Modified body mass index z‐scores in children in New York City during the COVID‐19 pandemic

Abstract

Abstarct Objectives Determine whether the negative impact of the COVID‐19 pandemic on weight gain trajectories among children attending well‐child visits in New York City persisted after the public health restrictions were reduced. Study Design Multicenter retrospective chart review study of 7150 children aged 3–19 years seen for well‐child care between 1 January 2018 and 4 December 2021 in the NYC Health and Hospitals system. Primary outcome was the difference in annual change of modified body mass index z ‐score (mBMIz) between the pre‐pandemic and early‐ and late‐pandemic periods. The mBMIz allows for tracking of a greater range of BMI values than the traditional BMI z ‐score. The secondary outcome was odds of overweight, obesity, or severe obesity. Multivariable analyses were conducted with each outcome as the dependent variable, and year, age category, sex, race/ethnicity, insurance status, NYC borough, and baseline weight category as independent variables. Results The difference in annual mBMIz change for pre‐pandemic to early‐pandemic = 0.18 (95% confidence interval [CI]: 0.15, 0.20) and for pre‐pandemic to late‐pandemic = 0.04 (95% CI: 0.01, 0.06). There was a statistically significant interaction between period and baseline weight category. Those with severe obesity at baseline had the greatest mBMIz increase during both pandemic periods and those with underweight at baseline had the lowest mBMIz increase during both pandemic periods. Conclusion In NYC, the worsening mBMIz trajectories for children associated with COVID‐19 restrictions did not reverse by 2021. Decisions about continuing restrictions, such as school closures, should carefully weigh the negative health impact of these policies.

Long-term Effects of the COVID-19 Lockdown on Weight Status, Eating Habits, and Lifestyle Changes Related to School-aged Children in Bandar Abbas, Iran

“…Our results also indicate a signi cant rise in the number of children suffering from overweight and obesity (3%) during this period. Our ndings are consistent with recent studies that have shown an increase in the prevalence of overweight and obesity among children and adolescents ranged from 7-13% during quarantine (11)(12)(13)(14)(15). Differences in higher rates of overweight and obesity in other studies may be attributed to variations in the timeframes for measuring and comparing weight and height among participants, as well as differences in sample sizes.…”

Increased Rates of Hospitalized Children with Type 1 and Type 2 Diabetes Mellitus in Central Brooklyn during the COVID-19 Pandemic

“…We did not specifically look at longitudinal changes in BMI in the same cohort, although the observed BMI z -scores based on our data was not different in our study from prepandemic to pandemic years. In another study examining the changes in BMI z -score in pediatric patients in municipal hospitals across NYC, there was an increase in annual BMI z -score from 2018 to 2019 by 3.1% and from 2019 to 2020 by 34.3% in the general pediatric population [ 13 ] which helps lend suspicion that perhaps the observed increased hospitalizations of T2DM or new-onset T2DM may be due to weight changes.…”

“…Several researchers reported an increase of obesity risk factors and rates of obesity during lockdown and suggested that it may lead to metabolic decompensation, triggering the increase of T2DM [13][14][15][16]. Recent studies also found increased incidence and prevalence rates of presentation of T2DM [6,11,[17][18][19].…”

Understanding family dynamics of obesity: Do parents and children lose and gain weight together?

“…Outside of the FBT literature, there has been limited epidemiological investigation into the relationship between parent and child weight trajectories. During the COVID‐19 pandemic, excessive weight gain had been reported in both adult and pediatric populations 24–28 . Additionally, having children at home was a significant predictor of pandemic weight gain among adults 29 .…”

“…During the COVID-19 pandemic, excessive weight gain had been reported in both adult and pediatric populations. [24][25][26][27][28] Additionally, having children at home was a significant predictor of pandemic weight gain among adults. 29 Elucidating the natural relationship between parent and child weight trajectories may facilitate the designing of appropriate large-scale public health weight reduction interventions.…”