Children's Eating Habits, Physical Activity, Sleep, and Media Usage before and during COVID-19 Pandemic in Poland

Evolution of Sleep Duration and Screen Time Between 2018 and 2022 Among Canadian Adolescents: Evidence of Drifts Accompanying the COVID-19 Pandemic

PURPOSE

We quantified the joint evolution of sleep duration and screen time between 2018 and 2022 in a large sample of adolescents from Quebec, Canada, to ascertain changes that occurred during the COVID-19 pandemic.

METHODS

A natural experiment design was used to compare variations from year to year and in association with the pandemic outbreak. Using structural equation modeling on data collected between 2018 and 2022 among adolescents attending 63 high schools, we analyzed the joint evolution of sleep duration and screen time while adjusting for previous year values, concurrent flourishing score, sex, age, and family level of material deprivation.

RESULTS

A total of 28,307 adolescents, aged on average 14.9 years, were included in the analyses. Between 2019 and 2022, sleep duration increased by 9.6 (5.7, 13.5) minutes and screen time by 129.2 (120.5, 138.0) minutes on average. In 2022, the adolescents spent almost equal amounts of time sleeping and using screens. Lower flourishing scores were associated with shorter sleep duration and lengthier screen time. Girls' screen time became similar to boys' over time.

DISCUSSION

Adolescents now spend almost equal amounts of time sleeping and using screens, a situation that calls for urgent public health actions. These findings highlight the importance of tracking changes in adolescents' behaviours over time, to design and implement interventions adapted to the changing health needs of different groups.

Primary School-Aged Children's Physical Activity Level, Eating Habit, and Sleeping Pattern Changes During the COVID-19 Pandemic in Indonesia

Background and objective This study aims to explore the effect of physical distancing on physical activity, eating habits, and sleeping patterns among Indonesian primary schoolchildren during the COVID-19 pandemic. Methodology This cross-sectional study was conducted from October to December 2020, involving 489 primary schoolchildren. Parents/caregivers were queried about changes in their children's physical activity (utilizing the Physical Activity Questionnaire for Older Children - PAQ-C), eating habits (via a questionnaire modified from Southeast Asian Nutrition Surveys - SEANUTS), and sleeping patterns (assessed using the Children's Sleep Habits Questionnaire - CSHQ) both before and during the pandemic. Various sociodemographic characteristics and income status were also obtained. Paired univariate and multivariate analyses were conducted where applicable. Results In comparison to the period before the pandemic, both the PAQ-C score and active proportion significantly decreased during the pandemic (P = 0.000). Children consumed more snacks (322, 65.8%) but less canned and processed foods (180, 36.8%, and 128, 26.2%, respectively). Sleep duration and sufficiency increased significantly, with a CSHQ score mean of 48.62 ± 9.88 (P = 0.000, P = 0.004), and sleep disturbance was observed in 391 (79.96%) subjects. Conclusions Children were physically less active during the COVID-19 pandemic. They also experienced variable changes in eating habits based on parental employment, family income and expenses, and the presence of governmental support. While more children had longer sleep duration and more achieved the recommended sleep time, sleep disturbance happened in most subjects.

Body Mass Index Trends before and during the COVID-19 Pandemic in Primary School Students in Split-Dalmatia County, Croatia: A Retrospective Study

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.

How the COVID-19 pandemic and related school closures reduce physical activity among children and adolescents in the WHO European Region: a systematic review and meta-analysis

BACKGROUND

Emerging research suggests that physical activity among children and adolescents decreased during the COVID-19 pandemic. However, a differentiated overview of European youth is lacking. In particular, no systematic analysis has been conducted to date on the impact of heterogeneous pandemic restrictions and school closures within European countries, and with regard to potentially vulnerable groups.

METHODS

We searched seven databases and included studies for children and adolescents (≤ 19 years) of the WHO European Region that compared physical activity during the COVID-19 pandemic with a pre-pandemic baseline using validated measurement instruments. We used the Oxford Stringency Index and School Closure Index as indicators of restriction stringency. Screening for eligibility, data extraction, assessment of the study risk of bias (using the 'Risk of Bias in Non-randomized Studies - of Exposure' [ROBINS-E]) and certainty grading of evidence (using the GRADE approach), were all done in duplicate. Unpublished data was requested from study authors. Data were pooled in random effects models. An a priori protocol was published, reporting is carried out in accordance with the 'Preferred Reporting Items for Systematic Review and Meta-Analyses' (PRISMA) statement.

RESULTS

Of 14,897 non-duplicate records, 26 publications (n = 15,038 pre-pandemic, n = 13,041 during pandemic) met full inclusion criteria. Comparison before and during the COVID-19 pandemic revealed a significant reduction in total physical activity (standardized mean difference [SMD], -0.57 [95%CI, -0.95; -0.20]) and moderate-to-vigorous physical activity (SMD, -0.43 [95% CI, -0.75; -0.10]), corresponding to a decrease of 12 min per day (a 20% reduction of the WHO recommendation). A decrease in sporting activity was also recorded. Subgroup analyses suggested that middle childhood (aged 8-12) and adolescents were particularly affected by the decline. School closures were associated with a reduction in physical activity. The certainty of evidence for all outcomes was low.

CONCLUSIONS

A sharp decline in all forms of physical activity was recorded among European children and adolescents during the COVID-19 pandemic. This decline was higher during periods of school closure and mainly affected younger schoolchildren and adolescents. Immediate action by policy-makers and practitioners, as well as evidence-based public health strategies, are imperative in reversing this trend.

TRIAL REGISTRATION

PROSPERO: CRD42023395871.

A Sociodemographic Analysis of the Impact of COVID-19-Related Schools' Closure on the Diet and Physical Activity of Children and Adolescents in Qatar

OBJECTIVES

To assess the impact of the COVID-19-related closure of government schools in Qatar on children and adolescents' dietary habits and physical activities and associated sociodemographic factors.

METHODS

An analytical cross-sectional study was conducted between June and August 2022 utilizing the national electronic health records system in Qatar to extract a sampling frame of students enrolled in governmental schools, specifically targeting students in 3rd to 9th grades, stratified by sex and developmental stage. A stratified sampling technique was employed to randomly select a proportionate number of students from each stratum, and data were collected through telephone interviews with the parents of selected students.

RESULTS

A total of 1546 interviews were completed by the end of the study. Of the included sample, 845 (54.7%) were between 8 and 11 years of age (middle childhood), while the rest were 12-15 years old (young teens and teenagers). Male to female ratio was almost 1:1. We found a significant decrease in the intake of vegetables, increases in the intake of soft drinks, fried food, fast food, and sweets, and a reduction in physical activity during schools' closure compared to before. Higher parental educational levels, maternal employment, and having a positive family history of obesity and/or overweight in first-degree relatives were significantly associated with adverse lifestyle changes during schools' closure.

CONCLUSION

The trends of lifestyle changes reported in this study during the periods of COVID-19-related schools' closure were found to be going in a health-compromising direction. These results underscore the importance of implementing targeted interventions to promote healthy lifestyles during such disruptions and emphasize the need to address lifestyle changes beyond emergencies and outbreaks to mitigate potential long-term health consequences, including the increased risk of non-communicable diseases.

Adolescents' Lifestyle Determinants in Relation to Their Nutritional Status during COVID-19 Pandemic Distance Learning in the North-Western Part of Romania-A Cross-Sectional Study

Several studies have examined how the lockdown restrictions enforced to halt the spread of COVID-19 have affected adults' movement behaviors; however, there is limited information regarding the effects on youth. This study aimed to report on the lifestyle habits of adolescents during COVID-19 pandemic remote learning and explore associations between the participants' bodyweight and lifestyle behaviors. We used a cross-sectional study applied to 285 students studying in the gymnasium. The response rate was 74.21%. They completed an online questionnaire regarding lifestyle, eating habits, and nutritional status (assessed by the Body Mass Index-BMI). The study was conducted in January-February 2021. The percentage of overweight and obese was higher among boys (p = 0.001). The mean sleep duration was 8.12 (SD:1.284) hours per night, and was higher in boys than in girls. The respondents met the physical activity (PA) recommendation for their age, based mainly on unorganized PA. The screen time was 4-6 h or more for the majority of the respondents. Dietary habits included a high consumption of comfort food, like cereals, sweets, soft drinks, snacks, and fried food, but a lower consumption of vegetables and fast food. The regression analyses showed that the BMI was correlated with the BMI of the parents and the number of hours spent in front of the computers in free time. The study identified behavioral and environmental factors that can be modified with effective strategies to reduce overweight and obesity among school students and to promote a healthy lifestyle.

Survey of the Adequacy of Brazilian Children and Adolescents to the 24-Hour Movement Guidelines before and during the COVID-19 Pandemic

The 24-Hour Movement Guidelines provide specific recommendations on movement behaviors for children and adolescents. The objective of this study was to verify the adequacy of children and adolescents to the guidelines for moderate to vigorous physical activity, recreational screen time, and sleep duration, and the overall adequacy to the guidelines, before and during the COVID-19 pandemic. A cross-sectional study was conducted with parents or guardians of children or adolescents from different regions of Brazil using a digital interview form including sociodemographic characteristics of families, moderate to vigorous physical activity, recreational screen time, and sleep duration before and during the pandemic. Statistically significant variation was observed in both groups in relation to moderate to vigorous physical activity and recreational screen time between the two periods evaluated. Overall adequacy to the guidelines before the pandemic was 19.28% for children from Group 1 (0-5 years old) and 39.50% for those from Group 2 (6 to 17 years old). During the pandemic, it corresponded to 3.58% in Group 1 and 4.94% in Group 2 (p-value between periods ≤0.001). This study showed the significant impact of pandemic restrictions on reducing overall compliance and physical activity, and increasing screen time among Brazilian children and adolescents.

Impact of the COVID-19 Pandemic on Nutrition, Sleep, Physical Activity, and Mood Disorders of Polish Children

The harmful consequences of the COVID-19 pandemic on children are its impact on eating habits, physical activity, sleep, and mood disorders. In the future, this may result in a higher prevalence of obesity and diet-related diseases. Therefore, this study aimed to assess the impact of the COVID-19 pandemic on children's eating behavior and lifestyle. The study was conducted using a proprietary questionnaire on dietary and lifestyle habits before and during the pandemic, and the reasons for changes due to the pandemic. The study involved 294 parents of children in grades 1-8 in elementary schools in two regions of Poland. The survey showed that during the pandemic, the percentage of children eating five regular meals daily, including fruits and vegetables, and engaging in daily physical activity decreased. However, the percentage of children spending more than 4 h a day in front of a screen increased (p < 0.05). The main reasons for changes in eating habits and physical activity were less eating out, lack of motivation, obstruction, and lack of access to sports facilities (p < 0.05). The pandemic had a significant impact on reduced levels of physical activity and increased time spent in front of a screen. In summary, among the reasons for changes in children's dietary and lifestyle habits, factors related to the pandemic itself, i.e., social restrictions, restrictions, closure of schools and other facilities, and fear of coronavirus infection, had the greatest impact.

Increased adolescent game usage and health-related risk behaviors during the COVID-19 pandemic

This study examines adolescent game usage and corresponding health-related risk behaviors during a period of limited social interaction and activity due to the COVID-19 pandemic. Participants included 225 middle- and 225 high-school students in Seoul who completed a survey online from October 1 to 30, 2021. The study measured participants' game usage level and the health-related risk behavior index. Findings showed that participants who engaged in excessive gaming showed higher levels of health-related risk behaviors. A multivariate analysis of variance was conducted to compare the health-related risk behaviors of students in the general, potential, and high-risk groups on excessive gaming. Results indicated that female students in the high-risk group showed higher stress levels and fatigue (f = 5.549, p < .01, Cohen's d = 0.016) than the males of the same group. However, male students showed higher physical inactivity levels (f = 3.195, p > .05, Cohen's d = 0.009) than females. The post hoc test indicated clear sex distinctions among the general, potential, and high-risk groups on excessive gaming (p < .001). Among the high-risk game usage group, female students displayed a higher level of risk behaviors than males. Adolescent gaming addiction should be considered an emotional and behavioral disorder for which parental guidance and support are needed, and counseling experts and professionals must come together to provide a cure and reform program.

The impacts of physical activity on psychological and behavioral problems, and changes in physical activity, sleep and quality of life during the COVID-19 pandemic in preschoolers, children, and adolescents: A systematic review and meta-analysis

Background

The COVID-19 pandemic has greatly affected the level of physical activity (PA). However, little is known about its effect on health outcomes.

Methods

Articles without language restrictions published from the database inception through March 16, 2022, were retrieved using the CINAHL Complete, Cochrane Library, EMBASE, Medline, PubMed, and PsycINFO databases. High-quality articles assessing the effect of PA on psychological and behavioral problems. Additionally, PA, QoL, and/or sleep problems before and during the pandemic were included. Articles without data regarding PA or involving non-general populations were excluded. The PRISMA and MOOSE guidelines were followed. Data quality of the selected articles was assessed using the Newcastle-Ottawa Scale and GRADE approach. Data were pooled using a random-effects model and sensitivity analysis if heterogenicity was high (I 2 ≥ 50%). The relationship between PA and psychological and behavioral problems; and changes in PA, QoL, and sleeping patterns before and during the pandemic in preschoolers, children, and adolescents were investigated. A meta-analysis was conducted; odds ratios (ORs), mean differences (MD), and standardized MDs (SMDs) were calculated.

Results

Thirty-four articles involving 66,857 participants were included. The results showed an overall significant protective effect between PA and psychological and/or behavioral problems (OR = 0.677; 95% CI = 0.630, 0.728; p-value <0.001; I 2   = 59.79%). This relationship was also significant in the subgroup analysis of children (OR = 0.690; 95% CI = 0.632, 0.752; p-value <0.001; I 2   = 58.93%) and adolescents (OR = 0.650; 95% CI = 0.570, 0.741; p-value <0.001; I 2   = 60.85%); however, no data on the relationship in preschoolers were collected. In addition, the overall time spent on PA significantly decreased by 23.2 min per day during the COVID-19 pandemic (95% CI = -13.5, -32.9; p-value <0.001; I 2   = 99.82%). Moreover, the results showed an overall significant decrease in QoL (SMD = -0.894, 95% CI = -1.180, -0.609, p-value <0.001, I 2   = 96.64%). However, there was no significant difference in sleep duration during the COVID-19 pandemic (MD = 0.01 h per day, 95% CI = -0.027, 0.225; p-value = 0.125; I 2   = 98.48%).

Conclusion

During the pandemic, less PA was contributed to poor QoL and sleep quality. However, increases in PA are associated with reduced occurrences of psychological and behavioral problems. Implementing recovery plans to address the health effect of the pandemic is essential.

Impact of the COVID-19 pandemic on children's sleep habits: an ECHO study

BACKGROUND

Sleep in childhood is affected by behavioral, environmental, and parental factors. We propose that these factors were altered during the COVID-19 pandemic. This study investigates sleep habit changes during the pandemic in 528 children 4-12 years old in the US, leveraging data from the Environmental Influences on Child Health Outcomes (ECHO) Program.

METHODS

Data collection occurred in July 2019-March 2020 (pre-pandemic) and two pandemic periods: December 2020-April 2021 and May-August 2021. Qualitative interviews were performed in 38 participants.

RESULTS

We found no changes in sleep duration, but a shift to later sleep midpoint during the pandemic periods. There was an increase in latency at the first pandemic collection period but no increase in the frequency of bedtime resistance, and a reduced frequency of naps during the pandemic. Qualitative interviews revealed that parents prioritized routines to maintain sleep duration but were more flexible regarding timing. Children from racial/ethnic minoritized communities slept less at night, had later sleep midpoint, and napped more frequently across all collection periods, warranting in-depth investigation to examine and address root causes.

CONCLUSIONS

The COVID-19 pandemic significantly impacted children sleep, but parental knowledge of the importance of sleep might have played a significant protective role.

IMPACT

During the COVID-19 pandemic, US children changed their sleep habits, going to bed and waking up later, but their sleep duration did not change. Sleep latency was longer. Parental knowledge of sleep importance might have played a protective role. Regardless of data collection periods, children from racial/ethnic minoritized communities slept less and went to bed later. This is one of the first study on this topic in the US, including prospective pre-pandemic qualitative and quantitative data on sleep habits. Our findings highlight the pandemic long-term impact on childhood sleep. Results warrants further investigations on implications for overall childhood health.

Parental Perspectives Regarding the Impact of the COVID-19 Pandemic on Their Children

Background: The COVID-19 pandemic has brought profound changes to the health of families worldwide. Yet, there is limited research regarding its impact on children. The pandemic may exacerbate factors associated with excess weight, which is particularly concerning due to the potential association between excess weight and severity of COVID-19 infection. This study investigates parental perspectives of changes in fruit/vegetable (FV) intake, processed food (PF) intake, outdoor playtime (OP), physical activity (PA) levels, and recreational screen time (RST) among children living in Michigan during the pandemic. Methods: The study team and community partners developed and distributed a survey using snowball sampling to reach families living largely in Central and Southeastern Michigan. Nonlinear mixed-effects proportional odds models were used to examine associations between child weight status along with demographic/household factors and changes in five weight-related behaviors. Results: Parents (n = 1313; representing 2469 children) reported a decrease in OP, FV, and PA levels, while there was an increase in RST and PF intake among their children. Household income was protective against a decrease in OP, PA, and FV but was associated with increased RST. Children's weight status was associated with decreased FV. Age was negatively associated with OP and PA, and positively associated with RST. Conclusions: These findings suggest an adverse influence of the pandemic on weight-related behaviors, particularly among adolescents in families with lower incomes and those with excess weight. Further work is needed to measure any impact on BMI trajectory and to identify interventions to reverse negative effects.

The Impact of the COVID-19 Lockdown on Sugar-Sweetened Beverage Consumption in Children in Saudi Arabia: A Mixed-Methods Study

(1) Background: In 2020, there seems to have been a global shift in lifestyle and eating habits with the emergence of the coronavirus disease 2019 (COVID-19) and the ensuing lockdowns implemented by national governments. This study assessed the impact of the COVID-19 lockdown on SSBs consumption among healthy 6-11 years old children in Saudi Arabia; (2) Methods: This is a mixed-methods study, incorporating a quantitative component, which was a validated Arabic online questionnaire completed by parents, and a qualitative component, involving structured interviews with 10 selected parents using a criterion sampling method; (3) Results: There was a small decrease in consumption reported during lockdown across all SSBs types (soft drinks, n = 58 (13.9%); juices: n = 115 (27.6%); flavored milk: n = 93 (22.3%)). The results showed that with every increase in the dental pain scale there was a positive odd (AOR:0.64; p = 0.001) of decreased consumption of SSBs. Several themes related to increase and decrease SSBs consumption emerged; (4) Conclusions: There was a small decrease in SSBs consumption during lockdown reported by parents. Several themes emerged that can be used to strategize against problematic eating behavior, enabling such provisions as family dietary interventions, which target both parents and children.

The Associations between 24-Hour Movement Behaviours and Quality of Life in Preschoolers: A Compositional Analysis of Cross-Sectional Data from 2018-2021

Studies show that the quality of life (QoL) of preschoolers is closely related to physical activity (PA), sedentary behaviour (SB), and sleep (SL). Yet many researchers looked at these 24-h movement behaviours as behaviours that are independent of one another when examining the association of QoL with these behaviours. The main purpose of the present study was to describe the temporal trends in PA, SB, and SL in preschoolers and the concomitant association with QoL of children. Annual cross-sectional data on QoL and 24-h movement behaviours of 8045 Singaporean preschoolers were collected from 2018 to 2021. Compositional analysis, linear regression, and isotemporal replacement approaches were used to examine changes in PA, SB, and SL from 2018-2021 and how these changes were associated with QoL. Temporal trends in movement behaviours showed that PA and SL decreased after 2020. During 2018-2021, the association of PA and QoL in preschoolers was characterised by a 'U' curve (βPA-2018 = 3.06, p < 0.001; βPA-2019 = 1.43, p < 0.05; βPA-2020 = -0.43, p > 0.05; βPA-2021 = 2.82, p < 0.001), while SL and QoL were characterised by an inverted 'U' curve (βSL-2018 = -2.39, p < 0.001; βSL-2019 = -0.27, p > 0.05; βSL-2020 = 2.00, p < 0.01; βSL-2021 = -0.21, p > 0.05). SB was significantly and negatively associated with QoL after 2020, with 2020 identified as the inflection point for the change in SB (βSB-2018 = 0.67, p > 0.05; βSB-2019 = -1.16, p > 0.05; βSB-2020 = -1.56, p < 0.01; βSB-2021 = -2.61, p < 0.01). Using a time re-allocation technique to treat the 2021 data, reallocating time from SB to PA or to SL predicted improvements in QoL of preschoolers (Pall < 0.05). The study provided useful information on the temporal trends in PA, SB, SL, and QoL of preschoolers over four years. Additionally, these data provided insights into how changes in QoL are predicted by changes in duration in the 24-h movement behaviours.

Eating habits of children and adolescents during the COVID-19 era: A systematic review

The COVID19 pandemic has affected all aspects of people's lives. Eating habit plays a crucial role in children and adolescents' physical and mental development and the impacts might last until adulthood. This systematic review aimed to summarize a comprehensive and updated overview of eating habits changes due to COVID19 confinements among children and adolescents. A systematic literature search was performed in three databases for all the English studies published from the start of the confinements until April 2022. Two researchers screened articles independently and included observational studies which evaluated children's and adolescents' eating habits before and during confinements. The quality of the included studies was assessed by Newcastle-Ottawa Quality Assessment checklists for cross-sectional and cohort studies. Among 2,436 studies, 39 final full-text articles were included. The total participants of this systematic review consist of 157,900 children and adolescents. Seven categories were identified: daily eating patterns, junk food, beverage, fruits and vegetables, milk and dairy, protein-rich foods, and legumes and cereals. In summary, most of the included studies reported a significant increase in consumption of home-cooked meals, amount of food, snack, french fries, sweets, fruits, vegetables, legumes, bread, and bakery products. On the other hand, studies demonstrated significantly lower intake of fast food and soft drink. The studies reported controversial results about breakfast consumption, sugar-added drinks, caffeinated drinks, milk and dairy products, protein-rich foods (including meat, fish, egg and chicken, and poultry), rice, and cereal. Changes in children's and adolescents' eating habits during the COVID-19 era were both positive and negative, for example, a decrease in fast food, fruit, and vegetable consumption vs. an increase in snacking and sweet consumption. Both changes have significant short-term and long-term impacts on population health. This study could provide us with insight into the changes in eating habits in children and adolescents in the COVID-19 era which we can use to limit the negative consequences on health.

Beyond lockdowns: a systematic review of the impacts of COVID-19 lockdowns on dietary pattern, physical activity, body weight, and food security

Context

COVID-19 lockdowns may have impacted dietary patterns and nutritional outcomes in many populations.

Objective

The aim of this review was to evaluate the impacts of COVID-19 lockdowns on nutritional patterns, investigating behaviors in the periods before, during, and after lockdowns.

Data Source

This systematic review followed the PRISMA-P methodology. The articles included were identified by searching the key words in Web of Science, PubMed, and Scopus. The key words used in the search included: “COVID19” AND “diet*”, “coronavirus” AND “diet*”, “coronavirus 2” AND “diet*”, “COVID19” AND “nutri*”, “coronavirus” AND “nutri*”, “coronavirus 2” AND “nutri*”, “COVID19” AND “food”.

Data Extraction

Twenty-two original studies were included in this review. Data extraction tables were created for recording author names, year of publication, location of study, duration, lockdown phase, design, methods, aims, number of participants, age, gender, health status, education, socioeconomic status, dietary patterns, food security, physical activity, body weight change or body mass index, and associations with sociodemographic characteristics.

Data Analysis

Impacts of lockdowns on eating patterns, physical activity, body weight or body mass index, and food security were the primary outcomes investigated. Secondary outcomes investigated were associations with sociodemographic characteristics.

Conclusion

COVID-19 lockdowns were associated with significant changes in dietary and lifestyle behaviors of worldwide populations. Impacts were seen during and post-lockdown likely due to more time spent at home, working from home, decreased food availability and accessibility, and augmented stress associated with lockdown.

The Impact of COVID-19-Related Living Restrictions on Eating Behaviours in Children and Adolescents: A Systematic Review

The COVID-19 pandemic prompted the imposition of physical and social distancing measures worldwide. Emerging data suggest that younger age groups may be particularly vulnerable to the adverse mental health impacts of the pandemic. Since the start of the COVID-19 pandemic, there has been an unprecedented increase in demand for child and adolescent eating disorder services. The aim of this review was to systematically review and appraise the current literature on the impact of COVID-19-related living restrictions on the eating behaviours of children and adolescents. Searches of eight electronic databases were conducted in March 2021 and December 2021 for published and grey literature on eating behaviours of population samples of children and adolescents (aged 18 months to 18 years old) who were exposed to COVID-19-related living restrictions. Of 3165 retrieved references, sixteen studies were included in this review, comprising data from 125, 286 participants. There was a pattern towards healthier eating behaviours among children and adolescents during the COVID-19 lockdown. However, young people from lower socioeconomic groups showed a tendency towards more unhealthy eating behaviours, and there was an association between mood difficulties and greater changes in eating; this suggests that such groups may be more vulnerable to the adverse health consequences of lockdowns.

Health Problems of Students during Distance Learning in Central and Eastern Europe: A Cross-Sectional Study of Poland and Ukraine

The COVID-19 pandemic has significantly disrupted the functioning of society. Issues of deteriorating health were among the main problems resulting from restrictions such as self-isolation, social distancing, and remote education. The aim of this research was to attempt to probe the psychophysical condition of students after more than a year of remote education. The survey method (CAPI) was used to collect the data on a representative sample of 1000 students in Poland and 1022 in Ukraine. The research sample was selected in a randomly stratified manner, taking into account such characteristics as: gender, age, and place of residence. The results of the research showed that 44% of Polish and 50% of Ukrainian students experienced health problems. The burden of remote education mainly contributed to the reduction of physical fitness. Young Poles more often paid attention to the deterioration of mental well-being, and Ukrainians to the deterioration of their physical condition. Based on the conducted analyses, it was also established that health problems appeared more often among the females, students with lower social support and with lower trust levels. The main risk factors were Internet addiction, secondary effects of the pandemic, and negative remote education experiences. Research has shown that remote education and problems that arise in students' households during the pandemic may have significantly contributed to the deterioration of their psychophysical condition.

Health Behavior Changes during the COVID-19 Pandemic: A Longitudinal Analysis among Children

This longitudinal study compared children’s health behaviors before the COVID-19 pandemic versus during the pandemic. This analysis examined the association between individual-level characteristics and health behavior change. Four prospective cohort studies in the Environmental influences on Child Health Outcomes (ECHO) Program contributed data. Children aged 4−12 years and their caregivers were recruited in California, Colorado, North Dakota, and New Hampshire. Dietary intake, physical activity, screen time, and sleep duration were assessed with questionnaires pre-pandemic and during the pandemic. The final sample included 347 children: 47% female and 62% non-Hispanic White. Compared with pre-pandemic, weekday screen time duration was higher during the pandemic (3.0 vs. 4.5 h, p < 0.001). Unadjusted increases in screen time duration differed by race and ethnicity: 1.3 h/day for non-Hispanic White children, 2.3 h/day for Hispanic children, and 5.3 h/day for non-Hispanic Black children. Overall, no changes occurred in sugar-sweetened beverage (SSB) intake (p = 0.26), discretionary food intake (p = 0.93), and physical activity (p = 0.15). Sleep duration increased by 30 min among children who did not meet sleep recommendations pre-pandemic. Child sex and maternal education level were not associated with health behavior change. The pandemic may have exacerbated disparities in some health behaviors. Families may need support to re-establish healthy routines.

The Impact of Digital Screen Time on Dietary Habits and Physical Activity in Children and Adolescents

Background: Over the last few decades, the time children spend using electronic devices has increased significantly. The aim of the study was to evaluate the impact of screen time on dietary behaviors and physical activity in children and adolescents. Methods: An online survey was conducted among parents of preschool and school-aged children during the COVID-19 lockdown in Poland. There were 3127 surveys used in the analysis. Results: Survey responses referred to 1662 (53%) boys and 1465 (47%) girls, with a mean age of 12.1 ± 3.4 years. During a routine weekday, most children (71%) spent >4 h on educational activities using electronic devices, and 43% of children spent 1−2 h using devices for recreational purposes. The majority of children (89%) were exposed to screens during meals, and ate snacks between main meals (77%). There was an association between screen time and the exposure to screens during meals, and between screen time and time spent performing physical activity. Conclusions: This study revealed that the majority of children were exposed to screens during meals, which is a risk factor of obesity. The promotion of the judicious use of digital devices and healthy dietary habits associated with the use of screens may be an important component of obesity prevention strategies.

Impact of mild COVID-19 on balance function in young adults, a prospective observational study

Balance is of essential importance in human life. The aim of the study is to examine the incidence of balance impairments in young adults who have recovered from mild COVID-19. The study involved 100 subjects, divided into two groups: the study group (50 individuals) comprised subjects who had recovered from mild COVID-19, and the control group (50 individuals) consisted of healthy subjects matched for gender and age. Balance was assessed using a force platform and clinical tests such as: timed up and go test, 15-s step test, sit-to-stand test and 6-min walk test. The assessment on the platform showed greater balance impairments in the trials with eyes closed; more specifically, compared to the controls, in trials with double-leg support the subjects from the study group acquired significantly higher scores in X average (lateral coordinates) (p < 0.05), Path length, V average (average Centre of Foot Pressure Velocity) (p < 0.05) and Area circular (p < 0.01), with even more significant results in trials with single-leg support in X average (p < 0.001), Y average (anterior–posterior coordinates) (p < 0.001) and Path length (p = 0.004). Higher scores in the timed up and go test were found in the study group (p = 0.013). The control group had higher scores in the remaining tests. The current findings show that mild COVID-19 may lead to balance impairments in young adults. Statistically significant differences in balance were found between the subjects in the study group and the healthy controls. Further studies in this area should take into account more age groups, and patients recovered from severe COVID-19, and should investigate long-term consequences of COVID-19 reflected by balance problems.

Anxiety towards COVID-19, Fear of Negative Appearance, Healthy Lifestyle, and Their Relationship with Well-Being during the Pandemic: A Cross-Cultural Study between Indonesia and Poland

The COVID-19 pandemic has led to massive changes in almost all aspects of human life, including emotional states such as anxiety and fear, perspectives about healthy lifestyles, and psychological outcomes. This study aimed to disentangle the mechanisms that underlie the relationships of anxiety towards COVID-19 and fear of negative appearance with well-being, we also investigated the effects of cultural variations on levels of anxiety, fear of negative appearance, healthy lifestyles, and well-being. A total of 881 Indonesians (n = 172) and Poles (n = 709) participated in this study. Participants completed self-report measures of psychological well-being, anxiety, fear of negative appearance, compulsive exercise, and eating disorders. Multigroup structural equation modelling (SEM) was used. The results showed no statistically meaningful relationship between anxiety towards COVID-19 and well-being. However, it was found that, in the Polish sample, compulsive exercise and eating disorders mediated the relationship between fear of negative appearance and well-being. Cultural differences were also found in the mean scores of all examined constructs, with eating disorders being an exception. Therefore, this study highlights cultural aspects that determine emotional states, healthy lifestyles, and well-being.

Health-Related Quality of Life in Spanish Schoolchildren and Its Association with the Fitness Status and Adherence to the Mediterranean Diet

Background: Health-related quality of life (HRQoL) allows knowing the subject’s feelings in distress and well-being, as well as perception of current and future health. Objective: To assess associations between health-related quality of life, fitness status, and adherence to the Mediterranean diet in Spanish children and adolescents. Methods: A cross-sectional study was carried out in a sample of 305 (47.2% women) children and adolescents aged between 8 and 16 years, in the primary and secondary schools of the province of Ávila (central Spain) (NCT05380674). Subjects were classified according to their quality of life: group 1 (highest quality of life) > group 2 (medium quality of life) > group 3 (lowest quality of life). Results: More participants in group 1 showed higher adherence to Mediterranean diet (70.8%) than other groups (group 2: 55.0%; group 3: 43.4%). It was less likely to find optimal levels of muscle strength as quality of life decreased (OR; 95% CI: group 2: 0.535; 0.303−0.955; and group 3: 0.424; 0.234−0.768). Similar trends were found for speed and agility, but only group 3 showed significant results (OR; 95% CI: group 3: 0.297; 0.162−0.545). Flexibility was also the worst in groups 2 and 3 (OR; 95% CI: G2: 0.403; 0.213−0.762; and group 3: 0.520; 0.282−0.958). Conclusion: High fitness status and adherence to the Mediterranean diet were associated with improved health-related quality of life in schoolchildren of central Spain.

A Longitudinal Approach to the Relationships Among Sleep, Behavioral Adjustment, and Maternal Depression in Preschoolers

This study aimed to investigate the longitudinal associations between children’s sleep duration (SD) and problems (SPs), behavioral adjustment [externalizing behaviors (EB) and internalizing behaviors (IB)], and maternal depressive symptoms (MDS) in preschoolers over a period of 3 years (4–6 years of age). For this purpose, latent growth modeling (LGM) was conducted using 2012(W₅) to 2014(W₇) data from the National Panel Study on Korean Children (PSKC), while controlling for family contextual factors (i.e., responsive parenting, developmental stimulations, and marital conflict) and child temperament (children’s negative emotionality). First, children who slept longer at four were concurrently associated with lower levels of EB, while more SPs were associated with higher levels of EB and IB, concurrently. Second, greater decreases in SPs were associated with greater decline in EB and IB. Higher levels of MDS at four were associated with higher levels of child EB, IB, and SPs, concurrently. However, no longitudinal associations were found between the rates of change in MDS and children’s sleep and adjustment (EB and IB). Finally, the magnitude of the associations among the variables was greater overall in the SPs models than in the SD models. These findings suggest that addressing sleep problems, rather than sleep duration, seem to be more important in predicting and preventing young children’s adjustment problems and also that more attention should be paid to MDS during preschool years as much as during the postpartum period for better child adjustment outcomes.

Physical Activity, Eating Habits and Mental Health during COVID-19 Lockdown Period in Serbian Adolescents

The COVID-19 pandemic has impacted almost every aspect of life, especially daily physical activity and healthy eating habits but also mental health. Our study aimed to examine the relationship between the physical activity level, eating habits and mental health of Serbian adolescents during the COVID-19 pandemic. A total of 3506 students from the territory of the Republic of Serbia participated in this study. IPAQ-short version and HBSC-FFQ were used to assess physical activity level and eating habits, along with self-rated health. Moderate correlations were identified between physical activity, eating habits and mental health, along with average physical activity, very high life satisfaction (β = 0.177, p < 0.01) and very low emotional distress (β = −0.150, p < 0.01). A significant predictor of mental health was the frequency of breakfast on weekdays (β = 0.167, p < 0.01 for life satisfaction and β = −0.153, p < 0.01 for emotional distress), but not on weekends. Since the pandemic’s course is uncertain, the focus should be on maintaining good physical activity, nutrition and well-being.

COVID-19: Effects of Pandemic Related Restrictions on Physical Activity, Screen Time, and Mental Well-being in German adolescents

Objective: To describe the impact of the COVID-19 pandemic-related restrictions (PR) in April and May 2020 on physical activity (PA), sedentary screen time (SST), and mental well-being (MWB) in German adolescents, and to analyze associations between these variables. Methods: The Münster District Government invited all secondary school students (aged 11-17) in the region to take part in the online survey that assessed PA, SST, and MWB. For data analysis, we calculated descriptive statistics and ran linear regression analysis. Results: 1,038 students (627 [60.4%] female; 14.18 [± 1.97] years) were included in the analysis. During the PR, a marked decline in overall PA (p < .001) and a significant increase (p < .001) in SST were observed. One-third of the students reported worrying more and being less satisfied with their lives since PR. A decrease in life satisfaction (ß = -.524, p < .001) as well as an increase in general worrying (ß = -.336, p = .015) were associated with a decrease in PA during PR. Conclusion: The results show that the restrictions led to a decrease in physical activity, which may have detrimental effects on the students' mental and physical health.

Use of digital screens by adolescents and association on sleep quality: a systematic review

This study aimed to analyze the influence of digital screen use on adolescents’ quality of sleep. This systematic review was recorded on PROSPERO (CRD42020203403) and conducted according to PRISMA guidelines. Studies covering adolescents from 10 to 19 years were included without language or publication restrictions which answered the following guiding question: “Does the use of digital screen influence adolescents’ quality sleep?”. Article search included the following databases: (MEDLINE/PubMed), LILACS, SciELO, Scopus, EMBASE, Web of Science, IBECS, Cochrane Library, ClinicalTrials.gov, and Open Gray. The following descriptors were used: “Sleep Quality”, “Screen Time”, and “Adolescent”. The Newcastle-Ottawa Scale (NOS) assessed the methodological quality of the cohort studies, and a modified NOS was used to assess the cross-sectional ones. In total, 2,268 articles were retrieved, of which 2,059 were selected for title and abstract reading, after duplicates were deleted. After this stage, 47 articles were selected for full reading, resulting in the 23 articles which compose this review. Excessive use of digital screens was associated with worse and shorter sleep, showing, as its main consequences, night awakenings, long sleep latency, and daytime sleepiness. The use of mobile phones before bedtime was associated with poor quality of sleep among adolescents. Our evaluation of the methodological quality of the chosen studies found seven to be poor and 16, moderate.

Impact of COVID-19 pandemic lockdown on movement behaviours of children and adolescents: a systematic review

INTRODUCTION

Several studies have examined how the lockdown restrictions enforced to halt the spread of COVID-19 have affected children and adolescents' movement behaviours, but there is a need to synthesise these findings. Therefore, we conducted this systematic review to examine the impact of COVID-19 lockdown on children and adolescents' movement behaviours.

METHODS

We searched eight databases and grey literature for relevant studies of all study designs; and conducted a narrative analysis of the results following synthesis without meta-analysis guidelines. We used appropriate tools to assess the risk of bias in quantitative and qualitative studies. We compared changes in physical activity, screen time and sleep duration and quality from before to during the COVID-19 lockdown.

RESULTS

This review included 71 studies reporting data from 35 countries and territories, mostly from high-income economies. A majority of the studies used a cross-sectional design and had fair to poor-quality ratings. Most studies reported reduced physical activity, increased screen time and longer sleep hours among children and adolescents. Children and adolescents facing strict lockdowns saw a larger decline in physical activity and a sharper increase in screen time than those under mild restrictions.

CONCLUSION

COVID-19-related lockdowns were detrimental to children and adolescents' movement behaviours, with stricter lockdowns tending to have a bigger impact. Children and adolescents under COVID-19 restrictions are likely to be less active, spend more time on screen, and sleep longer hours than before the lockdown. More studies from low-income and middle-income countries could provide a clearer picture of the impact.

PROSPERO REGISTRATION NUMBER

CRD42021245924.

The Impact of Nutritional and Lifestyle Changes on Body Weight, Body Composition and Cardiometabolic Risk Factors in Children and Adolescents during the Pandemic of COVID-19: A Systematic Review

The coronavirus (COVID-19) pandemic and the measures taken by most countries to curb virus transmission, such as social distancing, distance learning, population, home confinement and disruption of all organized activities, has affected children and adolescents worldwide. The aim of this review was to assess the role of diet and lifestyle changes due to COVID-19 measures on body weight/composition and cardiometabolic risk factors in children and adolescents. An electronic search was conducted in PUBMED, COCHRANE, Google Scholar and SCOPUS databases up to 31 October 2021. 15 eligible studies were identified. According to the studies included in the analysis, COVID-19 measures seem to have had a negative impact on the diets and lifestyles of children and adolescents, with a consequent increase in body weight and central fat accumulation. On the other hand, the parental presence and control resulted in better glycaemic control in children with diabetes mellitus (DM) Type 1, but the effect of the pandemic in the glycaemic control of children with DM2 2 is controversial. Finally, diet and lifestyle changes had a differential impact on children’s hypertension prevalence. These findings point to the need for public policy measures to prevent obesity and its complications, to and improve diet and lifestyle during the continuing and yet unresolved COVID-19 epidemic.

The Nutrition-COVID-19 Interplay: a Review

Purpose of Review

Nutritional status is affected by the COVID-19 pandemic, directly or indirectly. Even with the recent rollout of the coronavirus disease 2019 (COVID-19) vaccines and availability of medicines such as remdesivir, and monoclonal antibodies, host nutritional status is pivotal in the fight against the acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and outcomes. The purpose of this review is to discuss the effects of COVID-19-related lockdown on lifestyle behaviors, and the nutritional consequences, and the direct sequelae of the infection on nutrition including potential nutritional interventions.

Recent Findings

The COVID-19-related lockdown imposed radical changes in lifestyle behaviors with considerable short-term and long-term health and nutritional consequences including weight gain and obesity and increased cardiometabolic risk, consistently linked to worsened prognosis. The extent of the impact was dependent on food insecurity, overall stress and disordered eating, physical inactivity, and exposure to COVID-19-related nutrition information sources. COVID-19 could directly induce inflammatory responses and poor nutrient intake and absorption leading to undernutrition with micronutrient deficiencies, which impairs immune system function with subsequent amplified risk of infection and disease severity. Nutrition interventions through nutrition support, dietary supplementation, and home remedies such as use of zinc, selenium, vitamin D, and omega-3 fatty acids showed the most significant promise to mitigate the course of COVID-19 infection and improve survival rates.

Summary

The nutrition-COVID-19 relationship and related dietary changes mimic a vicious cycle of the double burden of malnutrition, both obesity and undernutrition with micronutrient deficiencies, which promote infection, disease progression, and potential death.

Effect of Nutritional Habits on the Glycemic Response to Different Carbohydrate Diet in Children with Type 1 Diabetes Mellitus

Unhealthy eating habits are associated with obesity, metabolic syndrome, and increased insulin resistance in young patients with type 1 diabetes mellitus (T1DM), and may impact the possible benefit from dietary interventions on glycaemic control. This study determines how nutritional patterns influence the quality of dietary intervention with a 30% or 50% carbohydrate diet in terms of glycaemic control measured with continuous glucose monitoring (CGM). Eating habits were obtained with a frequency-of-consumption questionnaire (FFQ-6) before the diet assessment. Altogether, we collected CGM and FFQ-6 data from 30 children (16 boys and 14 girls aged 10-17 years) with T1DM subjected to two consecutive 3-day nutritional plans. From these, 23 patients met the CGM data quality criteria for further analysis. Furthermore, high accuracy achieved in training (95.65%) and V-fold cross-validation (81.67%) suggest a significant impact of food habits in response to introduced nutritional changes. Patients who consumed more vegetables or grains (>4 times per day), more wheat products (>once per day), fewer fats (<1.5 times per day), and ranked fruit juice as the most common selection in the drinks category achieved glycaemic control more often after the introduction of a 30% carbohydrate diet, as opposed to those with different dietary patterns, whose glycaemic control was negatively impacted after switching to this diet. Additionally, the 50% carbohydrate diet was safe for all patients in the context of glycaemic control.

The Outcome of COVID-19 Lockdown on Changes in Body Mass Index and Lifestyle among Croatian Schoolchildren: A Cross-Sectional Study

Globally, the COVID-19 pandemic altered adults' and children's lifestyles and habits, causing an increase in body weight. Adolescents are sensitive to habit changes and, because of their insufficient capacity to deal with the unexpected COVID-19 changes, were at greater risk of noncommunicable disease development due to the consequences of adopting unhealthy habits. The survey aimed to reveal the changes in nutritional status and lifestyle habits of school children in Croatia and to assess their nutrition knowledge and emotional state and feelings about COVID-19 lockdown. Self-reported data from 1370 school children aged 10 to 15 years were obtained to examine the influence of the lockdown on their nutritional status, lifestyle and emotional status, and to assess their nutrition knowledge. The study revealed that the COVID-19 lockdown has caused an increase in the proportion of overweight and obesity among Croatian school children who changed their lifestyle habits towards being less physically active, spending more time using screen-based media and revealing potential psychological distress. However, the schoolchildren had a high adherence to the Mediterranean diet assessed with the Mediterranean Diet Quality Index for children and adolescents KIDMED index and had good nutrition knowledge. Public health programs promoting a healthy lifestyle and involving the whole family, in a school environment, could provide children with a healthy adulthood.

Physical Activity, Screen Time, Sedentary and Sleeping Habits of Polish Preschoolers during the COVID-19 Pandemic and WHO's Recommendations: An Observational Cohort Study

BACKGROUND

Restrictions related to the COVID-19 pandemic may lead to a significant decrease in physical activity, an increase in sedentary behavior, and thus also such things as screen time or a change in health behavior patterns. The survey aimed to compare levels of physical activity, screen time, hours spent sitting and sleeping time among Polish children aged 3-5 years of age before and during the COVID-19 pandemic.

METHODS

We identified 3000 respondents under five years of age, at Polish kindergartens. The questionnaire consists of 62 questions according to the recommendations of health behavior in school-aged children. The questionnaire was completed by the parents of these children.

RESULTS

Only 30.77% of children complied with WHO criteria before the pandemic. During the pandemic, the percentage of children meeting the recommendations for physical activity decreased even more. Children spent much more time in a sitting position before the restrictions. The children slept as recommended 10-13 h a day, and the pandemic caused an increase in sleep duration of 10-18%. Most children had a limited time allowed for the use of electronic devices already before the pandemic, but during the pandemic the results negatively decreased by 71.54%.

CONCLUSIONS

The results clearly indicate decreased physical activity and increased screen time. It is also crucial to develop recommendations for prevention management strategies of sedentary lifestyles in the youngest group.