Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan 18;36(3):e21.
doi: 10.3346/jkms.2021.36.e21.

The Impact of the Coronavirus Disease-2019 Pandemic on Childhood Obesity and Vitamin D Status

Hyun Mi Kang  1 , Dae Cheol Jeong  1 , Byung Kyu Suh  1 , Moon Bae Ahn  2
Affiliations

The Impact of the Coronavirus Disease-2019 Pandemic on Childhood Obesity and Vitamin D Status

Hyun Mi Kang et al. J Korean Med Sci. .

Abstract

Background: The risk of weight gain as a consequence of school closure in children during the coronavirus disease-2019 (COVID-19) pandemic has been recognized. This study was performed to investigate changes in anthropometric and metabolic parameters in children following a 6-month period of social distancing and school closure due to the pandemic.

Methods: This retrospective cohort study was conducted in school-aged children that were on routine follow-up at the Growth Clinic of Seoul St. Mary's Hospital. Changes in body mass index (BMI) standard deviation scores (z-scores), lipid profiles, and vitamin D levels were investigated. The 1-year period prior to school closure was defined as "pre-COVID-19 period," and the subsequent 6-month period as "COVID-19 period."

Results: Overall, 226 children between 4 to 14 years old without comorbidities were assessed. On average, their BMI z-scores increased by 0.219 (95% confidence interval [CI], 0.167-0.271; P < 0.001) in the COVID-19 period compared to the pre-COVID-19 period, and the proportion of overweight or obesity increased from 23.9% in the pre-COVID-19 period to 31.4% in the COVID-19 period. The number of days after school closure (P = 0.004) and being in the normoweight category in the pre-COVID-19 period (P = 0.017) were factors associated with an increased BMI in the COVID-19 period. The mean triglyceride (105.8 mg/dL vs. 88.6 mg/dL, P < 0.001) and low-density lipoprotein-cholesterol (100.2 mg/dL vs. 94.0 mg/dL, P = 0.002) levels were higher, whereas the calcidiol level (18.9 mg/dL vs. 23.8 mg/dL, P < 0.001) was lower in the COVID-19 period compared to the pre-COVID-19 period.

Conclusion: Within 6 months, increased childhood obesity and vitamin D deficiencies were observed. The duration of school closure was significantly associated with an increased BMI and being normoweight does not exclude the risks for gaining weight.

Keywords: Calcidiol; Overweight; School Closure; Social Distancing.

PubMed Disclaimer

Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Flow chart of the cases included in this study. A final 226 cases were included in this study.
COVID-19 = coronavirus disease 2019.
Fig. 2
Fig. 2. BMI z-scores of the cases in the pre-COVID-19 period and COVID-19 period. The mean BMI z-score of the patients in the COVID-19 period was significantly higher compared to the pre-COVID-19 period in the normoweight and underweight group. In the normoweight group, the mean BMI z-scores of this group increased by 0.263 (95% CI, 0.199–0.328; P < 0.001).
COVID-19 = coronavirus disease 2019, BMI = body mass index, CI = confidence interval.
Fig. 3
Fig. 3. Changes in the weight status category from the pre-COVID-19 period to the COVID-19 period. The proportion of overweight or obesity increased from 23.9% in the pre-COVID-19 period to 31.4% in the COVID-19 period.
COVID-19 = coronavirus disease 2019.
Fig. 4
Fig. 4. Linear regression model showing the difference in BMI z-score during the pre-COVID -19 period and COVID-19 period. After 47 days of school closure, a positive increase in BMI z-scores of the cases is observed. Each circle represents the difference in BMI z-score (COVID-19 period BMI z-score – pre-COVID-19 period BMI z-score) in each case included. Circles located in the grey area of the graph show weight loss in the COVID-19 period compared to the pre-COVID-19 period, whereas circles in the white area show weight gain.
BMI = body mass index, COVID-19 = coronavirus disease 2019.
See this image and copyright information in PMC

References

    1. Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomed. 2020;91(1):157–160. - PMC - PubMed
    1. Korean Disease Control and Prevention Agency. The updates on COVID-19 in Korea as of 1 March. [Updated March 1, 2020]. [Accessed October 3, 2020]. https://www.cdc.go.kr/board/board.es?mid=a30402000000&bid=0030.
    1. An R. Projecting the impact of the coronavirus disease-2019 pandemic on childhood obesity in the United States: a microsimulation model. J Sport Health Sci. 2020;9(4):302–312. - PMC - PubMed
    1. Foster CE, Horwitz A, Thomas A, Opperman K, Gipson P, Burnside A, et al. Connectedness to family, school, peers, and community in socially vulnerable adolescents. Child Youth Serv Rev. 2017;81:321–331. - PMC - PubMed
    1. Wang YC, Vine S, Hsiao A, Rundle A, Goldsmith J. Weight-related behaviors when children are in school versus on summer breaks: does income matter? J Sch Health. 2015;85(7):458–466. - PubMed