the increase was caused by coronavirus disease 2019 infection, or just associated with environmental changes and stressors during the pandemic is unclear. Further studies are needed to determine whether this rise is limited to the US and whether it will persist over time.
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Affiliation(s)
- Sheela N Magge
- Division of Pediatric Endocrinology and Diabetes, Johns Hopkins Hospital/Johns Hopkins University School of Medicine, Baltimore, MD
| | - Risa M Wolf
- Division of Pediatric Endocrinology and Diabetes, Johns Hopkins Hospital/Johns Hopkins University School of Medicine, Baltimore, MD
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus/Children's Hospital Colorado, Aurora, CO
| | - Elizabeth A Brown
- Division of Pediatric Endocrinology and Diabetes, Johns Hopkins Hospital/Johns Hopkins University School of Medicine, Baltimore, MD
| | - Valeria C Benavides
- Department of Pediatrics, Division of Endocrinology, University of Illinois, College of Medicine of Peoria/Children's Hospital of Illinois, Peoria, IL
| | - Monica E Bianco
- Department of Pediatrics, Division of Pediatric Endocrinology, Northwestern University/Ann and Robert H Lurie Children's Hospital, Chicago, IL
| | - Lily C Chao
- Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA
| | - Anna Cymbaluk
- Department of Pediatric Diabetes and Endocrinology, Texas Children's Hospital/Baylor College of Medicine, Houston, TX
| | - Pinar Gumus Balikcioglu
- Division of Pediatric Endocrinology and Diabetes and Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC
| | - Kelsee Halpin
- Division of Endocrinology and Diabetes, University of Missouri-Kansas City School of Medicine, Children's Mercy Kansas City, Kansas City, MO
| | - Daniel S Hsia
- Our Lady of the Lake Children's Hospital/Pennington Biomedical Research Center, Baton Rouge, LA
| | - Lina Huerta-Saenz
- Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, Penn State Health Children's Hospital/Penn State College of Medicine, Hershey, PA
| | - Jane J Kim
- Department of Pediatrics, Division of Pediatric Endocrinology, University of California San Diego/Rady Children's Hospital San Diego, San Diego, CA
| | - Seema Kumar
- Department of Pediatrics, Division of Pediatric Endocrinology, Mayo Clinic, Rochester, MN
| | - Lorraine E Levitt Katz
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Brynn E Marks
- Division of Endocrinology and Diabetes, Children's National Hospital, Washington DC
| | - Anna Neyman
- Department of Pediatrics, Indiana University School of Medicine/Riley Hospital for Children, Indianapolis, IN
| | - Katie L O'Sullivan
- Section of Adult & Pediatric Endocrinology, Diabetes & Metabolism, University of Chicago Medical Center, Chicago, IL
| | - Sabitha Sasidharan Pillai
- Division of Pediatric Endocrinology, Warren Alpert Medical School of Brown University/Hasbro Children's Hospital, Providence, RI
| | - Amy S Shah
- Division of Pediatric Endocrinology, Cincinnati Children's Hospital Medical Center & The University of Cincinnati, Cincinnati, OH
| | - Ashley H Shoemaker
- Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, Vanderbilt University Medical Center, Nashville, TN
| | | | - Shylaja Srinivasan
- Department of Pediatrics, Division of Endocrinology, University of California, San Francisco, San Francisco, CA
| | - Inas H Thomas
- Department of Pediatrics, Pediatric Endocrinology, University of Michigan, Ann Arbor, MI
| | - Jeanie B Tryggestad
- Department of Pediatrics, Section of Diabetes/Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Maha F Yousif
- Department of Pediatrics, Pediatric Endocrinology, University of Texas Southwestern, Dallas, TX
| | - Megan M Kelsey
- Department of Pediatrics, University of Colorado Anschutz Medical Campus/Children's Hospital Colorado, Aurora, CO.
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24
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Mandelbaum J, Harrison SE. Primary Care Clinicians' Perceived Role in Addressing Childhood Obesity in the Southern United States. South Med J 2022; 115:824-830. [PMID: 36318948 DOI: 10.14423/smj.0000000000001468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVES Primary care is an opportune setting to promote healthy behaviors for children and families. In 2007, an expert committee recommended that pediatric primary care clinicians assess nutrition and physical activity at wellness visits and offer recommendations; however, little is known about what pediatric primary care clinicians perceive their role as in childhood weight management. This qualitative study aimed to describe the perceived role of pediatric primary care clinicians in the prevention and treatment of childhood obesity in South Carolina, a state in the southern United States with high rates of childhood obesity. METHODS Pediatric primary care clinicians (n = 23) from South Carolina were recruited for two focus groups. Participants were asked semistructured, open-ended questions, and audio recordings were transcribed verbatim. Themes and subthemes were identified through an iterative coding and consensus-building process with two coders. Excerpts coded under the parent code of "clinician role" centered on three themes: conducting assessments, making referrals, and providing education. RESULTS Pediatric primary care clinicians in South Carolina coalesced around the important role of addressing childhood obesity within primary care. Notably, clinicians primarily discussed treatment rather than prevention strategies and described changes in the scope of their practice over time as a result of the increasing numbers of pediatric patients with obesity. CONCLUSIONS Addressing childhood obesity within primary care is a critical component of obesity prevention and treatment in the southern United States. Effective, sustainable prevention and treatment within primary care will depend on the involvement of pediatric clinicians, thus emphasizing the importance of understanding how they perceive their role within this setting.
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Affiliation(s)
- Jennifer Mandelbaum
- From the Departments of Health Promotion, Education, and Behavior and Psychology, University of South Carolina, Columbia
| | - Sayward E Harrison
- From the Departments of Health Promotion, Education, and Behavior and Psychology, University of South Carolina, Columbia
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25
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Ge W, Hu J, Xiao Y, Liang F, Yi L, Zhu R, Yin J. COVID-19‒Related Childhood BMI Increases in China: A Health Surveillance‒Based Ambispective Cohort Analysis. Am J Prev Med 2022; 63:647-655. [PMID: 35688722 PMCID: PMC9072804 DOI: 10.1016/j.amepre.2022.04.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 03/23/2022] [Accepted: 04/20/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION The COVID-19 pandemic‒related BMI gain and obesity prevalence changes in children have not been clearly elucidated, especially in China. This study aims to assess the impact of pandemic-related BMI and obesity prevalence change in Chinese children aged 8-12 years. METHODS On the basis of the Health Promotion Program for Children and Adolescents in Suzhou of China, a total of 72,175 children aged 8-12 years with complete data during 2017-2020 were included. Yearly BMI z-score changes and age- and sex-adjusted BMI changes before (2017-2019) and during (2019-2020) the pandemic were calculated. Multivariate mixed linear models were used to examine the possible difference in annual BMI change rate before and during the pandemic among subgroups. RESULTS The obesity prevalence slightly increased from 12.29% (2017) to 13.28% (2019) but substantially increased to 15.29% in 2020. The mean yearly change in BMI z-score before and during the pandemic were 0.039 (95% CI=0.037, 0.042) and 0.131 (95% CI=0.125, 0.138), respectively, yielding a difference of 0.092 (95% CI=0.087, 0.096). Similarly, changes and age- and sex-adjusted BMI increased by 0.191 (95% CI=0.179, 0.202) during the pandemic compared with those of previous years. Meanwhile, the increase in BMI changes in 2019-2020 compared with that before the pandemic was more obvious in boys than in girls and in underweight or normal-weight children than in their overweight and obese counterparts. CONCLUSIONS BMI gain increased among Chinese children aged 8-12 years during the pandemic. There is an urgent need to formulate effective public health policies to reduce the risk of pandemic-related childhood obesity.
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Affiliation(s)
- Wenxin Ge
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jia Hu
- Suzhou Center for Disease Prevention and Control, Suzhou, China; State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Suzhou Institute of Advanced Study in Public Health, Gusu School, Nanjing Medical University, Suzhou, China
| | - Yue Xiao
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Fei Liang
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Liping Yi
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Rushun Zhu
- Taicang Science and Education New Ton Community Health Service Center, Taichang, China
| | - Jieyun Yin
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China.
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26
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Freedman DS, Kompaniyets L, Daymont C, Zhao L, Blanck HM. Weight gain among US adults during the COVID-19 pandemic through May 2021. Obesity (Silver Spring) 2022; 30:2064-2070. [PMID: 35822832 PMCID: PMC9349426 DOI: 10.1002/oby.23511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/19/2022] [Accepted: 06/03/2022] [Indexed: 12/02/2022]
Abstract
OBJECTIVE There have been conflicting reports concerning weight gain among adults during the COVID-19 epidemic. Although early studies reported large weight increases, several of these analyses were based on convenience samples or self-reported information. The objective of the current study is to examine the pandemic-related weight increase associated with the pandemic through May 2021. METHODS A total of 4.25 million adults (18 to 84 years) in an electronic health record database who had at least two weight measurements between January 2019 and February 2020 and one after June 2020 were selected. Weight changes before and after March 2020 were contrasted using mixed-effects regression models. RESULTS Compared with the pre-pandemic weight trend, there was a small increase (0.1 kg) in weight in the first year of the pandemic (March 2020 through March 2021). Weight changes during the pandemic varied by sex, age, and initial BMI, but the largest mean increase across these characteristics was < 1.3 kg. Weight increases were generally greatest among women, adults with BMI of 30 or 35 kg/m2 , and younger adults. CONCLUSIONS The results indicate that the mean weight gain among adults during the COVID-19 pandemic may be small.
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Affiliation(s)
- David S. Freedman
- Division of Nutrition, Physical Activity, and ObesityCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Lyudmyla Kompaniyets
- Division of Nutrition, Physical Activity, and ObesityCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Carrie Daymont
- Departments of Pediatrics and Public Health SciencePenn State College of MedicineHersheyPennsylvaniaUSA
| | - Lixia Zhao
- Division of Nutrition, Physical Activity, and ObesityCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Heidi M. Blanck
- Departments of Pediatrics and Public Health SciencePenn State College of MedicineHersheyPennsylvaniaUSA
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27
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Nagashima Y, Inokuchi M, Yasui Y, Uchida K, Tokumura M, Hasegawa T. Impact of school closure due to the coronavirus disease 2019 pandemic on body mass index in Japanese children: Retrospective longitudinal study. J Paediatr Child Health 2022; 58:1841-1846. [PMID: 35841347 DOI: 10.1111/jpc.16122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 11/27/2022]
Abstract
AIM During the coronavirus disease 2019 pandemic, the governments of many countries responded to high levels of infection with lockdowns. As a result, some children were reported to experience weight gain. The aim of the present study was to examine the impact of school closures on body mass index (BMI) in Japanese children. METHODS This was a retrospective study of students enrolled in the participating schools (6- to 11-year-old elementary school students and 12- to 14-year-old junior high school students) between 2015 and 2020. Using school health check-up data, annual changes in the BMI standard deviation score (ΔBMI-SDS) were calculated. We compared ΔBMI-SDS in 2019-2020 with the corresponding control years. RESULTS 19 565 children with complete data were included in the analysis. Median ΔBMI-SDS in 2019-2020 were 0.24-0.35 in elementary school boys, 0.10-0.13 in junior high school boys, -0.02 to 0.15 in elementary school girls and -0.14 to -0.10 in junior high school girls. In comparison with every control year, ΔBMI-SDS in 2019-2020 were significantly higher in elementary school boys (control years: -0.07 to 0.14) and junior high school boys (control years: -0.04 to 0.06), and significantly lower in junior high school girls (control years: -0.06 to 0.09). CONCLUSION BMI-SDS increased significantly in elementary and junior high school boys, but decreased significantly in junior high school girls. The pandemic appears to have had an impact on Japanese children that was different from other countries.
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Affiliation(s)
- Yuka Nagashima
- Health Center, Keio University, Yokohama-shi, Japan.,Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Mikako Inokuchi
- Health Center, Keio University, Yokohama-shi, Japan.,Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Yosuke Yasui
- Health Center, Keio University, Yokohama-shi, Japan.,Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Keiko Uchida
- Health Center, Keio University, Yokohama-shi, Japan.,Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Mitsuaki Tokumura
- Health Center, Keio University, Yokohama-shi, Japan.,Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Tomonobu Hasegawa
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
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28
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Marlow AL, King BR, Phelan HT, Smart CE. Adolescents with type 1 diabetes can achieve glycemic targets on intensive insulin therapy without excessive weight gain. Endocrinol Diabetes Metab 2022; 5:e352. [PMID: 35715954 PMCID: PMC9258989 DOI: 10.1002/edm2.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/10/2022] [Accepted: 05/14/2022] [Indexed: 11/12/2022] Open
Abstract
Introduction The aim of this study was to compare glycemic control and body mass index standard deviation score (BMI‐SDS) before and after implementation of intensive insulin therapy using multiple daily injection (MDI) or continuous subcutaneous insulin infusion (CSII) in adolescents with type 1 diabetes (T1D) attending a large multidisciplinary paediatric diabetes clinic in Australia. Methods Prospective data were collected for cross‐sectional comparison of youth aged 10.0–17.9 years (n = 669) from routine follow‐up visits to the diabetes clinic in 2004, 2010, and 2016. Outcome measures included HbA1c; BMI‐SDS; and insulin regimen. Results BMI‐SDS remained stable between 2004 to 2016 in the 10–13 and 14–17 year age group (0.7 vs. 0.5, p = .12 and 0.7 vs. 0.7, p = .93, respectively). BMI‐SDS was not different across HbA1c groups; <53 mmol/mol (7.0%), 53 to <75 mmol/mol (<7.0 to <9.0%) and >75 mmol/mol (>9.0%) in 2004 (p = .873), 2010 (p = .10) or 2016 (p = .630). Mean HbA1c decreased from 2004 to 2016 in the 10–13 year (69 mmol/mol (8.4%) vs. 57 mmol/mol (7.4%), p = <.001) and 14–17 year group (72 mmol/mol (8.7%) vs. 63 mmol/mol (7.9%), p = <.001). Prior to the implementation of MDI and CSII in 2004 only 10% of 10–13 year olds and 8% of 14–17 year olds achieved the international target for glycemic control (HbA1c 53 mmol/mol [<7.0%]). In 2016, this increased to 31% of 10–13 year olds and 21% of 14–17 year olds. Conclusions BMI‐SDS did not increase with the change to intensive insulin therapy despite a doubling in the number of adolescents achieving the recommended glycemic target of <7.0% (53 mmol/mol). HbA1c was not associated with weight gain.
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Affiliation(s)
- Alexandra L. Marlow
- School of Medicine and Public Health University of Newcastle Callaghan New South Wales Australia
- Hunter Medical Research Institute New Lambton Heights New South Wales Australia
| | - Bruce R. King
- School of Medicine and Public Health University of Newcastle Callaghan New South Wales Australia
- Hunter Medical Research Institute New Lambton Heights New South Wales Australia
- Department of Pediatric Endocrinology and Diabetes John Hunter Children's Hospital New Lambton Heights New South Wales Australia
| | - Helen T. Phelan
- Department of Pediatric Endocrinology and Diabetes John Hunter Children's Hospital New Lambton Heights New South Wales Australia
| | - Carmel E. Smart
- School of Medicine and Public Health University of Newcastle Callaghan New South Wales Australia
- Hunter Medical Research Institute New Lambton Heights New South Wales Australia
- Department of Pediatric Endocrinology and Diabetes John Hunter Children's Hospital New Lambton Heights New South Wales Australia
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Miller A, Bochner R, Sohler N, Calixte R, Chan C, Umpaichitra V, Shalmiyev E, Novikova N, Desai N, Seigel W, Chin V, Periasamy S, Waldman L, Bamji M, Nagpal N, Duh‐Leong C, Reznik M, Messito M, Bargman R. Modified body mass index z-scores in children in New York City during the COVID-19 pandemic. Pediatr Obes 2022; 17:e12958. [PMID: 35770679 PMCID: PMC9350030 DOI: 10.1111/ijpo.12958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/02/2022] [Accepted: 06/13/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Determine whether the negative impact of the COVID-19 pandemic on weight gain trajectories among children attending well-child visits in New York City persisted after the public health restrictions were reduced. STUDY DESIGN Multicenter retrospective chart review study of 7150 children aged 3-19 years seen for well-child care between 1 January 2018 and 4 December 2021 in the NYC Health and Hospitals system. Primary outcome was the difference in annual change of modified body mass index z-score (mBMIz) between the pre-pandemic and early- and late-pandemic periods. The mBMIz allows for tracking of a greater range of BMI values than the traditional BMI z-score. The secondary outcome was odds of overweight, obesity, or severe obesity. Multivariable analyses were conducted with each outcome as the dependent variable, and year, age category, sex, race/ethnicity, insurance status, NYC borough, and baseline weight category as independent variables. RESULTS The difference in annual mBMIz change for pre-pandemic to early-pandemic = 0.18 (95% confidence interval [CI]: 0.15, 0.20) and for pre-pandemic to late-pandemic = 0.04 (95% CI: 0.01, 0.06). There was a statistically significant interaction between period and baseline weight category. Those with severe obesity at baseline had the greatest mBMIz increase during both pandemic periods and those with underweight at baseline had the lowest mBMIz increase during both pandemic periods. CONCLUSION In NYC, the worsening mBMIz trajectories for children associated with COVID-19 restrictions did not reverse by 2021. Decisions about continuing restrictions, such as school closures, should carefully weigh the negative health impact of these policies.
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Affiliation(s)
- Assia Miller
- New York City Health and Hospitals Kings County HospitalBrooklynNew YorkUSA,State University of New York Downstate Health Sciences UniversityBrooklynNew YorkUSA
| | - Risa Bochner
- New York City Health and Hospitals Kings County HospitalBrooklynNew YorkUSA,State University of New York Downstate Health Sciences UniversityBrooklynNew YorkUSA
| | - Nancy Sohler
- City University of New York School of MedicineManhattanNew YorkUSA
| | - Rose Calixte
- State University of New York Downstate Health Sciences UniversityBrooklynNew YorkUSA
| | - Cameron Chan
- City University of New York School of MedicineManhattanNew YorkUSA
| | - Vatcharapan Umpaichitra
- New York City Health and Hospitals Kings County HospitalBrooklynNew YorkUSA,State University of New York Downstate Health Sciences UniversityBrooklynNew YorkUSA
| | - Elman Shalmiyev
- New York City Health and Hospitals Central OfficeManhattanNew YorkUSA
| | - Natalia Novikova
- New York City Health and Hospitals Central OfficeManhattanNew YorkUSA
| | - Ninad Desai
- New York City Health and Hospitals Kings County HospitalBrooklynNew YorkUSA
| | - Warren Seigel
- New York City Health and Hospitals Coney Island HospitalBrooklynNew YorkUSA
| | - Vivian Chin
- New York City Health and Hospitals Kings County HospitalBrooklynNew YorkUSA,State University of New York Downstate Health Sciences UniversityBrooklynNew YorkUSA
| | - Sundari Periasamy
- New York City Health and Hospitals Harlem HospitalManhattanNew YorkUSA
| | - Lee Waldman
- New York City Health and Hospitals Kings County HospitalBrooklynNew YorkUSA
| | - Mahrukh Bamji
- New York City Health and Hospitals Metropolitan HospitalManhattanNew YorkUSA
| | - Nikita Nagpal
- New York City Health and Hospitals Bellevue HospitalManhattanNew YorkUSA,New York University Grossman School of MedicineManhattanNew YorkUSA
| | - Carol Duh‐Leong
- New York City Health and Hospitals Bellevue HospitalManhattanNew YorkUSA,New York University Grossman School of MedicineManhattanNew YorkUSA
| | - Makhmood Reznik
- New York City Health and Hospitals Coney Island HospitalBrooklynNew YorkUSA
| | - Mary Messito
- New York City Health and Hospitals Kings County HospitalBrooklynNew YorkUSA,New York University Grossman School of MedicineManhattanNew YorkUSA
| | - Renee Bargman
- New York City Health and Hospitals Kings County HospitalBrooklynNew YorkUSA,State University of New York Downstate Health Sciences UniversityBrooklynNew YorkUSA,New York City Health and Hospitals Coney Island HospitalBrooklynNew YorkUSA
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30
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Obesity and COVID-19 in Children and Adolescents: Reciprocal Detrimental Influence—Systematic Literature Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137603. [PMID: 35805260 PMCID: PMC9266144 DOI: 10.3390/ijerph19137603] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/19/2022] [Accepted: 06/21/2022] [Indexed: 12/11/2022]
Abstract
The dramatic lifestyle changes forced by COVID-19-related lockdown promoted weight gain, with a stronger impact on obese subjects, at higher risk of severe infection. The PubMed database was searched to identify original studies assessing: (1) the extent and risk factors of lockdown-induced weight increase; and (2) the impact of obesity on the risk of hospital admission in children and adolescents. A systematic literature review and meta-analyses were performed. Twenty out of 13,986 identified records were included. A significant weight increase was reported in the majority of subjects, with no apparent gender or age differences. It was induced by a higher consumption of hypercaloric/hyperglycemic/junk food and/or the reduction of physical activity, often associated with an altered sleep–wake cycle. On the other hand, obesity increased the risk of hospitalization (OR = 4.38; 95% C.I. 1.46–13.19; p = 0.009; I2 = 96%) as compared to the normal weight population. COVID-19 and obesity represent epidemic conditions with reciprocal detrimental impact. Urgent public health interventions, targeting the various age and social strata, and involving governmental authorities, health care personnel, teachers and families are warranted to increase awareness and actively promote healthy lifestyles to contrast pediatric obesity and its detrimental consequences at a global level.
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Eneli I, Xu J, Pratt K. Change in weight category among youth early in the COVID-19 pandemic. Clin Obes 2022; 12:e12522. [PMID: 35385212 PMCID: PMC9111858 DOI: 10.1111/cob.12522] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/13/2022] [Accepted: 02/15/2022] [Indexed: 11/26/2022]
Abstract
Remote learning and shelter-in-place orders during the COVID-19 pandemic are associated with obesity risk factors such as decreased physical activity, altered routines and sleep schedules, increased screen time, and non-nutritious food choices. The objective of this brief report is to describe change in weight category 3-6 months after the onset of the pandemic in a cohort of 4509 low-income youth. Inclusion criteria were youth aged 2-17 years with weight and height measure in a large primary care network between 1 January and 30 March 2020 (Q1), designated as pre-COVID period; and 1 June-30 September 2020, (Q3), as early-COVID period. Change in weight category was assessed between Q1 and Q3. Adjusting for visit type and time lapse, logistic regression was conducted to examine the association between weight category change and age, sex, and race/ethnicity. The proportion of youth with overweight or obesity increased from 37.8% to 44.6%; and declined by 5.6% in the healthy weight category. Over the 3-6 month period, 23.1% of youth gained ≥5 kg, 4.3% gained ≥10 kg, and 17.8% increased their BMI by ≥2 units. Among underweight youth, 45.3% switched to the healthy weight category, with a median weight gain of 2.1 kg (interquartile range [IQR] = 2.1 kg). Median weight gain was highest among those youth with severe obesity (5.8 kg, IQR = 5.2 kg). Younger age (2-9 years), female and ethnic-minority youth were more likely to change to a higher/worse weight category. Significant weight gain occurred in the first 3-6 months of the pandemic among low-income youth, reflecting the short-term effects of the pandemic.
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Affiliation(s)
- Ihuoma Eneli
- Center for Healthy Weight & NutritionNationwide Children's HospitalColumbusOhioUSA
- The Ohio State University College of MedicineColumbusOhioUSA
- Division of Primary Care PediatricsNationwide Children's HospitalColumbusOhioUSA
| | - Jinyu Xu
- Center for Healthy Weight & NutritionNationwide Children's HospitalColumbusOhioUSA
| | - Keeley Pratt
- The Ohio State University College of MedicineColumbusOhioUSA
- Department of Human Sciences, College of Education and Human EcologyThe Ohio State UniversityColumbusOhioUSA
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Schefelker J, Zhang X, Dodge A, Marten K, Dimailig G, Bartlett HL, Peterson AL. Impact of the COVID-19 pandemic on cardiometabolic health parameters in children with preexisting dyslipidemia. J Clin Lipidol 2022; 16:643-648. [PMID: 35798651 PMCID: PMC9232258 DOI: 10.1016/j.jacl.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 06/02/2022] [Accepted: 06/13/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Juliette Schefelker
- Department of Pediatrics, Division of Pediatric Cardiology, University of Wisconsin School of Medicine and Public Health, USA
| | - Xiao Zhang
- Department of Pediatrics, Division of Pediatric Cardiology, University of Wisconsin School of Medicine and Public Health, USA
| | - Ann Dodge
- Department of Pediatrics, Division of Pediatric Cardiology, University of Wisconsin School of Medicine and Public Health, USA
| | - Kristen Marten
- Department of Pediatrics, Division of Pediatric Cardiology, University of Wisconsin School of Medicine and Public Health, USA
| | - Greigory Dimailig
- Department of Pediatrics, Division of Pediatric Cardiology, University of Wisconsin School of Medicine and Public Health, USA
| | - Heather L Bartlett
- Department of Pediatrics, Division of Pediatric Cardiology, University of Wisconsin School of Medicine and Public Health, USA
| | - Amy L Peterson
- Department of Pediatrics, Division of Pediatric Cardiology, University of Wisconsin School of Medicine and Public Health, USA.
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Change in BMI and Fitness among Primary School Children in Austria: A 24-Month Follow-Up Study of 303 Children Measured before and during the Ongoing COVID-19 Pandemic. Sports (Basel) 2022; 10:sports10050078. [PMID: 35622487 PMCID: PMC9147516 DOI: 10.3390/sports10050078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 12/24/2022] Open
Abstract
The ongoing COVID-19 pandemic not only impacted the health of school children directly through SARS-CoV-2 infections, but the associated closures of schools and sports facilities also resulted in long-term negative side effects. The aim of this study was to investigate the effects of COVID-19-related mitigation measures on the health and fitness status of primary school children in Austria. A total of 303 primary school children participated in the longitudinal study. Data on height, weight, and fitness were collected before the COVID-19 pandemic (September 2019) and at one-year intervals (September 2020 and September 2021) during the course of the pandemic. In the first year, from September 2019 to September 2020, there were alarming increases in body mass index (BMI) standard deviation scores (SDSs) (from 0.32 to 0.49) and dramatic decreases in both cardiorespiratory endurance (CRE) (from 0.49 to −0.43) and action speed (from −0.31 to −0.64). In the second year (September 2020 to September 2021), the BMI scores stabilized, and improvements in CRE were observed, especially in the subgroup of children who were members of sports clubs. In the future, more initiatives and projects, in addition to sports club activities, should be started and expanded, particularly in schools, to specifically counteract the observed health damage and, thus, have a positive effect on the development of all children, especially those without sports club membership.
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Jone PN, John A, Oster ME, Allen K, Tremoulet AH, Saarel EV, Lambert LM, Miyamoto SD, de Ferranti SD. SARS-CoV-2 Infection and Associated Cardiovascular Manifestations and Complications in Children and Young Adults: A Scientific Statement From the American Heart Association. Circulation 2022; 145:e1037-e1052. [PMID: 35400169 DOI: 10.1161/cir.0000000000001064] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Coronavirus disease 2019 (COVID-19) resulted in a global pandemic and has overwhelmed health care systems worldwide. In this scientific statement, we describe the epidemiology, pathophysiology, clinical presentations, treatment, and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and multisystem inflammatory syndrome in children and young adults with a focus on cardiovascular manifestations and complications. We review current knowledge about the health consequences of this illness in children and young adults with congenital and acquired heart disease, the public health burden and health disparities of this infection in these populations, and vaccine-associated myocarditis.
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35
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Could COVID-19′s Aftermath on Children’s Health Be Felt into the 22nd Century? CHILDREN 2022; 9:children9040482. [PMID: 35455526 PMCID: PMC9031144 DOI: 10.3390/children9040482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 03/26/2022] [Accepted: 03/29/2022] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic has massively affected people’s health, societies, and the global economy. Our lives are no longer as they were before COVID-19, and, most likely, will never be the same again. We hypothesize that the effect of the COVID-19 pandemic on population health and the economy will last for a very long time and will still be felt in the 22nd century. Our hypothesis is based on evidence from the 1918–1919 influenza pandemic, the Dutch famine during the Second World War, and the 2007–2008 economic crisis, as well as from the rationally predicted impact of COVID-19 on human development. We expect that the COVID-19 pandemic, including the mitigation measures taken against it, will affect children’s development in multiple ways, including obesity, both while in utero and during critical and sensitive windows of development, including the early childhood years and those of puberty and adolescence. The psychosocial and biological impact of this effect will be considerable and unequally distributed. The implications will last at least a lifetime, and, through inter-generational transmission, will likely take us to future generations, into the 22nd century. We argue for the urgent need of designing and initiating comprehensive longitudinal cohort studies to closely monitor the long-term effects of COVID-19 on children conceived, born, and raised during the pandemic. Such an approach requires a close and effective collaboration between scientists, healthcare providers, policymakers, and the younger generations, and it will hopefully uncover evidence necessary to understand and mitigate the impact of the pandemic on people’s lives in the 21st and 22nd centuries.
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Zubkiewicz-Kucharska A, Wikiera B, Noczyńska A. Weight gain in type 1 diabetes during the SARS-CoV-2 pandemic. Does lockdown affect the metabolic control of pediatric patients? Front Endocrinol (Lausanne) 2022; 13:991269. [PMID: 36313778 PMCID: PMC9597863 DOI: 10.3389/fendo.2022.991269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND AIMS Due to the severe acute respiratory syndrome coronavirus 2 pandemic, governments of many countries decided to implement lockdowns, which included school closures. This major lifestyle change also applied to people with diabetes. The aim of this paper was to analyze how the COVID-19 pandemic and related restrictions influenced the metabolic compensation of diabetes in the pediatric population. METHODS Patients with type 1 diabetes (T1D), treated by one therapeutic team, who in 2020 and 2021 paid at least two in-person visits in the outpatient clinic, were included in the study. The time in range (TIR) and HbA1c, as well as the total daily dose (TDD) of insulin and BMI from the visit before the announcement of the pandemic restrictions (March 2020) and during the lockdown (second visit after 6 months) and within the period of loosened restrictions (two visits in 2021) were analyzed. RESULTS A total of 185 patients with T1D were included in the study (96 boys), aged 2-18 years (11.5 ± 3.5); 135 of them (72.9%) use CSII and 142 (76.8%) use CGM or FGM. During the first months of the studied period, despite comparable (p>0.05) TIR (57.5 ± 21.4% vs. 59.9 ± 20.5%), improvement of HbA1c was noticed (7.9 ± 1.6% vs. 7.5 ± 1.4%, p=0.0336), whereas in the following months, both HbA1c and TIR were comparable. Also, the TDD increased significantly (from 37.3 ± 18.9 units/day on the first visit up to 46.8 ± 22.7 units/day on the last visit, p=0.0003); however, TDD/kg remained constant (p>0.05) (0.8 ± 0.2 units/kg/day vs. 0.8 ± 0.3 units/kg/day) possibly due to an increased BMI (19.1 ± 3.7 kg/m2 vs. 20.9 ± 4.1 kg/m2, p=0.0001). The percentage of basal insulin in the TDD remained stable (p>0.05) (39.7 ± 11.3% vs. 39.3 ± 13.6%). Furthermore, a significant (p=0.0001) change in the BMI percentile was noticed [from 58.9 ± 26.2 percentiles (%iles) before lockdown vs. 64.6 ± 26.0%iles on the second visit]. However, the BMI percentile returned to baseline (58.1 ± 28.4%iles) at the visit at the end of the observation period. CONCLUSIONS The parameters of metabolic control in pediatric patients with T1D during the pandemic period remained stable; however, weight gain and an increase in daily insulin dose have been observed, possibly due to reduced physical activity.
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Zhu PH, Mhango SN, Vinnakota A, Mansour M, Coss-Bu JA. Effects of COVID-19 Pandemic on Nutritional Status, Feeding Practices, and Access to Food Among Infants and Children in Lower and Middle-Income Countries: a Narrative Review. CURRENT TROPICAL MEDICINE REPORTS 2022; 9:197-206. [PMID: 36249489 PMCID: PMC9549037 DOI: 10.1007/s40475-022-00271-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2022] [Indexed: 01/11/2023]
Abstract
Purpose of Review The COVID-19 pandemic has affected children across the planet and the consequences on their health, nutritional status, and social structure have been more pronounced in low- and middle-income countries (LMICs). This review will focus on the effects of the COVID-19 pandemic on infant growth and feeding practices and access to food and obesity prevalence among children in LMICs. An electronic search was performed on MEDLINE and Embase to identify relevant articles in the English language. Recent Findings A higher prevalence of infections by the SARS-CoV-2 virus and a lower mortality rate were found in children in LMICs compared to western countries. In 2020, 22% and 52% of the wasting and deaths in children under 5 years of age in LMICS came from the sub-Saharan Africa region, respectively. Despite the decrease in stunting from 40% in 1990 to 24.2% in 2019, the prevalence remains above 30% in LMICs. Regarding breastfeeding practices in LMICs, many organizations recommend breastfeeding for infants and children born to infected mothers with SARS-CoV-2. This pandemic has resulted in higher food insecurity and disruption to access to health care and nutrition-related programs from schools; this situation has been more detrimental for younger children from LMICs. Summary Given the devastating effects of the COVID-19 pandemic on the nutritional status, higher food insecurity, and lack of access to health care for infants and children in LMICs, efforts from government, world organizations, and non-for-profit institutions should be implemented to ameliorate the effects of this pandemic.
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Affiliation(s)
- Paola Hong Zhu
- Division of Critical Care Medicine, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA ,Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA
| | - Susan Nita Mhango
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
| | - Anirudh Vinnakota
- Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA
| | - Marwa Mansour
- Division of Critical Care Medicine, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA ,Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA
| | - Jorge A. Coss-Bu
- Division of Critical Care Medicine, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA ,Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA
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Vogel M, Geserick M, Gausche R, Beger C, Poulain T, Meigen C, Körner A, Keller E, Kiess W, Pfäffle R. Age- and weight group-specific weight gain patterns in children and adolescents during the 15 years before and during the COVID-19 pandemic. Int J Obes (Lond) 2022; 46:144-152. [PMID: 34556774 PMCID: PMC8458556 DOI: 10.1038/s41366-021-00968-2] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 09/02/2021] [Accepted: 09/10/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES There is a concern that measures aiming to limit a further spread of COVID-19, e.g., school closures and social distancing, cause an aggravation of the childhood obesity epidemic. Therefore, we compared BMI trends during the 15 years before and during the COVID-19 pandemic. SUBJECTS/METHODS To assess the change in weight dynamics during the first months of COVID-19, we compared the trends of 3-month change in BMI-SDS (ΔBMI-SDS) and the proportions of children showing a high positive (HPC) or high negative (HNC) weight change between 2005 and 2019 and the respective changes from 2019 (pre-pandemic) to 2020 (after the onset of anti-pandemic measures) in more than 150,000 children (9689 during the pandemic period). The period of 3 months corresponds approximately to the first lockdown period in Germany. RESULTS During the COVID-19 pandemic, we found a substantial weight gain across all weight and age groups, reflected by an increase in the 3-month change in BMI-SDS (β = 0.05, p < 0.001), an increase in the proportion of children showing HPC (OR = 1.4, p < 0.001), and a decrease in the proportion of children showing HNC (OR = 0.7, p < 0.001). Besides, we found the same trends since 2005 on a low but stable level with a yearly increase of ΔBMI-SDS by β = 0.001 (p < 0.001), the odds of HPC increased by ORhigh_pos = 1.01 (p < 0.001), and the odds of HNC decreased by ORhigh_neg = 0.99 (p < 0.001). These rather small effects accumulated to β = 0.02, ORhigh_pos = 1.14, and ORhigh_pos = 0.85 over the whole period 2005-2019. Alarmingly, both the long-term and the short-term effects were most pronounced in the obese subgroup. CONCLUSIONS There are positive dynamics in different measures of weight change, indicating a positive trend in weight gain patterns, especially within the group of children with obesity. These dynamics are likely to be escalated by COVID-19-related measures. Thus, they may lead to a significant further aggravation of the childhood obesity pandemic.
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Affiliation(s)
- Mandy Vogel
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany.
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany.
| | - Mandy Geserick
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Ruth Gausche
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Christoph Beger
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Tanja Poulain
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Christof Meigen
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Antje Körner
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Eberhard Keller
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Wieland Kiess
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Roland Pfäffle
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
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39
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Vandoni M, Codella R, Pippi R, Carnevale Pellino V, Lovecchio N, Marin L, Silvestri D, Gatti A, Magenes VC, Regalbuto C, Fabiano V, Zuccotti G, Calcaterra V. Combatting Sedentary Behaviors by Delivering Remote Physical Exercise in Children and Adolescents with Obesity in the COVID-19 Era: A Narrative Review. Nutrients 2021; 13:4459. [PMID: 34960011 PMCID: PMC8706684 DOI: 10.3390/nu13124459] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/06/2021] [Accepted: 12/10/2021] [Indexed: 02/07/2023] Open
Abstract
The coexistence of childhood obesity (or its risk) and COVID-19 pandemic put children and adolescents in greater risk to develop respiratory and cardiovascular diseases. In fact, the restrictions introduced to limit the spread of the virus had detrimental effects on various lifestyle components, especially in young population. This resulted in augmented levels of physical inactivity and sedentary behaviors and a reduced time spent in play outdoors or sport practices. Contrariwise, the increased use of technology led clinicians, teachers, and trainers to maintain relations with obese children/adolescents so as to reduce sedentary behaviors and the associated health risks. This narrative review aims to describe the role of Telehealth and Tele-exercise as useful tools in the management of pediatric obesity during COVID-19 pandemic. Telehealth and Tele-exercise were effective in promoting self-monitoring and behavioral changes, including adherence to exercise training programs in children and adolescents. Moreover, tele-exercise platforms such as applications or exergames allowed flexible scheduling, limiting the infection risks.
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Affiliation(s)
- Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (V.C.P.); (A.G.)
| | - Roberto Codella
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20138 Milan, Italy;
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy
| | - Roberto Pippi
- Healthy Lifestyle Institute, C.U.R.I.A.Mo. (Centro Universitario Ricerca Interdipartimentale Attività Motoria), Department of Medicine and Surgery, University of Perugia, 06126 Perugia, Italy;
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (V.C.P.); (A.G.)
- Department of Industrial Engineering, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Nicola Lovecchio
- Department of Human and Social Science, University of Bergamo, 24127 Bergamo, Italy;
| | - Luca Marin
- Laboratory for Rehabilitation Medicine and Sport (LARMS), 00133 Rome, Italy;
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta;
| | - Dario Silvestri
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta;
| | - Alessandro Gatti
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (V.C.P.); (A.G.)
| | - Vittoria Carlotta Magenes
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (V.F.); (G.Z.); (V.C.)
| | - Corrado Regalbuto
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Valentina Fabiano
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (V.F.); (G.Z.); (V.C.)
- Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (V.F.); (G.Z.); (V.C.)
- Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
| | - Valeria Calcaterra
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (V.F.); (G.Z.); (V.C.)
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy;
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40
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Lafave LMZ, Webster AD, McConnell C, Van Wyk N, Lafave MR. The Impact of COVID-19 on Eating Environments and Activity in Early Childhood Education and Care in Alberta, Canada: A Cross-Sectional Study. Nutrients 2021; 13:4247. [PMID: 34959799 PMCID: PMC8706784 DOI: 10.3390/nu13124247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 11/24/2022] Open
Abstract
Early childhood education and care (ECEC) environments influence children's early development and habits that track across a lifespan. The purpose of this study was to explore the impact of COVID-19 government-mandated guidelines on physical activity (PA) and eating environments in ECEC settings. This cross-sectional study involved the recruitment of 19 ECEC centers pre-COVID (2019) and 15 ECEC centers during COVID (2020) in Alberta, Canada (n = 34 ECEC centers; n = 83 educators; n = 361 preschoolers). Educators completed the CHEERS (Creating Healthy Eating and activity Environments Survey) and MEQ (Mindful Eating Questionnaire) self-audit tools while GT3X+ ActiGraph accelerometers measured preschooler PA. The CHEERS healthy eating environment subscale was greater during COVID-19 (5.97 ± 0.52; 5.80 ± 0.62; p = 0.02) and the overall score positively correlated with the MEQ score (r = 0.20; p = 0.002). Preschoolers exhibited greater hourly step counts (800 ± 189; 649 ± 185), moderate-to-vigorous PA (MVPA) (9.3 ± 3.0 min/h; 7.9 ± 3.2 min/h) and lower sedentary times (42.4 ± 3.9 min/h; 44.1 ± 4.9 min/h) during COVID-19 compared to pre-COVID, respectively (p < 0.05). These findings suggest the eating environment and indices of child physical activity were better in 2020, which could possibly be attributed to a change in government-mandated COVID-19 guideline policy.
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Affiliation(s)
- Lynne M. Z. Lafave
- Department of Health and Physical Education, Mount Royal University, Calgary, AB T3E 6K6, Canada; (A.D.W.); (C.M.); (N.V.W.); (M.R.L.)
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Cena H, Fiechtner L, Vincenti A, Magenes VC, De Giuseppe R, Manuelli M, Zuccotti GV, Calcaterra V. COVID-19 Pandemic as Risk Factors for Excessive Weight Gain in Pediatrics: The Role of Changes in Nutrition Behavior. A Narrative Review. Nutrients 2021; 13:4255. [PMID: 34959805 PMCID: PMC8707175 DOI: 10.3390/nu13124255] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 12/17/2022] Open
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, social isolation, semi-lockdown, and "stay at home" orders were imposed upon the population in the interest of infection control. This dramatically changes the daily routine of children and adolescents, with a large impact on lifestyle and wellbeing. Children with obesity have been shown to be at a higher risk of negative lifestyle changes and weight gain during lockdown. Obesity and COVID-19 negatively affect children and adolescents' wellbeing, with adverse effects on psychophysical health, due in large part to food choices, snacking between meals, and comfort eating. Moreover, a markable decrease in physical activity levels and an increase in sedentary behavior is associated with weight gain, especially in children with excessive weight. In addition, obesity is the most common comorbidity in severe cases of COVID-19, suggesting that immune dysregulation, metabolic unbalance, inadequate nutritional status, and dysbiosis are key factors in the complex mechanistic and clinical interplay between obesity and COVID-19. This narrative review aims to describe the most up-to-date evidence on the clinical characteristics of COVID-19 in children and adolescents, focusing on the role of excessive weight and weight gain in pediatrics. The COVID-19 pandemic has taught us that nutrition education interventions, access to healthy food, as well as family nutrition counselling should be covered by pediatric services to prevent obesity, which worsens disease outcomes related to COVID-19 infection.
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Affiliation(s)
- Hellas Cena
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, 27100 Pavia, Italy; (H.C.); or (M.M.)
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.V.); (R.D.G.)
| | - Lauren Fiechtner
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA 02114, USA;
- Division of Gastroenterology and Nutrition, Massachusetts General Hospital for Children, Boston, MA 02114, USA
- Center for Pediatric Nutrition, Harvard Medical School, Boston, MA 02115, USA
| | - Alessandra Vincenti
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.V.); (R.D.G.)
| | | | - Rachele De Giuseppe
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.V.); (R.D.G.)
| | - Matteo Manuelli
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, 27100 Pavia, Italy; (H.C.); or (M.M.)
| | - Gian Vincenzo Zuccotti
- Pediatric Department, “V. Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (G.V.Z.)
- “L. Sacco” Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy
| | - Valeria Calcaterra
- Pediatric Department, “V. Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (G.V.Z.)
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
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Changes in Tobacco Use Patterns among Veterans in San Diego during the Recent Peak of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211923. [PMID: 34831686 PMCID: PMC8623485 DOI: 10.3390/ijerph182211923] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/11/2021] [Accepted: 11/11/2021] [Indexed: 12/12/2022]
Abstract
The prevalence of tobacco use increases in times of stress; however, during the initial stage of the COVID-19 pandemic, tobacco use rates stayed the same in most populations. Previous work focused on the initial months of the pandemic, while this study examined the changes in tobacco use during a later peak period of the pandemic. We used data from 61,852 visits to the VA San Diego Healthcare System from November 2019 to February 2021, divided into pre-, early, and peak pandemic periods. Multinomial logistic regression was used to test whether the odds of being a daily or non-daily tobacco user varied over time, by demographic group, or with the presence of specific psychiatric diagnoses. Younger Veterans had a greater reduction in the prevalence of non-daily tobacco use between the early and peak periods, while older Veterans had a rise in daily use from pre- to the early pandemic, which returned to baseline during the peak. Individuals with substance use disorder and serious mental illness diagnoses were more likely to report tobacco use, but psychiatric diagnoses did not predict change over time. These findings demonstrate factors that potentially contribute to changes in tobacco use during a public health crisis and may help guide future targeted cessation efforts.
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Kołota A, Głąbska D. Analysis of Food Habits during Pandemic in a Polish Population-Based Sample of Primary School Adolescents: Diet and Activity of Youth during COVID-19 (DAY-19) Study. Nutrients 2021; 13:nu13113711. [PMID: 34835967 PMCID: PMC8622037 DOI: 10.3390/nu13113711] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/19/2021] [Accepted: 10/19/2021] [Indexed: 02/07/2023] Open
Abstract
The improper dietary behaviors of children and adolescents during the COVID-19 pandemic, which are associated with lockdowns and reduced physical activity, are a complex problem, potentially resulting in increased risk of diet-related diseases, including overweight and obesity and their consequences. The aim of the study was to assess the food habits during the COVID-19 pandemic and to define their association with physical activity and body mass changes in a Polish population of primary school adolescents within the Diet and Activity of Youth During COVID-19 (DAY-19) Study. The DAY-19 Study was conducted in June 2020 in a national cohort of 1334 primary school students aged 10–16 years, recruited based on a stratified random sampling of schools (sampling counties from voivodeships and schools from counties). The Adolescent Food Habits Checklist (AFHC) was used to assess food habits, associated with food purchase, preparation, and consumption, which in the studied group were analyzed separately for the period before (retrospective data) and during the COVID-19 pandemic (prospective data). The recognizable physical activity changes and recognizable body mass changes were also assessed (retrospective data) and respondents were classified as those declaring that their physical activity and body mass decreased, remained stable, or increased during the COVID-19 pandemic. It was observed that during the COVID-19 pandemic the majority of food habits changed in a statistically significant way (p < 0.05). Within food purchase habits, the number of respondents who declared choosing a low-fat lunch away from home decreased, often buying pastries or cakes decreased, and buying a low-fat crisps brand increased (p < 0.05). Within food preparation habits, the number of respondents who declared trying to keep overall fat intake down increased, trying to keep overall sugar intake down increased, eating at least one serving of vegetables or salad with evening meal increased, and usually including some chocolate and/or biscuits in a packed lunch decreased (p < 0.05). Within food consumption habits, the number of respondents who declared making sure that they eat at least one serving of fruit a day increased, eating at least three servings of fruit most days increased, making sure that they eat at least one serving of vegetables or salad a day increased, trying to ensure that they eat plenty of fruit and vegetables increased, often choosing a fruit when they have a snack between meals increased, eating at least three servings of fruit most days increased, and generally trying to have a healthy diet increased (p < 0.05). It was concluded that in the period of the COVID-19 pandemic and resultant remote education, adolescents in Poland presented different food habits than before, while the majority of changes were positive. The positive food purchase, preparation, and consumption habits were observed mainly in sub-groups of adolescents declaring decreased body mass or increased physical activity during the COVID-19 pandemic. It may be suggested that physical activity may support positive changes of dietary behaviors and while combined positive changes of diet and increased physical activity, they may effectively promote body mass reduction in adolescents.
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