Food Insecurity and Pediatric Obesity: a Double Whammy in the Era of COVID-19

Tester, June M.; Rosas, Lisa G.; Leung, Cindy W.

doi:10.1007/s13679-020-00413-x

Cited by 113 publications

(111 citation statements)

References 107 publications

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“…There may be an interaction between food insecurity, malnutrition and obesity, contributing to poor health and premature death [ 4 ]. For families with limited purchasing access to nutrient-dense foods (e.g., fresh fruits and vegetables), the ‘’per calorie’’ cost is higher than calorie-dense junk foods [ 32 ]. According to the present review, during the COVID-19 pandemic, the percentage of families reporting difficulty accessing food in the US increased by 20% due to financial reasons, anxiety, difficulty of access as stores were closed and fear of transmitting the virus [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Obesity in Children and Adolescents during COVID-19 Pandemic

et al. 2021

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Background: The COVID-19 pandemic has led to special circumstances and changes to everyday life due to the worldwide measures that were imposed such as lockdowns. This review aims to evaluate obesity in children, adolescents and young adults during the COVID-19 pandemic. Methods: A literature search was conducted to evaluate pertinent studies up to 10 November 2020. Results: A total of 15 articles were eligible; 9 identified 17,028,111 children, adolescents and young adults from 5–25 years old, 5 pertained to studies with an age admixture (n = 20,521) and one study included parents with children 5–18 years old (n = 584). During the COVID-19 era, children, adolescents and young adults gained weight. Changes in dietary behaviors, increased food intake and unhealthy food choices including potatoes, meat and sugary drinks were noted during the ongoing COVID-19 pandemic. Food insecurity associated with financial reasons represents another concern. Moreover, as the restrictions imposed reduced movements out of the house, physical activity was limited, representing another risk factor for weight gain. Conclusions: COVID-19 restrictions disrupted the everyday routine of children, adolescents and young adults and elicited changes in their eating behaviors and physical activity. To protect them, health care providers should highlight the risk of obesity and provide prevention strategies, ensuring also parental participation. Worldwide policies, guidelines and precautionary measures should ideally be established.

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Section: Discussionmentioning

confidence: 99%

Obesity in Children and Adolescents during COVID-19 Pandemic

et al. 2021

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“…Evidence suggests that mal/undernourishment results in a weakened immune function, and those with obesity and co‐morbidities such as type 2 diabetes are more likely to suffer worsened outcomes from COVID‐19 (GNR, 2020). The pandemic adds more of a challenge for obesity prevention, particularly as children and young people from economically disadvantaged areas are most vulnerable (PHE, 2020; Tester et al, 2020). Current research suggests COVID‐19 has relatively mild effects on children and young people (Chanchlani et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…Also, little is known of how schools’ contextual differences present a challenge to the development of consistent approaches, and therefore, more needs to be understood with regard to school types and demographics ( e.g . location, food access and the number of students living with food insecurity; Tester et al, 2020). COVID‐19 has highlighted and further exacerbated problems in the school setting as a health promoting environment.…”

Section: Discussionmentioning

confidence: 99%

‘Pizza every day – why?’: A survey to evaluate the impact of COVID‐19 guidelines on secondary school food provision in the UK

et al. 2021

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The nutritional requirements of adolescence and the reported poor UK eating behaviours of young people are a significant public health concern. Schools are recognised as an effective ‘place’ setting to enable improvement to nutrition outcomes. The COVID‐19 pandemic resulted in UK school closures from March 2020. In re‐opening in September 2020, schools were required to meet guidelines to ensure the minimised impact of COVID‐19 on the population (DfE 2020). We aimed to evaluate the impact of COVID‐19 school guidelines on secondary and post‐16 (16–18 years) food provision. An online survey was posted on 8th October to 1st December 2020, targeted at young people, parents and staff of secondary/post‐16 education establishments in the UK. Two hundred and fifty‐two responses were received, of which 91% reported a change in their school food provision, 77% reported time for lunch was shortened and 44% indicated the provision was perceived as less healthy during September 2020 (post‐lockdown school return) compared with March 2020 (pre‐lockdown). Analyses demonstrated that time, limited choice and healthiness impacted negatively upon young people's school food experience. The COVID‐19 pandemic has presented a huge challenge to the delivery of healthy school food to young people. Therefore, schools require more support in following national food standards and incorporating nutrition education and behaviour change strategies within current guidelines.

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“…There is concern that nutrition deterioration combined with governments' social and physical restrictions to stop the virus's spread is likely to impact obesity rates. Indeed, concerns around the potential increase in obesity rates have been expressed by the USA and UK [9,10]. Low-to midincome countries will likely not be protected from the same fate.…”

Section: Summary Of the Covid-19 Pandemicmentioning

confidence: 99%

When a pandemic and an epidemic collide: COVID-19, gut microbiota, and the double burden of malnutrition

Littlejohn

Finlay

2021

BMC Med

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Background It is estimated that the COVID-19 pandemic will drastically increase all forms of malnutrition. Of particular concern, yet understated, is the potential to increase the double burden of malnutrition (DBM) epidemic. This coexistence of undernutrition together with overweight and obesity, or diet-related non-communicable disease (NCD), within low- to middle-income countries (LMICs) is increasing rapidly. Although multiple factors contribute to the DBM, food insecurity (FI) and gut microbiota dysbiosis play a crucial role. Both under- and overnutrition have been shown to be a consequence of food insecurity. The gut microbiota has also been recently implicated in playing a role in under- and overnutrition, with altered community structure and function common to both. The pandemic has already caused significant shifts in food availability which has immediate effects on the gut microbiome. In this opinion paper, we discuss how COVID-19 may indirectly exacerbate the DBM through food insecurity and the gut microbiome. Main text The World Food Programme (WFP) estimates that 265 million people in LMICs will experience acute hunger in 2020 due to the pandemic, nearly doubling the original projection of 135 million. Global border closures to food trade, loss of food production, and stark decline in household income will exacerbate starvation while simultaneously necessitating that families resort to calorie-dense, nutrient-poor foods, thereby increasing obesity. While food insecurity, which is the persistent lack of consistent access to adequate and nutrient-rich foods, will primarily drive nutrition behavior, the gut microbiome is perhaps a key biological mechanism. Numerous human and animal studies describe low diversity and an increase in inflammatory species as characteristic features of the undernourished and overnourished gut microbiota. Indeed, fecal transplant studies show that microbiota transfer from undernourished and overnourished humans to germ-free mice lacking a microbiome transfers the physical and metabolic phenotype, suggesting a causal role for the microbiota in under- and overnutrition. The observed microbiome dysbiosis within severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) coupled with the DBM presents a viscous cycle. Conclusion Low- to mid-income countries will likely see an increase in the DBM epidemic. Providing access to nutritious foods and protecting individuals’ gut microbiome to “flatten the curve” of the DBM trajectory should be prioritized.

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Food Insecurity and Pediatric Obesity: a Double Whammy in the Era of COVID-19

Cited by 113 publications

References 107 publications

Obesity in Children and Adolescents during COVID-19 Pandemic

Obesity in Children and Adolescents during COVID-19 Pandemic

‘Pizza every day – why?’: A survey to evaluate the impact of COVID‐19 guidelines on secondary school food provision in the UK

When a pandemic and an epidemic collide: COVID-19, gut microbiota, and the double burden of malnutrition

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