Secular change in selected motor performance parameters and BMI in Swiss primary school children from 2014-2021: The Sportcheck+ study.

It is important to monitor secular trends in children's motor performance, as healthy and physically active children are more likely to become healthy and physically active adults. However, studies with regular and standardized monitoring of motor performance in childhood are scarce. Additionally, the impact of COVID-19 mitigation measures on secular trends is unknown. This study describes secular changes in balancing backwards, jumping sidewards, 20-m sprint, 20-m Shuttle Run Test (SRT) and anthropometric data in 10'953 Swiss first graders from 2014 to 2021. Multilevel mixed-effects models were used to estimate secular trends for boys vs. girls, lean vs. overweight and fit vs. unfit children. The potential influence of COVID-19 was also analysed. Balance performance decreased (2.8% per year), whereas we found improvements for jumping (1.3% per year) and BMI (-0.7% per year). 20-m SRT performance increased by 0.6% per year in unfit children. Children affected by COVID-19 measures had an increased BMI and were more overweight and obese, but motor performance was mostly higher. In our sample, secular changes in motor performance show promising tendencies from 2014 to 2021. The effects of COVID-19 mitigation measures on BMI, overweight and obesity should be monitored in additional birth cohorts and follow-up studies.

Analysis of Determinants of Food Preferences in a Polish Population-Based Sample of Primary School Adolescents: Diet and Activity of Youth during COVID-19 (DAY-19) Study.

For the choices of food products, food preferences are crucial, as they influence the intake of nutrients and the resultant quality of diet, but in Poland, no studies of food preferences were conducted during the COVID-19 pandemic on a population of young adolescents. The aim of this study was to analyze the determinants of food preferences in a Polish population-based sample of primary school adolescents as part of the Diet and Activity of Youth during COVID-19 (DAY-19) Study. The DAY-19 Study focused on a national sample of a population of primary school adolescents who were recruited based on cluster sampling of participants from counties and schools, yielding a sample of 5039 individuals. Their food preferences were assessed using the Food Preference Questionnaire (FPQ), and they were compared in subgroups stratified by (1) gender: male and female; (2) age: younger (10-13 years) and older (14-16 years); (3) place of residence: urban and rural; (4) Body Mass Index (BMI): underweight, normal body weight, and overweight/obese (assessed based on Polish growth reference values); and (5) physical activity level: low and moderate (assessed using the International Physical Activity Questionnaire for children aged 10-13 (IPAQ-C) and adolescents aged 14-16 (IPAQ-A)). In the population of adolescents, no statistically significant differences in food preferences between subgroups stratified by gender were observed (p > 0.05). For boys, none of the studied factors (age, place of residence, BMI, physical activity level) was statistically significant determinant of food preferences (p < 0.05), while for girls, all of them were statistically significant determinants (p > 0.05). All the assessed factors (age, place of residence, BMI, physical activity level) in girls were associated with preferences for snacks, and older girls, those from a rural environment, those who were underweight and overweight/obese, as well as those having a low physical activity level declared a higher preference for snacks than younger ones (p = 0.0429), those from an urban environment (p = 0.0484), those of a normal body weight (p = 0.0091), and those having a moderate physical activity level (p = 0.0083). Similarly, girls from rural environments declared a higher preference for starches than those from urban environments (p = 0.0103), and girls having a low physical activity level declared a higher preference for fruit than those having a moderate physical activity level (p = 0.0376). Taking this into account, the population of girls, in particular, needs dedicated educational actions to support proper nutritional habits. Additionally, older age, living in a rural environment, being underweight and overweight/obese, and having a low physical activity level may be indicated as factors predisposing one to food preferences potentially promoting unhealthy dietary habits.

Impact of the COVID-19 kindergarten closure on overweight and obesity among 3- to 7-year-old children.

BACKGROUND: Knowledge on the impact of the temporary kindergarten closure policy under COVID-19 in 2020 on childhood overweight and obesity is inadequate. We aimed to examine differences in rates of overweight and obesity from 2018 to 2021 among kindergarten children aged 3-7 years. METHODS: Overweight was defined as body mass index (BMI) > 1 standard deviation (SD) for age and sex, and obesity was defined as BMI > 2 SD for age and sex. Generalized linear mixed modeling was used for analysis. RESULTS: A total of 44,884 children and 71,216 growth data points from all 57 public kindergartens in Jiading District, Shanghai, China were analyzed. The rates of obesity from 2018 to 2021 were 6.9%, 6.6%, 9.5%, and 7.3% in boys and 2.8%, 2.8%, 4.5%, and 3.1% in girls, respectively. The rates of overweight from 2018 to 2021 were 14.3%, 14.3%, 18.2%, and 15.3% in boys and 10.6%, 10.9%, 13.9%, and 11.6% in girls. The rates of obesity and overweight among kindergarten children in 2020 were significantly higher than those in 2018, 2019, and 2021. Compared to 2020, the odds ratios of the obesity rate in 2018, 2019, and 2021 were 0.67 [95% confidence interval (CI) = 0.58-0.77, P < 0.001], 0.72 (95% CI = 0.64-0.80, P < 0.001) and 0.81 (95% CI = 0.72-0.92, P = 0.001), respectively. The odds ratios of the overweight rate in 2018, 2019, and 2021 were 0.75 (95% CI = 0.69-0.82, P < 0.001), 0.78 (95% CI = 0.72-0.84, P < 0.001), and 0.89 (95% CI = 0.81-0.97, P = 0.008), respectively, compared to 2020. CONCLUSIONS: The rates of overweight and obesity significantly increased among kindergarten children in 2020 after the 5-month kindergarten closure. It was critical to provide guidance to caregivers on fostering a healthy lifestyle for children at home under public health emergencies.

Association between Types of Screen Time and Weight Status during the COVID-19 Pandemic: A Longitudinal Study in Children and Adolescents.

BACKGROUND: This study aimed to investigate the changes in distinct types of screen time and explore their longitudinal association with children and adolescents' weight status. METHODS: A two-wave longitudinal study was conducted among 2228 children and adolescents (6-19 years) in Shanghai, China, before and during the pandemic. Recreational screen time (watching TV/videos, online gaming, using social media, and browsing webpages), educational screen time (online homework and online class), and BMI were measured using a self-reported questionnaire. Mixed-effects models were constructed to assess the associations between screen time and weight status. RESULTS: The prevalence of overweight and obesity was 20.5% and 10.2% at baseline, respectively. Both recreational and educational screen time increased significantly over two months. While recreational screen time was found to be a risk factor for obesity, it was not the case for educational screen use. Specifically, adolescents who spent more time watching TV/videos had a higher obesity risk (OR = 1.576). No significant associations were found in children. CONCLUSIONS: Overweight and obesity were prevalent among children and adolescents in China. Reducing screen-based activities is a promising strategy to prevent unhealthy weight gain in Chinese children and adolescents, while it is necessary to consider the content and distinguish between educational and recreational screen use.

Laboratory Findings in Children with Excess Body Weight in Romania.

Background and Objectives: Childhood obesity has been increasing at a worrisome pace and emerging as a non-infectious pandemic in the pediatric population in recent years. Raising awareness on this problem is of utmost importance, in order to take action to control body weight from an early age. Materials and Methods: We performed a retrospective study among overweight or obese children evaluated on an outpatient basis in the Department of Pediatric Endocrinology of a tertiary care hospital in Bucharest Romania in 2021 in order to identify laboratory changes occurring according to age and sex. Results: A total of 268 children were included in the analysis, with a median age of 10.9 years (IQR: 8.3, 13.3 years); 61.8% were obese and 38.2% overweight. We identified a subclinical pro-inflammatory status characterized by increased neutrophil count (12.7%) and increased C-reactive protein (16.4%). Biochemically, we identified the highest increases for uric acid (35.4%). More than half of the children included in the study had dyslipidemia-specific changes: high low-density lipoprotein cholesterol (LDL) (50.0%), low high-density lipoprotein cholesterol (HDL) (58.9%) and increased triglyceride levels (12.7%), especially children with a body mass-index (BMI) percentile above 95%. Increased thyroid stimulating hormone (TSH) was identified in 20.3% and low thyroxine (T4) level in 13.4%, especially in females. Conclusions: Early measures to control excess body weight are needed since preventing obesity is easier than treating it. However, this is often difficult to do in our country because parents frequently do not recognize the problem until it is advanced. Furthermore, doctors are not always adequately prepared and sometimes they do not have the support of the health systems to provide children in need with the adequate care. Educational strategies and awareness of issue should be revisited in current post-pandemic context that facilitates increase of obesity prevalence in children. Increase of efficient communication could be achieved by pointing to these objective findings.

Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population Health and Health Inequalities.

Since the start of the COVID-19 pandemic in early 2020, governments around the world have adopted an array of measures intended to control the transmission of the SARS-CoV-2 virus, using both pharmaceutical and non-pharmaceutical interventions (NPIs). NPIs are public health interventions that do not rely on vaccines or medicines and include policies such as lockdowns, stay-at-home orders, school closures, and travel restrictions. Although the intention was to slow viral transmission, emerging research indicates that these NPIs have also had unintended consequences for other aspects of public health. Hence, we conducted a narrative review of studies investigating these unintended consequences of NPIs, with a particular emphasis on mental health and on lifestyle risk factors for non-communicable diseases (NCD): physical activity (PA), overweight and obesity, alcohol consumption, and tobacco smoking. We reviewed the scientific literature using combinations of search terms such as 'COVID-19', 'pandemic', 'lockdowns', 'mental health', 'physical activity', and 'obesity'. NPIs were found to have considerable adverse consequences for mental health, physical activity, and overweight and obesity. The impacts on alcohol and tobacco consumption varied greatly within and between studies. The variability in consequences for different groups implies increased health inequalities by age, sex/gender, socioeconomic status, pre-existing lifestyle, and place of residence. In conclusion, a proper assessment of the use of NPIs in attempts to control the spread of the pandemic should be weighed against the potential adverse impacts on other aspects of public health. Our findings should also be of relevance for future pandemic preparedness and pandemic response teams.

Differential diagnosis of precocious puberty in girls during the COVID-19 pandemic: a pilot study.

BACKGROUND: To investigate the differential diagnosis of girls aged 6 to 8 years with idiopathic premature thelarche (IPT) and central precocious puberty (CPP) during the COVID-19 pandemic. We explored predicted adult height (PAH) discrepancy to guide appropriate diagnosis and treatment. METHODS: From January 2020 to December 2021, Chinese girls aged 6 to 8 years with precocious puberty were recruited. They were divided into IPT and CPP groups. Clinical characteristics, including height, weight, body mass index (BMI), basal luteinizing hormone (LH), oestradiol, uterine length and volume, follicle numbers (d > 4 mm) and bone age (BA) were recorded. We analysed differential diagnosis and PAH discrepancy in both groups. Binary logistic regression analysis was used to explore risk factors for CPP, and receiver operating characteristic (ROC) curves were generated to evaluate the diagnostic value of related indexes. RESULTS: Sixty patients, including 40 girls with IPT and 20 girls with CPP, were recruited. The prevalence of overweight and obesity in the entire cohort was 25% (15/60) and was significantly higher in IPT than CPP, 32.5% (13/40) vs. 10% (2/20), respectively (P=0.045). There were significant differences in LH, uterine volume, follicle numbers and BA (P<0.05). The impaired PAH of IPT and CPP was 0.01 ± 1.19 SD and 0.62 ± 0.94 SD with significant differences (P=0.047). Logistic regression analysis showed that LH and follicle numbers were independent risk factors for CPP. The ROC curve showed that the area under the curve (AUC) of LH and follicle numbers were 0.823 and 0.697. The sensitivity and specificity of LH with a cut off of 0.285 IU/L were 78.9% and 77.8%. The sensitivity and specificity of follicle numbers with a cut off of 3.5 were 89.5% and 52.8%. CONCLUSION: The prevalence of overweight and obesity in 6- to 8-year-old girls with precocious puberty was high. Auxological data should not be used in the differential diagnosis of IPT and CPP. Basal LH above 0.285 IU/L and follicle numbers greater than 4 were important features suggestive of CPP. PAH was impaired in individuals with CPP, but it was not impaired in individuals with IPT.

A systematic review of the burden of, access to services for and perceptions of patients with overweight and obesity, in humanitarian crisis settings.

INTRODUCTION: Excess body weight causes 4 million deaths annually across the world. The number of people affected by humanitarian crises stands at a record high level with 1 in 95 people being forcibly displaced. These epidemics overlap. Addressing obesity is a post-acute phase activity in non-communicable disease management in humanitarian settings. Information is needed to inform guidelines and timing of interventions. The objective of this review was to explore the prevalence of overweight and obesity in populations directly affected by humanitarian crises; the cascade of care in these populations and perceptions of patients with overweight and obesity. METHODS: Literature searches were carried out in five databases. Grey literature was identified. The population of interest was non-pregnant, civilian adults who had experience of humanitarian crises (armed conflict, complex emergencies and natural disasters). All study types published from January 1st, 2011, were included. Screening, data extraction and quality appraisal were carried out in duplicate. A narrative synthesis is presented. RESULTS: Fifty-six reports from forty-five studies were included. Prevalence estimates varied widely across the studies and by subgroups. Estimates of overweight and obesity combined ranged from 6.4% to 82.8%. Studies were heterogenous. Global distribution was skewed. Increasing adiposity was seen over time, in older adults and in women. Only six studies were at low risk of bias. Body mass index was the predominant measure used. There were no studies reporting cascade of care. No qualitative studies were identified. CONCLUSION: Overweight and obesity varied in crisis affected populations but were rarely absent. Improved reporting of existing data could provide more accurate estimates. Worsening obesity may be prevented by acting earlier in long-term crises and targeting risk groups. The use of waist circumference would provide useful additional information. Gaps remain in understanding the existing cascade of care. Cultural norms around diet and ideal body size vary.

Obesity increased the risk of SARS-CoV-2 positivity in children.

AIM: To determine the effects of obesity in childhood on SARS-CoV-2 infection. METHODS: A population-based, cross-sectional study combining the Israeli Growth Survey and COVID-19 data for children with at least one SARS-CoV-2 test from 16 February 2020 to 20 December 2021. Overweight and obesity status were based on body mass index and the Center for Disease Control criteria. Multivariate logistics regression was performed to validate reliability for weight categories at the age of approximately 6 years compared with weights at approximately 12 years. RESULTS: A total of 444 868 records for children with an overall positivity rate of 22% were studied. The mean age was 9.5 years. The odds ratios of children with obesity or overweight after controlling for sex at 6 years to test positive were 1.07-1.12 and 1.06-1.08 (depending on the model), respectively, compared to those with healthy range body mass index. CONCLUSION: Excess weight appears to increase the risk of SARS-CoV-2 infection. This finding should be considered for public health planning. For example, children with overweight and obesity should be prioritised for vaccination. Excess weight in childhood can be harmful at a young age and not only for long-term health.

Prolonged body weight gain, lifestyle changes and health-related quality of life in children during the COVID-19 pandemic lockdown: A follow-up study.

BACKGROUND: Further investigation is needed to define the impact of long-term pandemic lockdown in children. OBJECTIVES: To examine changes in body mass index z-score (zBMI), lifestyle, Health-Related Quality of Life and proportion of overweight or obesity (OW/OB) in 6- to 9-year-old children in Argentina. METHODS: Observational study with baseline measurements prior to lockdown and follow-up after eight months of strict restrictive measures (November 2020, first visit, n = 144) and after ten months of partial reopening (September 2021, second visit, n = 108). Anthropometric changes from baseline to first visit in lockdown group (LG) were compared with a historical control group (HCG, n = 134). Follow-up visits included anthropometric measures, lifestyle questionnaire and Pediatric Quality of Life Inventory. RESULTS: Change in zBMI was higher in LG [median, IQR: 0.46 (-0.00; 0.83)] vs HCG [median, IQR: 0.02 (-0.31; 0.27)]; p < 0.001, particularly in children with pre-existing OW/OB. In LG, zBMI was higher at first and second visit vs baseline (p < 0.001) and in second visit vs first visit for boys (p = 0.037) but not for girls. The proportion of children with OW/OB increased from baseline (43.5%) to first (56.5%) and second visit (58.3%) (p = 0.029). Unlike girls, the proportion of boys with OW/OB increased from baseline to first and second visit (p = 0.045). Change in zBMI was higher in children with less healthy habits (p < 0.001). CONCLUSIONS: Weight gain continued to increase in boys when lockdown measurements were eased, although sedentary behaviors decreased and quality of life improved, indicating that the effects of pandemic lockdown could be difficult to reverse.

Body mass index combined with (waist + hip)/height accurately screened for normal-weight obesity in Chinese young adults.

OBJECTIVES: Only a few studies have explored the prevalence of normal-weight obesity in young adults or the development of a simple evaluation index for body fat percentage. Therefore, this study aimed to examine the prevalence of normal-weight obesity in young Chinese adults and use anthropometric measurements to develop an evaluation index. METHODS: In total, 1322 college students participated in the study and were divided into the normal-weight lean, normal-weight obese, and overweight and obese groups based on their body mass index and body fat percentage. The differences in body composition, circumference, and circumference ratio among these three groups were examined. RESULTS: When exploring the correlation between the circumference ratio and body fat percentage, the circumference ratio was suitable for early screening of abnormal body fat percentage, and the cutoff value was calculated. Body composition and circumference were significantly different among the three groups: (waist + hip)-to-height, hip-to-height, and waist-to-height ratios were strongly correlated with body fat percentage. CONCLUSIONS: (Waist + hip)-to-height ratio can be used as a simple evaluation index for indicating abnormal body fat percentage when higher than 1.032 in male and 1.047 in female individuals. Downregulating the normal upper limit for body mass index to 24.4 and 23.8 kg/m2 in male and female individuals, respectively, is recommended. Body mass index combined with (waist + hip)-to-height ratio allowed for more accurate screening of normal-weight obesity as an easy and cost-free evaluation measure for abnormal body fat percentage.

Rural-Urban Differences in Physical Fitness and Overweight Prevalence of Children and Adolescents from Central South China.

PURPOSE: This present study aims to determine the rural-urban differences in physical fitness and overweight prevalence among children and adolescents from Central South China. METHODS: All the original parameters of physical fitness indicators for 216,718 participants aged from 7 to 15 years old were obtained from the website of the Chinese National Student Physical Fitness Database and were analyzed by SPSS. RESULTS: (1) Children and adolescents from rural areas were observed to have a more adverse physical fitness ratio, and the urban-rural differences were identified in each physical fitness indicator. (2) Rural areas had a higher overweight prevalence (p < 0.01). When compared to urban cities, overweight students from rural towns measured a significantly poorer cardiorespiratory and muscular fitness in primary school (p < 0.05), while the result in middle school was showed the opposite. (3) Rural-urban residence and sex were the moderately correlated factors for muscular fitness among overweight students. CONCLUSIONS: Urban children and adolescents in central south China had an overall healthier profile than their rural peers, particularly in overweight groups. The government and related functional departments should take the factors of rural-urban residence and sex of students into consideration when building a state strategy and interventions to promote physical activity and health.

Remote work and back pain during the COVID-19 pandemic in adults and older population in South Brazil.

This article aims to investigate the association between remote work and Back Pain during the COVID-19 pandemic, and to analyze this relationship according to the body mass index. Population-based, cross-sectional study carried in two cities in southern Brazil, in individuals aged 18 years and over. Data were collected through household interviews from October to January 2020/21. Outcomes: back pain (cervical, thoracic, lumbar/acute, chronic) and pain intensity. Exposure variable: remote work. For the analyses, Poisson regression with robust adjustment for variance was used, stratified by BMI (eutrophic vs overweight/obese), and restricted to those who had worked in the past month. 1,016 had worked during the pandemic, average 42 years old (SD = 14), varying from 18 to 93 years. Remote work was performed by 7.7% of the individuals. Prevalence of back pain: 25.6% (95%CI: 19.5 to 31.7%). Overweight/obese remote workers felt pain acute cervical pain PR = 2.82 (95%CI: 1.15 to 6.92); chronic low back PR = 1.85 (95%CI: 1.04 to 3.29); acute thoracic PR = 1.81(95%CI: 3.76 to 8.68) compared to those who did not work. About one in four remote workers reported back pain during of the COVID-19 pandemic. BMI proved to be an important moderator between outcomes and exposure variable.

Prevalence and trends in obesity and severe obesity in Korean children and adolescents, 2007-2020: A population-based study.

BACKGROUND: The age-adjusted prevalence of child and adolescent obesity has been stabilized in the Korean population, although severe obesity has increased with adverse health effects. In this study, we detailed the prevalence of and trends in overweight, obesity, and severe obesity in Korean children and adolescents by age group and sex from a nationally representative sample, using a new, 2017 age- and sex-specific reference for body mass index. METHODS: We collected Korea National Health and Nutrition Examination Survey data from the years 2007-2020. A total of 23,595 subjects (11,210 females) aged 2-18 years were included in this study. We calculated the recent prevalence of overweight and obesity, including severe obesity, by weighted data from 2019 and 2020. RESULTS: The prevalence of overweight and obesity (class II and class III obesity) was 23.5% and 14.2% (2.5% and 0.5%), respectively. Males showed a higher prevalence of overweight and obesity. Adolescents aged 13-15 years showed the highest prevalence of severe obesity. A positive linear trend was significant for overweight (p = 0.025), class I obesity (p < 0.001), and class II obesity (p = 0.002) for both sexes and all ages combined. However, the trend of obesity prevalence was different in each subgroup. Comparing pre- and post- COVID-19 pandemic, obesity prevalence seemed to increase, but not significantly. CONCLUSIONS: Despite previous reports that obesity in children and adolescents has remained stable, we found that the prevalence of overweight, obesity, and severe obesity has increased in Korean children and adolescents. The effects of COVID-19 on this trend require further evaluation.

Feeding intolerance during prolonged prone position in overweight and obese patients with severe COVID-19.

Introduction: Objective: the aim of this study was to compare the incidence rate of feeding intolerance (FI) during supine (SP) or prone positioning (PP) in critically ill COVID-19 patients. Methods: this was a retrospective cohort study of critically ill patients with overweight or obesity who received enteral nutrition (EN) in prone or supine positioning continuously during the first five days of mechanical ventilation. Nutritional risk, anthropometric measurements and body composition were assessed at the first 24 hours upon Intensive Care Unit (ICU) admission. Biochemical and clinical variables (Sequential Organ Failure Assessment [SOFA], Acute Physiology and Chronic Health Evaluation II [APACHE II], Acute Kidney Injury [AKI] or comorbidities diagnosis) were collected. Pharmacotherapy (prokinetics, sedatives or neuromuscular blocking agents) and FI incidence (gastric residual volume [GRV] ≥ 200 ml or ≥ 500 ml, vomiting or diarrhea) were daily recorded. Constipation was defined as the absence of evacuation for five consecutive days. Results: eighty-two patients were included. Higher rate of prophylactic prokinetic prescription was observed in PP (42.8 vs 12.5 %, p = 0.002). GRV ≥ 200 in supine position was not different when compared to PP (p = 0.47). Vomiting episodes in supine compared to PP showed no difference between groups (15 % vs 24 %, p = 0.31). No differences in diarrhea events were detected (10 % vs 4.7 %, p = 0.36). Constipation was common in both groups (95 % vs 82 %, p = 0.06). Conclusion: FI during prone position was not different in comparison to supine position. Routinely use of prokinetics in continuous prone position may help to prevent FI incidence. Algorithm development is necessary for FI prevention and treatment so to avoid EN interruptions and adverse clinical outcomes.

Introducción: Objetivo: comparar la incidencia de intolerancia a la alimentación entre pacientes críticos en posición supino (PS) o prono (PP). Métodos: cohorte retrospectiva de pacientes bajo ventilación mecánica por distrés respiratorio por COVID-19 y sobrepeso y obesidad, quienes recibieron nutrición enteral (NE) en PP o PS. Se evaluaron riesgo nutricional, mediciones antropométricas y composición corporal en las primeras 24 horas de ingreso a la Unidad de Cuidados Intensivos (UCI). Se recolectaron variables bioquímicas y clínicas (Sequential Organ Failure Assessment [SOFA], Acute Physiology and Chronic Health Evaluation II [APACHE II], lesión renal aguda y otras comorbilidades). Se registró el esquema de farmacoterapia prescrita durante los primeros cinco días (procinéticos, sedantes y bloqueadores neuromusculares). Se evaluó la incidencia de intolerancia a la alimentación, definida como la presencia de residuo gástrico (RG) ≥ 200 o ≥ 500 ml, vómito, diarrea o estreñimiento. Resultados: fueron incluidos 82 pacientes. Se observó una mayor prescripción de procinéticos como terapia profiláctica en PP (42,8 vs. 12,5 %, p = 0,002). No se observaron diferencias en RG ≥ 200 ml (p = 0,47) ni vómito (p = 0,31) entre ambos grupos. No se observaron diferencias en episodios de diarrea (10 % en PS vs. 4,7 % en PP, p = 0,36). El estreñimiento fue común en ambos grupos de estudio (95 vs. 82 %, p = 0,06). Conclusiones: la PP no se relaciona con una mayor incidencia de intolerancias a la alimentación. El uso rutinario de procinéticos durante la PP continua puede ayudar a prevenir la incidencia de dichas intolerancias. Es necesario el desarrollo de algoritmos para la prevención y tratamiento de las intolerancias a la alimentación para evitar interrupciones en la NE y desenlaces no deseables.

Comparison of anthropometric parameters and laboratory test results before and after the COVID-19 outbreak among Chinese children aged 3-18 years.

Objective: To compare the physiological health of Chinese children around the COVID-19 lockdown. Methods: We extracted data on children's anthropometric and laboratory parameters from May to November in both 2019 and 2020 from the Health Checkup Center, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China. Overall, 2162 children aged 3~18 years without comorbidities in 2019 and 2646 in 2020 were assessed. Mann Whitney U tests were used to compare differences between the above health indicators before and after COVID-19 outbreak. Quantile regression analyses adjusted for age, sex and body mass index (BMI) were also used in analysis. Chi-square tests and Fisher's exact tests were used for comparing differences of categorical variables. Results: Compared with children examined in 2019 before the outbreak, children in 2020 had a higher median z score of BMI for age (-0.16 vs. -0.31), total cholesterol (TC, 4.34 vs. 4.16 mmol/L), low density lipoprotein cholesterol (LDL-C, 2.48 vs. 2.15 mmol/L), high density lipoprotein cholesterol (HDL-C, 1.45 vs. 1.43 mmol/L) and serum uric acid (290 vs. 282 µmol/L), and a lower hemoglobin (Hb, 134 vs. 133 g/L), triglycerides (TG, 0.70 vs. 0.78 mmol/L) and 25(OH)D (45.8 vs. 52.2 nmol/L), all P < 0.05. No differences were identified for waist height ratio, blood pressure and fasting glucose (both P > 0.05). However, in regression models after adjusting, BMI, TC, LDL-C, blood glucose and sUA were positively correlated with year; while Hb, TG and 25(OH)D were negatively correlated with year (all P < 0.05). Accordingly, children in 2020 had a higher prevalence of overweight/obesity (20.6 vs. 16.7%, P < 0.001), hypercholesterol (16.2%vs. 10.2%, P < 0.001), high LDL-C (10 vs. 2.9%, P < 0.001), hyperuricemia (18.9 vs.15.1%, P = 0.002), vitamin D deficiency (22.6 vs. 8.1%, P < 0.001) and a lower prevalence of high TG (4.3 vs. 2.8%, P = 0.018) compared with children in 2019. Conclusion: In this real-world study, we found that long-term lockdown due to COVID-19 outbreak might cause adverse impact on children's metabolic health, which might increase their future risk of cardiovascular diseases. Thus, parents, health professionals, educationists, and caregivers should pay more attention to children's dietary pattern and lifestyle, especially in this new normal against COVID-19.

High Levels of Glycated Hemoglobin (HbA1c) Are Associated with Physical Inactivity, and Part of This Association Is Mediated by Being Overweight.

The COVID-19 pandemic has generated substantial changes in the lives of the population, such as increased physical inactivity, which can lead to being overweight and, consequently, repercussions on glucose homeostasis. A cross-sectional study based on the adult population of Brazil was conducted by stratified, multistage probability cluster sampling (October and December 2020). Participants were classified as physically active or inactive during leisure time according to the recommendations of the World Health Organization. HbA1c levels were categorized as normal (≤6.4%) or with glycemic changes (≥6.5%). The mediating variable was being overweight (overweight and obese). Descriptive, univariate, and multivariate logistic regression analyses examined the association between physical inactivity and glycemic changes. Mediation was analyzed using the Karlson-Holm-Breen method to verify the influence of being overweight on the association. We interviewed 1685 individuals, mostly women (52.4%), 35-59 years old (45.8%), race/ethnicity brown (48.1%), and overweight (56.5%). The mean HbA1c was 5.68% (95% CI: 5.58-5.77). Mediation analysis verified that physically inactive participants during leisure time were 2.62 times more likely to have high levels of HbA1c (OR: 2.62, 95% CI: 1.29-5.33), and 26.87% of this effect was mediated by over-weight (OR: 1.30: 95% CI: 1.06-1.57). Physical inactivity at leisure increases the chances of high levels of HbA1c, and part of this association can be explained by being overweight.

Increased Prevalence of Overweight and Obesity and Incidence of Prediabetes and Type 2 Diabetes During the COVID-19 Pandemic, Active Component Service Members, U.S. Armed Forces, 2018 to 2021

This study evaluated trends in the prevalence of overweight, obesity, and diabetes among active component service members between 2018 and 2021, before and after the start of the COVID-19 pandemic. This study also investigated the incidence of prediabetes and type 2 diabetes mellitus (T2DM) diagnoses during the same period. Between 2018 and 2021, the prevalence of obesity among active component service members who completed a Periodic Health Assessment (PHA) increased from 16.1% to 18.8%. The incidence of prediabetes increased from 588.2 to 763.8 cases per 100,000 person-years (p-yrs), and the incidence of T2DM increased from 55.5 to 69.6 per 100,000 p-yrs. The largest relative increases in obesity prevalence were in the youngest (<30 years) age categories. Navy members and Hispanic service members experienced the largest absolute and relative increases in rates of new diabetes diagnoses. These findings indicate that during the COVID-19 pandemic active component service members experienced increased prevalence of obesity, prediabetes, and diabetes. Evaluation of lifestyle factors associated with these chronic diseases among service members may be useful to enhance deployment readiness and operational effectiveness.

National data showed an increased prevalence of overweight and obesity among four-year-old Swedish children during the first year of COVID-19.

AIM: This paper summarised national data on the prevalence of overweight and obesity among 4-year-old children in Sweden in 2020, the first year of the COVID-19 pandemic. It compares this with data from 2018. Differences between regions and sex were identified. METHODS: Comparative data from Swedish Child Health Services were available for 18/21 regions. Chi-square tests were used to compare data from 2018 and 2020 and to examine differences between the sexes. Sex and year were examined through interaction tests. RESULTS: In 2020, 13.3% of the 100 001 children had overweight or obesity: 15.1% of the girls and 11.6% of the boys (p < 0.001). In 2018, 11.4% of the 105 445 children had overweight or obesity: 13.2% of the girls and 9.4% of the boys. This was an overall increase of 16.6% (p = 0.000) in the national Swedish data from 2018 to 2020. The increase between the years was greater for obesity (31.8%, p = 0.000) than for overweight (13.3%, p = 0.000). CONCLUSION: The prevalence of overweight and obesity among 4-year-olds in Sweden increased during the COVID-19 pandemic and needs to be addressed. The prevalence needs to be followed as part of prevention programmes and to evaluate health interventions.

Changes in Lifestyle and Body Weight in Children and Adolescents during the COVID-19 Pandemic: A Representative Survey of Parents in Germany.

INTRODUCTION: The public restrictions taken during the COVID-19 pandemic have substantially affected lifestyle and health behavior of children and adolescents. In Germany, little is known how these changes influenced daily life in families with children and adolescents. METHODS: A cross-sectional survey was performed in April/May 2022 across Germany, similar to a survey performed in 2020. Parents (N = 1,004, 20-65 years) with at least one child aged 3-17 years filled in an online questionnaire released by the Forsa Institute for Social Research and Statistical Analysis. Fifteen questions related to eating habits, dietary patterns, physical activity, media consumption, fitness, mental health, and body weight were included, and standard socioeconomic parameters were assessed. RESULTS: Parents' answers indicated that there was a parental self-reported weight gain in every sixth child since the beginning of the COVID-19 pandemic. This was most obvious in children from families with lower household income and preexisting overweight. Parents also reported that lifestyle patterns had worsened: 70% reported an increase of media consumption during leisure time, 44% a decrease in daily physical activity, and 16% the worsening of dietary habits (e.g., 27% stated to eat more cake and sweets). Children aged 10-12 years were most severely affected. CONCLUSION: Negative health effects related to the COVID-19 pandemic are predominantly observed in children 10-12 years of age and in children from families with low household income, suggesting a worsening social disparity. Political action is urgently needed to tackle the adverse consequences of the COVID-19 pandemic on childhood lifestyle and health.