R Glenn Weaver1, Ethan T Hunt2, Bridget Armstrong2, Michael W Beets2, Keith Brazendale3, Gabrielle Turner-McGrievy4, Russell R Pate2, Shawn D Youngstedt5, Roddrick Dugger2, Hannah Parker2, Lauren von Klinggraeff2, Alexis Jones2, Sarah Burkart2, Layton Ressor-Oyer2. 1. Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina. Electronic address: weaverrg@mailbox.sc.edu. 2. Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina. 3. Department of Health Sciences, UCF College of Health Professions and Sciences, University of Central Florida, Orlando, Florida. 4. Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina. 5. Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona.
Abstract
INTRODUCTION: The COVID-19 pandemic may have negatively impacted children's weight status owing to the closure of schools, increased food insecurity and reliance on ultraprocessed foods, and reduced opportunities for outdoor activity. METHODS: In this interrupted time-series study, height and weight were collected from children (n=1,770 children, mean age=8.7 years, 55.3% male, 64.6% Black) and were transformed into BMI z-score in each August/September from 2017 to 2020. Mixed-effects linear regression estimated yearly BMI z-score change before the COVID-19 pandemic year (i.e., 2017-2019) and during the COVID-19 pandemic year (i.e., 2019-2020). Subgroup analyses by sex, race (i.e., Black, White, other race), weight status (overweight or obese and normal weight), and grade (i.e., lower=kindergarten-2nd grade and upper=3rd-6th grade) were conducted. RESULTS: Before the COVID-19 pandemic, children's yearly BMI z-score change was +0.03 (95% CI= -0.10, 0.15). Change during the COVID-19 pandemic was +0.34 (95% CI=0.21, 0.47), an acceleration in BMI z-score change of +0.31 (95% CI=0.19, 0.44). For girls and boys, BMI z-score change accelerated by +0.33 (95% CI=0.16, 0.50) and +0.29 (95% CI=0.12, 0.46), respectively, during the pandemic year. Acceleration in BMI z-score change during the pandemic year was observed for children who were Black (+0.41, 95% CI=0.21, 0.61) and White (+0.22, 95% CI=0.06, 0.39). For children classified as normal weight, BMI z-score change accelerated by +0.58 (95% CI=0.40, 0.76). Yearly BMI z-score change accelerated for lower elementary/primary (+0.23, 95% CI=0.08, 0.37) and upper elementary/primary (+0.42, 95% CI=0.42, 0.63) children. CONCLUSIONS: If similar BMI z-score accelerations occurred for children across the world, public health interventions to address this rapid unhealthy BMI gain will be urgently needed.
INTRODUCTION: The COVID-19 pandemic may have negatively impacted children's weight status owing to the closure of schools, increased food insecurity and reliance on ultraprocessed foods, and reduced opportunities for outdoor activity. METHODS: In this interrupted time-series study, height and weight were collected from children (n=1,770 children, mean age=8.7 years, 55.3% male, 64.6% Black) and were transformed into BMI z-score in each August/September from 2017 to 2020. Mixed-effects linear regression estimated yearly BMI z-score change before the COVID-19 pandemic year (i.e., 2017-2019) and during the COVID-19 pandemic year (i.e., 2019-2020). Subgroup analyses by sex, race (i.e., Black, White, other race), weight status (overweight or obese and normal weight), and grade (i.e., lower=kindergarten-2nd grade and upper=3rd-6th grade) were conducted. RESULTS: Before the COVID-19 pandemic, children's yearly BMI z-score change was +0.03 (95% CI= -0.10, 0.15). Change during the COVID-19 pandemic was +0.34 (95% CI=0.21, 0.47), an acceleration in BMI z-score change of +0.31 (95% CI=0.19, 0.44). For girls and boys, BMI z-score change accelerated by +0.33 (95% CI=0.16, 0.50) and +0.29 (95% CI=0.12, 0.46), respectively, during the pandemic year. Acceleration in BMI z-score change during the pandemic year was observed for children who were Black (+0.41, 95% CI=0.21, 0.61) and White (+0.22, 95% CI=0.06, 0.39). For children classified as normal weight, BMI z-score change accelerated by +0.58 (95% CI=0.40, 0.76). Yearly BMI z-score change accelerated for lower elementary/primary (+0.23, 95% CI=0.08, 0.37) and upper elementary/primary (+0.42, 95% CI=0.42, 0.63) children. CONCLUSIONS: If similar BMI z-score accelerations occurred for children across the world, public health interventions to address this rapid unhealthy BMI gain will be urgently needed.
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