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Chacón V, Chung M, Folta SC, Hennessy E, Macfarlane H, Roberto CA, Tovar A, Wilson NLW, Economos CD. The longitudinal association between caregivers' perceived competence and autonomy and children's dietary consumption before and 10 months into the COVID-19 pandemic. Appetite 2024; 195:107205. [PMID: 38242361 DOI: 10.1016/j.appet.2024.107205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/21/2024]
Abstract
The COVID-19 pandemic has been stressful, potentially affecting caregivers' feeding choices. Caregivers play a role in shaping children's diets, yet few studies have explored how their competence and autonomy, defined by the Self-Determination Theory, impact children's diets. We examined the relationship between caregivers' autonomy and competence and their feeding practices before and during the first year of the pandemic. A national convenience sample of caregivers with 3-12-year-old children completed an online survey during two time-periods. Questions adapted from the Intrinsic Motivation Inventory measured perceived competence and autonomy for feeding fruits and vegetables (F/V) and limiting sugar-sweetened beverages (SSBs) and desserts. National Health and Nutrition Examination Survey Dietary Screener questions measured children's consumption of F/V, SSBs, and desserts. Paired t-tests examined how child consumption and caregiver's perceived competence and autonomy changed, and logistic regressions examined whether caregivers' competence and autonomy predicted the change in child consumption and if changes in competence and autonomy were associated with changes in child consumption. Caregivers (n = 597) were mostly Black/African American (33.0%) or Latina/o/x (42.7%) and older than 30 years (84.1%). Children's consumption did not change overall, but caregivers' competence for feeding F/V increased, and their competence for limiting SSBs and desserts decreased. Caregiver competence and autonomy before COVID-19 did not predict child dietary consumption during the pandemic. However, change in competence was a significant predictor of the change in child consumption of F/V [OR (95%CI): 0.70 (0.57, 0.86)]. The association between caregiver's perceived competence for feeding F/V and child consumption remained positive and significant in both periods [OR (95%CI) pre and during COVID: 2.09 (1.69, 2.57) - 2.40 (1.88, 3.06)]. This study can inform behavioral interventions supporting caregivers' competence and autonomy around feeding choices.
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Affiliation(s)
- Violeta Chacón
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA.
| | - Mei Chung
- Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA
| | - Sara C Folta
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA
| | - Erin Hennessy
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA
| | - Hannah Macfarlane
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA
| | - Christina A Roberto
- Department of Medical Ethics & Health Policy, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive Blockley Hall, Philadelphia, PA, 19104-4884, USA
| | - Alison Tovar
- Department of Behavioral and Social Sciences, Center for Health Promotion and Health Equity, Brown School of Public Health, Brown University, Providence, RI 02912 USA
| | - Norbert L W Wilson
- Duke Divinity School, Sanford School of Public Policy, and Director of the World Food Policy Center, Duke University, Durham, NC, 27708, USA
| | - Christina D Economos
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA
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Davis A, Lancaster B, Fleming K, Swinburne Romine R, Forseth B, Nelson EL, Dreyer Gillette M, Faith M, Sullivan DK, Pettee Gabriel K, Dean K, Olalde M. Effectiveness of a paediatric weight management intervention for rural youth (iAmHealthy): Primary outcomes of a cluster randomised control trial. Pediatr Obes 2024; 19:e13094. [PMID: 38173133 PMCID: PMC10922440 DOI: 10.1111/ijpo.13094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Youth in rural areas are disproportionally affected by obesity. Given the unique barriers rural populations face, tailoring and increasing access to obesity interventions is necessary. OBJECTIVE This paper evaluates the effectiveness of iAmHealthy, a family-based paediatric obesity intervention delivered to rural children, compared to a Newsletter Control. METHODS Participating schools (n = 18) were randomly assigned to iAmHealthy or Newsletter Control. iAmHealthy consists of individual health coaching and group sessions delivered via televideo to a participant's home. The child and parent's body mass index (BMI), child physical activity and child dietary intake were assessed at baseline, post-treatment (8 months) and follow-up (20 months). Multilevel modeling estimated the effect of treatment at both time points. RESULTS Parent and child dyads were recruited (n = 148) and randomised to iAmHealthy (n = 64) or the Control group (n = 84). The Control group had significant increases in child BMIz from baseline to follow-up. iAmHealthy youth had no significant changes in BMIz from baseline to post or follow-up. Child dietary intake, physical activity and parent BMI results are also discussed. CONCLUSIONS This trial extends previous paediatric obesity work by simultaneously increasing convenience and dose of treatment. Results suggest iAmHealthy resulted in a change in BMIz trajectories and long-term health behaviour for youth.
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Affiliation(s)
- Ann Davis
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Brittany Lancaster
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kandace Fleming
- Lifespan Institute, University of Kansas, Lawrence, Kansas, USA
| | | | - Bethany Forseth
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- Department of Physical Therapy, Rehabilitation Science, & Athletic Training, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Eve-Lynn Nelson
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Meredith Dreyer Gillette
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- Department of Pediatrics, Developmental and Behavioral Sciences, Children's Mercy Kansas City, Kansas City, Missouri, USA
| | - Myles Faith
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, University at Buffalo - SUNY, Buffalo, New York, USA
| | - Debra K Sullivan
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- Department of Dietetics & Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kelley Pettee Gabriel
- Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kelsey Dean
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- Department of Pediatrics, Developmental and Behavioral Sciences, Children's Mercy Kansas City, Kansas City, Missouri, USA
| | - Megan Olalde
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas, USA
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Rhodes ET, Phan TLT, Earley ER, Eneli I, Haemer MA, Highfield NC, Khan S, Kim G, Kirk S, Sullivan EM, Stoll JM, Werk LN, Zeribi KA, Forrest CB, Lannon C. Patient-Reported Outcomes to Describe Global Health and Family Relationships in Pediatric Weight Management. Child Obes 2024; 20:1-10. [PMID: 36827448 PMCID: PMC10790547 DOI: 10.1089/chi.2022.0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Background: Patient-reported outcomes (PROs) can assess chronic health. The study aims were to pilot a survey through the PEDSnet Healthy Weight Network (HWN), collecting PROs in tertiary care pediatric weight management programs (PWMP) in the United States, and demonstrate that a 50% enrollment rate was feasible; describe PROs in this population; and explore the relationship between child/family characteristics and PROs. Methods: Participants included 12- to 18-year-old patients and parents of 5- to 18-year-olds receiving care at PWMP in eight HWN sites. Patient-Reported Outcomes Measurement Information System (PROMIS®) measures assessed global health (GH), fatigue, stress, and family relationships (FR). T-score cut points defined poor GH or FR or severe fatigue or stress. Generalized estimating equations explored relationships between patient/family characteristics and PROMIS measures. Results: Overall, 63% of eligible parents and 52% of eligible children enrolled. Seven sites achieved the goal enrollment for parents and four for children. Participants included 1447 children. By self-report, 44.6% reported poor GH, 8.6% poor FR, 9.3% severe fatigue, and 7.6% severe stress. Multiple-parent household was associated with lower odds of poor GH by parent proxy report [adjusted odds ratio (aOR) 0.69, 95% confidence interval (CI) 0.55-0.88] and poor FR by self-report (aOR 0.36, 95% CI 0.17-0.74). Parents were significantly more likely to report that the child had poor GH and poor FR when a child had multiple households. Conclusions: PROs were feasibly assessed across the HWN, although implementation varied by site. Nearly half of the children seeking care in PWMP reported poor GH, and family context may play a role. Future work may build on this pilot to show how PROs can inform clinical care in PWMP.
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Affiliation(s)
- Erinn T. Rhodes
- Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA
| | - Thao-Ly T. Phan
- Department of General Pediatrics, Nemours Children's Health System/Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Elizabeth R. Earley
- Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ihuoma Eneli
- Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA
| | - Matthew A. Haemer
- Section of Nutrition, Department of Pediatrics, University of Colorado, Denver, CO, USA
| | | | - Saba Khan
- The Healthy Weight Program and Policy Lab, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Grace Kim
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Shelley Kirk
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- The Heart Institute and Center for Better Health and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Janis M. Stoll
- Division of Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Lloyd N. Werk
- Department of Pediatrics, Nemours Children's Hospital, Orlando, FL, USA
| | - Karen Askov Zeribi
- Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Christopher B. Forrest
- Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Carole Lannon
- Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Ng HY, Chan LTW. Prediabetes in children and adolescents: An updated review. World J Clin Pediatr 2023; 12:263-272. [PMID: 38178932 PMCID: PMC10762598 DOI: 10.5409/wjcp.v12.i5.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/05/2023] [Accepted: 10/16/2023] [Indexed: 12/08/2023] Open
Abstract
Prediabetes, the precursor of type 2 diabetes mellitus, is an intermediate stage between normal glucose homeostasis and overt diabetes. This asymptomatic metabolic state is increasingly prevalent in pediatric population and is very difficult to detect without appropriate screening. Studies have shown that a certain proportion of children with prediabetes will develop diabetes in a few years. Even more alarming is the evidence that youth-onset diabetes has a more aggressive clinical course with progressive beta-cell decline and accelerated end-organ damage. Despite its importance, several aspects involving prediabetes in childhood are disputed or unknown. This review presents the latest insights into this challenging entity and outlines a simplified screening approach to aid clinical practice. In summary, childhood prediabetes is an important clinical condition indicating the need for proper screening and timely intervention.
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Affiliation(s)
- Hak Yung Ng
- Department of Paediatrics and Adolescent Medicine, Tseung Kwan O Hospital, Hong Kong, China
| | - Louis Tsz Wang Chan
- Department of Paediatrics and Adolescent Medicine, Tseung Kwan O Hospital, Hong Kong, China
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Weihrauch-Blüher S, Huizinga O, Joisten C, Pflanz J, Torbahn G, Wiegand S, Holzapfel C, Hauner H. Changes in Lifestyle and Body Weight in Children and Adolescents during the COVID-19 Pandemic: A Representative Survey of Parents in Germany. Obes Facts 2023; 16:301-312. [PMID: 36882019 PMCID: PMC10627114 DOI: 10.1159/000529116] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 01/04/2023] [Indexed: 03/09/2023] Open
Abstract
INTRODUCTION The public restrictions taken during the COVID-19 pandemic have substantially affected lifestyle and health behavior of children and adolescents. In Germany, little is known how these changes influenced daily life in families with children and adolescents. METHODS A cross-sectional survey was performed in April/May 2022 across Germany, similar to a survey performed in 2020. Parents (N = 1,004, 20-65 years) with at least one child aged 3-17 years filled in an online questionnaire released by the Forsa Institute for Social Research and Statistical Analysis. Fifteen questions related to eating habits, dietary patterns, physical activity, media consumption, fitness, mental health, and body weight were included, and standard socioeconomic parameters were assessed. RESULTS Parents' answers indicated that there was a parental self-reported weight gain in every sixth child since the beginning of the COVID-19 pandemic. This was most obvious in children from families with lower household income and preexisting overweight. Parents also reported that lifestyle patterns had worsened: 70% reported an increase of media consumption during leisure time, 44% a decrease in daily physical activity, and 16% the worsening of dietary habits (e.g., 27% stated to eat more cake and sweets). Children aged 10-12 years were most severely affected. CONCLUSION Negative health effects related to the COVID-19 pandemic are predominantly observed in children 10-12 years of age and in children from families with low household income, suggesting a worsening social disparity. Political action is urgently needed to tackle the adverse consequences of the COVID-19 pandemic on childhood lifestyle and health.
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Affiliation(s)
- Susann Weihrauch-Blüher
- Clinic for Pediatrics I, Pediatric Endocrinology, University Hospital Halle (Saale), Halle (Saale), Germany
| | | | - Christine Joisten
- Department for Physical Activity in Public Health, German Sport University, Institute of Movement and Neurosciences, Cologne, Germany
| | - Juliane Pflanz
- Center for Social-Pediatric Care/Pediatric Endocrinology and Diabetology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Gabriel Torbahn
- Department of Pediatrics, Paracelsus Medical University, Klinikum Nürnberg, Universitätsklinik der Paracelsus Medizinischen Privatuniversität Nürnberg, Nuremberg, Germany
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
| | - Susanna Wiegand
- Center for Social-Pediatric Care/Pediatric Endocrinology and Diabetology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Christina Holzapfel
- Institute for Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany,
| | - Hans Hauner
- Institute for Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
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Pierce SL, Kompaniyets L, Freedman DS, Goodman AB, Blanck HM. Children's rates of BMI change during pre-pandemic and two COVID-19 pandemic periods, IQVIA Ambulatory Electronic Medical Record, January 2018 Through November 2021. Obesity (Silver Spring) 2023; 31:693-698. [PMID: 36350181 PMCID: PMC9877959 DOI: 10.1002/oby.23643] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Many US youth experienced accelerated weight gain during the early COVID-19 pandemic. Using an ambulatory electronic health record data set, the authors compared children's rates of BMI change in three periods: pre-pandemic (January 2018-February 2020), early pandemic (March-December 2020), and later pandemic (January-November 2021). METHODS This study used mixed-effects models to examine differences in rates of change in BMI, weight, and obesity prevalence among the three periods. Covariates included time as a continuous variable, a variable indicating in which period each BMI was taken, sex, age, and initial BMI category. RESULTS In a longitudinal cohort of 241,600 children aged 2 through 19 years with ≥4 BMI measurements, the monthly rates of BMI change (kilograms per meters squared) were 0.056 (95% CI: 0.056-0.057) in the pre-pandemic period, 0.104 (95% CI: 0.102-0.106) in the early pandemic, and 0.035 (95% CI: 0.033-0.036) in the later pandemic. The estimated prevalence of obesity in this cohort was 22.5% by November 2021. CONCLUSIONS In this large, geographically diverse cohort of US youth, accelerated rates of BMI change observed during 2020 were largely attenuated in 2021. Positive rates indicate continued weight gain rather than loss, albeit at a slower rate. Childhood obesity prevalence remained high, which raises concern about long-term consequences of excess weight and underscores the importance of healthy lifestyle interventions.
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Affiliation(s)
- Samantha Lange Pierce
- Division of Nutrition, Physical Activity, and ObesityNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaGAUSA
| | - Lyudmyla Kompaniyets
- Division of Nutrition, Physical Activity, and ObesityNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaGAUSA
| | - David S. Freedman
- Division of Nutrition, Physical Activity, and ObesityNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaGAUSA
| | - Alyson B. Goodman
- Division of Nutrition, Physical Activity, and ObesityNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaGAUSA
- U.S. Public Health Service Commissioned CorpsRockvilleMDUSA
| | - Heidi M. Blanck
- Division of Nutrition, Physical Activity, and ObesityNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaGAUSA
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Dietz WH. The COVID-19 lockdown increased obesity disparities; will the increases in type 2 diabetes continue? Obesity (Silver Spring) 2023; 31:699-702. [PMID: 36447419 PMCID: PMC9877697 DOI: 10.1002/oby.23662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/15/2022] [Accepted: 11/20/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVE The aim of this study was to compare the prevalence of the increases in pediatric obesity during the COVID-19 lockdown with the annual increases in obesity in the National Health and Nutrition Examination Survey (NHANES). METHODS This study compared two reports of increases in the prevalence of obesity in youth during the COVID-19 lockdown with the annual rate of increase in obesity in NHANES. RESULTS When expressed as multiples, the changes in prevalence among elementary school children observed in two population-based surveys were 28 to 63 times greater than the annual changes in the prevalence of obesity observed in NHANES. Increases in Black and Hispanic youth were greater than those in White youth. The net impact of the COVID-19 lockdown increased the disparities in obesity among this age group. CONCLUSIONS The rapid increases in obesity are likely to persist and may be associated with an increase in the prevalence of severe obesity as these children age. Furthermore, the increased susceptibility to diabetes in Hispanic and Black children, as well as the reported increase in diabetes among 0- to 18-year-old individuals during the COVID-19 pandemic, may lead to an increased incidence of type 2 diabetes in minority youth with obesity.
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Affiliation(s)
- William H. Dietz
- Redstone Global Center for Prevention and Wellness, George Washington University School of Public Health, George Washington UniversityWashingtonDCUSA
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Dopke KM, Pattison KL, Schaefer EW, Fogel BN, Sekhar DL. Effects of COVID-19 pandemic on pediatric weight: A retrospective chart review. Prev Med Rep 2023; 31:102109. [PMID: 36619801 PMCID: PMC9806925 DOI: 10.1016/j.pmedr.2022.102109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 12/05/2022] [Accepted: 12/31/2022] [Indexed: 01/03/2023] Open
Abstract
The COVID-19 pandemic forced United States school closures in March 2020. Students moved to online learning, fostering a sedentary lifestyle. As the pandemic heightened population disparities, the impact on weight gain may also be unequally distributed. This study aimed to evaluate changes in body mass index (BMI) z-scores and weight percentiles of pediatric patients during the pandemic and associated demographics to identify those at risk for weight gain. Methods included a retrospective chart review of patients 5-18 years-old with a well-visit in the three years 2018, 2019 and 2020; first identified with a well-visit in August-September of 2020. BMI z-scores and weight percentiles were analyzed using a correlated errors regression model appropriate for longitudinal data. This longitudinal approach was used to model outcomes by patient demographics. Interaction terms with time were evaluated for each variable. Of 728 patients, mean age was 9.7 years (2018); 47 % female, 70 % white, and 23 % publicly insured. BMI z-score did not increase significantly from 2018-2019 versus 2019-2020. Weight percentile demonstrated a slight trajectory increase over these same time points. Publicly insured patients demonstrated significantly greater increase in BMI z-score versus privately insured patients (p = 0.009). Mean differences between groups increased from 0.26 in 2018 (95 % CI [0.07, 0.45]) to 0.42 in 2020 (95 % CI [0.23, 0.61]). Results were similar for weight percentile. Publicly insured pediatric patients experienced significant increase in BMI-z score and weight percentile, but over time this trajectory remained constant. The results support targeting at risk subgroups in addressing long-term impacts of the pandemic.
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Affiliation(s)
- Kelly M. Dopke
- Pediatrics, Penn State College of Medicine, Hershey, PA, United States,Corresponding author at: 90 Hope Drive, A145, Hershey, PA 17033, United States.
| | | | - Eric W. Schaefer
- Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Benjamin N. Fogel
- Pediatrics, Penn State College of Medicine, Hershey, PA, United States
| | - Deepa L. Sekhar
- Pediatrics, Penn State College of Medicine, Hershey, PA, United States
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Chen S, Kracht CL, Beyl RA, Staiano AE. Temporal Changes in Energy-Balance Behaviors and Home Factors in Adolescents with Normal Weight and Those with Overweight or Obesity. INTERNATIONAL JOURNAL OF PHYSICAL ACTIVITY AND HEALTH 2023; 2:5. [PMID: 37675056 PMCID: PMC10481771 DOI: 10.18122/ijpah.020205.boisestate] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
This study aimed to examine the temporal changes in energy-balance behaviors and home factors in adolescents with normal weight and those with overweight or obesity (OWOB). Adolescents or parent proxies completed survey assessments two to four years before (T0; n = 82 ), ≤ six months before (T1; n = 68 ), and ≤ three months after the COVID-19 pandemic outbreak (T2; n = 82 ), to capture energy-balance behaviors (i.e., physical activity [PA], screen time, sleep) and home factors (i.e., food environment, food worry, parent support for PA). At T0 and T1 (before pandemic), participants visited our laboratory for anthropometric measurements. At T2, parent proxies also completed a survey to report the COVID-19 pandemic exposure and impact. The participating families experienced moderate levels of pandemic exposure and impact, although exposure was higher in the OWOB group F 1,78 = 5.50 , p < . 05 . Repeated-measure multivariate analyses of covariance (RM-MACOVAs) did not show significant time by weight status interaction effects (p > 0.05 ; adjusted for race and sex). However, the models detected significant time (T0 vs. T2) by race (White vs. non-White) interaction effect λ 7,66 = 0.81 , p < 0.05 , with greater increase in food worry F 1,72 = 4.36 , p < . 05 but less increase in screen time F 1,72 = 4.54 , p < . 05 among the non-White group. Graphical visualization depicted some favorable change patterns in adolescents with normal weight (vs. those with OWOB) for certain behaviors and home factors (e.g., number of days per week ≥ 60 mins PA, food worry). These findings suggest that the COVID-19 pandemic exerted greater adverse effects on adolescents with OWOB and specifically on screen time and food worry among non-White adolescents.
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