How much did the closure of day care centers and schools during the COVID-19 pandemic affect children’s height and weight status? To answer this question, the Mother and Child Welfare Department (PMI) of the department of Val-de-Marne, France, conducted a quasi-exhaustive survey of all children in the second year of preschool (children 4.5 years of age on average), since a medical checkup is performed every year in this age group. The pseudonymized data of 48,119 children (out of a total of 48,680) were collected for the 2018-2019, 2019-2020, and 2020-2021 academic years.
The children’s height and weight statuses were evaluated by means of the body mass index z-score (BMIz), which “smooths out” the BMI as a function of age and sex. A BMIz of 25-30 indicates overweight and a BMIz > 30 indicates obesity.
In addition, the evaluation factored in the area that the school each child attended was in, which was categorized as a “normal” area, priority education network area (réseaux d’éducation prioritaire [REP], 26% of children), or high-priority education network area (REP+, 3% of children), which has the greatest social problems.
In the first year of the study, before the COVID-19 pandemic, 86.8% of children were neither overweight nor obese.
In terms of numbers, the percentage of children with overweight increased significantly by 2.6%, and the percentage of children with obesity increased by 1.8% in 2020-2021, compared with the baseline year 2018-2019. In terms of risk, in multivariate analysis, the risk for overweight was significantly higher (odds ratio [OR], 1.37 [1.28-1.47]), as was the risk for obesity (OR, 1.70 [1.51-1.89]).
Being a girl increased the risk for overweight (OR, 1.65 [1.55-1.75]) and obesity (OR, 1.63 [1.4-1.80].
Living in an REP area increased the risk for overweight (OR, 1.52 [1.42-1.62]) and obesity (OR, 1.92 [1.74-2.13]), as did living in an REP+ area (OR, 1.54 [1.30-1.82] and OR, 2.04 [1.60-2.61], respectively).
Eating at a cafeteria reduced the risk for overweight (OR, 0.89 [0.82-0.96]) and obesity (OR, 0.87 [0.77-0.98], as did attending a day care center (OR, 0.93 [0.87-0.99] and OR, 0.85 [0.76-0.95], respectively).
There are several hypothesized causes to explain these results, none of which are exhaustive. The following two are well-documented in the literature:
The reduction in physical activity, compounded by the restriction of outings owing to parents’ fear that their child would contract COVID-19.
The increase in snacking and consumption of processed products during the lockdown.
This study underscores a well-known association between overweight, obesity, and unfavorable socioeconomic situation. Moreover, the pandemic increased socioeconomic inequalities, which seems to have had a consequent impact on children’s health, especially since prevention messages regarding diet and physical activity all but disappeared during the pandemic.
It is not evident whether the observed increase in overweight and obesity is persisting. Nevertheless, the authors fear that the harmful habits acquired will be perpetuated and they urge PMI professionals to implement preventive actions with families.
This article was translated from Univadis France.