Virtual learning due to covid-19 pandemic and body weight changes  in children aged 6-12 years

Nadhira Haliza Aulia; Andintia Aisyah Santoso; Mutiara Ramadhanty; Bintang Wirawan; Frida Soesanti

Nadhira Haliza Aulia Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Andintia Aisyah Santoso Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Mutiara Ramadhanty Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Bintang Wirawan Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Frida Soesanti Department of Child Health, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo General Hospital, Jakarta, Indonesia

Keywords: body weight, children, COVID-19, virtual learning

Abstract

Background The COVID-19 pandemic has led to school closures and virtual learning implementation. The situation has affected children's lifestyles and created an obesogenic environment.

Objective To evaluate the impact of virtual learning during the pandemic on body weight changes in children.

Methods This cross-sectional study was conducted on 6-12 years age children who experienced virtual school learning in Jakarta, Indonesia. Parents or guardians were asked to complete an online questionnaire about lifestyle changes and children's anthropometric data both before and during the virtual learning period. Changes in the weight-for-age Z-score (WAZ) and BMI Z-score (BMIZ) were analyzed using the Wilcoxon signed-rank test.

Results A total of 206 children were assessed. There was a significant relation between virtual learning due to the COVID-19 pandemic and WAZ and BMIZ changes among children aged 6-12 years. Approximately 64% of the children experienced WAZ decrement (P value = 0.000), and 77.1% experienced BMIZ decrement (P value = 0.000).

Conclusion This study do not align with existing studies' indicating that the pandemic lead to weight gain in children. Instead, the results shows that virtual learning period causes both WAZ and BMIZ to decrease.

References

1. United Nations International Children’s Emergency Fund. Covid-19 and School Closure [updated 2021 march; cited 2022 Sept 24]. Available from: https://data.unicef.org/resources/one-year-of-covid-19-and-school-closures/
2. Singh S, Roy D, Sinha K, Parveen S, Sharma G, Joshi G. Impact of COVID-19 and lockdown on mental health of children and adolescents: a narrative review with recommendations. Psychiatry Res. 2020;293:113429. DOI: https://doi.org/10.1016/j.psychres.2020.113429
3. Pujia R, Ferro Y, Maurotti S, Khoory J, Gazzaruso C, Pujia A, et al. The effects of COVID-19 on the eating habits of children and adolescents in Italy: a pilot survey study. Nutrients. 2021;13:2641. DOI: https://doi.org/10.3390/nu13082641
4. Rossi L, Behme N, Breuer C. Physical activity of children and adolescents during the COVID-19 pandemic-a scoping review. Int J Environ Res Public Health. 2021;18:11440. DOI: https://doi.org/10.3390/ijerph182111440
5. Trott M, Driscoll R, Irlado E, Pardhan S. Changes and correlates of screen time in adults and children during the COVID-19 pandemic: a systematic review and meta-analysis. EClinicalMedicine. 2022;48:101452. DOI: https://doi.org/10.1016/j.eclinm.2022.101452
6. Sharma M, Aggarwal S, Madaan P, Saini L, Bhutani M. Impact of COVID-19 pandemic on sleep in children and adolescents: a systematic review and meta-analysis. Sleep Med. 2021;84:259-67. DOI: https://doi.org/10.1016/j.sleep.2021.06.002
7. Tester JM, Rosas LG, Leung CW. Food insecurity and pediatric obesity: a double whammy in the era of COVID-19. Curr Obes Rep. 2020;9:442-50. DOI: https://doi.org/ 10.1007/s13679-020-00413-x
8. La Fauci G, Montalti M, Di Valerio Z, Gori D, Salomoni MG, Salussolia A, et al. Obesity and COVID-19 in children and adolescents: reciprocal detrimental influence-systematic literature review and meta-analysis. Int J Environ Res Public Health. 2022;19:7603. DOI: https://doi.org/ 10.3390/ijerph19137603
9. 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;9:302-12. DOI: https://doi.org/10.1016/j.jshs.2020.05.006
10. Brooks CG, Spencer JR, Sprafka JM, Roehl KA, Ma J, Londhe AA, et al. Pediatric BMI changes during COVID-19 pandemic: an electronic health record-based retrospective cohort study. EClinicalMedicine. 2021;38:101026. DOI: https://doi.org/ 10.1016/j.eclinm.2021.101026
11. Hu J, Liu J, Wang J, Shen M, Ge W, Shen H, et al. Unfavorable progression of obesity in children and adolescents due to COVID-19 pandemic: a school-based survey in China. Obesity. 2021;29:1907-15. DOI: https://doi.org/ 10.1002/oby.23276
12. Cipolla C, Curatola A, Ferretti S, Giugno G, Condemi C, Delogu AB, et al. Eating habits and lifestyle in children with obesity during the COVID19 lockdown: a survey in an Italian center. Acta Biomed. 2021;92:e2021196. DOI: https://doi.org/10.23750/abm.v92i2.10912
13. Miller A, Bochner R, Sohler N, Calixte R, Chan C, Umpaichitra V, et al. Modified body mass index z-scores in children in New York City during the COVID-19 pandemic. Pediatr Obes. 2022;17:e12958. DOI: https://doi.org/10.1111/ijpo.12958
14. Oddo VM, Maehara M, Rah JH. Overweight in Indonesia: an observational study of trends and risk factors among adults and children. BMJ Open. 2019;9:e031198. DOI: https://doi.org/10.1136/bmjopen-2019-031198
15. Weaver RG, Hunt ET, Armstrong B, Beets MW, Brazendale K, Turner-McGrievy G, et al. COVID-19 leads to accelerated increases in children's BMI Z-Score gain: an interrupted time-series study. Am J Prev Med. 2021;61:161-9. DOI: https://doi.org/ 10.1016/j.amepre.2021.04.007
16. Woo S, Yang H, Kim Y, Lim H, Song HJ, Park KH. Sedentary time and fast-food consumption associated with weight gain during COVID-19 lockdown in children and adolescents with overweight or obesity. J Korean Med Sci. 2022;37:e103. DOI: https://doi.org/ 10.3346/jkms.2022.37.e103
17. Adams EL, Caccavale LJ, Smith D, Bean MK. Food insecurity, the home food environment, and parent feeding practices in the era of COVID-19. Obesity. 2020;28:2056-63. DOI: https://doi.org/10.1002/oby.22996
18. Rachmi CN, Li M, Alison Baur L. Overweight and obesity in Indonesia: prevalence and risk factors-a literature review. Public Health. 2017;147:20-9. DOI: https://doi.org/ 10.1016/j.puhe.2017.02.002
19. Schwarzfischer P, Gruszfeld D, Socha P, Luque V, Closa-Monasterolo R, Rousseaux D, et al. Effects of screen time and playing outside on anthropometric measures in preschool aged children. PLoS One. 2020;15:e0229708. DOI: https://doi.org/10.1371/journal.pone.0229708
20. Bordon S, Srebernich SM, Bernardi JLD, Leandro-Merhi VA. Screen time, body mass index and neck circumference: is there an association with social class in children?. Rev Bras Cineantropom Desempenho Hum. 2019;21:e58235. DOI: https://doi.org/10.1590/1980-0037.2019v21e58235
21. Loo BKG, Okely AD, Pulungan A, Jalaludin MY. Asia-Pacific consensus statement on integrated 24-hour activity guidelines for children and adolescents. Br J Sports Med. 2022;56:539-45. DOI: https://doi.org/10.1136/bjsports-2021-104527
22. Dunton GF, Do B, Wang SD. Early effects of the COVID-19 pandemic on physical activity and sedentary behavior in children living in the U.S. BMC Public Health. 2020;20:1351. DOI: https://doi.org/10.1186/s12889-020-09429-3
23. Androutsos O, Perperidi M, Georgiou C, Chouliaras G. Lifestyle changes and determinants of children's and adolescents' body weight increase during the first COVID-19 lockdown in Greece: the COV-EAT study. Nutrients. 2021;13:930. DOI: https://doi.org/ 10.3390/nu13030930
24. Cooper CB, Neufeld EV, Dolezal BA, Martin JL. Sleep deprivation and obesity in adults: a brief narrative review. BMJ Open Sport Exerc Med. 2018;4:e000392. DOI: https://doi.org/ 10.1136/bmjsem-2018-000392
25. Paruthi S, Brooks LJ, D'Ambrosio C, Hall WA, Kotagal S, Lloyd RM, et al. Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine. J Clin Sleep Med. 2016;12:785-6. DOI: https://doi.org/ 10.5664/jcsm.5866