Associations between Changes in Body Weight Status and High Blood Pressure among Lithuanian Children and Adolescents during the COVID-19 Pandemic: A Retrospective Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Blood Pressure Measurements
2.3. Anthropometric Measurements
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Variables | Total (n = 2430) | Boys (n = 1275) | Girls (n = 1155) | p # |
---|---|---|---|---|
Changes in weight status from baseline to follow-up: | 0.004 | |||
Normal weight A and normal weight B | 1646 (67.7) | 814 (63.8) | 832 (72.0) * | |
Normal weight A and overweight B | 206 (8.5) | 120 (9.4) | 86 (7.4) | |
Normal weight A and obesity B | 18 (0.7) | 12 (0.9) | 6 (0.5) | |
Overweight A and normal weight B | 90 (3.7) | 47 (3.7) | 43 (3.7) | |
Overweight A and overweight B | 268 (11.0) | 156 (12.3) | 112 (9.7) * | |
Overweight A and obesity B | 58 (2.4) | 37 (2.9) | 21 (1.9) | |
Obesity A and normal weight B | 6 (0.2) | 3 (0.2) | 3 (0.3) | |
Obesity A and overweight B | 15 (0.6) | 8 (0.6) | 7 (0.6) | |
Obesity A and obesity B | 123 (5.2) | 78 (6.2) | 45 (3.9) * |
Variables | Normal BP | HBP | p # |
---|---|---|---|
Characteristics at baseline | |||
Boys | |||
BMI categories: | <0.001 | ||
Normal weight | 757 (79.9) | 189 (57.6) * | |
Overweight | 148 (15.6) | 92 (28.0) * | |
Obesity | 42 (4.5) | 47 (14.4) * | |
BMI categories: | <0.001 | ||
Normal weight | 757 (79.9) | 189 (57.6) * | |
Overweight/obesity | 190 (20.1) | 139 (42.4) * | |
WC percentile categories: | <0.001 | ||
<90th | 909 (96.0) | 280 (85.4) * | |
≥90th | 38 (4.0) | 48 (14.6) * | |
Age (years) | 9.91 ± 2.21 | 11.95 ± 2.60 | <0.001 |
Weight (kg) | 38.07 ± 12.85 | 54.71 ± 17.29 | <0.001 |
Height (cm) | 144.61 ± 14.99 | 159.54 ± 16.88 | <0.001 |
BMI (kg/m2) | 17.72 ± 3.11 | 21.02 ± 4.03 | <0.001 |
HC (cm) | 74.98 ± 9.28 | 87.06 ± 10.43 | <0.001 |
MUAC (cm) | 21.00 ± 2.75 | 24.42 ± 3.29 | <0.001 |
NC (cm) | 28.82 ± 10.09 | 31.68 ± 3.76 | <0.001 |
WC (cm) | 61.14 ± 8.48 | 71.49 ± 11.19 | <0.001 |
WrC (cm) | 13.96 ± 1.35 | 15.55 ± 1.45 | <0.001 |
BRI | 4.24 ± 0.91 | 4.04 ± 1.08 | 0.001 |
TMI (kg/m3) | 12.29 ± 1.95 | 13.24 ± 2.46 | <0.001 |
WHR | 0.82 ± 0.06 | 0.82 ± 0.06 | 0.782 |
WHtR | 0.42 ± 0.05 | 0.45 ± 0.07 | <0.001 |
SBP (mm Hg) | 103.16 ± 8.88 | 124.72 ± 9.33 | <0.001 |
DBP (mm Hg) | 59.58 ± 6.99 | 67.70 ± 8.58 | <0.001 |
MAP (mm Hg) | 77.54 ± 6.38 | 91.19 ± 6.42 | <0.001 |
PP (mm Hg) | 43.57 ± 9.18 | 57.02 ± 12.51 | <0.001 |
Girls | |||
BMI categories: | <0.001 | ||
Normal weight | 761 (83.9) | 163 (65.7) * | |
Overweight | 114 (12.6) | 62 (25.0) * | |
Obesity | 32 (3.5) | 23 (9.3) * | |
BMI categories: | <0.001 | ||
Normal weight | 761 (83.9) | 163 (65.7) * | |
Overweight/obesity | 146 (16.1) | 85 (34.3) * | |
WC percentile categories: | <0.001 | ||
<90th | 880 (97.0) | 225 (90.7) * | |
≥90th | 27 (3.0) | 23 (9.3) * | |
Age (years) | 10.09 ± 2.41 | 11.37 ± 2.63 | <0.001 |
Weight (kg) | 37.90 ± 12.67 | 47.82 ± 14.85 | <0.001 |
Height (cm) | 144.51 ± 14.86 | 152.22 ± 13.76 | <0.001 |
BMI (kg/m2) | 17.64 ± 3.14 | 20.20 ± 4.14 | <0.001 |
HC (cm) | 75.12 ± 10.09 | 83.19 ± 11.24 | <0.001 |
MUAC (cm) | 20.79 ± 2.69 | 22.93 ± 3.25 | <0.001 |
NC (cm) | 27.57 ± 2.68 | 29.27 ± 2.59 | <0.001 |
WC (cm) | 58.96 ± 7.64 | 65.05 ± 10.19 | <0.001 |
WrC (cm) | 13.58 ± 1.26 | 14.49 ± 1.41 | <0.001 |
BRI | 4.06 ± 0.95 | 4.02 ± 1.04 | 0.214 |
TMI (kg/m3) | 12.22 ± 1.88 | 13.28 ± 2.52 | <0.001 |
WHR | 0.79 ± 0.07 | 0.78 ± 0.07 | 0.280 |
WHtR | 0.41 ± 0.05 | 0.43 ± 0.06 | <0.001 |
SBP (mm Hg) | 102.82 ± 8.87 | 121.45 ± 9.67 | <0.001 |
DBP (mm Hg) | 60.60 ± 6.86 | 71.04 ± 7.54 | <0.001 |
MAP (mm Hg) | 78.00 ± 6.46 | 91.81 ± 6.14 | <0.001 |
PP (mm Hg) | 42.22 ± 8.69 | 50.40 ± 11.88 | <0.001 |
Characteristics at follow-up | |||
Boys | |||
BMI categories: | <0.001 | ||
Normal weight | 660 (73.1) | 204 (54.8) * | |
Overweight | 184 (20.4) | 100 (26.9) * | |
Obesity | 59 (6.5) | 68 (18.3) * | |
BMI categories: | <0.001 | ||
Normal weight | 660 (73.1) | 204 (54.8) * | |
Overweight/obesity | 243 (26.9) | 168 (45.2) * | |
WC percentile categories: | <0.001 | ||
<90th | 852 (94.4) | 313 (84.1) * | |
≥90th | 51 (5.6) | 59 (15.9) * | |
Age (years) | 11.60 ± 2.11 | 13.61 ± 2.45 | <0.001 |
Weight (kg) | 48.01 ± 13.78 | 66.53 ± 18.68 | <0.001 |
Height (cm) | 156.50 ± 13.90 | 169.59 ± 14.23 | <0.001 |
BMI (kg/m2) | 19.28 ± 3.48 | 22.81 ± 4.70 | <0.001 |
HC (cm) | 81.20 ± 9.61 | 92.11 ± 11.49 | <0.001 |
MUAC (cm) | 22.73 ± 2.79 | 25.81 ± 3.35 | <0.001 |
NC (cm) | 29.54 ± 2.61 | 32.70 ± 3.07 | <0.001 |
WC (cm) | 65.22 ± 9.69 | 75.36 ± 12.92 | <0.001 |
WrC (cm) | 14.60 ± 1.33 | 15.93 ± 1.44 | <0.001 |
BRI | 3.72 ± 0.86 | 3.64 ± 0.97 | 0.023 |
TMI (kg/m3) | 12.36 ± 2.18 | 13.49 ± 2.73 | <0.001 |
WHR | 0.80 ± 0.06 | 0.82 ± 0.73 | 0.010 |
WHtR | 0.42 ± 0.06 | 0.45 ± 0.07 | <0.001 |
SBP (mm Hg) | 103.35 ± 10.15 | 125.01 ± 11.58 | <0.001 |
DBP (mm Hg) | 66.11 ± 6.17 | 75.07 ± 8.75 | <0.001 |
MAP (mm Hg) | 81.45 ± 6.52 | 95.65 ± 6.81 | <0.001 |
PP (mm Hg) | 37.24 ± 9.60 | 49.94 ± 14.91 | <0.001 |
Changes in weight status from baseline to follow-up: | <0.001 | ||
Normal weight A and normal weight B | 624 (69.1) | 190 (51.1) * | |
Overweight/obesity A and normal weight B | 36 (4.0) | 14 (3.8) | |
Normal weight A and overweight/obesity B | 85 (9.4) | 47 (12.6) | |
Overweight/obesity A and overweight/obesity B | 158 (17.5) | 121 (32.5) * | |
Girls | |||
BMI categories: | <0.001 | ||
Normal weight | 681 (79.0) | 197 (67.2) * | |
Overweight | 147 (17.1) | 58 (19.8) | |
Obesity | 34 (3.9) | 38 (13.0) * | |
BMI categories: | <0.001 | ||
Normal weight | 681 (79.0) | 197 (67.2) * | |
Overweight/obesity | 181 (21.0) | 96 (32.8) * | |
WC percentile categories: | <0.001 | ||
<90th | 836 (97.0) | 264 (90.1) * | |
≥90th | 26 (3.0) | 29 (9.9) * | |
Age (years) | 12.04 ± 2.39 | 12.36 ± 2.58 | 0.152 |
Weight (kg) | 47.95 ± 12.91 | 53.63 ± 14.80 | <0.001 |
Height (cm) | 156.17 ± 11.48 | 158.54 ± 11.09 | 0.007 |
BMI (kg/m2) | 19.36 ± 3.54 | 21.05 ± 4.40 | <0.001 |
HC (cm) | 82.78 ± 10.26 | 87.02 ± 11.26 | <0.001 |
MUAC (cm) | 22.45 ± 2.58 | 23.72 ± 3.14 | <0.001 |
NC (cm) | 28.47 ± 2.24 | 29.40 ± 2.61 | <0.001 |
WC (cm) | 61.84 ± 8.43 | 65.73 ± 10.99 | <0.001 |
WrC (cm) | 14.07 ± 1.09 | 14.57 ± 1.27 | <0.001 |
BRI | 3.46 ± 0.73 | 3.61 ± 0.87 | 0.033 |
TMI (kg/m3) | 12.40 ± 2.08 | 13.28 ± 2.62 | <0.001 |
WHR | 0.75 ± 0.06 | 0.76 ± 0.07 | 0.291 |
WHtR | 0.40 ± 0.05 | 0.41 ± 0.07 | <0.001 |
SBP (mm Hg) | 102.45 ± 9.98 | 116.80 ± 10.25 | <0.001 |
DBP (mm Hg) | 67.69 ± 5.65 | 79.00 ± 6.76 | <0.001 |
MAP (mm Hg) | 82.01 ± 6.51 | 94.57 ± 5.73 | <0.001 |
PP (mm Hg) | 34.76 ± 8.48 | 37.80 ± 12.41 | 0.001 |
Changes in weight status from baseline to follow-up: | <0.001 | ||
Normal weight A and normal weight B | 647 (75.1) | 185 (63.1) * | |
Overweight/obesity A and normal weight B | 34 (3.9) | 12 (4.1) | |
Normal weight A and overweight/obesity B | 65 (7.5) | 27 (9.2) | |
Overweight/obesity A and overweight/obesity B | 116 (13.5) | 69 (23.6) * |
References
- NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in underweight and obesity from 1990 to 2022: A pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet 2024, 403, 1027–1050. [Google Scholar] [CrossRef] [PubMed]
- Tsiros, M.D.; Tian, E.J.; Shultz, S.P.; Olds, T.; Hills, A.P.; Duff, J.; Kumar, S. Obesity, the new childhood disability? An umbrella review on the association between adiposity and physical function. Obes. Rev. 2020, 21, e13121. [Google Scholar] [CrossRef] [PubMed]
- Lindberg, L.; Danielsson, P.; Persson, M.; Marcus, C.; Hagman, E. Association of childhood obesity with risk of early all-cause and cause-specific mortality: A Swedish prospective cohort study. PLoS Med. 2020, 17, e1003078. [Google Scholar] [CrossRef] [PubMed]
- Taghizadeh, S.; Abbasalizad-Farhangi, M.; Pourali, F.; Asghari-Jafarabadi, M. Predictors of Childhood High Blood Pressure among Overweight and Obese Children and Adolescents according to the Lifestyle-Scoring Algorithm Using Data from Iranian Health Care Reform Plan. Clin. Nutr. Res. 2021, 10, 243–256. [Google Scholar] [CrossRef] [PubMed]
- Huh, Y.; Park, H.S. Associations of overweight and obesity with cardiometabolic risk factor clusters among Korean adolescents. Sci. Rep. 2024, 14, 3581. [Google Scholar] [CrossRef] [PubMed]
- Cui, Y.; Zhang, F.; Wang, H.; Wu, J.; Zhang, D.; Xing, Y.; Shen, X. Children who appeared or remained overweight or obese predict a higher follow-up blood pressure and higher risk of hypertension: A 6-year longitudinal study in Yantai, China. Hypertens. Res. 2023, 46, 1840–1849. [Google Scholar] [CrossRef]
- Wang, X.; Dong, Y.; Huang, S.; Dong, B.; Ma, J.; Liang, W. Change of weight status during school age and its association with late adolescent blood pressure: Results from a 15-year longitudinal study in China. Front. Public Health 2022, 10, 980973. [Google Scholar] [CrossRef]
- Government of the Republic of Lithuania: Quarantine Announced throughout the Territory of the Republic of Lithuania (Attached Resolution) 2020. Available online: https://koronastop.lrv.lt/en/news/quarantine-announced-throughout-the-territory-of-the-republic-of-lithuania-attached-resolution-1 (accessed on 17 May 2024).
- Ministry of Education, Science and Sports. Quarantine Is Announced throughout Lithuania 2020. Available online: https://smsm.lrv.lt/lt/naujienos/svietimas-covid-19-salygomis/operaciju-vadovo-sprendimai/archyvas/ (accessed on 22 May 2024).
- Chang, T.H.; Chen, Y.C.; Chen, W.Y.; Chen, C.Y.; Hsu, W.Y.; Chou, Y.; Chang, Y.H. Weight Gain Associated with COVID-19 Lockdown in Children and Adolescents: A Systematic Review and Meta-Analysis. Nutrients 2021, 13, 3668. [Google Scholar] [CrossRef]
- Karatzi, K.; Poulia, K.A.; Papakonstantinou, E.; Zampelas, A. The Impact of Nutritional and Lifestyle Changes on Body Weight, Body Composition and Cardiometabolic Risk Factors in Children and Adolescents during the Pandemic of COVID-19: A Systematic Review. Children 2021, 8, 1130. [Google Scholar] [CrossRef]
- Nagata, J.M.; Yang, J.; Alsamman, S.; Al-Shoaibi, A.A.A.; Ganson, K.T.; Pettee Gabriel, K.; Baker, F.C. Higher blood pressure and weight observed among early adolescents during the COVID-19 pandemic. Am. J. Prev. Cardiol. 2023, 14, 100508. [Google Scholar] [CrossRef]
- Schefelker, J.; Zhang, X.; Dodge, A.; Marten, K.; Dimailig, G.; Bartlett, H.L.; Peterson, A.L. Impact of the COVID-19 pandemic on cardiometabolic health parameters in children with preexisting dyslipidemia. J. Clin. Lipidol. 2022, 16, 643–648. [Google Scholar] [CrossRef] [PubMed]
- Eckert, A.J.; Linke, S.; Schwab, K.O.; von dem Berge, T.; Schönau, E.; Duran, I.; Dost, A.; Joisten, C.; Bartelt, H.; Braune, K.; et al. Changes in cardiovascular risk factors among children and young adults with type 1 diabetes during the COVID-19 pandemic compared to previous years-Results from the German DPV registry. J. Diabetes 2023, 15, 15–26. [Google Scholar] [CrossRef] [PubMed]
- Ekström, S.; Andersson, N.; Kull, I.; Georgelis, A.; Ljungman, P.L.S.; Melén, E.; Bergström, A. Changes in lifestyle, adiposity, and cardiometabolic markers among young adults in Sweden during the COVID-19 pandemic. BMC Public Health 2023, 23, 1026. [Google Scholar] [CrossRef] [PubMed]
- Ramírez Manent, J.I.; Altisench Jané, B.; Sanchís Cortés, P.; Busquets-Cortés, C.; Arroyo Bote, S.; Masmiquel Comas, L.; López; González, Á.A. Impact of COVID-19 Lockdown on Anthropometric Variables, Blood Pressure, and Glucose and Lipid Profile in Healthy Adults: A before and after Pandemic Lockdown Longitudinal Study. Nutrients 2022, 14, 1237. [Google Scholar] [CrossRef]
- He, Z.; Zhang, Y.; Xu, X.; Mei, Y.; Rahmani, J.; Seraj, S.S.; Qi, X. COVID-19 Pandemic Impact on Cardiometabolic Markers in Adults in Chongqing, China: A Retrospective Cohort Study. Front. Public Health 2022, 10, 859488. [Google Scholar] [CrossRef]
- Zaborskis, A.; Petrauskiene, A.; Gradeckiene, S.; Vaitkaitiene, E.; Bartasiūte, V. Overweight and increased blood pressure in preschool-aged children. Medicina 2003, 39, 1200–1207. [Google Scholar]
- Kuciene, R.; Dulskiene, V. Associations between tri-ponderal mass index, body mass index, and high blood pressure among children and adolescents: A cross-sectional study. Sci. Rep. 2023, 13, 18148. [Google Scholar] [CrossRef]
- Stankute, I.; Dulskiene, V.; Kuciene, R. Associations between Neck Circumference, Mid-Upper Arm Circumference, Wrist Circumference, and High Blood Pressure among Lithuanian Children and Adolescents: A Cross-Sectional Study. Nutrients 2024, 16, 677. [Google Scholar] [CrossRef]
- Meaney, E.; Alva, F.; Moguel, R.; Meaney, A.; Alva, J.; Webel, R. Formula and nomogram for the sphygmomanometric calculation of the mean arterial pressure. Heart 2000, 84, 64. [Google Scholar] [CrossRef]
- Flynn, J.T.; Falkner, B.E. New Clinical Practice Guideline for the Management of High Blood Pressure in Children and Adolescents. Hypertension 2017, 70, 683–686. [Google Scholar] [CrossRef]
- Flynn, J.T.; Kaelber, D.C.; Baker-Smith, C.M.; Blowey, D.; Carroll, A.E.; Daniels, S.R.; de Ferranti, S.D.; Dionne, J.M.; Falkner, B.; Flinn, S.K.; et al. Subcommittee on Screening and Management of High Blood Pressure in Children. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics 2017, 140, e20171904. [Google Scholar] [CrossRef] [PubMed]
- Cole, T.J.; Bellizzi, M.C.; Flegal, K.M.; Dietz, W.H. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ 2000, 320, 1240–1243. [Google Scholar] [CrossRef] [PubMed]
- Fernández, J.R.; Redden, D.T.; Pietrobelli, A.; Allison, D.B. Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents. J. Pediatr. 2004, 145, 439–444. [Google Scholar] [CrossRef] [PubMed]
- Luordi, C.; Maddaloni, E.; Bizzarri, C.; Pedicelli, S.; Zampetti, S.; D’Onofrio, L.; Moretti, C.; Cappa, M.; Buzzetti, R. Wrist circumference is a biomarker of adipose tissue dysfunction and cardiovascular risk in children with obesity. J. Endocrinol. Investig. 2020, 43, 101–107. [Google Scholar] [CrossRef] [PubMed]
- Thomas, D.M.; Bredlau, C.; Bosy-Westphal, A.; Mueller, M.; Shen, W.; Gallagher, D.; Maeda, Y.; McDougall, A.; Peterson, C.M.; Ravussin, E.; et al. Relationships between body roundness with body fat and visceral adipose tissue emerging from a new geometrical model. Obesity Silver Spring 2013, 21, 2264–2271. [Google Scholar] [CrossRef]
- Iacopetta, D.; Catalano, A.; Ceramella, J.; Pellegrino, M.; Marra, M.; Scali, E.; Sinicropi, M.S.; Aquaro, S. The Ongoing Impact of COVID-19 on Pediatric Obesity. Pediatr. Rep. 2024, 16, 135–150. [Google Scholar] [CrossRef]
- Myette, R.L.; Flynn, J.T. The ongoing impact of obesity on childhood hypertension. Pediatr. Nephrol. 2024. [Google Scholar] [CrossRef]
- Qiu, N.; He, H.; Qiao, L.; Ding, Y.; Ji, S.; Guo, X.; Luo, J.; Luo, Z.; Li, Y.; Pang, H.; et al. Sex differences in changes in BMI and blood pressure in Chinese school-aged children during the COVID-19 quarantine. Int. J. Obes. 2021, 45, 2132–2136. [Google Scholar] [CrossRef]
- Song, K.; Jung, S.Y.; Yang, J.; Lee, H.S.; Kim, H.S.; Chae, H.W. Change in Prevalence of Hypertension among Korean Children and Adolescents during the Coronavirus Disease 2019 (COVID-19) Outbreak: A Population-Based Study. Children 2023, 10, 159. [Google Scholar] [CrossRef]
- Maltoni, G.; Zioutas, M.; Deiana, G.; Biserni, G.B.; Pession, A.; Zucchini, S. Gender differences in weight gain during lockdown due to COVID-19 pandemic in adolescents with obesity. Nutr. Metab. Cardiovasc. Dis. 2021, 31, 2181–2185. [Google Scholar] [CrossRef]
- Jarnig, G.; Jaunig, J.; Kerbl, R.; Strenger, V.; Haeusler, G.; van Poppel, M.N.M. Acceleration in BMI gain following COVID-19 restrictions. A longitudinal study with 7- to 10-year-old primary school children. Pediatr. Obes. 2022, 17, e12890. [Google Scholar] [CrossRef] [PubMed]
- Shalitin, S.; Phillip, M.; Yackobovitch-Gavan, M. Changes in body mass index in children and adolescents in Israel during the COVID-19 pandemic. Int. J. Obes. 2022, 46, 1160–1167. [Google Scholar] [CrossRef] [PubMed]
- Miregård, J.; Nowicka, P.; Nylander, C. National data showed an increased prevalence of overweight and obesity among four-year-old Swedish children during the first year of COVID-19. Acta Paediatr. 2023, 112, 1269–1274. [Google Scholar] [CrossRef] [PubMed]
- Long, X.; Li, X.Y.; Jiang, H.; Shen, L.D.; Zhang, L.F.; Pu, Z.; Gao, X.; Li, M. Impact of the COVID-19 kindergarten closure on overweight and obesity among 3- to 7-year-old children. World J. Pediatr. 2023, 19, 469–477. [Google Scholar] [CrossRef] [PubMed]
- Moliterno, P.; Donhauser, V.; Widhalm, K. Childhood Obesity Trends among 8-11-Year-Olds: Insights from a School Sample in Vienna, Austria (2017–2023). Children 2024, 11, 431. [Google Scholar] [CrossRef]
- Weaver, R.G.; Hunt, E.T.; Armstrong, B.; Beets, M.W.; Brazendale, K.; Turner-McGrievy, G.; Pate, R.R.; Youngstedt, S.D.; Dugger, R.; Parker, H.; 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, e161–e169. [Google Scholar] [CrossRef]
- Jenssen, B.P.; Kelly, M.K.; Powell, M.; Bouchelle, Z.; Mayne, S.L.; Fiks, A.G. COVID-19 and Changes in Child Obesity. Pediatrics 2021, 147, e2021050123. [Google Scholar] [CrossRef]
- Woolford, S.J.; Sidell, M.; Li, X.; Else, V.; Young, D.R.; Resnicow, K.; Koebnick, C. Changes in Body Mass Index Among Children and Adolescents During the COVID-19 Pandemic. JAMA 2021, 326, 1434–1436. [Google Scholar] [CrossRef]
- Azrak, M.Á.; Fasano, M.V.; Avico, A.J.; Sala, M.; Casado, C.; Padula, M.; Kruger, A.L.; Malpeli, A.; Andreoli, M.F. Prolonged body weight gain, lifestyle changes and health-related quality of life in children during the COVID-19 pandemic lockdown: A follow-up study. Eur. J. Clin. Nutr. 2023, 77, 460–467. [Google Scholar] [CrossRef]
- Hu, J.; Liu, J.; Wang, J.; Shen, M.; Ge, W.; Shen, H.; Zhang, T.; Yang, H.; Yin, J. Unfavorable progression of obesity in children and adolescents due to COVID-19 pandemic: A school-based survey in China. Obes. Silver Spring 2021, 29, 1907–1915. [Google Scholar] [CrossRef]
- Weihrauch-Blüher, S.; Huizinga, O.; Joisten, C.; Pflanz, J.; Torbahn, G.; Wiegand, S.; Holzapfel, C.; Hauner, H. Changes in Lifestyle and Body Weight in Children and Adolescents during the COVID-19 Pandemic: A Representative Survey of Parents in Germany. Obes. Facts. 2023, 16, 301–312. [Google Scholar] [CrossRef] [PubMed]
- Anderson, L.N.; Yoshida-Montezuma, Y.; Dewart, N.; Jalil, E.; Khattar, J.; De Rubeis, V.; Carsley, S.; Griffith, L.E.; Mbuagbaw, L. Obesity and weight change during the COVID-19 pandemic in children and adults: A systematic review and meta-analysis. Obes. Rev. 2023, 24, e13550. [Google Scholar] [CrossRef] [PubMed]
- Jha, S.; Mehendale, A.M. Increased Incidence of Obesity in Children and Adolescents Post-COVID-19 Pandemic: A Review Article. Cureus 2022, 14, e29348. [Google Scholar] [CrossRef] [PubMed]
- Vasile, C.M.; Padovani, P.; Rujinski, S.D.; Nicolosu, D.; Toma, C.; Turcu, A.A.; Cioboata, R. The Increase in Childhood Obesity and Its Association with Hypertension during Pandemics. J. Clin. Med. 2023, 12, 5909. [Google Scholar] [CrossRef] [PubMed]
- Piątkowska-Chmiel, I.; Krawiec, P.; Ziętara, K.J.; Pawłowski, P.; Samardakiewicz, M.; Pac-Kożuchowska, E.; Herbet, M. The Impact of Chronic Stress Related to COVID-19 on Eating Behaviors and the Risk of Obesity in Children and Adolescents. Nutrients 2023, 16, 54. [Google Scholar] [CrossRef]
- Yang, Y.D.; Xie, M.; Zeng, Y.; Yuan, S.; Tang, H.; Dong, Y.; Zou, Z.; Dong, B.; Wang, Z.; Ye, X.; et al. Impact of short-term change of adiposity on risk of high blood pressure in children: Results from a follow-up study in China. PLoS ONE 2021, 16, e0257144. [Google Scholar] [CrossRef]
- Parker, E.D.; Sinaiko, A.R.; Kharbanda, E.O.; Margolis, K.L.; Daley, M.F.; Trower, N.K.; Sherwood, N.E.; Greenspan, L.C.; Lo, J.C.; Magid, D.J.; et al. Change in Weight Status and Development of Hypertension. Pediatrics 2016, 137, e20151662. [Google Scholar] [CrossRef]
- Araújo, J.; Ramos, E.; Barros, H. Decreases in adiposity reduce the risk of hypertension: Results from a prospective cohort of adolescents. Prev. Med. 2019, 120, 1–7. [Google Scholar] [CrossRef]
- Suglia, S.F.; Clark, C.J.; Gary-Webb, T.L. Adolescent obesity, change in weight status, and hypertension: Racial/ethnic variations. Hypertension 2013, 61, 290–295. [Google Scholar] [CrossRef]
- Fan, H.; Zhu, Q.; Zhang, X. Child Excess Weight Status, Adult Excess Weight Status, and Cardiometabolic Risk Profile. Front. Pediatr. 2020, 8, 301. [Google Scholar] [CrossRef]
- El-Medany, A.Y.M.; Birch, L.; Hunt, L.P.; Matson, R.I.B.; Chong, A.H.W.; Beynon, R.; Hamilton-Shield, J.; Perry, R. What Change in Body Mass Index Is Required to Improve Cardiovascular Outcomes in Childhood and Adolescent Obesity through Lifestyle Interventions: A Meta-Regression. Child. Obes. 2020, 16, 449–478. [Google Scholar] [CrossRef] [PubMed]
- Warhadpande, M.; Sainz, K.; Jacobson, M.S. Effects of the COVID-19 Pandemic on Pediatric and Adolescent ASCVD Risk Factors. Curr. Atheroscler. Rep. 2023, 25, 591–596. [Google Scholar] [CrossRef] [PubMed]
Variables | Total (n = 2430) | Boys (n = 1275) | Girls (n = 1155) | p # |
---|---|---|---|---|
Characteristics in baseline study | ||||
BMI categories: | 0.002 | |||
Normal weight | 1870 (77.0) | 946 (74.2) | 924 (80.0) * | |
Overweight | 416 (17.1) | 240 (18.8) | 176 (15.2) * | |
Obesity | 144 (5.9) | 89 (7.0) | 55 (4.8) * | |
BMI categories: | 0.001 | |||
Normal weight | 1870 (77.0) | 946 (74.2) | 924 (80.0) * | |
Overweight/obesity | 560 (23.0) | 329 (25.8) | 231 (20.0) * | |
WC percentile categories: | 0.010 | |||
<90th | 2294 (94.4) | 1189 (93.3) | 1105 (95.7) * | |
≥90th | 136 (5.6) | 86 (6.7) | 50 (4.3) * | |
BP categories: | 0.014 | |||
NBP | 1854 (76.3) | 947 (74.3) | 907 (78.5) * | |
HBP | 576 (23.7) | 328 (25.7) | 248 (21.5) * | |
Age (years) | 10.40 ± 2.50 | 10.43 ± 2.48 | 10.36 ± 2.51 | 0.438 |
Weight (kg) | 41.24 ± 14.96 | 42.35 ± 15.88 | 40.03 ± 13.78 | 0.003 |
Height (cm) | 147.37 ± 16.00 | 148.45 ± 16.81 | 146.17 ± 14.96 | 0.011 |
BMI (kg/m2) | 18.39 ± 3.61 | 18.57 ± 3.67 | 18.19 ± 3.53 | 0.007 |
HC (cm) | 77.50 ± 10.92 | 78.08 ± 10.94 | 76.85 ± 10.86 | 0.008 |
MUAC (cm) | 21.58 ± 3.13 | 21.88 ± 3.26 | 21.25 ± 2.95 | <0.001 |
NC (cm) | 28.79 ± 6.83 | 29.56 ± 8.99 | 27.94 ± 2.75 | <0.001 |
WC (cm) | 62.12 ± 9.70 | 63.80 ± 10.30 | 60.27 ± 8.62 | <0.001 |
WrC (cm) | 14.08 ± 1.48 | 14.37 ± 1.54 | 13.77 ± 1.35 | <0.001 |
BRI | 4.12 ± 0.96 | 4.19 ± 0.96 | 4.05 ± 0.97 | <0.001 |
TMI (kg/m3) | 12.49 ± 2.11 | 12.53 ± 2.13 | 12.45 ± 2.08 | 0.327 |
WHR | 0.80 ± 0.07 | 0.82 ± 0.06 | 0.79 ± 0.07 | <0.001 |
WHtR | 0.42 ± 0.05 | 0.43 ± 0.05 | 0.41 ± 0.05 | <0.001 |
SBP (mm Hg) | 107.81 ± 12.51 | 108.70 ± 13.03 | 106.82 ± 11.85 | 0.002 |
DBP (mm Hg) | 62.23 ± 8.24 | 61.67 ± 8.23 | 62.84 ± 8.22 | <0.001 |
MAP (mm Hg) | 81.01 ± 8.65 | 81.05 ± 8.75 | 80.96 ± 8.55 | 0.860 |
PP (mm Hg) | 45.58 ± 11.05 | 47.03 ± 11.72 | 43.98 ± 10.04 | <0.001 |
Characteristics in follow-up study | ||||
BMI categories: | <0.001 | |||
Normal weight | 1742 (71.7) | 864 (67.8) | 878 (76.0) * | |
Overweight | 489 (20.1) | 284 (22.2) | 205 (17.7) * | |
Obesity | 199 (8.2) | 127 (10.0) | 72 (6.3) * | |
BMI categories: | <0.001 | |||
Normal weight | 1742 (71.7) | 864 (67.8) | 878 (76.0) * | |
Overweight/obesity | 688 (28.3) | 411 (32.2) | 277 (24.0) * | |
WC percentile categories: | <0.001 | |||
<90th | 2265 (93.2) | 1165 (91.4) | 1100 (95.2) * | |
≥90th | 165 (6.8) | 110 (8.6) | 55 (4.8) * | |
BP categories: | 0.035 | |||
NBP | 1765 (72.6) | 903 (70.8) | 862 (74.6) * | |
HBP | 665 (27.4) | 372 (29.2) | 293 (25.4) * | |
Age (years) | 12.15 ± 2.42 | 12.18 ± 2.39 | 12.12 ± 2.44 | 0.348 |
Weight (kg) | 51.50 ± 15.92 | 53.41 ± 17.52 | 49.39 ± 13.63 | <0.001 |
Height (cm) | 158.63 ± 13.65 | 160.32 ± 15.20 | 156.77 ± 11.43 | <0.001 |
BMI (kg/m2) | 20.06 ± 4.04 | 20.31 ± 4.19 | 19.79 ± 3.84 | 0.011 |
HC (cm) | 84.13 ± 11.03 | 84.38 ± 11.34 | 83.85 ± 10.68 | 0.701 |
MUAC (cm) | 23.22 ± 3.08 | 23.63 ± 3.28 | 22.77 ± 2.78 | <0.001 |
NC (cm) | 29.63 ± 2.92 | 30.46 ± 3.10 | 28.70 ± 2.37 | <0.001 |
WC (cm) | 65.63 ± 10.94 | 68.18 ± 11.67 | 62.82 ± 9.30 | <0.001 |
WrC (cm) | 14.61 ± 1.40 | 14.99 ± 1.49 | 14.19 ± 1.16 | <0.001 |
BRI | 3.60 ± 0.84 | 3.70 ± 0.89 | 3.50 ± 0.77 | <0.001 |
TMI (kg/m3) | 12.66 ± 2.34 | 12.69 ± 2.41 | 12.63 ± 2.26 | 0.979 |
WHR | 0.78 ± 0.07 | 0.81 ± 0.07 | 0.75 ± 0.07 | <0.001 |
WHtR | 0.41 ± 0.06 | 0.43 ± 0.06 | 0.40 ± 0.05 | <0.001 |
SBP (mm Hg) | 107.97 ± 13.39 | 109.67 ± 14.46 | 106.09 ± 11.83 | <0.001 |
DBP (mm Hg) | 69.59 ± 7.98 | 68.72 ± 8.12 | 70.56 ± 7.72 | <0.001 |
MAP (mm Hg) | 85.40 ± 8.83 | 85.59 ± 9.24 | 85.20 ± 8.36 | 0.664 |
PP (mm Hg) | 38.38 ± 11.74 | 40.95 ± 12.78 | 35.53 ± 9.71 | <0.001 |
Changes in weight status from baseline to follow-up: | <0.001 | |||
Normal weight A and normal weight B | 1646 (67.7) | 814 (63.8) | 832 (72.0) * | |
Overweight/obesity A and normal weight B | 96 (4.0) | 50 (3.9) | 46 (4.0) | |
Normal weight A and overweight/obesity B | 224 (9.2) | 132 (10.4) | 92 (8.0) * | |
Overweight/obesity A and overweight/obesity B | 464 (19.1) | 279 (21.9) | 185 (16.0) * |
Variables | Normal BP | HBP | p # |
---|---|---|---|
Characteristics in baseline study | |||
All participants | |||
BMI categories: | <0.001 | ||
Normal weight | 1518 (81.9) | 352 (61.1) * | |
Overweight | 262 (14.1) | 154 (26.7) * | |
Obesity | 74 (4.0) | 70 (12.2) * | |
BMI categories: | <0.001 | ||
Normal weight | 1518 (81.9) | 352 (61.1) * | |
Overweight/obesity | 336 (18.1) | 224 (38.9) * | |
WC percentile categories: | <0.001 | ||
<90th | 1789 (96.5) | 505 (87.7) * | |
≥90th | 65 (3.5) | 71 (12.3) * | |
Age (years) | 10.00 ± 2.31 | 11.70 ± 2.62 | <0.001 |
Weight (kg) | 37.98 ± 12.76 | 51.74 ± 16.63 | <0.001 |
Height (cm) | 144.56 ± 14.92 | 156.39 ± 16.02 | <0.001 |
BMI (kg/m2) | 17.68 ± 3.12 | 20.66 ± 4.10 | <0.001 |
HC (cm) | 75.04 ± 9.68 | 85.39 ± 10.95 | <0.001 |
MUAC (cm) | 20.90 ± 2.72 | 23.78 ± 3.35 | <0.001 |
NC (cm) | 28.21 ± 7.48 | 30.64 ± 3.51 | <0.001 |
WC (cm) | 60.07 ± 8.15 | 68.72 ± 11.22 | <0.001 |
WrC (cm) | 13.77 ± 1.32 | 15.09 ± 1.52 | <0.001 |
BRI | 4.15 ± 0.93 | 4.03 ± 1.06 | 0.001 |
TMI (kg/m3) | 12.26 ± 1.92 | 13.26 ± 2.48 | <0.001 |
WHR | 0.80 ± 0.07 | 0.80 ± 0.07 | 0.895 |
WHtR | 0.42 ± 0.05 | 0.44 ± 0.07 | <0.001 |
SBP (mm Hg) | 102.99 ± 8.87 | 123.31 ± 9.61 | <0.001 |
DBP (mm Hg) | 60.08 ± 6.94 | 69.14 ± 8.31 | <0.001 |
MAP (mm Hg) | 77.76 ± 6.43 | 91.46 ± 6.31 | <0.001 |
PP (mm Hg) | 42.91 ± 8.96 | 54.17 ± 12.67 | <0.001 |
Characteristics in follow-up study | |||
All participants | |||
BMI categories: | <0.001 | ||
Normal weight | 1341 (76.0) | 401 (60.3) * | |
Overweight | 331 (18.8) | 158 (23.8) * | |
Obesity | 93 (5.2) | 106 (15.9) * | |
BMI categories: | <0.001 | ||
Normal weight | 1341 (76.0) | 401 (60.3) * | |
Overweight/obesity | 424 (24.0) | 264 (39.7) * | |
WC percentile categories: | <0.001 | ||
<90th | 1688 (95.6) | 577 (86.8) * | |
≥90th | 77 (4.4) | 88 (13.2) * | |
Age (years) | 11.81 ± 2.26 | 13.06 ± 2.58 | <0.001 |
Weight (kg) | 47.98 ± 13.36 | 60.85 ± 18.23 | <0.001 |
Height (cm) | 156.34 ± 12.77 | 164.72 ± 14.05 | <0.001 |
BMI (kg/m2) | 19.32 ± 3.51 | 22.04 ± 4.65 | <0.001 |
HC (cm) | 81.97 ± 9.96 | 89.87 ± 11.66 | <0.001 |
MUAC (cm) | 22.60 ± 2.70 | 24.89 ± 3.42 | <0.001 |
NC (cm) | 29.02 ± 2.49 | 31.25 ± 3.31 | <0.001 |
WC (cm) | 63.57 ± 9.25 | 71.12 ± 13.01 | <0.001 |
WrC (cm) | 14.34 ± 1.25 | 15.33 ± 1.52 | <0.001 |
BRI | 3.60 ± 0.81 | 3.63 ± 0.93 | 0.846 |
TMI (kg/m3) | 12.38 ± 2.13 | 13.40 ± 2.68 | <0.001 |
WHR | 0.78 ± 0.07 | 0.79 ± 0.08 | 0.001 |
WHtR | 0.41 ± 0.05 | 0.43 ± 0.07 | <0.001 |
SBP (mm Hg) | 102.91 ± 10.08 | 121.39 ± 11.73 | <0.001 |
DBP (mm Hg) | 66.88 ± 5.98 | 76.80 ± 8.17 | <0.001 |
MAP mm Hg) | 81.72 ± 6.52 | 95.17 ± 6.38 | <0.001 |
PP (mm Hg) | 36.03 ± 9.15 | 44.59 ± 15.11 | 0.001 |
Changes in weight status from baseline to follow-up: | <0.001 | ||
Normal weight A and normal weight B | 1271 (72.0) | 375 (56.4) * | |
Overweight/obesity A and normal weight B | 70 (4.0) | 26 (3.9) | |
Normal weight A and overweight/obesity B | 150 (8.5) | 74 (11.1) * | |
Overweight/obesity A and overweight/obesity B | 274 (15.5) | 190 (28.6) * |
Variables | Boys | Girls | Total | |||
---|---|---|---|---|---|---|
OR (95% CI) | aOR1 (95% CI) | OR (95% CI) | aOR1 (95% CI) | OR (95% CI) | aOR2 (95% CI) | |
Changes in weight status from baseline to follow-up: | ||||||
Normal weight A and normal weight B | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
Overweight/obesity A and normal weight B | 1.28 (0.68–2.42) NS | 0.93 (0.46–1.90) NS | 1.23 (0.63–2.43) NS | 1.23 (0.63–2.44) NS | 1.26 (0.79–2.00) NS | 1.14 (0.70–1.85) NS |
Normal weight A and overweight/obesity B | 1.82 (1.23–2.69) | 2.40 (1.58–3.64) | 1.45 (0.90–2.34) NS | 1.53 (0.95–2.48) NS | 1.67 (1.24–2.26) | 1.95 (1.43–2.66) |
Overweight/obesity A and overweight/obesity B | 2.52 (1.89–3.35) | 3.13 (2.29–4.28) | 2.08 (1.48–2.92) | 2.13 (1.52–3.00) | 2.35 (1.89–2.92) | 2.58 (2.06–3.23) |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Stankute, I.; Dulskiene, V.; Kuciene, R. Associations between Changes in Body Weight Status and High Blood Pressure among Lithuanian Children and Adolescents during the COVID-19 Pandemic: A Retrospective Cohort Study. Nutrients 2024, 16, 3256. https://doi.org/10.3390/nu16193256
Stankute I, Dulskiene V, Kuciene R. Associations between Changes in Body Weight Status and High Blood Pressure among Lithuanian Children and Adolescents during the COVID-19 Pandemic: A Retrospective Cohort Study. Nutrients. 2024; 16(19):3256. https://doi.org/10.3390/nu16193256
Chicago/Turabian StyleStankute, Ieva, Virginija Dulskiene, and Renata Kuciene. 2024. "Associations between Changes in Body Weight Status and High Blood Pressure among Lithuanian Children and Adolescents during the COVID-19 Pandemic: A Retrospective Cohort Study" Nutrients 16, no. 19: 3256. https://doi.org/10.3390/nu16193256