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

Abstract

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.

The Ongoing Impact of COVID-19 on Pediatric Obesity

“…Koebnick et al (2023) [128] reported that the COVID-19 pandemic lockdown led to excess body weight, particularly for Black and Hispanic youth, which varied depending on social factors related to race and ethnicity. Long et al (2023) [129] examined the impact of the COVID-19 kindergarten closure from 2018 to 2021 on overweight and obesity among 3-7 year-old children. It was found that the rates of overweight and obesity significantly increased in 2020 after a 5-month kindergarten closure.…”

Impact of lockdown on the growth of children in China aged 3-6 years during the COVID-19 pandemic

“…Current studies investigating the impact of COVID-19 lockdown mostly focused on adults or school-age children, and only two studies investigated the growth status of kindergarten children during COVID-19 lockdown ( 27 , 28 ), leaving a significant knowledge gap in the potential impact of lockdowns on the growth of preschool children. Preschool or kindergarten period is a key developmental stage ( 29 ), and unhealthy behaviors during preschool period may lead to substantial impact on their health and development which could last for their whole life.…”

“…But due to the high transmissibility of Omicron variant, there were a large number of small lockdowns in 2022. Two previous studies by Wen ( 27 ) and by Long ( 28 ) investigating the impact of lockdown on kindergarten children in China discussed the major lockdown in 2020 only, and impact of the large number of small lockdowns in 2022 in China was still unknown. Hypothesis of this study was that similar to the major lockdown in 2020, the lockdowns in 2022 which were small in scale but large in numbers could also have negative impacts on children’s health and growth by promoting weight gain and slowing the increase of height of kindergarten children.…”

“…Study on the physical activities of children during COVID-19 lockdown also revealed less weight gain in physicallyactive children (13). Indeed, observational studies from many different countries (including the United States, Austria, Australia, Israel, Italy, Syria, the Netherlands, Jordan, and China) revealed increased rates of overweight and obesity in children during the COVID-19 pandemic and lockdown period (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). In addition, a previous study also found that height increase of kindergarten children was slower in 2020 compared to other years (27).…”

Safety of SARS-CoV-2 test-to-stay in daycare: a regression discontinuity in time analysis

“…1,2 Systematic screenings for severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infections contributed to daycare re-openings, counteracting the profound impact of stay-at-home orders on the development and health of children. 1,[3][4][5][6] However, burden of post-exposure quarantine for children exposed to infected children persisted amid rising incidence of infections. 7 Test-to-stay approaches supplanted the conventional practice of post-exposure quarantine by frequent serial testing for 5-10 subsequent days and reduced the burden of post-exposure quarantine.…”