Increase seen in pediatric BMI during pandemic, study finds

ANAHEIM, Calif.­­­—A study that tracked body mass index (BMI) two years prior to the pandemic and one year after the start of the pandemic in a primarily Medicaid pediatric population in Norfolk, Virginia, found a significant increase in BMI during that time.

When these differences were analyzed by gender, the increase was only significant for the female cohort, according to the study, “Examining the Effects of COVID-19 Lifestyle on Pediatric BMI.” There was an 11% mean increase in the BMI of girls, the study found.

The authors also observed there was a significant correlation between screen time and family time increases during the pandemic and rising pediatric BMIs, as families spent more time at home because of the lockdowns.

Data was collected from 238 patients (51% female identifying, 49% male identifying, and the majority were African-American/Black) with an average age of 9.47 for females and 9.57 for males. Pediatric patients and their parents/guardians were given a questionnaire that examined six potential sources for lifestyle changes that could affect BMI, including fast food intake, time spent with electronic devices, and children’s activity levels.

Dr. John Harrington, one of the senior authors of this study and the division director of General Academic Pediatrics at Children’s Hospital of The King’s Daughters in Norfolk, Virginia, said the study shows how difficult the lockdowns were on families as parents worried about their children being outside and around others, children missed out on physical education classes and team sports at school, and more time was spent scrolling social media and playing video games.

“This study reinforces that the health of all communities was negatively impacted by the pandemic, especially lower income and predominantly African-American communities,” he said.

The authors note that this study provides an additional understanding of what factors negatively impact BMI in children. By determining the factors that are linked the most with an increase in BMI, this study can allow health care providers to develop ways to guide their patients toward healthier lifestyle choices in an increasingly technological world, the authors note. Greater resources also are needed in communities with high poverty rates, a lack of access to green spaces, and few options to buy healthful produce, the authors point out.

 Third-year medical student Rylie N. Mainville is scheduled to present an abstract of the study, available below, Saturday, Oct. 8, 2022, at 12:30 p.m. To request an interview with Ms. Mainville or Dr. John Harrington or another abstract author, journalists may contact Ms. Mainville at mainvirn@evms.edu or Dr. Harrington at john.harrington@chkd.org.

 Please note: Only the abstract is being presented at the meeting. In some cases, the researcher may have more data available to share with media, or may be preparing a longer article for submission to a journal. 

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org. Reporters can access the meeting program and other relevant meeting information through the AAP meeting website at http://www.aapexperience.org/

Program Name: 2022 AAP National Conference & Exhibition

Abstract Title: Examining the Effects of Covid-19 Lifestyle on Pediatric BMI

Rylie Mainville

Norfolk, VA, United States

Although the prevalence of childhood obesity in America had been stabilizing prior to the Covid-19 pandemic, a population-based study in Pennsylvania published in May 2021 showed the rate to be increasing again. There is incomplete understanding of the potential causes and implications of the effects of the pandemic and its associated adopted lifestyle on the rate of increase in childhood Body Mass Index (BMI). The objective of our study was to assess the trajectory of pediatric BMI during the pandemic versus the trajectory prior to the beginning of the Covid-19 pandemic.

Patients between the ages of 4 and 17, seen for >2 years and having recorded BMIs for at least 2 visits separated by one year, were enrolled at General Academic Pediatric (GAP) at Children’s Hospital of The King’s Daughters (CHKD) in Norfolk, VA during their well check. Consented patients over the age of 8 and parents/guardians were administered a questionnaire that examined six different potential sources for lifestyle changes that could impact BMI. Generalized Estimating Equation (GEE) model and Spearman correlation were utilized for statistical analyses between variables. Data was collected from 238 patients (51% female identifying, 49% male identifying; majority African-American/Black) with an average age of 9.47 for females and 9.57 for males.

We found that BMI percentile did increase significantly over the time period examined (beginning of the Covid-19 shutdown to May 2021; p < 0.001), however, when separated by sex, the increase is more significant for females (Fig. 1). The increase in BMI percentile over the pandemic correlated positively with an increase in family time (R = 0.164, p < 0.010) and an increase in screen time (R = 0.160, p < 0.012) over the last year. These results, and the other four lifestyle modification questions included in this study can be seen in Table 1.

These results of this predominantly African-American sample correlate well with the previous population-based study that children’s BMI has increased during the pandemic and more so in females. Two significant factors in this trend were increased time spent with family and increased screen time. As BMI increase is multifactorial, future directions of this study could be aimed at investigating the root source of these changes and other unexpected implications. The results of this study could help families and medical practitioners combat this alarming increase in pediatric BMI, which will likely stay with us long after Covid-19 lifestyle modifications or no longer at play.

Estimated Marginal Means of BMI

Figure 1 – Changes in trajectory and means of pediatric BMI separated by sex

Table 1

Questionnaire Answer Correlations with BMI

Table 1 – Correlations seen between questions included in questionnaire and their respective statistical analyses.