Coronavirus may exacerbate childhood obesity
School food wasn't ideal, but shuttered schools are worse
Covid-19 is mainly a disease of adults, and kids’ infections tend to be mild. Nevertheless, children are greatly affected by the pandemic, which indirectly altered their physical, mental, developmental and educational lives. Schools around the world have been closed for months, and kids have been spending most of their time indoor, much of it in front of screens.
Kids’ diets changed as a result. The school food environment isn’t ideal: school cafeterias’ offerings aren’t the healthiest. Physical activity at school is often insufficient. Closed schools, however, hurt those that are most at risk of poor diets, weight gain and obesity.
How do we know that? Several studies show that kids gain more unhealthy weight over summer break, and that weight gain is even more pronounced among Hispanic, African-American and children that are already overweight. Social and racial disparities widen over summer break not just academically but also nutritionally.
The pandemic is like a greatly extended summer break, only a more sedentary one.
Lunch can’t go virtual
In a recent paper in the Journal Obesity, public health experts led by Andrew Rundle warn that Covid-19 can be much worse that the average summer vacation. “The closing of schools and the shelter‐in‐place orders create food environment and physical activity challenges for children,” they write.
Why’s that? Kids are missing out on subsidized school lunches, and food insecurity is linked with risk of obesity and weight gain. Households also appear to be stocking up on ultra-processed, and calorie dense foods. On top of that, sports activities and leagues are closed, as are playgrounds, and it takes more of an effort to stay active.
The authors call for and commend innovative approaches, such as the continuation of school meals as grab-and-go, bussing of meals to kids’ homes along their usual pickup route, and remote physical education.
Childhood obesity spikes
One of the first studies of kids’ weight gain trajectory under Covid-19 comes from Verona, Italy. The study included 41 overweight children and teens that are part of an ongoing long-term study. Compared to their behavior in the same months in 2019, lockdown in March and April 2020 resulted in an additional daily meal, 5 extra hours of screen time, 2.5 fewer hours of exercise per week, and a dramatic increase in sugary drink, junk food and red meat consumption. The study does not include weight and height measurements, and it’s a small sample. It nevertheless alerts us to what lockdowns and school closures can do, especially to people struggling with obesity.
It’s cruel irony that the illness caused by the new coronavirus is exacerbated by obesity, yet fighting viral spread may increase this very risk factor for severe disease. Poor eating habits not only increase the risk of overweight and obesity, they’re also associated with chronic inflammation, which worsens our immune response.
Junk food shamelessly promoted
Another recent paper in Obesity titled Good deeds and cheap marketing–The food industry in the times of Covid-19 praises the generous donation of food and money by fast-food corporations.
But Covid-19 has also been used as a marketing strategy. The article describes a few examples: Coca Cola released an image with spaces between the letters of its name to imply social distancing. Some companies offer ideas for coping with boredom, such as Jumex, a Mexican juice company, that created a “bowling alley” out of its used cans on Facebook. Others promote their products with activities for children. Hostess Snacks posted an ad on Twitter showing a woman running towards a bag of donuts with hashtags such as #AtHomeWorkout and #TreatYourself.
Taking advantage of a crisis is perhaps what companies need to do to survive and remain competitive, the authors, Mariel White, Claudia Nieto, and Simon Barquera admit, however, marketing unhealthy foods promotes an obesogenic environment, and exploits our harmful relationship with foods that promote disease. There’s no doubt that marketing affects kids' and teens' choices even more than it influences adults, and lastly, they note, we’re probably exposed to more marketing than ever, that with all that the extra screen time and less to do.
“If we wish to treat obesity seriously by promoting healthier environments and societies that can better respond to health challenges – such as the Covid-19 pandemic – then there is no doubt that the food industry’s strategies are working against this goal and should be effectively regulated,” they conclude.
(Pepsi was mocked for this soda ad on a COVID-19 testing site banner. The sign has since been taken down.)
Covid-19 is a tragic reminder that what we eat is crucial to our health. It will take a long time to fully understand the full spectrum of risk factors for severe disease, but we already know that unhealthy diets are the major driver of underlying conditions such as type 2 diabetes, high blood pressure, heart disease and obesity, which are clearly associated with increased rates of hospitalization and death from Covid-19.
The pandemic should renew our commitment to improve the quality of our diet, we need to make healthy food more accessible especially to those of us who are vulnerable and food insecure. Now more than ever, we need to commit to a healthy lifestyle: eat well, exercise, keep a healthy weight.
Dr. Ayala