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Effects of COVID-19 on Lifestyle Behaviors in Children with Obesity

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: closed (10 September 2022) | Viewed by 66687

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Special Issue Editors

Prof. Dr. Livio Luzi

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1. Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20122 Milano MI, Italy
2. Clinical Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS Multimedica, 20099 Sesto San Giovanni and Ospedale San Giuseppe, MIlano MI, Italy
Interests: obesity; diabetes; COVID-19; sports nutrition; exercise

Prof. Dr. Gianvincenzo Zuccotti

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Guest Editor

1. Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy
2. Department of Pediatrics, Buzzi Children’s Hospital, 20157 Milano, Italy
Interests: pediatric infectious diseases; pediatric nutrition; children; malnutrition; obesity; global health; telemedicine; digital health; preventive medicine; translational research
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Prof. Dr. Ileana Marina Terruzzi

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Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
Interests: nutraceuticals; nutrigenomics; functional nutrition; cell and tissue metabolism; oxidative stress; obesity; insulin resistance
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Dr. Anna Ferrulli

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1. Deptartment of Biomedical Sciences for Health, Università degli Studi di Milano, 20131 Milano, MI, Italy
2. Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS Multimedica, 20099 Sesto San Giovanni and Ospedale San Giuseppe, Milan, MI, Italy
Interests: obesity; type 2 diabetes; metabolic diseases; obesity treatment; neuromodulation; eating behaviour; cardiovascular diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Thirty-eight percent of the United States population is constituted by individuals with obesity. An increasing figure of obesity prevalence is also present in children and adolescents. Obesity, along with diabetes mellitus, is a predisposing factor for the development and for adverse outcomes of COVID-19. Conversely, infection with SARS-CoV-2 can induce diabetes mellitus and, potentially, also obesity in the long term, same as other viral infections. The bidirectional relationship between obesity/diabetes and SARS-CoV-2 infection may partially explain the appearance of “long COVID-19” syndrome and its related co-morbidities, such as cognitive dysfunction and cardiopulmonary diseases. In this Special Issue, we will unravel the bidirectional relationship between obesity and COVID-19 with a multidisciplinary editorial approach: Endocrinologists, pediatricians, nutritionists, and internists will cover several innovative COVID-19-related aspects of the respective scientific fields. The content of this special issue will cover: 1. Lifestyle behavioral changes during lockdown periods in children and adolescents; 2. Telemedicine and telehealth for the management of metabolic diseases during the COVID-19 pandemic; 3. Long COVID-19 syndrome: impact of obesity and diabetes; 4. Nutraceutical interventions for treating adipose tissue dysfunctions, systemic inflammation, and metabolic disturbances in SARS-CoV-2 infection; 5. Innate and adaptive immunity, obesity, and SARS-CoV-2 infection; 6. Novel treatments for obesity in the contest of COVID-19.

Prof. Dr. Livio Luzi
Prof. Dr. GianVincenzo Zuccotti
Dr. Ileana Marina Terruzzi
Dr. Anna Ferrulli
Guest Editors

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Keywords

obesity
COVID-19
children
nutrition
exercise
metabolic syndrome
telemedicine
brain stimulation

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Published Papers (10 papers)

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Editorial

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4 pages, 205 KiB

Open AccessEditorial

Editorial for the Special Issue “Effects of COVID-19 on Lifestyle Behaviors in Children with Obesity”

by Anna Ferrulli, Ileana Terruzzi, Gianvincenzo Zuccotti and Livio Luzi

Nutrients 2023, 15(12), 2652; https://doi.org/10.3390/nu15122652 - 7 Jun 2023

Viewed by 1106

Abstract

During the last four decades, the prevalence of obesity has increased dramatically worldwide; concomitantly, a progressive rise in the prevalence of obesity, diabetes, and other nutrition-related chronic diseases has also been observed in childhood [...] Full article

(This article belongs to the Special Issue Effects of COVID-19 on Lifestyle Behaviors in Children with Obesity)

Research

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16 pages, 508 KiB

Open AccessArticle

Body Mass and Emotional Eating: Emotional Eater Questionnaire (EEQ) in the Polish Adolescents’ COVID-19 Experience (PLACE-19) Study

by Dominika Skolmowska, Dominika Głąbska and Dominika Guzek

Nutrients 2022, 14(4), 828; https://doi.org/10.3390/nu14040828 - 16 Feb 2022

Cited by 18 | Viewed by 4985

Abstract

Stress caused by the Coronavirus Disease 2019 (COVID-19) pandemic may lead to emotional eating which may have a negative impact on the weight status. This study aimed to analyze the association between emotional eating and body mass, as well as changes in body mass during the COVID-19 pandemic, within the Polish Adolescents’ COVID-19 Experience (PLACE-19) Study. A total of 1126 Polish adolescents, aged 15–20, were included. A random quota sampling was performed within a national sample, and emotional eating was assessed using Emotional Eater Questionnaire (EEQ). Based on the declared height and weight before and during the pandemic, the respondents were categorized according to their body mass (malnourished, normal weight, overweight, obese) and changes in body mass during the COVID-19 pandemic (lost weight, no body mass change, gained weight). Higher EEQ scores were achieved by female respondents compared with males (p < 0.0001), respondents who stated that they gained weight during the pandemic compared with those who stated either weight loss or no body mass change (p < 0.0001), and overweight and obese respondents compared with those who had normal weight and who were malnourished (p < 0.0001). A higher share of emotional eaters and very emotional eaters was found among female respondents, respondents stating weight gain during the pandemic, and overweight and obese respondents, compared with the other ones (p < 0.0001). Based on the findings, it may be concluded that among Polish adolescents gender, body mass, and body mass change during the COVID-19 pandemic are the major determinants of emotional eating behaviors and that female individuals, obese individuals, and those gaining weight are especially vulnerable to emotional eating behaviors. The results of the study suggest that the issue of emotional eating should be addressed in general public health policy and appropriate education should be provided to vulnerable groups such as female and obese adolescents. Full article

(This article belongs to the Special Issue Effects of COVID-19 on Lifestyle Behaviors in Children with Obesity)

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10 pages, 2215 KiB

Open AccessArticle

Weight Gain Associated with COVID-19 Lockdown in Children and Adolescents: A Systematic Review and Meta-Analysis

by Tu-Hsuan Chang, Yu-Chin Chen, Wei-Yu Chen, Chun-Yu Chen, Wei-Yun Hsu, Yun Chou and Yi-Hsin Chang

Nutrients 2021, 13(10), 3668; https://doi.org/10.3390/nu13103668 - 19 Oct 2021

Cited by 146 | Viewed by 10743

Abstract

Background: Lockdown is an effective nonpharmaceutical intervention to reduce coronavirus disease 2019 (COVID-19) transmission, but it restricts daily activity. We aimed to investigate the impact of lockdown on pediatric body weight and body mass index (BMI). Methods: The systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. Four online databases (EMBASE, Medline, the Cochrane Library and CINAHL) were searched. Results: The pooled results showed that lockdown was associated with significant body weight gain (MD 2.67, 95% CI 2.12–3.23; p < 0.00001). The BMI of children with comorbidities or obesity did not change significantly. The BMI of general population was significantly higher during lockdown than before the pandemic (MD 0.94, 95% CI 0.32–1.56; p = 0.003). However, heterogeneity was high (I² = 84%). Among changes in weight classification, increases in the rates of obesity (OR 1.23, 95% CI 1.10–1.37; p = 0.0002) and overweight (OR 1.17, 95% CI 1.06–1.29; p = 0.001) were reported. Conclusions: Our meta-analysis showed significant increases in body weight and BMI during lockdown among school-age children and adolescents. The prevalence of obesity and overweight also increased. The COVID-19 pandemic worsened the burden of childhood obesity. Full article

(This article belongs to the Special Issue Effects of COVID-19 on Lifestyle Behaviors in Children with Obesity)

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12 pages, 946 KiB

Open AccessEditor’s ChoiceArticle

The Effects of COVID-19 on the Eating Habits of Children and Adolescents in Italy: A Pilot Survey Study

by Roberta Pujia, Yvelise Ferro, Samantha Maurotti, Janin Khoory, Carmine Gazzaruso, Arturo Pujia, Tiziana Montalcini and Elisa Mazza

Nutrients 2021, 13(8), 2641; https://doi.org/10.3390/nu13082641 - 30 Jul 2021

Cited by 67 | Viewed by 9819

Abstract

Nutrition during childhood and adolescence is very important for growth and can have long-term health implications. The COVID-19 lockdown caused significant changes in everyday life, including in children and adolescents. This study evaluated the effects of the first COVID-19 lockdown on eating habits and body weight in children and adolescents. An online cross-sectional survey was carried out among the parents of children (5–9 years) and adolescents (10–14 years) living in Italy. The online self-administered questionnaire included demographic and anthropometric data (reported weight and height) weight and dietary habit changes during the COVID-19 lockdown in Italy (March to June 2020). A total of 439 participants were included. We found a change in eating habits with an increase in consumption of sweet packaged snacks (34%) and processed meat (25%), as well as bread, pizza and bakery products (47%). We also found an increase in vegetable, fresh fruit and legume intake (19%), and a reduction in sweet beverage and candy intake. A total of 59.7% of the participants reported body weight gain, with adolescents gaining more than children (67% vs. 55%, p = 0.010, respectively). In children, body weight gain was associated with a change in body height and increased consumption of dairy products and sweet packaged snacks, while in adolescents it was associated with an increased intake of comfort foods and processed meat. Our data highlighted the need to carefully monitor eating behaviors to avoid the establishment of unhealthy eating habits and prevent obesity in children and adolescents during periods of self-isolation. Full article

(This article belongs to the Special Issue Effects of COVID-19 on Lifestyle Behaviors in Children with Obesity)

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Review

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17 pages, 356 KiB

Open AccessReview

The Effects of COVID-19 Pandemic and Lockdown on Pediatric Nutritional and Metabolic Diseases: A Narrative Review

by Maria Elena Capra, Brigida Stanyevic, Antonella Giudice, Delia Monopoli, Nicola Mattia Decarolis, Susanna Esposito and Giacomo Biasucci

Nutrients 2023, 15(1), 88; https://doi.org/10.3390/nu15010088 - 24 Dec 2022

Cited by 21 | Viewed by 4240

Abstract

SARS-CoV-2 was the first pathogen implied in a worldwide health emergency in the last decade. Containment measures have been adopted by various countries to try to stop infection spread. Children and adolescents have been less clinically involved by COVID-19, but the pandemic and consequent containment measures have had an important influence on the developmental ages. The COVID-19 pandemic and the subsequent lockdown periods have influenced the nutrition and lifestyles of children and adolescents, playing an epigenetic role in the development of nutrition and metabolic diseases in this delicate age group. The aim of our review is to investigate the effects of the COVID-19 pandemic on nutrition and metabolic diseases in the developmental ages. Moreover, we have analyzed the effect of different containment measures in children and adolescents. An increase in being overweight, obesity and type 2 diabetes mellitus has been detected. Concerning type 1 diabetes mellitus, although a validated mechanism possibly linking COVID-19 with new onset type 1 diabetes mellitus has not been yet demonstrated, barriers to the accessibility to healthcare services led to delayed diagnosis and more severe presentation of this disease. Further studies are needed to better investigate these relationships and to establish strategies to contain the nutritional and metabolic impact of new pandemics in the developmental ages. Full article

(This article belongs to the Special Issue Effects of COVID-19 on Lifestyle Behaviors in Children with Obesity)

12 pages, 293 KiB

Open AccessReview

Eating Habits and Body Weight Changes Induced by Variation in Smell and Taste in Patients with Previous SARS-CoV-2 Infection

by Anna Ferrulli, Pamela Senesi, Ileana Terruzzi and Livio Luzi

Nutrients 2022, 14(23), 5068; https://doi.org/10.3390/nu14235068 - 29 Nov 2022

Cited by 11 | Viewed by 3649

Abstract

Olfactory and gustatory dysfunction are recognized as common symptoms in patients with COVID-19, with a prevalence ranging, respectively, between 41–61% and 38.2–49%. This review focused on relating the variations in dietary habits with the reduction/loss of smell and/or taste in patients who contracted the COVID-19 infection. Primarily, we reviewed the main pathological mechanisms involved in COVID 19-induced anosmia/dysosmia and ageusia/dysgeusia. Then, we explored and summarized the behavioural changes in food intake and body weight during the COVID-19 pandemic in relation to sensory impairment and the underlying mechanisms. Most studies on this topic argue that the altered chemosensory perception (taste and smell) mainly induces reduced appetite, leading to a faster fullness sensation during the consumption of a meal and, therefore, to a decrease in body weight. On the other hand, a reduced perception of the food’s sensory properties may trigger compensatory responses that lead some individuals to increase food intake with a different effect on body weight. Regarding body weight, most studies evaluated malnutrition in patients hospitalized for COVID-19; more studies are warranted to investigate nutritional status specifically in non-hospitalized patients with olfactory and gustatory dysfunctions caused by COVID-19 infection. Full article

(This article belongs to the Special Issue Effects of COVID-19 on Lifestyle Behaviors in Children with Obesity)

21 pages, 1019 KiB

Open AccessReview

Immunonutrition and SARS-CoV-2 Infection in Children with Obesity

by Enza D’Auria, Valeria Calcaterra, Elvira Verduci, Michele Ghezzi, Rossella Lamberti, Sara Vizzuso, Paola Baldassarre, Erica Pendezza, Veronica Perico, Alessandra Bosetti and Gian Vincenzo Zuccotti

Nutrients 2022, 14(9), 1701; https://doi.org/10.3390/nu14091701 - 20 Apr 2022

Cited by 7 | Viewed by 3672

Abstract

Since the beginning of the SARS-CoV-2 pandemic, there has been much discussion about the role of diet and antiviral immunity in the context of SARS-CoV-2 infection. Intake levels of vitamins D, C, B12, and iron have been demonstrated to be correlated with lower COVID-19 incidence and mortality. Obesity has been demonstrated to be an independent risk for the severity of COVID-19 infection in adults and also in children. This may be due to different mechanisms, mainly including the gut dysbiosis status observed in obese children. Moreover, the existence of a gut–lung axis added new knowledge to on the potential mechanisms by which diet and dietary substances may affect immune function. The aim of this narrative review is to address the intricate inter-relationship between COVID-19, immune function, and obesity-related inflammation and to describe the role of nutrients and dietary patterns in enhancing the immune system. Two ways to fight against COVID-19 disease exist: one with an antiviral response through immune system boosting and another with antioxidants with an anti-inflammatory effect. In the current pandemic situation, the intake of a varied and balanced diet, rich in micronutrients and bioactive compounds including fibers, should be recommended. However, clinical studies conducted on children affected by SARS-CoV-2 infection and comorbidity are warranted. Full article

(This article belongs to the Special Issue Effects of COVID-19 on Lifestyle Behaviors in Children with Obesity)

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19 pages, 732 KiB

Open AccessReview

Combatting Sedentary Behaviors by Delivering Remote Physical Exercise in Children and Adolescents with Obesity in the COVID-19 Era: A Narrative Review

by Matteo Vandoni, Roberto Codella, Roberto Pippi, Vittoria Carnevale Pellino, Nicola Lovecchio, Luca Marin, Dario Silvestri, Alessandro Gatti, Vittoria Carlotta Magenes, Corrado Regalbuto, Valentina Fabiano, Gianvincenzo Zuccotti and Valeria Calcaterra

Nutrients 2021, 13(12), 4459; https://doi.org/10.3390/nu13124459 - 14 Dec 2021

Cited by 41 | Viewed by 9804

Abstract

The coexistence of childhood obesity (or its risk) and COVID-19 pandemic put children and adolescents in greater risk to develop respiratory and cardiovascular diseases. In fact, the restrictions introduced to limit the spread of the virus had detrimental effects on various lifestyle components, especially in young population. This resulted in augmented levels of physical inactivity and sedentary behaviors and a reduced time spent in play outdoors or sport practices. Contrariwise, the increased use of technology led clinicians, teachers, and trainers to maintain relations with obese children/adolescents so as to reduce sedentary behaviors and the associated health risks. This narrative review aims to describe the role of Telehealth and Tele-exercise as useful tools in the management of pediatric obesity during COVID-19 pandemic. Telehealth and Tele-exercise were effective in promoting self-monitoring and behavioral changes, including adherence to exercise training programs in children and adolescents. Moreover, tele-exercise platforms such as applications or exergames allowed flexible scheduling, limiting the infection risks. Full article

(This article belongs to the Special Issue Effects of COVID-19 on Lifestyle Behaviors in Children with Obesity)

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20 pages, 856 KiB

Open AccessFeature PaperReview

COVID-19 Pandemic as Risk Factors for Excessive Weight Gain in Pediatrics: The Role of Changes in Nutrition Behavior. A Narrative Review

by Hellas Cena, Lauren Fiechtner, Alessandra Vincenti, Vittoria Carlotta Magenes, Rachele De Giuseppe, Matteo Manuelli, Gian Vincenzo Zuccotti and Valeria Calcaterra

Nutrients 2021, 13(12), 4255; https://doi.org/10.3390/nu13124255 - 26 Nov 2021

Cited by 62 | Viewed by 6482

Abstract

During the coronavirus disease 2019 (COVID-19) pandemic, social isolation, semi-lockdown, and “stay at home” orders were imposed upon the population in the interest of infection control. This dramatically changes the daily routine of children and adolescents, with a large impact on lifestyle and wellbeing. Children with obesity have been shown to be at a higher risk of negative lifestyle changes and weight gain during lockdown. Obesity and COVID-19 negatively affect children and adolescents’ wellbeing, with adverse effects on psychophysical health, due in large part to food choices, snacking between meals, and comfort eating. Moreover, a markable decrease in physical activity levels and an increase in sedentary behavior is associated with weight gain, especially in children with excessive weight. In addition, obesity is the most common comorbidity in severe cases of COVID-19, suggesting that immune dysregulation, metabolic unbalance, inadequate nutritional status, and dysbiosis are key factors in the complex mechanistic and clinical interplay between obesity and COVID-19. This narrative review aims to describe the most up-to-date evidence on the clinical characteristics of COVID-19 in children and adolescents, focusing on the role of excessive weight and weight gain in pediatrics. The COVID-19 pandemic has taught us that nutrition education interventions, access to healthy food, as well as family nutrition counselling should be covered by pediatric services to prevent obesity, which worsens disease outcomes related to COVID-19 infection. Full article

(This article belongs to the Special Issue Effects of COVID-19 on Lifestyle Behaviors in Children with Obesity)

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24 pages, 2184 KiB

Open AccessReview

Telehealth: A Useful Tool for the Management of Nutrition and Exercise Programs in Pediatric Obesity in the COVID-19 Era

by Valeria Calcaterra, Elvira Verduci, Matteo Vandoni, Virginia Rossi, Elisabetta Di Profio, Vittoria Carnevale Pellino, Valeria Tranfaglia, Martina Chiara Pascuzzi, Barbara Borsani, Alessandra Bosetti and Gianvincenzo Zuccotti

Nutrients 2021, 13(11), 3689; https://doi.org/10.3390/nu13113689 - 20 Oct 2021

Cited by 44 | Viewed by 10315

Abstract

The COVID-19 pandemic has led to the implementation of policies that mandate various restrictions on daily life, including social distancing, the closure of public services and schools, and movement limitations. Even though these restrictive measures decreased the COVID-19 spread, they may have detrimental effects on various lifestyle components such as physical inactivity, sedentary behavior, and dietary habits, influencing the maintenance of weight and contributing to obesity among children and adolescents. The coexistence of childhood obesity and COVID-19 and changes in the bioecological environment have put children and adolescents at increased risk for developing obesity and exacerbating the severity of this disorder. The use of telehealth technology is a modern approach useful for the delivery of health care services by health care professionals, where distance is a critical factor. Telehealth is effective in promoting increased self-monitoring and behavioral change, and provides the opportunity to perform online nutritional support and exercise training programs to promote a healthy lifestyle and reduce sedentary behaviors in children and adolescents. Telehealth, including tele-exercise and tele-nutrition, has the potential to address many of the key challenges in providing health services, including in patients with obesity during the COVID-19 outbreak. This narrative review aims to describe the role of telehealth as an opportunity in the management of pediatric obesity in the COVID-19 era, and to deliver nutrition and exercise programs for the maintenance of health. Full article

(This article belongs to the Special Issue Effects of COVID-19 on Lifestyle Behaviors in Children with Obesity)

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