Ann Pediatr Endocrinol Metab.  2024 Jun;29(3):174-181. 10.6065/apem.2346094.047.

The impacts of COVID-19 on childhood obesity: prevalence, contributing factors, and implications for management

• Kim MJ
• Kim M
• Yoon JY
• Cheon CK
• Yoo S

• KMID: 2556674
• DOI: http://doi.org/10.6065/apem.2346094.047

Abstract

Purpose
This study aimed to identify changes in the prevalence of obesity and related diseases among children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic.
Methods
This study was conducted using data from the 2016–2021 Korean National Health and Nutrition Examination Survey and included 3,861 children and adolescents aged 10–18 years. The prevalence of obesity and related diseases was adjusted for age, sex, and income. We also analyzed the socioeconomic, nutritional, and physical activity items in the survey.
Results
During the COVID-19 pandemic, there was a significant increase in the prevalence of obesity (p=0.02), central obesity (p=0.001), mean body mass index (BMI, p=0.03), and hemoglobin A1c (p=0.005) among children and adolescents aged 10–18 years. The intake of food and calories was significantly reduced in the normal-weight group (p=0.001 and <0.001) but not in the obese group. Incidences of skipping breakfast increased and eating out decreased, regardless of obesity status. However, the changes in health behaviors were not significant. The prevalence of central obesity and increased BMI showed a significant linear association between children and their parents, especially in the 10–12-year-old age group. A clear increase in the proportion of metabolically unhealthy children and adolescents was observed in the obese group, and the frequency of central obesity in parents also increased.
Conclusion
The number of metabolically unhealthy, obese children and adolescents increased during the COVID-19 pandemic. Age-specific strategies that consider growth, development, and genetic and social factors are required. Health strategies targeting the entire family are required to develop healthier habits.

Keyword

Obesity; Child; Prevalence; Metabolic disease; COVID-19

Figure

• 

  Fig. 1. Trends and proportions of obesity and normal weight with or without metabolic unhealthiness over time. The proportion of MUHO tended to increase, whereas that of MHNW tended to decrease annually between 2016 and 2021. The rate of change was largest in 2020–2021. The odds ratios (confidence interval, P for trend) of MUHO, MHO, MUHNW, and MHNW were 1.123 (1.049–1.201, P<0.001), 1.006 (0.918–1.101, P=0.905), 0.983 (0.936–1.032, P=0.480), and 0.951 (0.907-0.997, P=0.035), respectively. MUHO, metabolically unhealthy obesity; MHO, metabolically healthy obesity; MUHNW, metabolically unhealthy normal weight; MHNW, metabolically healthy normal weight.

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  Fig. 2. Comparison of exercise and lifestyle. (A, B) The number of strength training days and days with physical activity ≥60 minutes were compared before and during the COVID-19 pandemic. (C–E) Durations of sleep and inactivity were compared before and during the COVID-19 pandemic. Values are presented as means with confidence intervals. COVID-19, coronavirus disease 2019. *Information on physical activity for more than 60 minutes was not available before 2016.

Reference

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