Abstract
Background/ObjectivesThere 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/MethodsTo 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.ResultsDuring 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.ConclusionsThere 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.
Highlights
On March 11, 2020, the World Health Organization termed the COVID-19 outbreak a pandemic
Besides adverse psychological effects like increased anxiety and loneliness [1, 2], different scientists worry about an increase in overweight and obesity caused by a decline in physical activity (PA), an increase in sedentary behavior (SB), and a change in dietary behavior [3, 4] associated with increased snacking [5] or higher consumption of ultra-processed food [6]
These effects accumulated to OR15y = 1.14 and OR15y = 0.85, whereas we found no difference in the trend between age population
Summary
On March 11, 2020, the World Health Organization termed the COVID-19 outbreak a pandemic. Many countries have been affected and took measures to limit infection rates. Those measures included social distancing, home confinement, the closure of shops, sports and cultural facilities, and schools and nurseries. Several studies showed a decrease in PA accompanied by an increase in SB in children during the COVID-19-induced confinement [5,6,7,8]. Monitoring children’s weight status is of particular interest because childhood obesity is likely to persist into adulthood [11]. With 158,000,000 affected children, childhood obesity is a pandemic on its own [12]. In the context of COVID-19, obesity increases the likelihood of severe disease progression, even in children [13, 15]
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