Significant improvement in dietary behaviors and quality of life among adolescents with obesity in the COVID19 lockdown through telehealth

ABSTRACT

Background: COVID19 Lockdown resulted in an extreme change in daily lifestyle with a significant increase in weight and loss of quality of life, as well as an increase in the risk of secondary health conditions even in young people. One reason for this is a fatal change in the nutritional situation, especially among adolescents. Convincing models to counter this problem are missing so far. Multiprofessional training programs could reveal an outstanding effect for secondary prevention of obesity in youth. Telehealth measures were successfully implemented several times during the COVID19 pandemic. Method(s) Adolescents (8-17 years) with severe obesity referred through a large obesity consultation were interviewed using standardized dietary behavior questionnaires (FEV-K, FFL-K, FFV-K) and quality of life questionnaires (WHO-5, KIND-L) and enrolled in a structured multimodal education program for adolescents with overweight. The program content (sports, nutrition, medicine, psychology) was tought exclusively video-based. After the end of the program (12 months), the patients were interviewed again regarding eating behavior and quality of life. In addition, a clinical examination including analysis of blood parameters was performed before and after the program. The results were analyzed and compared with results from the pre-pandemic period (2017 - 2019). Result(s) 108 children and adolescents (mean age 12.1 yrs;male 46.2%, BMI SDS 2.21) were studied and telemedicated. Based on a significantly increased intake of fatty and sugary foods and an increased amount of meals per day (7.2 meals per day), a significantly increased intake of vegetables and fruits as well as a massive decrease of sweets, snacks and soft drinks was observed after program participation, which corresponds to a significant improvement in dietary behavior also compared to the pre-pandemic period. The amount of meals per day decreased to 4.1 meals per day. The quality of life of the adolescents increased significantly. The BMI SDS and the blood parameters (cholesterol, triglycerides, HOMA index) showed a decreasing trend, which roughly corresponds to the effect of the pre-pandemic period. Discussion and Conclusion(s) This study demonstrated a beneficial effect on dietary behaviors and quality of life of adolescents with obesity during lockdown through video-based structured education. Future research needs to show the extent to which this effect is replicable with respect to new periods of contact restriction. It is possible that telemedicine obesity education components can reach a large number of patients and especially families in rural areas, and thus can be a supraregional support for adolescents with obesity.