COVID-19 Related School Closings and Risk of Weight Gain Among Children.

Andrew Rundle and colleagues wrote a Perspective article for The Obesity Society’s journal Obesity, to call attention to the COVID-19 pandemic’s likely longer-term effect on children’s health. In many areas of the U.S., the COVID-19 pandemic has closed schools and some of these school systems are not expected to re-open this school year. COVID-19, through these school closures, may exacerbate the epidemic of childhood obesity and increase disparities in obesity risk.

While much has been written about poor food and physical activity environments in schools, the data show that children experience unhealthily weight gain, not during the school year, but primarily during the summer months when they are out of school.  Von Hippel and colleagues have documented increases in student’s weight and the prevalence of obesity and overweight across three school years, with increases in obesity and overweight prevalence occurring only during summer recess.  Unhealthy weight gain over the summer school recess is particularly apparent for Hispanic and African American youth, and children already experiencing overweight. Importantly, the data show that the weight gained during the summer months is maintained during the school year and accrues summer to summer.  Furthermore, obesity experienced as young as age 5 has been shown to be associated with significantly higher BMI through to age 50 and higher fat mass at age 50.

The authors anticipate that the COVID-19 pandemic will likely double out-of-school time this year for many children in the U.S. and in addition will exacerbate the risk factors for weight gain associated with summer recess.  There is a dual food environment issue with the COVID-19 school closures: 1) school closures increase food insecurity for many families, which is linked to unhealthy weight in children; and 2) as households stock up on shelf-stable foods, they appear to be purchasing ultra-processed, calorie-dense comfort foods.   In regards to physical activity, social distancing and stay at home orders issued in cities across the globe reduce the opportunities for physical activity among children, particularly for children in urban areas living in small apartments.  Sedentary activities and screen time are expected to expand under social distancing orders; available data show that online video game usage is already soaring.  Screen time is associated with experiencing overweight/obesity in childhood, likely because of the dual issues of sedentary time and the association between screen time and snacking.

The authors discuss some possible interventions for reducing risk factors for unhealthy weight gain during the school closures.