COVID-19 lockdown and overweight in schoolchildren: 2 sides of the coin

Abstract

The COVID-19 pandemic has generated changes in various fields of human life. In education, the abrupt change from face-to-face to virtuality has been a challenge, especially in low- and middle-income countries that lack infrastructure, funding, and continuous training for teachers and students on technological tools in education. A special population that is at risk in many aspects is the infant population, which does not have the capacity to face this type of changes in a mature and prepared way. Recently, a study was published where the authors inquired about aspects related to the socioeconomic and behavioral sphere, and their influence on overweight in children1, showing that many of these factors have intensified in the current pandemic, such as the inability to buy healthy foods, the scarcity of the same foods and family dysfunction, which can affect the cardiometabolic health of this population1. Similar results were shown by Parra-García et al2, who recently reviewed the topic of the indirect impact of the pandemic on the paediatric population in this journal, concluding that it is a challenge to identify all these problems in the global context2. However, we consider it necessary to comment on a paradoxical situation that is currently occurring, and which has a substantial impact on the weight and metabolic health of schoolchildren: feeding at home during confinement vs. feeding during classroom instruction. Systematic reviews and meta-analyses have found a substantial and unfavorable impact on mental health in children and adolescents3,4. Up to 80% of this population group3–5, present neuropsychiatric disorders such as anxiety, depression, irritability, inattention, distress (due to virtual academic overload), fear, and sleep disturbances3,4. This has set off alarm bells in several scientific societies, in order to adopt measures to reduce the risk of suffering complications in the short and medium term, such as school dropout, self-injury, domestic violence, persistent and aggressive behavioral disorder, suicide, among others3,4. One particular disorder that is complex to understand and manage during this global catastrophe, because it depends on external factors such as economic, social and cultural factors, is disordered eating in children and adolescents6,7. Fernández-Aranda et al8 state that eating disorders can be generated mainly secondary to conditions such as large intake of food, anorexia nervosa and bulimia nervosa, which ultimately result in changes in cardiovascular risk and short-term decompensations such as electrolyte disturbances and fragility8. Generally, in schools where there is access to a wide variety of foods, in the case of schools that do not have a predetermined, structured and specialized food program, the student can buy his or her own food. In this order of ideas, depending on the availability of foods, which are generally hyper-caloric packaged foods and sugary drinks, so is the child/adolescent’s diet. Theoretically, as the shift from face-to-face to virtuality takes place, food at home should counteract this nutritional imbalance. However, the reality is different. Due to the ravages of COVID-19 on the household economy, the social inequity experienced in certain countries and the fear of contagion, acquiring healthy and quality food is not easy9. Therefore, many households tend to consume hypercaloric food at home, or buy inexpensive canned food, which threatens the child’s nutrition. This situation seems to be a risk factor difficult to control, since it does not depend on the attitude of the parents and the child to establish a healthy nutritional plan, but on the economic and local availability of healthy food. It seems, then, that schoolchildren’s nutrition at this time is in check, and it is expected that in the near future, a notable increase in overweight and obesity in schoolchildren will be observed. Therefore, it is necessary to research and design plans that go hand in hand with public policies to mitigate the impact that the child’s metabolic health suffers and will suffer, especially exacerbated by neuropsychiatric disorders prevalent during the pandemic and postpandemic era. Ethical approval None. Sources of funding None. Author contribution All authors equally contributed to the analysis and writing of the manuscript. Conflicts of interest disclosure The authors declare that they have no financial conflict of interest with regard to the content of this report. Research registration unique identifying number (UIN) None. Guarantor Sabrina Rahman, Department of Public Health, Independent University-Bangladesh, Dhaka, Bangladesh.