Increased incidence of overweight and obesity among preschool Swedish children during the COVID-19 pandemic

Abstract

Background The COVID-19 pandemic has had wide effects on child health globally. Increased prevalence of childhood obesity has been observed by a number of countries during the pandemic. The absence of a formal societal lockdown during the pandemic, made Sweden stand out compared to other countries. This study aims to examine changes in BMI among preschool children in Sweden before and during COVID-19 pandemic. Methods Retrospective population-based cross-sectional study, with longitudinal follow-up for a portion of the children. The study included 25 049 children from three Swedish regions, with growth measures at 3- (n = 16 237), 4- (n = 14 437) and 5-years of age (n = 11 711). Care Need Index was used as a socioeconomic parameter at health centre level. Results There was an increase in BMI in children aged three (P = 0.028) and four (P<0.001) during the COVID-19 pandemic. Obesity in 3-year-old girls increased from 2.8% to 3.9%. Four-year-olds increased in obesity, and overweight (girls) and the prevalence of underweight decreased in boys. No change in BMI was observed in 5-year-olds. Children in areas of low socioeconomic status had higher risk of obesity. Conclusions Overweight and obesity increased among 3- and 4-year-old children in Sweden, findings that were accentuated in children attending child health centres in areas with lower socioeconomic status. The COVID-19 pandemic is likely to have affected health behaviours negatively in Swedish preschool children. Our results expose the need for extended efforts directed to prevent childhood obesity, especially targeting lower socioeconomic areas.

Unique Swedish data on young children's growth help to fill the gap identified by the World Health Organization

“…It seems that COVID‐19 played against a backdrop of social or genetic vulnerability, where some children were more prone to developing obesity when their support structures vanished. A similar pattern was observed in a partly longitudinal study on 25 049 children aged 3–5 years from three regions in Sweden 3 . In that study, overweight and obesity increased more among children attending Child Health Services in less socially privileged areas 3 .…”

“…A similar pattern was observed in a partly longitudinal study on 25 049 children aged 3–5 years from three regions in Sweden 3 . In that study, overweight and obesity increased more among children attending Child Health Services in less socially privileged areas 3 . The Miregård et al paper discusses how a regional social care need index only partly correlated with their data on overweight and obesity in four‐year‐old children.…”

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

“…In 2020, Sörmland had the highest Care Need Index, followed by Västmanland, while Halland, Norrbotten and Västerbotten had the lowest Care Need Index in the country. On the contrary, a recent study on 3‐ to 5‐year‐olds in three Swedish regions showed that children in areas of low Care Need Index had a higher risk of obesity 27 . Larger, national studies with individual data are needed to further outline the socioeconomic association.…”

“…On the contrary, a recent study on 3-to 5-year-olds in three Swedish regions showed that children in areas of low Care Need Index had a higher risk of obesity. 27 Larger, national studies with individual data are needed to further outline the socioeconomic association.…”

Childhood Overweight and Obesity During and After the COVID-19 Pandemic

“…2 Sweden reported increased childhood overweight and obesity during the COVID-19 pandemic despite absence of a formal lockdown. 3 In Sweden, regular visits to child health services are free for children aged 0 to 6 years. The visits include growth measurements.…”