COVID-19 Pandemic May Exacerbate Childhood Obesity

Public health scientists predict that school closures due to the COVID-19 pandemic will exacerbate the epidemic of childhood obesity in the United States. Andrew Rundle, DrPH, associate professor of epidemiology at Columbia University Mailman School of Public Health, and colleagues expect that COVID-19-related school closures will double out‐of‐school time this year for many children in the U.S. and will exacerbate risk factors for weight gain associated with summer recess.

The Perspective article appears in Obesity, the journal of the Obesity Society.

In many areas of the U.S., the COVID‐19 pandemic has closed schools and some of these school systems are not expected to re‐open this school year. The experiences in Hong Kong, Taiwan, and Singapore suggest that social distancing orders, if lifted after short periods, will have to be periodically re‐instated to control COVID‐19 flare-ups.

While much has been written about poor food and lack of physical activity in schools, the data show that children experience unhealthy weight gain primarily during the summer months when they are out of school. Unhealthy weight gain over the summer school recess is particularly apparent for Hispanic and African-American youth, and children who are already overweight.

“There could be long-term consequences for weight gained while children are out of school during the COVID-19 pandemic,” says Rundle, who specializes in research to prevent childhood obesity. “Research shows that weight gained over the summer months is maintained during the school year and accrues summer to summer. When a child experiences obesity, even at a young age, they are at risk for higher, unhealthy weight, all the way into middle age.”

Staying at Home During the Pandemic May Contribute to Obesity

As households stock up on shelf-stable foods, they appear to be purchasing ultra-processed, calorie-dense comfort foods. In regards to physical activity, social distancing and stay at home orders reduce the opportunities for exercise, particularly for children in urban areas living in small apartments. Sedentary activities and screen time are expected to expand under social distancing orders; available data show that online video game usage is already soaring. Screen time is associated with experiencing overweight/obesity in childhood, likely because of the dual issues of sedentary time and the association between screen time and snacking.

How to Prevent Childhood Obesity During the Pandemic

The authors present several interventions for reducing risk factors for unhealthy weight gain during school closures:

• Some school districts are offering students grab-and-go meals at school sites or via buses running along their regular pick-up routes. Research shows that food insecurity is associated with unhealthy weight among children, and addressing food insecurity will likely have long term benefits for child health.
   
• Farmers markets, which often provide specialty and ethnic produce and prepared foods valued by immigrant communities. As such, cities and states should consider them as part of essential food services, but also create social distancing plans for such markets.
   
• As schools build their remote teaching capacity, they should make physical education a priority, with home lesson plans for physical activity and/or streaming exercise classes.

“The COVID‐19 pandemic is responsible for widespread sickness and death, straining healthcare systems, shutting down economies, and closing school districts,” says Rundle. “While it is a priority to mitigate its immediate impact, it is important to consider ways to prevent its long-term effects, including new risks for childhood obesity.”

The study’s co-authors are Yoosun Park, Smith College School for Social Work; Julie B. Herbstman and Eliza W. Kinsey, Columbia Mailman School; and Y. Claire Wang, New York Academy of Medicine. Support for the research was provided by the National Institutes of Health (OD023290, HD101657, HL141427).