Has COVID-19 impacted the global fight against adolescent obesity?

ABSTRACT

Aims• Explore international literature published in the years 2020-2021 to determine the prevalence of adolescent obesity and identify any changes following the introduction of COVID-19 lockdown measures.• Determine changes in weight and anthropometric measurements in adolescents during this period (2020-2021).• Consider correlations between changes in physical activity, eating habits and screen-time following COVID-19 lockdowns and changes in anthropometric measures.• Explore the impact of economic and environmental inequalities on weight gain and obesity.MethodsPeer-reviewed publications published between 1st January 2020 - 1st December 2021 were identified via systematic searching of three electronic databases, CINAHL, PubMed and OVID. Designated medical subject headings (MeSH) terms and free text search terms relating to the research question including ’COVID-19’, ‘obesity’, and ‘adolescents’ were used to identify relevant articles for inclusion. Those executed in all global settings, published in the English language, and with participants aged 10-18-years-old were included. Any anthropometric measure of obesity, including body mass index, body weight and body fat index were considered. Grey literature searches were also conducted using Goggle Scholar. Data was extracted onto a pre piloted data collection form capturing population, intervention/exposure, comparators, and outcomes (PICO). A narrative analysis was produced based around identified themes.ResultsOverall nine studies were deemed suitable for inclusion. No UK based studies were identified, but global findings were captured including those conducted in the USA, China, South Korea, Germany, India, and Italy. Two studies compared anthropometric measures before and after school closures due to COVID-19. Six reported anthropometric changes before and after/during COVID-19 lockdowns, and one reported pre-pandemic versus pandemic changes in anthropometry. COVID-19 resulted in increased screen times, reduced physical activity and changes in nutritional habits. Key themes included gender- weight gain was higher in adolescent males than females, ethnicity- those from Hispanic backgrounds showed higher levels of obesity, parental factors- obese parents increased the likelihood of adolescent obesity (70%), lower socioeconomic status presented with 2.5 times increase in body weight, and behavioural changes- this included reduced physical activity, increased sedentary behaviour and dietary changes with increased snacking reported.ConclusionOur findings show that there was an increase in the prevalence of adiposity, obesity prevalence and weight gain alongside changes in eating habits and activity levels across several regions between 2020-2021. COVID-19 infection control measures such as school closures increased sedentary behaviours e.g. screen-time for both education and leisure, and negatively influenced nutrition. There is a need for ongoing surveillance and intervention in particular for those identified at risk groups from our included articles. All healthcare professionals and governmental bodies have a role to play in addressing this issue. Further work will be required in order to explore the long-term effects of COVID-19 and its true impact on adolescent obesity.