Effects of COVID‐19 lockdown on lifestyle behaviors in children with obesity: Longitudinal study update

Abstract

Objective A previous report from our group identified directionally unfavorable dietary and lifestyle behavior trends in longitudinally monitored children and adolescents with obesity early in the COVID‐19 pandemic lockdown. The current study aimed at extending these previous observations in youths with obesity on the dietary and lifestyle behavioral consequences of the extended COVID‐19 lockdown in Verona, Italy. Methods The sample included 32 children and adolescents with obesity participating in the longitudinal OBELIX study. Diet and lifestyle information were collected pre‐pandemic, 3 weeks into the national lockdown, and 9 months later when home confinement continued to be mandatory. Changes in outcomes over the study time points were evaluated for significance using repeated‐measures ANOVA and post‐hoc pairwise t ‐tests with Bonferroni corrections. Results As previously reported, meals/day, fried potato intake, and red meat ingestion increased significantly ( p < 0.001) during the initial lockdown. Sleep time and screen time increased and sports participation decreased significantly ( p < 0.001) during the initial lockdown. These changes in health behaviors remained significantly different from baseline at the second lockdown assessment, with the exception sleep time returned to baseline levels. Conclusions Unfavorable diet and lifestyle behavioral changes in response to the initial COVID‐19 lockdown in children and adolescents with obesity have largely been sustained over the course of the pandemic. There is an urgent need to intervene on these behaviors to prevent further deleterious effects on long‐term child health; access to weight management care is critically important for these children. In addition to intervening on these behaviors, our findings should help to inform ongoing lockdown policies.

Longitudinal changes in juvenile and adolescent body mass indices before, during, and after the COVID‐19 lockdown in New Zealand

“…Older adolescents and adults report reductions in physical activity and increases in snacking outside of regular meals (Gerritsen et al 2021;Murphy et al 2021). These New Zealand studies did not include participation by younger groups, though studies in Canada (Moore et al 2020) and Italy (Pietrobelli et al 2022) document substantial adverse impacts on physical activity and diet among children and adolescents during the pandemic. Additionally, while we are not aware of surveys documenting changes in sleep patterns during the New Zealand lockdown period, such changes may have contributed given what has been documented earlier in New Zealand (Nixon et al 2008) and elsewhere (Moore et al 2020;Moreno et al 2021;Pietrobelli et al 2020Pietrobelli et al , 2022Weaver et al 2019).…”

“…These New Zealand studies did not include participation by younger groups, though studies in Canada (Moore et al 2020) and Italy (Pietrobelli et al 2022) document substantial adverse impacts on physical activity and diet among children and adolescents during the pandemic. Additionally, while we are not aware of surveys documenting changes in sleep patterns during the New Zealand lockdown period, such changes may have contributed given what has been documented earlier in New Zealand (Nixon et al 2008) and elsewhere (Moore et al 2020;Moreno et al 2021;Pietrobelli et al 2020Pietrobelli et al , 2022Weaver et al 2019). Pietrobelli et al (2022) note, however, that changes in sleep patterns that took place early in the quarantine period were not found later on.…”

The impact of the COVID-19 pandemic on cardiovascular health behaviors and risk factors: A new troubling normal that may be here to stay

“… 50 Moreover, greater consumption of fruit juice, pasta, fried potato intake, red meat, sweets, salty/total snacks, and breakfast foods, which are associated with increases in body weight in children and adolescents, has also been reported as result of the COVID-19 lockdown. 48 , 51 , 52 Notably, adoption of riskier dietary practices clearly translated to excess weight gain, though these observations were disproportionately more evident in those with a pre-existing elevation in body weight. For example, Cena et al showed that children with obesity prior to the pandemic appear to be at a higher risk of negative lifestyle changes (e.g., poor diet, reduced PA) and weight gain during lockdown.…”

“… 52 Children with pre-existing obesity were also more likely to have lower states of wellbeing and psychophysical health, attributed largely to poor food choices, increased snacking between meals, and greater intake of comfort-foods. 52 If poor dietary practices are sustained, as one small cohort study suggests, 48 these findings could have far-reaching implications on long-term pediatric health that warrants both acknowledgement and urgent action to implement earlier behavioral screening and intervention strategies, especially in overweight/obese children at high risk of adverse health trajectories.…”

Surgical Outcomes with and without Prism Adaptation of Cases with Acute Acquired Comitant Esotropia Related to Prolonged Digital Device Use

“…[9][10][11][12][13][14] The use of DDs by adolescents and young adults has dramatically increased within the past decade, particularly during lockdowns associated with the coronavirus disease 2019 pandemic. [15][16][17] As a pathological etiology for this new type of AACE, Lee et al and Yilmaz et al speculated that excessive use of DDs would induce strong increases in the tone of both medial rectus muscles following long-acting accommodative efforts and disruption of vergence. 8,10 All patients presenting with this condition are instructed to limit or reduce the use of DDs, resulting in improved esodeviation in some patients.…”