But while it was possible to find ways schools can prevent increases in BMI, it has been more difficult to figure out how to replicate those conditions when classes are not in place. For example, only about three million of the 22 million children who have free or discounted lunch during the school year receive the meals they are entitled to in the summer. These meals tend to be more nutritionally balanced than the cheaper, high-calorie foods that families resort to when food becomes scarce. Inconsistent access to food can also cause physiological changes that increase the risk of obesity; School closings and job losses during the pandemic have greatly increased the number of children without a stable source of food. In June 2020, more than 27 percent of US households with children were food insecure; In about two-thirds of them, there was evidence that the children, in addition to adults, were not getting enough to eat – more than 5.5 times as much as was reported for all of 2018, according to the Brookings Institution. In addition, many families with sufficient resources bought more ultra-processed, long-life groceries for convenience and in preparation for possible lockdowns or supply bottlenecks.
The crisis forced federal, state and local authorities to improvise new ways to provide more balanced meals for children outside of school. In order to limit the risk of infection and to reach more students, the USDA has offered an exemption from the so-called “community feeding”, according to which children have to eat on site. This enabled the caregivers to collect meals worth several days; some districts have converted school buses that run on their regular lines into a food delivery service. The agency also made all children eligible for a free lunch through September 2021, removing the paperwork and stigma required to qualify, says Eliza Kinsey, professor of epidemiology at the Mailman School of Public Health and author of Obesity Paper. Such “program flexibility”, she emphasizes, “could be used in other, non-Covid contexts”, for example in summer or in the event of other disruptions such as hurricane and forest fire closures.
It stands to reason that wider access to nutritious foods would help prevent childhood obesity in the future. Schools also play a central role in collecting nationally representative health data for children, a process that has been disrupted by school closings. We don’t yet know if the nearly 2 percentage point increase seen in the Philadelphia area will be similar across the country – or how much expanded feeding programs have mitigated the many and varied risk factors for obesity caused by the pandemic.
Yet other pediatric hospital networks are reporting worrying increases not only in obesity but also in related illnesses. In a study published in April in the journal Diabetes Care, researchers found a sharp increase in 2020 compared to previous years in the number of children admitted to Children’s Hospital Los Angeles with a severe form of emerging type 2 diabetes . emerged diabetic ketoacidosis. That could be because children were eating inferior food and exercising less, according to lead author Lily Chao, interim diabetes director at the hospital. It could also be that coronavirus worries caused families to postpone treating their children’s symptoms until they were in diabetic ketoacidosis.
A better understanding of how and why the pandemic affects children – not just physically, but also emotionally and academically – would improve the ability of pediatricians, parents and policy makers to facilitate their recovery. Unfortunately, it is clear that there is “no silver bullet for children whose BMI has increased,” says Black. And she adds, “It’s not healthy for children to think about losing weight.” Instead of trying to reverse a previous BMI increase, a better strategy is to slow down future ones and establish healthy habits. There’s good news in the fact that children are prone to growth spurts during puberty, says Risa Wolf, a pediatric endocrinologist at Johns Hopkins Hospital; This can allow them to redistribute extra weight to a higher frame. Wolf suggests that parents focus on integrating physical activity into their children’s daily routine; the CDC recommends 60 minutes for school-age children. And removing fruit juices and sodas from children’s diets is an easy way to significantly reduce sugar and calorie intake, says Chao.