Pediatric BMI changes during COVID-19 pandemic: An electronic health record-based retrospective cohort study

Brooks, Corinne G.; Spencer, Jessica R.; Sprafka, J. Michael; Roehl, Kimberly A.; José, Ma; Londhe, Ajit; He, Fang; Cheng, Alvan; Brown, Carolyn; Page, John H.

doi:10.1016/j.eclinm.2021.101026

Cited by 66 publications

(115 citation statements)

References 21 publications

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“…Our findings are in line with several studies on COVID-19-related weight changes in adults [ 9 , 10 ] and children [ 31 – 34 ] and studies on weight gain in children associated with the economic crisis in 2007–2008 [ 17 , 18 , 35 ] or the great Fukushima earthquake 2011 [ 19 , 36 ]. Zheng et al showed that the initial increase of BMI and obesity prevalence persisted or even aggravated at least two years after the earthquake.…”

Section: Discussionsupporting

confidence: 92%

“…In line with our results, they found an excessive acceleration of BMI-SDS change in the younger children, with rates two times as high as before. Moreover, they also found children with overweight and obesity more severely affected than their normal weight peers [ 34 ]. In addition, several other studies reported a remarkable weight gain in children associated with COVID-related lockdown periods (Korea, n = 169, pediatric patients [ 38 ]; US, n = 29, elementary school children [ 39 ]; China, n = 445, children aged 7–12 years [ 40 ]; China, n = 10,082, students of high schools, colleges, and graduate schools aged >16 years [ 41 ]; Italy, n = 51, adolescents with obesity aged 10–18 [ 32 ]; Greece n = 397, children and adolescents aged 2–18 years [ 42 ]).…”

Section: Discussionmentioning

confidence: 99%

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Age- and weight group-specific weight gain patterns in children and adolescents during the 15 years before and during the COVID-19 pandemic

et al. 2021

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Background/Objectives There 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/Methods To 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. Results During 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. Conclusions There 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.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Age- and weight group-specific weight gain patterns in children and adolescents during the 15 years before and during the COVID-19 pandemic

et al. 2021

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“…BMI for age was slightly higher in the 2020 COVID-19 context preschool group (16.4 ± 2.6 kg/m 2 ) compared to the 2019 group (15.8 ± 1.6 kg/m 2 ). This is consistent with reports worldwide that identify an increase in BMI as a result of COVID-19 in preschoolaged children [48][49][50], youth 6-12 years [51], and adults [52]. However, the increased BMI appears to conflict with the increased healthy eating CHEERS subscale, MVPA levels, and step count in the 2020 COVID-19 context preschoolers.…”

Section: Covid-19 and Preschooler's Bmisupporting

confidence: 90%

The Impact of COVID-19 on Eating Environments and Activity in Early Childhood Education and Care in Alberta, Canada: A Cross-Sectional Study

et al. 2021

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Early childhood education and care (ECEC) environments influence children’s early development and habits that track across a lifespan. The purpose of this study was to explore the impact of COVID-19 government-mandated guidelines on physical activity (PA) and eating environments in ECEC settings. This cross-sectional study involved the recruitment of 19 ECEC centers pre-COVID (2019) and 15 ECEC centers during COVID (2020) in Alberta, Canada (n = 34 ECEC centers; n = 83 educators; n = 361 preschoolers). Educators completed the CHEERS (Creating Healthy Eating and activity Environments Survey) and MEQ (Mindful Eating Questionnaire) self-audit tools while GT3X+ ActiGraph accelerometers measured preschooler PA. The CHEERS healthy eating environment subscale was greater during COVID-19 (5.97 ± 0.52; 5.80 ± 0.62; p = 0.02) and the overall score positively correlated with the MEQ score (r = 0.20; p = 0.002). Preschoolers exhibited greater hourly step counts (800 ± 189; 649 ± 185), moderate-to-vigorous PA (MVPA) (9.3 ± 3.0 min/h; 7.9 ± 3.2 min/h) and lower sedentary times (42.4 ± 3.9 min/h; 44.1 ± 4.9 min/h) during COVID-19 compared to pre-COVID, respectively (p < 0.05). These findings suggest the eating environment and indices of child physical activity were better in 2020, which could possibly be attributed to a change in government-mandated COVID-19 guideline policy.

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“…Previous research has shown the importance of active solicitation of information [68] and EMRs are now being used to help evaluate the effectiveness [69] and potential side effects [70,71] of COVID-19 vaccines. Similarly, EMR-based data has been utilized previously in studies looking at the effects of the COVID-19 pandemic as a stressor on people with bipolar disorder [72], the safety of the COVID-19 vaccine in pregnant women [73], the effect of COVID-19 on pregnancy outcomes [74], the effects of clinical characteristics on outcomes of COVID-19 patients [75][76][77], the factors that influence pharmacotherapy for tobacco dependence in the VA system [78], the effect of mental health disorders on COVID-19 mortality [79], COVID-19 vaccine adverse effects [68], and the effects of the COVID-19 pandemic on body mass index in children [80]. Thus, the present study builds upon a growing body of research examining similar effects of the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

Changes in Tobacco Use Patterns among Veterans in San Diego during the Recent Peak of the COVID-19 Pandemic

Fatollahi

Bentley

Doran

et al. 2021

IJERPH

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The prevalence of tobacco use increases in times of stress; however, during the initial stage of the COVID-19 pandemic, tobacco use rates stayed the same in most populations. Previous work focused on the initial months of the pandemic, while this study examined the changes in tobacco use during a later peak period of the pandemic. We used data from 61,852 visits to the VA San Diego Healthcare System from November 2019 to February 2021, divided into pre-, early, and peak pandemic periods. Multinomial logistic regression was used to test whether the odds of being a daily or non-daily tobacco user varied over time, by demographic group, or with the presence of specific psychiatric diagnoses. Younger Veterans had a greater reduction in the prevalence of non-daily tobacco use between the early and peak periods, while older Veterans had a rise in daily use from pre- to the early pandemic, which returned to baseline during the peak. Individuals with substance use disorder and serious mental illness diagnoses were more likely to report tobacco use, but psychiatric diagnoses did not predict change over time. These findings demonstrate factors that potentially contribute to changes in tobacco use during a public health crisis and may help guide future targeted cessation efforts.

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Pediatric BMI changes during COVID-19 pandemic: An electronic health record-based retrospective cohort study

Cited by 66 publications

References 21 publications

Age- and weight group-specific weight gain patterns in children and adolescents during the 15 years before and during the COVID-19 pandemic

Age- and weight group-specific weight gain patterns in children and adolescents during the 15 years before and during the COVID-19 pandemic

The Impact of COVID-19 on Eating Environments and Activity in Early Childhood Education and Care in Alberta, Canada: A Cross-Sectional Study

Changes in Tobacco Use Patterns among Veterans in San Diego during the Recent Peak of the COVID-19 Pandemic

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