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Pujia R, Ferro Y, Maurotti S, Khoory J, Gazzaruso C, Pujia A, Montalcini T, Mazza E. The Effects of COVID-19 on the Eating Habits of Children and Adolescents in Italy: A Pilot Survey Study. Nutrients 2021; 13:2641. [PMID: 34444801 PMCID: PMC8400531 DOI: 10.3390/nu13082641] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 12/16/2022] Open
Abstract
Nutrition during childhood and adolescence is very important for growth and can have long-term health implications. The COVID-19 lockdown caused significant changes in everyday life, including in children and adolescents. This study evaluated the effects of the first COVID-19 lockdown on eating habits and body weight in children and adolescents. An online cross-sectional survey was carried out among the parents of children (5-9 years) and adolescents (10-14 years) living in Italy. The online self-administered questionnaire included demographic and anthropometric data (reported weight and height) weight and dietary habit changes during the COVID-19 lockdown in Italy (March to June 2020). A total of 439 participants were included. We found a change in eating habits with an increase in consumption of sweet packaged snacks (34%) and processed meat (25%), as well as bread, pizza and bakery products (47%). We also found an increase in vegetable, fresh fruit and legume intake (19%), and a reduction in sweet beverage and candy intake. A total of 59.7% of the participants reported body weight gain, with adolescents gaining more than children (67% vs. 55%, p = 0.010, respectively). In children, body weight gain was associated with a change in body height and increased consumption of dairy products and sweet packaged snacks, while in adolescents it was associated with an increased intake of comfort foods and processed meat. Our data highlighted the need to carefully monitor eating behaviors to avoid the establishment of unhealthy eating habits and prevent obesity in children and adolescents during periods of self-isolation.
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Affiliation(s)
- Roberta Pujia
- Department of Medical and Surgical Science, University Magna Grecia, 88100 Catanzaro, Italy; (R.P.); (S.M.); (A.P.); (E.M.)
| | - Yvelise Ferro
- Department of Health Science, University Magna Grecia, 88100 Catanzaro, Italy
| | - Samantha Maurotti
- Department of Medical and Surgical Science, University Magna Grecia, 88100 Catanzaro, Italy; (R.P.); (S.M.); (A.P.); (E.M.)
| | - Janin Khoory
- Nutrition Unit, University Magna Grecia, 88100 Catanzaro, Italy;
| | - Carmine Gazzaruso
- Department Biomedical Science for Heath, University of Milan, 20133 Milano, Italy;
| | - Arturo Pujia
- Department of Medical and Surgical Science, University Magna Grecia, 88100 Catanzaro, Italy; (R.P.); (S.M.); (A.P.); (E.M.)
- Research Center for the Prevention and Treatment of Metabolic Diseases, University Magna Grecia, 88100 Catanzaro, Italy;
| | - Tiziana Montalcini
- Research Center for the Prevention and Treatment of Metabolic Diseases, University Magna Grecia, 88100 Catanzaro, Italy;
- Department of Clinical and Experimental Medicine, University Magna Græcia, 88100 Catanzaro, Italy
| | - Elisa Mazza
- Department of Medical and Surgical Science, University Magna Grecia, 88100 Catanzaro, Italy; (R.P.); (S.M.); (A.P.); (E.M.)
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102
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Dun Y, Ripley-Gonzalez JW, Zhou N, You B, Li Q, Li H, Zhang W, Thomas RJ, Olson TP, Liu J, Dong Y, Liu S. Weight gain in Chinese youth during a 4-month COVID-19 lockdown: a retrospective observational study. BMJ Open 2021; 11:e052451. [PMID: 34301671 PMCID: PMC8300557 DOI: 10.1136/bmjopen-2021-052451] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To observe the weight change in Chinese youth during a 4-month COVID-19 lockdown, and the association between weight change and mental health, physical activity and sedentary time changes, and dietary habits. DESIGN A retrospective observational study. SETTINGS Two universities located in Zhejiang and Hunan provinces, China. PARTICIPANTS This study enrolled 12 889 college students whose body weight was measured before the lockdown (1 December 2019-20 January 2020) at the two universities, and reported their weight measured at home or community after the end of the lockdown (1-23 May 2020) via an online follow-up questionnaire. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the weight change in Chinese youth during a 4-month lockdown resulting from the COVID-19 pandemic. The secondary outcomes were the relationships of weight change to COVID-19-related stress, depression, anxiety, physical activity and sedentary time changes, and dietary habits. RESULTS Participants' ages ranged from 17 to 27 years (M=19, SD=1) with 80.2% identified as female. The average absolute and relative changes in body weight were 2.6 (95% CI 2.0 to 3.2)) kg and 4.2% (95% CI 4.0% to 4.3%) for men, and 2.1 (1.9 to 2.4) kg and 4.2% (95% CI 3.9% to 4.4%) for women. An increase in overweight and obese individuals according to Asian cut-off points as a demographic percentage by 4.5% and 2.7% and 4.8% and 3.4% in men and women, respectively (P<0.001), was observed. Weight gain was significantly associated with increased sedentary time and an increase in COVID-19-related stress and depression score. CONCLUSION The present study's results suggest that the risk of weight gain in Chinese youth during the lockdown increased and that strategies to decrease sedentary time and improve mental health may be warranted to mitigate weight gain during and after the COVID-19 pandemic.
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Affiliation(s)
- Yaoshan Dun
- Division of Cardiac Rehabilitation, Department of Physical Medicine and Rehabilitation, Xiangya Hospital of Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jeffrey W Ripley-Gonzalez
- Division of Cardiac Rehabilitation, Department of Physical Medicine and Rehabilitation, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Nanjiang Zhou
- Division of Cardiac Rehabilitation, Department of Physical Medicine and Rehabilitation, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Baiyang You
- Division of Cardiac Rehabilitation, Department of Physical Medicine and Rehabilitation, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Qiuxia Li
- Division of Cardiac Rehabilitation, Department of Physical Medicine and Rehabilitation, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hui Li
- Division of Cardiac Rehabilitation, Department of Physical Medicine and Rehabilitation, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Wenliang Zhang
- Division of Cardiac Rehabilitation, Department of Physical Medicine and Rehabilitation, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Randal J Thomas
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Thomas P Olson
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jie Liu
- Department of Internal Medicine, Hunan Traditional Chinese Medical College, Zhuzhou, Hunan, China
| | - Yuchen Dong
- Medical College, Jinhua Polytechnic, Jinhua, Zhejiang, China
| | - Suixin Liu
- Division of Cardiac Rehabilitation, Department of Physical Medicine and Rehabilitation, Xiangya Hospital of Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
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103
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Shanmugam H, Di Ciaula A, Di Palo DM, Molina‐Molina E, Garruti G, Faienza MF, vanErpecum K, Portincasa P. Multiplying effects of COVID-19 lockdown on metabolic risk and fatty liver. Eur J Clin Invest 2021; 51:e13597. [PMID: 34032283 PMCID: PMC8209861 DOI: 10.1111/eci.13597] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/28/2021] [Accepted: 05/06/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Social containment measures imposed in Europe during the lockdown to face COVID-19 pandemic can generate long-term potential threats for metabolic health. METHODS A cohort of 494 non-COVID-19 subjects living in 21 EU countries were interviewed by an anonymous questionnaire exploring anthropometric and lifestyle changes during 1-month lockdown. A subgroup of 41 overweight/obese Italian subjects with previously diagnosed nonalcoholic fatty liver (NAFLD) joined the study following a 12-month follow-up period promoting weight loss by healthy lifestyle. RESULTS During the lockdown, body weight increased in 55% of subjects (average 2.4 ± 0.9 kg). Weight change increased with age, but not baseline body mass index. Subjects living in Italy had greater weight gain than those living in other European Countries. Weight gain during the lockdown was highest in subjects reporting no physical activity, and low adherence to Mediterranean diet. In the NAFLD group, weight gain occurred in 70% of cases. Subjects reporting weight loss during lockdown had decreased fatty liver score at 3 months before the lockdown, as compared with 1 year before. CONCLUSIONS Strict measures of social containment-even short-term-pave the way to the increased risk of metabolic abnormalities in the medium-long term. In this context, adherence to Mediterranean diet and regular physical activity play a protective role both in terms of weight gain and fatty liver development/progression, with implication for primary and secondary prevention. When adopting measures imposing social containment, intensive educational campaigns must increase public awareness about beneficial effects of healthy lifestyles.
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Affiliation(s)
- Harshitha Shanmugam
- Clinica Medica “A. Murri”Department of Biomedical Sciences and Human OncologyUniversity of Bari “Aldo Moro”BariItaly
| | - Agostino Di Ciaula
- Clinica Medica “A. Murri”Department of Biomedical Sciences and Human OncologyUniversity of Bari “Aldo Moro”BariItaly
| | - Domenica Maria Di Palo
- Clinica Medica “A. Murri”Department of Biomedical Sciences and Human OncologyUniversity of Bari “Aldo Moro”BariItaly
| | - Emilio Molina‐Molina
- Clinica Medica “A. Murri”Department of Biomedical Sciences and Human OncologyUniversity of Bari “Aldo Moro”BariItaly
| | - Gabriella Garruti
- Section of EndocrinologyDepartment of Emergency and Organ TransplantationsUniversity of Bari “Aldo Moro” Medical SchoolBariItaly
| | - Maria Felicia Faienza
- Paediatric SectionDepartment of Biomedical Sciences and Human OncologyUniversity of Bari “Aldo Moro”BariItaly
| | - Karel vanErpecum
- Department of Gastroenterology and HepatologyUniversity Medical CenterUtrechtthe Netherlands
| | - Piero Portincasa
- Clinica Medica “A. Murri”Department of Biomedical Sciences and Human OncologyUniversity of Bari “Aldo Moro”BariItaly
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104
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Action and Reaction of Pre-Primary and Primary School-Age Children to Restrictions during COVID-19 Pandemic in Greece. J Pers Med 2021; 11:jpm11060451. [PMID: 34070992 PMCID: PMC8224797 DOI: 10.3390/jpm11060451] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 12/31/2022] Open
Abstract
The fast-spreading coronavirus disease 2019 (COVID-19) pandemic forced countries to apply restrictive measures to counteract it. School closure was quickly adopted by health authorities. We aimed to investigate the compliance of children aged 4 to 12 years with the COVID-19 lockdown restrictions and evaluate the impact of school closure on the children’s educational, social, economic, and psychological outcomes. An online survey was distributed through a social networking platform to parents of pre-primary and primary school-age children. The study period was defined as from 27 November 2020 to 3 December 2020, two weeks after the school closure due to the general lockdown in Greece. This study showed that the school units were well-informed and complied with the protection measures against COVID-19. The pupils quickly adopted the protection measures, even those whose parents suggested masks were less effective. The quarantine-forced school closure highly impacted primary school children’s physical activity, quality of sleep, psychological status, eating habits, academic performance, and household income. Web use showed an increase, with the children over-spending extracurricular time in web activities. Our study highlights the need for long term monitoring of these aforementioned indices, and the development of COVID-19 mitigation measures that carefully incorporate effectiveness and societal impact.
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105
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Zhu S, Zhuang Y, Ip P. Impacts on Children and Adolescents' Lifestyle, Social Support and Their Association with Negative Impacts of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4780. [PMID: 33947146 PMCID: PMC8124290 DOI: 10.3390/ijerph18094780] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 12/12/2022]
Abstract
The impacts of the COVID-19 pandemic on physical and mental health-related behaviors among children and adolescents are likely to be profound and long-lasting. This study aimed to investigate the changes in lifestyle and social support and their associations with negative impacts due to the pandemic. A classroom survey using stratified random sampling and structured questionnaire was conducted among Hong Kong primary and secondary school students. The paper-and-pen survey, administered by well-trained research assistants, was completed by 2863 participants aged 9-17 years old (M = 12.6, SD = 1.3) at a brief school reopening six months after the outbreak of the COVID-19 pandemic. About 48% and 37% of the participants stated that they paid increased attention to physical and mental health, respectively. About 20% to 40% stated that they found more support from their friends and family members; only a small percentage reported decreased social support. Around 25% to 50% spent more time to rest, relax, and exercise. The aforementioned changes varied among genders, education groups, and socio-economic status. In general, higher perceived vulnerability, feeling more stressed, apprehensive, and helpless were associated with more reported positive lifestyle changes, including more social/family support, increased mental health awareness, and a positive lifestyle. These positive changes serve as important cushions against the negative impacts of COVID-19.
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Affiliation(s)
- Shimin Zhu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong, China;
| | - Yanqiong Zhuang
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong, China;
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China;
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