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Iacopetta D, Catalano A, Ceramella J, Pellegrino M, Marra M, Scali E, Sinicropi MS, Aquaro S. The Ongoing Impact of COVID-19 on Pediatric Obesity. Pediatr Rep 2024; 16:135-150. [PMID: 38391001 PMCID: PMC10885050 DOI: 10.3390/pediatric16010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/19/2024] [Accepted: 01/31/2024] [Indexed: 02/24/2024] Open
Abstract
In the developed world, pediatric obesity (PO) has been a major health concern since the last century, and this condition may lead to detrimental life-long physical and mental comorbidities. Currently, its prevalence has increased in low- and middle-income countries and in many high-income countries. Thus, the provision of effective and tailored care for children and their families has become vital. The social consequences of the COVID-19 pandemic are known everywhere, and among these, it has been argued that the COVID-19 pandemic has had a major impact on PO. Overall, the growth of PO over the last decade has been enhanced by the pandemic. During the COVID-19 pandemic, children, adolescents and young adults gained weight as the pediatric population dealt with sedentary lifestyles and changes in food habits. In this review, we want to highlight the impact that the COVID-19 pandemic had on PO.
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Affiliation(s)
- Domenico Iacopetta
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Alessia Catalano
- Department of Pharmacy-Drug Sciences, University of Bari "Aldo Moro", 70126 Bari, Italy
| | - Jessica Ceramella
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Michele Pellegrino
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Maria Marra
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Elisabetta Scali
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy
| | - Maria Stefania Sinicropi
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Stefano Aquaro
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
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Zucchini S, Scozzarella A, Maltoni G. Multiple influences of the COVID-19 pandemic on children with diabetes: Changes in epidemiology, metabolic control and medical care. World J Diabetes 2023; 14:198-208. [PMID: 37035223 PMCID: PMC10075036 DOI: 10.4239/wjd.v14.i3.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/28/2023] [Accepted: 02/22/2023] [Indexed: 03/15/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has heavily affected health worldwide, with the various forms of diabetes in children experiencing changes at various levels, including epidemiology, diabetic ketoacidosis rates and medical care. Type 1 diabetes showed an apparent increase in incidence, possibly owing to a direct damage of the virus to the β-cell. Diabetic ketoacidosis also increased in association with the general fear of referring patients to the hospital. Most children with diabetes (both type 1 and type 2) did not show a worsening in metabolic control during the first lockdown, possibly owing to a more controlled diet by their parents. Glucose sensor and hybrid closed loop pump technology proved to be effective in all patients with type 1 diabetes during the pandemic, especially because the downloading of data allowed for the practice of tele-medicine. Telemedicine has in fact grown around the world and National Health Systems have started to consider it as a routine activity in clinical practice. The present review encompasses all the aspects related to the effects of the pandemic on the different forms of diabetes in children.
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Affiliation(s)
- Stefano Zucchini
- Department of Pediatric, IRCCS AOU di Bologna, Bologna 40138, Italy
| | | | - Giulio Maltoni
- Department of Pediatric, IRCCS AOU di Bologna, Bologna 40138, Italy
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Vidmar AP, Salvy SJ, Wee CP, Pretlow R, Fox DS, Yee JK, Garell C, Glasner S, Mittelman SD. An addiction-based digital weight loss intervention: A multi-centre randomized controlled trial. Pediatr Obes 2023; 18:e12990. [PMID: 36484235 PMCID: PMC9905275 DOI: 10.1111/ijpo.12990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/07/2022] [Accepted: 11/02/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This randomized clinical trial tested the effectiveness of an addiction-based digital weight-loss intervention, focusing on withdrawal/abstinence from self-identified problem foods, snacking and excessive amounts at meals, and discomfort displacement, with and without coaching, compared to an in-person, multi-disciplinary, care model among adolescents with obesity. We hypothesized that the digital intervention with coaching would yield greater weight loss and lower delivery burden than the standard clinical arm, and greater participant engagement than the digital arm without coaching. METHODS Adolescents were randomized to app intervention, with or without coaching, or in-person multidisciplinary obesity intervention for 6 months. The primary outcome was change in %BMIp95 at weeks 12 and 24. A mixed-effects linear regression model was used to assess the association between change in %BMIp95 and intervention arm. We were also interested in assessing delivery burden, participant engagement and evaluating the relationships between weight change and demographic characteristics, mood, executive function and eating behaviours. RESULTS All adolescents (n = 161; BMI ≥95th%, age 16 ± 2.5 year; 47% Hispanic, 65% female, 59% publicly insured) lost weight over 24-weeks (-1.29%, [-1.82, -0.76], p < 0.0001), with no significant weight loss difference between groups (p = 0.3). Girls lost more weight than boys, whereas binge eating behaviour at baseline was associated with increase in %BMIp95 when controlling for other covariates. There was no association between ethnicity, mood, timing of intervention in relation to the pandemic, or executive function and change in %BMIp95 . CONCLUSIONS Contrary with our hypothesis, our results showed no difference in the change in BMI status between treatment arms. Since efficacy of this digital intervention was not inferior to in-person, multi-disciplinary care, this could offer a reasonable weight management option for clinicians, based on youth and family specific characteristics, such as accessibility, resources, and communication styles. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT035008353.
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Affiliation(s)
- Alaina P. Vidmar
- Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism, Children’s Hospital Los Angeles and Keck School of Medicine of USC, Los Angeles, California, USA
| | - Sarah J. Salvy
- Department of Medicine, Cedars-Sinai Medical Center, Research Center for Health Equity Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California, USA
| | - Choo Phei Wee
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Southern California Clinical Science Institute, Los Angeles, California, USA
| | | | - D. Steven Fox
- Department of Pharmaceutical and Health Economics, School of Pharmacy of the University of Southern California, Los Angeles, California, USA
| | - Jennifer K. Yee
- Division of Pediatric Endocrinology, Harbor-UCLA Medical Center, Harbor-UCLA Medical Center, Torrance, California, United States
| | - Cambria Garell
- Department of Pediatrics, Division of General Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Suzette Glasner
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, California, USA
| | - Steven D. Mittelman
- Department of Pediatrics, Division of General Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Department of Pediatrics, Division of Endocrinology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
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Ferguson K, Moore H, Kaidbey JH, Khattak S, Saeed A, Cogen FR, Streisand R, Sylvetsky AC. Impacts of the COVID-19 Pandemic on Pediatric Type 1 Diabetes Management: A Qualitative Study. Sci Diabetes Self Manag Care 2022; 48:522-532. [PMID: 36154537 PMCID: PMC9510960 DOI: 10.1177/26350106221125701] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: The purpose of this study was to understand impacts of the coronavirus (COVID-19) pandemic on pediatric type 1 diabetes management. Methods: In-depth qualitative interviews were conducted with 15 parents of children (age 6-12 years) with type 1 diabetes. Parents responded to 8 open-ended questions about their experiences managing their children’s type 1 diabetes during the COVID-19 pandemic. All interviews were transcribed, coded, and analyzed using qualitative thematic methods. Results: Parents reported both positive and negative aspects of managing their children’s type 1 diabetes during the COVID-19 pandemic. Facilitators of diabetes management included spending more time together at home and enhanced convenience of telehealth appointments and online supply ordering. Parents also described difficulties managing their children’s type 1 diabetes during the COVID-19 pandemic, including a lack of structure in their child’s daily routine, which led to increases in sedentary behavior. Furthermore, they reported psychosocial challenges of type 1 diabetes management, which were exacerbated by the pandemic. Conclusion: While the COVID-19 pandemic was described as having overall positive impacts on pediatric type 1 diabetes management, efforts to support parents in increasing children’s physical activity and reducing screen time are needed, along with readily accessible mental health resources for both parents and their children with type 1 diabetes.
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Affiliation(s)
- Kacey Ferguson
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Hailey Moore
- Division of Psychology and Behavioral Health, Children’s National Hospital, Washington, DC
| | - Jasmine H. Kaidbey
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Shazmenna Khattak
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Abbas Saeed
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Fran R. Cogen
- Division of Endocrinology, Children’s National Hospital, Washington, DC
| | - Randi Streisand
- Division of Psychology and Behavioral Health, Children’s National Hospital, Washington, DC
- School of Medicine and Health Sciences, The George Washington University, Washington, DC
| | - Allison C. Sylvetsky
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC
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Okuyama J, Izumi SI, Funakoshi S, Seto S, Sasaki H, Ito K, Imamura F, Willgerodt M, Fukuda Y. Supporting adolescents' mental health during COVID-19 by utilising lessons from the aftermath of the Great East Japan Earthquake. Humanit Soc Sci Commun 2022; 9:332. [PMID: 36187842 PMCID: PMC9510442 DOI: 10.1057/s41599-022-01330-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/31/2022] [Indexed: 06/16/2023]
Abstract
Historical data can determine how adolescents recover from difficult situations such as the Coronavirus disease 2019 (COVID-19) pandemic. This study analysed 3 years of data obtained from high-school students who had been affected by the 2011 Great East Japan Earthquake and consequently evidenced the importance of increasing resilience among affected adolescents. This involved identifying factors contributing to resilience through a model that assessed for each tsunami disaster. This model was determined by assessing the correlation between survivors' resilience scores and their measured psychological and lifestyle scores. This approach showed that, in all tsunami damage models, resilience was most affected by the depressed emotions. Thus, our approach suggests that interventions for improving the depressed mood may improve resilience in adolescents during the COVID-19 pandemic.
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Affiliation(s)
- Junko Okuyama
- Designated National University, Core Research Cluster of Disaster Science, Tohoku University, Sendai, Japan
- Department of Rehabilitation, Tohoku University, Sendai, Japan
| | - Shin-Ichi Izumi
- Department of Rehabilitation, Tohoku University, Sendai, Japan
| | | | - Shuji Seto
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Hiroyuki Sasaki
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Kiyoshi Ito
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Fumihiko Imamura
- Designated National University, Core Research Cluster of Disaster Science, Tohoku University, Sendai, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Mayumi Willgerodt
- Department of Child, Family, and Population Health Nursing at the University of Washington, Seattle, USA
| | - Yu Fukuda
- Notre Dame Seishin University, Okayama, Japan
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Saha S. Self-monitoring of blood glucose in gestational diabetes mellitus patients during the COVID-19 pandemic in low- and middle-income countries. World J Obstet Gynecol 2022; 11:17-19. [DOI: 10.5317/wjog.v11.i2.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/19/2021] [Accepted: 05/12/2022] [Indexed: 02/06/2023] Open
Abstract
Self-monitoring of blood glucose (SMBG) is critical for gestational diabetes mellitus (GDM) care. However, there are several hurdles to its practice during the coronavirus disease 2019 (COVID-19) pandemic in GDM patients in low- and middle-income countries when GDM care recommendations emphasize telemedicine-based care. Based on available knowledge, this letter proposes the following barriers to SMBG in these GDM patients during the ongoing COVID-19 pandemic: Poor internet connectivity, affordability of SMBG and digital applications to connect with healthcare providers, government-imposed social mobility restriction, psychological stress, and mental health conditions. Nevertheless, definitive evidence will only be acquired from rigorous research.
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Affiliation(s)
- Sumanta Saha
- Department of Community Medicine, R. G. Kar Medical College, Kolkata 700004, West Bengal, India
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Gnocchi M, D’Alvano T, Lattanzi C, Messina G, Petraroli M, Patianna VD, Esposito S, Street ME. Current evidence on the impact of the COVID-19 pandemic on paediatric endocrine conditions. Front Endocrinol (Lausanne) 2022; 13:913334. [PMID: 35992140 PMCID: PMC9388786 DOI: 10.3389/fendo.2022.913334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/18/2022] [Indexed: 01/08/2023] Open
Abstract
Severe acute respiratory coronavirus 2 (SARS-CoV-2) interacts with the host cells through its spike protein by binding to the membrane enzyme angiotensin-converting enzyme 2 (ACE2) and it can have a direct effect on endocrine function as ACE2 is expressed in many glands and organs with endocrine function. Furthermore, several endocrine conditions have features that might increase the risk of SARS-CoV-2 infection and the severity and course of the infection, as obesity for the underlying chronic increased inflammatory status and metabolic derangement, and for the possible changes in thyroid function. Vitamin D has immunomodulatory effects, and its deficiency has negative effects. Adrenal insufficiency and excess glucocorticoids affect immune conditions also besides metabolism. This review aims to analyze the rationale for the fear of direct effects of SARS-Cov-2 on endocrinological disorders, to study the influence of pre-existing endocrine disorders on the course of the infection, and the actual data in childhood. Currently, data concerning endocrine function during the pandemic are scarce in childhood and for many aspects definite conclusions cannot be drawn, however, data on properly managed patients with adrenal insufficiency at present are re-assuring. Too little attention has been paid to thyroid function and further studies may be helpful. The available data support a need for adequate vitamin D supplementation, caution in obese patients, monitoring of thyroid function in hospitalized patients, and confirm the need for an awareness campaign for the increased frequency of precocious puberty, rapidly progressive puberty and precocious menarche. The changes in lifestyle, the increased incidence of overweight and the change in the timing of puberty lead also to hypothesize that there might be an increase in ovarian dysfunction, as for example polycystic ovarian disease, and metabolic derangements in the next years, and in the future we might be facing fertility problems. This prompts to be cautious and maintain further surveillance.
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Calcaterra V, Verduci E, Vandoni M, Rossi V, Di Profio E, Carnevale Pellino V, Tranfaglia V, Pascuzzi MC, Borsani B, Bosetti A, Zuccotti G. Telehealth: A Useful Tool for the Management of Nutrition and Exercise Programs in Pediatric Obesity in the COVID-19 Era. Nutrients 2021; 13:3689. [PMID: 34835945 PMCID: PMC8618189 DOI: 10.3390/nu13113689] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/17/2021] [Accepted: 10/19/2021] [Indexed: 12/18/2022] Open
Abstract
The COVID-19 pandemic has led to the implementation of policies that mandate various restrictions on daily life, including social distancing, the closure of public services and schools, and movement limitations. Even though these restrictive measures decreased the COVID-19 spread, they may have detrimental effects on various lifestyle components such as physical inactivity, sedentary behavior, and dietary habits, influencing the maintenance of weight and contributing to obesity among children and adolescents. The coexistence of childhood obesity and COVID-19 and changes in the bioecological environment have put children and adolescents at increased risk for developing obesity and exacerbating the severity of this disorder. The use of telehealth technology is a modern approach useful for the delivery of health care services by health care professionals, where distance is a critical factor. Telehealth is effective in promoting increased self-monitoring and behavioral change, and provides the opportunity to perform online nutritional support and exercise training programs to promote a healthy lifestyle and reduce sedentary behaviors in children and adolescents. Telehealth, including tele-exercise and tele-nutrition, has the potential to address many of the key challenges in providing health services, including in patients with obesity during the COVID-19 outbreak. This narrative review aims to describe the role of telehealth as an opportunity in the management of pediatric obesity in the COVID-19 era, and to deliver nutrition and exercise programs for the maintenance of health.
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Affiliation(s)
- Valeria Calcaterra
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Elvira Verduci
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
- Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (V.C.P.)
| | - Virginia Rossi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Elisabetta Di Profio
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (V.C.P.)
| | - Valeria Tranfaglia
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Martina Chiara Pascuzzi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Barbara Borsani
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Alessandra Bosetti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
- Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
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Chua MWJ. Obesity and COVID-19: Take Two-Has Our Saw Been Adequately Sharpened? Obes Surg 2021; 31:4645-4646. [PMID: 34106399 PMCID: PMC8188153 DOI: 10.1007/s11695-021-05506-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Marvin Wei Jie Chua
- Endocrinology Service, Department of General Medicine, Sengkang General Hospital, 110 Sengkang East Way, 544886, Singapore, Singapore.
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