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Poon ETC, Fang Y, Chung LMY, Chan CKM, Or PPL, Sun F. A scoping review of physical activity-based interventions for obesity management in children and adolescents during the COVID-19 pandemic. Int J Obes (Lond) 2024; 48:302-314. [PMID: 38086902 DOI: 10.1038/s41366-023-01433-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 11/10/2023] [Accepted: 11/24/2023] [Indexed: 02/28/2024]
Abstract
Overweight and obesity have emerged as global health issues among children and adolescents. Restrictions related to the COVID-19 pandemic have aggravated the threat of paediatric obesity due to the prevalent reduction in physical activity (PA) in children and adolescents. However, this has also created an opportunity for healthcare professionals to explore new strategies to address this persistent problem. A systematically conducted scoping review was performed on 15 online databases to summarise and analyse the design, efficacy, and feasibility of PA-based weight management interventions for children and adolescents during the pandemic. Finally, we reviewed 23 eligible studies that were published between 2021 and 2023. The included interventions were presented to 1938 children and adolescents and 355 parents using a virtual or virtually blended face-to-face approach during the pandemic. The intervention design included a basic PA programme with three optional components (nutritional education, sociopsychological counselling, and medication consultations). Implementation generally resulted in favourable changes in body mass index (BMI) and/or body size or composition (primary outcomes), as well as health behaviours, physical health or fitness, and individual well-being (secondary outcomes). A longer duration of exposure to the intervention, female sex, and older age were associated with a higher efficacy of the included interventions. Moreover, the interventions showed high feasibility, with medium-high participant attendance, high acceptance/satisfaction in both children and adolescents and their parents and teachers, and strong participant engagement. This may be related to the high accessibility of health information, timely social support, and enhanced self-efficacy. In conclusion, both the virtual and blended delivery of well-planned weight management interventions during the pandemic show promise for the treatment and control of paediatric obesity. The lessons learned from the pandemic may help improve the design of future interventions and inform the proper integration of new technologies that have emerged in the post-pandemic world.
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Affiliation(s)
- Eric Tsz Chun Poon
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China.
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Louisa Ming Yan Chung
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Carmen Ka Man Chan
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Peggy Pui Lai Or
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Fenghua Sun
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
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Beynon C, Davies L. The impact of the COVID-19 pandemic on childhood obesity rates, by Health Board area, in Wales, UK. J Public Health (Oxf) 2024:fdae011. [PMID: 38324401 DOI: 10.1093/pubmed/fdae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND The aim of this study was to examine the possible impact of the coronavirus pandemic on rates of children living with obesity and severe obesity, by Health Board area in Wales. METHODS The pre-pandemic data consisted of all children included in the Wales Childhood Measurement Programme (2014/15-2018/19). The 2021/22 Child Measurement Programme data were used as the post-pandemic data set. Body mass index for obesity and severe obesity were calculated as 95th and 99.6th centiles, respectively. RESULTS Of the 163 277 children measured pre-pandemic (2014/15 to 2018/19), the overall prevalence of children with obesity and severe obesity were 12.1 and 3.2%, respectively. In the post-pandemic year (2021/22), obesity increased to 15.5% and severe obesity increased to 4.8%, with clear deprivation differentials (noting one of the seven Health Boards was unable to submit data post-pandemic). Two Health Boards had significantly higher rates of obesity post-pandemic compared to pre-pandemic. Increased levels of severe obesity were observed in all Health Boards with available data. CONCLUSION The post-pandemic rise in obesity and severe obesity in young children living in Wales demonstrates a need for more work on the prevention of obesity and severe obesity, targeting the early years and areas of socio-economic disadvantage.
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Affiliation(s)
- Claire Beynon
- Cardiff and Vale University Health Board, Cardiff CF14 4HH, UK
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Cai P, Liu Y, Yang Z, Luo Y, Zhang Y, Ye P, Yin X, Xiao N, Chen X, Wang M, Xiao B, Zhao H. Impact of lockdown on the growth of children in China aged 3-6 years during the COVID-19 pandemic. Front Endocrinol (Lausanne) 2024; 14:1301889. [PMID: 38234429 PMCID: PMC10791918 DOI: 10.3389/fendo.2023.1301889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/07/2023] [Indexed: 01/19/2024] Open
Abstract
Background Lockdowns in COVID-19 pandemic led to less physical activity and more intake of unhealthy food in children. The aim of this study was to investigate the negative impact of major lockdowns on the growth of children aged 3-6 years during COVID-19 pandemic period. Methods Physical examination results in 2019 to 2022 from 5834 eligible children (2972 males and 2862 females) from Southwestern China who were 3 years old in 2019 were retrospectively collected. Height and weight data points were extracted from the results, and percentiles of height (height%), weight (weight%), and BMI (BMI%), and rates of overweight and obesity were calculated and compared between different years during the pandemic. Results After analyzing the 15404 growth data points from 5834 children, a slowly increasing trend of height% from 2019 to 2022 was observed. Weight%, BMI%, overweight rate, obesity rate, and combined overweight and obesity rate had two peaks in 2020 and 2022 when major lockdowns were adopted and a drop in between (year 2021), except for obesity rate which did not drop in 2021. Similar results were shown after stratification by gender. Conclusion The lockdowns in COVID-19 pandemic promoted obesity of kindergarten children, but did not show any negative impact on their height growth possibly due to over-nutrition of children during lockdowns. More efforts need to be made to limit the increase of obesity rate in kindergarten children during possible future lockdowns.
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Affiliation(s)
- Peiling Cai
- School of Preclinical Medicine, Chengdu University, Chengdu, Sichuan, China
| | - Yuxuan Liu
- School of Preclinical Medicine, Chengdu University, Chengdu, Sichuan, China
- Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China
| | - Zhen Yang
- Maternal and Child Health Service Center of Wuhua District, Kunming, Yunnan, China
| | - Yueyao Luo
- School of Preclinical Medicine, Chengdu University, Chengdu, Sichuan, China
| | - Yanqiong Zhang
- Maternal and Child Health Service Center of Wuhua District, Kunming, Yunnan, China
| | - Peng Ye
- School of Preclinical Medicine, Chengdu University, Chengdu, Sichuan, China
| | - Xiaoling Yin
- Maternal and Child Health Service Center of Wuhua District, Kunming, Yunnan, China
| | - Nanying Xiao
- Maternal and Child Health Service Center of Wuhua District, Kunming, Yunnan, China
| | - Xinwei Chen
- Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China
| | - Mengping Wang
- School of Preclinical Medicine, Chengdu University, Chengdu, Sichuan, China
| | - Beili Xiao
- School of Preclinical Medicine, Chengdu University, Chengdu, Sichuan, China
- Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China
| | - Hongying Zhao
- Department of Pediatrics, Zhongshan Hospital of Xiamen University, Xiamen University, Xiamen, Fujian, China
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Hun Gamboa N, Salazar M, Aliste S, Aguilera C, Cárdenas ME. [Food quality in pre-school and school children in Chile during the COVID-19 pandemic]. NUTR HOSP 2023; 40:934-941. [PMID: 37334794 DOI: 10.20960/nh.04383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
Introduction Introduction: the COVID-19 pandemic can affect the quality of food and nutrition of preschoolers and schoolchildren through an increase in food insecurity of families, by measures such as confinement and closure of educational establishments, which affects the daily structure, feeding schedules, and quality of food. Objectives: analyze the overall food quality of preschool and school children in Chile during the COVID-19 pandemic. Methods: five hundred and fifty-one schoolchildren (22.5 % boys and 77.5 % girls) from five Chilean cities distributed in northern, central, and southern macro zones participated in a convenience sampling. The Global Food Quality Index was applied. The data were analyzed in the IBM SPSSV24 statistical program. Differences in proportions were analyzed employing crossed tables. Results: schoolchildren from rural areas presented lower eating quality than their urban peers (p = .005). Schoolchildren who eat with the whole family had better indicators of eating quality than those who ate alone (p = .002). In nine out of 12 dietary components, evaluated females present higher compliance with dietary recommendations. Conclusions: further research is needed on changes in dietary intake and dietary quality of children and their families during the pandemic. This will allow us to analyze the impact of the pandemic on eating behavior and its possible consequences.
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Affiliation(s)
- Nelson Hun Gamboa
- Escuela de Nutrición y Dietética. Facultad de Salud. Universidad Santo Tomás
| | - Massiel Salazar
- Escuela de Nutrición y Dietética. Facultad de Salud. Universidad Santo Tomás
| | - Sebastián Aliste
- Escuela de Ciencias del Deporte y Actividad Física. Universidad Santo Tomás
| | - Camilo Aguilera
- Escuela de Ciencias del Deporte y Actividad Física. Universidad Santo Tomás
| | - María Elvira Cárdenas
- Centro de Investigación, Familia, Trabajo y Ciudadanía. CIELO. Universidad Santo Tomás
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Zaccagni L, Rinaldo N, Mazzoni G, Mandini S, Masotti S, Toselli S, De Luca F, Gualdi-Russo E. Assessing the Impact of COVID-19 Prevention Measures on Adolescent Growth in Italy. Healthcare (Basel) 2023; 11:2101. [PMID: 37510542 PMCID: PMC10379597 DOI: 10.3390/healthcare11142101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/18/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
COVID-19 infection has caused increased morbidity and mortality worldwide. Several strategies have been adopted around the world to prevent its spread. Italy underwent a long lockdown for face-to-face educational activities, which were replaced with online classes. This longitudinal study aimed to analyze the effects of COVID-19 prevention measures on physical growth and body image perception in a sample of Italian adolescents who experienced the pandemic-induced lockdown in 2020. In particular, we wished to ascertain how lifestyle changes had affected their growth rates and health. Special attention was paid to increases in adiposity indicators (BMI, waist circumference, waist-to-height ratio) and weight caused by reduced physical activity, and consequent possible dissatisfaction with body image. We assessed the impact of school closures by comparing the annual growth rate and body image perception changes of adolescents (n = 60; age = 11.3 ± 0.4 years) who experienced this isolation with those in the following years who did not experience these restrictions (n = 68; age = 11.4 ± 0.3 years). As a consequence of the lockdown, our results indicate a greater annual growth rate in weight and other indices of adiposity (p < 0.05). As the virus is continuing to evolve and propagate, larger population studies can verify and confirm our findings. In promoting health policy to prevent the ongoing prevalence of obesity in adolescents, an accurate assessment of whether the increase in obesity rates during the pandemic is to be considered a temporary trend is highly recommended.
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Affiliation(s)
- Luciana Zaccagni
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121 Ferrara, Italy
- Center for Exercise Science and Sports, University of Ferrara, 44123 Ferrara, Italy
| | - Natascia Rinaldo
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121 Ferrara, Italy
- Center for Exercise Science and Sports, University of Ferrara, 44123 Ferrara, Italy
| | - Gianni Mazzoni
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121 Ferrara, Italy
- Center for Exercise Science and Sports, University of Ferrara, 44123 Ferrara, Italy
| | - Simona Mandini
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121 Ferrara, Italy
- Center for Exercise Science and Sports, University of Ferrara, 44123 Ferrara, Italy
| | - Sabrina Masotti
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121 Ferrara, Italy
- Center for Exercise Science and Sports, University of Ferrara, 44123 Ferrara, Italy
| | - Stefania Toselli
- Department for Life Quality Studies, University of Bologna, 47921 Rimini, Italy
| | - Federica De Luca
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121 Ferrara, Italy
| | - Emanuela Gualdi-Russo
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121 Ferrara, Italy
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Abstract
PURPOSE OF REVIEW The global epidemic of youth-onset obesity is tightly linked to the rising burden of cardiometabolic disease across the lifespan. While the link between childhood obesity and cardiovascular disease is established, this contemporary review summarizes recent and novel advances in this field that elucidate the mechanisms and impact of this public health issue. RECENT FINDINGS The review highlights the emerging data supporting the relationship between childhood adverse events, social determinants of health, and systemic and institutional systems as etiological factors. We also provide updates on new screening and treatment approaches including updated nutrition and dietary guidelines and benchmarks for pediatric obesity screening, novel pharmacological agents for pediatric obesity and type 2 diabetes such as glucagon-like 1 peptide receptor agonists, and we discuss the long-term safety and efficacy data on surgical management of pediatric obesity. The global burden of pediatric obesity continues to rise and is associated with accelerated and early vascular aging especially in youth with obesity and type 2 diabetes. Socio-ecological determinants of risk mediate and moderate the relationship of childhood obesity with cardiometabolic disease. Recognizing the importance of neighborhood level influences as etiological factors in the development of cardiovascular disease is critical for designing effective policies and interventions. Novel surgical and pharmacological interventions are effective pediatric weight-loss interventions, but future research is needed to assess whether these agents, within a socio-ecological framework, will be associated with abatement of the pediatric obesity epidemic and related increased cardiovascular disease risk.
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Affiliation(s)
- Stephanie T Chung
- Section on Pediatric Diabetes and Metabolism, National Institute of Diabetes & Digestive & Kidney Disease, NIH Bethesda, Bethesda, MD, USA
| | - Andrea Krenek
- Section on Pediatric Diabetes and Metabolism, National Institute of Diabetes & Digestive & Kidney Disease, NIH Bethesda, Bethesda, MD, USA
| | - Sheela N Magge
- Division of Pediatric Endocrinology and Diabetes, Johns Hopkins University School of Medicine, 200 N. Wolfe Street, Rubenstein Bldg, Rm 3114, Baltimore, MD, 21287, USA.
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Weihrauch-Blüher S, Huizinga O, Joisten C, Pflanz J, Torbahn G, Wiegand S, Holzapfel C, Hauner H. Changes in Lifestyle and Body Weight in Children and Adolescents during the COVID-19 Pandemic: A Representative Survey of Parents in Germany. Obes Facts 2023; 16:301-312. [PMID: 36882019 PMCID: PMC10627114 DOI: 10.1159/000529116] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 01/04/2023] [Indexed: 03/09/2023] Open
Abstract
INTRODUCTION The public restrictions taken during the COVID-19 pandemic have substantially affected lifestyle and health behavior of children and adolescents. In Germany, little is known how these changes influenced daily life in families with children and adolescents. METHODS A cross-sectional survey was performed in April/May 2022 across Germany, similar to a survey performed in 2020. Parents (N = 1,004, 20-65 years) with at least one child aged 3-17 years filled in an online questionnaire released by the Forsa Institute for Social Research and Statistical Analysis. Fifteen questions related to eating habits, dietary patterns, physical activity, media consumption, fitness, mental health, and body weight were included, and standard socioeconomic parameters were assessed. RESULTS Parents' answers indicated that there was a parental self-reported weight gain in every sixth child since the beginning of the COVID-19 pandemic. This was most obvious in children from families with lower household income and preexisting overweight. Parents also reported that lifestyle patterns had worsened: 70% reported an increase of media consumption during leisure time, 44% a decrease in daily physical activity, and 16% the worsening of dietary habits (e.g., 27% stated to eat more cake and sweets). Children aged 10-12 years were most severely affected. CONCLUSION Negative health effects related to the COVID-19 pandemic are predominantly observed in children 10-12 years of age and in children from families with low household income, suggesting a worsening social disparity. Political action is urgently needed to tackle the adverse consequences of the COVID-19 pandemic on childhood lifestyle and health.
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Affiliation(s)
- Susann Weihrauch-Blüher
- Clinic for Pediatrics I, Pediatric Endocrinology, University Hospital Halle (Saale), Halle (Saale), Germany
| | | | - Christine Joisten
- Department for Physical Activity in Public Health, German Sport University, Institute of Movement and Neurosciences, Cologne, Germany
| | - Juliane Pflanz
- Center for Social-Pediatric Care/Pediatric Endocrinology and Diabetology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Gabriel Torbahn
- Department of Pediatrics, Paracelsus Medical University, Klinikum Nürnberg, Universitätsklinik der Paracelsus Medizinischen Privatuniversität Nürnberg, Nuremberg, Germany
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
| | - Susanna Wiegand
- Center for Social-Pediatric Care/Pediatric Endocrinology and Diabetology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Christina Holzapfel
- Institute for Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany,
| | - Hans Hauner
- Institute for Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
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van de Pas KGH, Hesselink ML, Schlechtriem R, Arayess L, Kreutz JM, Vreugdenhil ACE. The Impact of the COVID-19 Pandemic on Lifestyle and Wellbeing of Children, Adolescents and Their Parents: A Qualitative Study. Children (Basel) 2022; 9. [PMID: 36553372 DOI: 10.3390/children9121929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
Prior studies have shown that changes in daily structure and habits due to the COVID-19 pandemic affected the lifestyle and wellbeing of families. This study aimed to obtain in-depth information on children's and adolescents' experiences regarding their lifestyle and wellbeing during the pandemic. Semi-structured interviews with fifteen families were carried out between May and November 2021. Directed content analysis was used to analyze the transcripts and fundamental qualitative description to describe the results. Children and adolescents revealed an overall unhealthier lifestyle and decreased wellbeing. These negative effects were even larger in adolescents and children with overweight or psychosocial complaints. Our results revealed that parents were actively involved in maintaining a normal daily structure. Furthermore, diet changes were inconsistent and dependent on food availability. An increase in screen time was experienced as inevitable, and external influences were necessary to keep children and adolescents active. Almost no effects were reported on physical health, whereas negative emotions were experienced in varying degrees. Moreover, the decrease in social interactions was reported as the most negative effect of the pandemic. The above-mentioned insights may contribute to the development of preventive measures to promote a healthy lifestyle and wellbeing of children and adolescents during future pandemics.
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