Gender differences in weight gain during lockdown due to COVID-19 pandemic in adolescents with obesity

doi:10.1016/j.numecd.2021.03.018

Nutrition, Metabolism and Cardiovascular Diseases

Volume 31, Issue 7, 30 June 2021, Pages 2181-2185

https://doi.org/10.1016/j.numecd.2021.03.018 Get rights and content

Highlights

•
Obese adolescents gained weight during lockdown due to pandemic.
•
Male obese adolescents spent more hours in sedentary activities and therefore were more harmed than females.
•
Decreased mild physical activity and increased hours spent in sedentary behaviour were the most responsible for weight gain.
•
Diet was only minimally responsible for weight increase during lockdown.

Abstract

Background and aim

Lockdown due to COVID-19 pandemic has forced a decrease in physical activity (PA), an increase in sedentary behavior (SB) and a possibly worsening of fat accumulation in already obese subjects.

The aim of this study was to investigate how social restriction may have contributed to weight changes in adolescents with obesity. Secondary aim was to evaluate possible parameters influencing weight changes.

Methods and results

Parameters of 51 obese adolescents were compared between two visits: within 2 months before 8 March, start of lockdown, and within 40 days after the end of it.

Results

Mean weight gain during lockdown was 2.8 ± 3.7 kg (p < 0.001). Weight increase was higher in males than in females (3.8 ± 3.4 kg vs 1.2 ± 3.7 kg, p = 0.02). The hours dedicated to SB increased (+2.9 ± 2.8 h/day; p < 0.001) while the hours of PA decreased (−1.0 ± 1.6 h/week; p < 0.001). Males spent more hours in SB than females (+3.8 ± 2.7 h/day vs +1.5 ± 2.5 h/day; p = 0.003). There were minor changes in diet during lockdown. The most significant variables influencing both delta BMI and waist/height ratio increase were hours devoted to SB during lockdown and differences in mild and moderate PA before and after lockdown.

Conclusions

Obese adolescents showed a worsening of obesity during lockdown, with males mainly affected, mainly due to a reduced mild PA and increased hours spent in SB.

Introduction

Containment strategies due to Coronavirus disease 2019 (COVID-19) have led to a consistent decrease in physical activity (PA) worldwide. In schoolchildren, the social restrictions consistently limited the opportunities for PA (considered as both sport activities and school-based PA, including walking to/from school) and social life, disrupting daily schedules. The studies led in paediatric patients, showed that retail and recreational mobility were reduced by 73.4%, while parks mobility by 46.3% [1]. As a whole, most studies performed during the COVID-19 pandemic observed a global reduction in PA in children and adolescents with a parallel increase in sedentary behavior (SB) [2]: the disproportion between caloric intake and calories consumed inevitably caused fat storage and BMI increase. It has been described that 48.6% of patients gained weight during lockdown [3]. Regular PA has well-known beneﬁts in health and has demonstrated to be effective in decreasing CV risk in general and mortality [4]. By contrast, SB has the opposite effect, counteracting the beneﬁts of PA [5].

It is known that almost 25% of the paediatric population is overweight, and according to WHO criteria, 4.3% is severely obese [6]. Other factors that can determine weight gain are the family and socio-economic background, the presence of obesity during adolescence, especially if obesity is severe, and the number of meals eaten in the family [7,8]. Finally, lockdown, started in Italy on 8th March 2020, could have been a facilitator of internet addiction, and with it addiction to online videogames [9].

Primary aim of our study was to investigate how social restriction may have contributed to BMI and waist/height ratio changes in a group of obese adolescents, focusing on the differences between males and females. Secondary aim was to evaluate which parameters had a major impact on possible weight gain.

Section snippets

Patients

Patients followed-up in our outpatient clinic dedicated to obesity were consecutively asked to participate to the study.

Inclusion criteria were: age between 10 and 18 years, primary obesity, normal glucose, HbA1c and TSH levels, availability of two consecutive follow-up visits: the first had to be prior to 8th March 2020 and within the previous 2 months. Patients were recalled for the second visit starting from the end of lockdown on 18th May 2020 to the end of June 2020. Exclusion criteria

Results

Fifty-one patients (31 males, 20 females) were examined. Mean age was 14.7 ± 2.1 years (males 14.8 ± 2.0 years, females 14.6 ± 2.3 years). Mean height was 168.3 ± 9.7 cm in males and 159.5 ± 7.4 cm in females, mean weight 93.8 ± 16.0 kg in males and 81.1 ± 10.8 kg in females. Table 1 shows anthropometric characteristics of the population. As shown, male patients showed a higher waist/height ratio than females. As for diet changes, male patients declared to have changed their diet in a higher

Discussion

Our study showed that during the lockdown period, our sample of obese adolescents gained weight mainly because they reduced the hours of mild PA and increased the hours dedicated to SB. This was particularly true for male patients, who showed a gain weight three times higher than the female patients and spent more than the twice the time in SB. The natural consequence of the lockdown, occurring also in Italy starting from 8th March, was the significant reduction in the mobility of people: it

Declaration of competing interest

The authors have nothing to disclose.

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© 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Short CommunicationGender differences in weight gain during lockdown due to COVID-19 pandemic in adolescents with obesity

Highlights

Abstract

Background and aim

Methods and results

Results

Conclusions

Introduction

Section snippets

Patients

Results

Discussion

Declaration of competing interest

Child Youth Serv Rev

Prog Cardiovasc Dis

Am JClin Nutr

Psychiatr Res

Nutr Res

J Pediatr

COVID-19: is there a role for immunonutrition in obese patient?

J Transl Med

The association between physical activity and chronic diseases in European adults

Eur J Sport Sci

Prevalence of severe obesity among primary school children in 21 European countries

Obes Facts

Short Communication
Gender differences in weight gain during lockdown due to COVID-19 pandemic in adolescents with obesity