Physical Changes of Preschool Children during COVID-19 School Closures in Fujian, China

Abstract

The COVID-19 pandemic may constitute an “obesogenic lifestyle” that results in exacerbating childhood obesity. However, studies investigating regional sociodemographic factors including different age groups or sexes in children with obesity are lacking. We aimed to clarify the high obesity prevalence populations of preschool children to provide a regional basis for children’s health policy during the COVID-19 school closures. From May to September 2019, a total of 29,518 preschool children were included in a large sample, multicenter cross-sectional study to explore physical status in Fujian Province by stratified cluster random sampling. In October 2019 and October 2020, we also conducted a cross-sectional study exploring physical development including changes in height, weight, and BMI of 1688 preschool children in Fuzhou before and after the COVID-19 school closures. Student’ s t-test, Mann–Whitney U test, or chi-square test was used to assess differences in physical development and overweight and obesity rates among preschool children before and after school closures. For regional factors, the weight of urban preschool children of all ages became higher after the outbreak (p (age 3–4) = 0.009; p (age 4–5) < 0.001; p (age 5–6) = 0.002). For sex factors, overweight and obesity in boys had a greater prevalence than in girls before and after the outbreak. In four age groups, overweight and obesity rates in the 5-year-old group (15.5% and 9.9%) were higher than before (11.4% and 6.0%). The weight and BMI of 4- to 5-year-old children also increased faster than before (p < 0.001). The COVID-19 pandemic has promoted the epidemic of childhood obesity. Living in urban/coastal (economically developed) areas, boys, and aged 4–6 years old may be a susceptible population to obesity development after the outbreak.

COVID-19 pandemic-related weight gain in the pediatric population declined after restrictions ended, except among obese patients

“…In fact, the intra-pandemic restrictions and associated lifestyle changes seem to have affected our study population regardless of their specific age. Contrary to our study, although they also showed that preschool children gained extra weight during the COVID-19 pandemic, Li et al ( 27 ) stated that there was an increase in weight gain with increasing age among preschoolers in China. Unlike our study, they did not follow individual patients but compared given age groups through the years, which makes direct comparison rather difficult.…”

Pediatric overweight and obesity increased in Israel during the COVID-19 period

“…There have been numerous recent reports about childhood obesity rates during the COVID period. These reports have used various methods and have originated from various locations [ 7 , 8 , 10 , 13 , 14 , 17 ]. Two related reports about children treated in Kaiser Permanente of Southern California found increasing rates of overweight and obesity in that population during the COVID period.…”

“…Many aspects of COVID-19, especially lockdowns and quarantines, contributed to an obesogenic lifestyle, such as reduced opportunities for physical activity and changes in dietary patterns [7][8][9]. Reports from many nations and many settings have suggested that pediatric overweight and obesity did increase during the peak years for COVID-19, 2020 and 2021 [7][8][9][10][11][12][13][14][15][16][17][18][19]. However, many of these reports have used convenience samples.…”