In the first 3 to 6 months of the COVID-19 pandemic, the proportion of overweight or obese children and teens from low-income families in Ohio climbed from 38% to 45%, suggests a study presented last week at the European Congress on Obesity in the Netherlands.
In the observational study, which was published online Apr 6 in Clinical Obesityresearchers from Nationwide Children’s Hospital and Ohio State University used primary-care electronic medical records to track the body mass index (BMI) of 4,509 children and teens aged 2 to 17 years from low-income families, comparing weight and height data from both before and after the pandemic began (Jan 1 to Mar 30, 2020 and Jun 1 to Sep 2020).
Healthy-weight category shrank
From before to after the beginning of the pandemic, the proportion of overweight or obese youth rose from 37.8% to 44.6%, while the share of healthy-weight youth fell by 5.6%. Overall, 23.1% of children and teens gained 5 or more kilograms (kg) (11 pounds), while 4.3% gained at least 10 kg (22 pounds), and 17.8% saw an increase in BMI of 2 or more units.
Of youth who were underweight before the pandemic, 45.3% moved into the healthy-weight range after a median gain of 2.1 kg (4.6 pounds). Among children and teens who stayed in the same weight category, median weight gain was greatest in those who were severely obese, at 5.8 kg (12.8 pounds), those who were obese (4.3 kg [9.5 pounds]), overweight (2.7 kg .) [5.6 pounds]), and healthy weight (1.7 kg [3.7 pounds]).
In an age-stratified analysis, boys aged 2 to 5 years were less likely than girls their age to move to concerning weight change (CWC) status, and Hispanic youth were more likely than their White counterparts to do so (odds ratio [OR]2.04).
Among 6- to 9-year-olds, boys were more likely than girls to move to CWC status (OR, 1.36). In the 10- to 13-year age group, the likelihood of change to CWC was higher among Black than White youth.
Most children (80.5%) were in the non-concerning weight change category, 73.8% stayed in their original weight category, 6.7% moved to a healthier weight category, and 19.5% moved from a healthier weight to CWC.
In a binomial logistic regression analysis, the chances of 2- to 5-year-olds and 6- to 9-year-olds moving to CWC status were higher than those of 14- to 17-year-olds (OR, 1.9).
Health disparities related to low income, minority race
In a European Association for the Study of Obesity news release, Ihuoma Eneli, MD, said that pandemic lockdowns may have exacerbated a long-regarded problem with overweight and obesity in the United States. “The early months of school closures, bans on social gatherings, disruptions to sleep and lack of exercise, increased screen time and snacking, as well as heightened stress and anxiety created the perfect storm for having issues with weight gain,” she said.
Eneli said that weight gain during childhood endures into adulthood and can have substantial health consequences such as type 2 diabetes and lead to increased healthcare utilization. “Poverty makes both obesity and its negative health effects more likely, and access to obesity care is disproportionately lower in the minority populations,” she said. “These new data underscore why urgent action is needed to close the gap between the most and least deprived to ensure every child has an equal chance to grow up healthy.”
Eneli called for studies tracking weight changes over a long period later in the pandemic. “Along with several negative pandemic-related consequences on child health (eg, increased mental health concerns, food in security, deficits in immunization coverage and school performance), addressing the excessive weight gain should be a top priority for families, administrators, or policymakers, she said.
The researchers said that the concerning findings in non-White youth may indicate a further widening of racial and ethnic disparities. “These results should inform decision making in short-term responses to catastrophic events, particularly when safety and social networks to support families are limited,” they wrote.