The kids aren't alright: COVID-fueled stress eating, inequities, lack of fitness expected to boost obesity, experts say
Pediatricians and public health experts predict a potentially dramatic increase in childhood obesity this year as months of pandemic eating, closed schools, stalled sports and public space restrictions extendindefinitely.
About one in seven children have met the criteria for childhood obesity since 2016, when the federal National Survey of Children's Healthchanged its methodology, a report out Wednesday by the Robert Wood Johnson Foundation found.
罗伯特·伍德·约翰逊基金会(Robert Wood Johnson Foundation)周三发布的一份报告发现，自2016年联邦全国儿童健康调查改变方法以来，约有七分之一的儿童达到了儿童肥胖的标准。
While the percentage of children considered obese declined slightly in the last 10 years, it isexpected to jump in 2020.
"We were making slow and steady progress until this,"said Diane Whitmore Schanzenbach, a Northwestern University economist and professor. "It's likely we will have wiped out a lot of the progress that we've made over the last decade in childhood obesity."
西北大学(Northwest University)经济学家兼教授Diane Whitmore Schanzenbach表示：“在此之前，我们一直在缓慢而稳定地取得进展。”“我们很可能已经抹去了过去十年来在儿童肥胖问题上取得的很多进展。”
Thetrend,already seen in pediatricoffices, is especially concerning as the Centers for Disease Control and Prevention this week expanded its definition of those at elevated risk of severe COVID-19 disease and death to include people with a body mass index of between 25 and 30. Previously, only those with a BMI 30 and higher were included. That couldmean 72% of all Americans are at higher risk of severe disease based only on their weight.
Obesity is a top risk factorfornearly all of the chronic health conditions that make COVID-19 more dangerous, including diabetes, hypertension. heart disease and cancer.And childhood obesity is a leading predictor of obesity later in life.
BMI factors in weight and height to measurebody fat.It can, however, overestimate body fat in people with muscular builds and underestimate it in thosewho have lost muscle, according to the National Institutes of Health.
美国国立卫生研究院(National Institutes Of Health)表示，BMI是衡量身体脂肪的体重和身高因素。然而，它可能高估肌肉身材的人的体脂，而低估那些失去肌肉的人的体脂。
Children are "gaining not insignificant amounts of weight," said Dr. Lisa Denike, who chairs pediatrics for Northwest Permanente in Portland, Oregon. "We've seen kids gain 10 to 20 pounds in a year, who may have had a BMI as a preteen in the 50 or 75th percentile and are now in the 95th percentile. That'sa significant crossing of percentiles into obesity."
俄勒冈州波特兰市西北永久医院(Northwest Permanente)儿科主任丽莎·德尼克(Lisa Denike)博士说，孩子们“体重增加的程度并不是微不足道的”。“我们已经看到孩子们在一年内增加了10到20磅，他们在青少年时期的BMI可能在50或75个百分位数，现在在95个百分位数。这是一个重要的百分位数进入肥胖症的阶段。”
Denike said one 11-year-old patient at his recent physical was found to havegained 40 pounds. Type 2diabetes rates in children are rising, and even though the boy doesn't have it now, Denike said, "I suspect he will in the coming years as his parents already have it."
"He's home in an environment struggling with parentswith same issues rather than learning in health class and having activity outside," she said. "Kids are reflections of what their parents do."
Racial, socioeconomic disparities
Disparities in childhood obesity rates have existed for decades and now mirror the disproportionate wayCOVID-19 is affectingpeople of color and thosewith low incomes, saidJamie Bussel, a senior program officer at the Robert Wood Johnson Foundation.
“In both cases, these outcomes reflect decades of disinvestment in specific communities and specific groups of people, often driven by the systemic racism and discrimination that are still so prevalent in our society,” he said.
Young people in households making less than the federal poverty level are more than twice as likely to be obese asthose at the highest income levels, the RWJF report said.The pandemic and ongoing economic recession made many of thefactors leading to obesity worse, includingpoverty and health disparities, said Bussel.
"We know that families switch to lower quality food when they face food insecurity – that is, more calorie-dense foods and less variety," said Schanzenbach.
Childhood obesity ranges from 11% in the highest income families to about 20% in low to middle-income ones, said Dacones. That contributes to higher obesity rates in Black and Hispanic populations, which include more people at lower income levels. In California, for example, she notedthenumber of people classified as food insecure increased from one in nine to one in six.
A July report by Northwestern University researchers found more than 41% of Black households with children experienced food insecuritybetween April 23 andJune 23 , compared to just under 40% of Hispanic households and just over 23% of white ones. The rates have declined for Blacks and Hispanic familiessince then but remained unchanged for white families.
"Even though it's not as bad as it was during the peak of the pandemic, food insecurity rates are still awful," saidSchanzenbach.
Poor fitness, eating disorders grow
Those who study food insecurity, mental health and fitness say trends already heading in the wrong direction are especially alarming now.
Jim Baugh is founder and president of PHIT America, which circulated a petition startingin August to require30 minutes of recess at least three times a week for all students. He notes nearly half of grade schools have no physical education and"kids are more sedentary than they've ever been." The U.S. ranks 47th out of 50 countries in the world in children's fitness.
吉姆·鲍格(Jim Baugh)是PHIT America的创始人兼总裁，该组织从8月开始散发请愿书，要求所有学生每周至少休息三次，休息时间不少于30分钟。他指出，近一半的小学没有体育课，“孩子们比以往任何时候都更久坐不动。”在世界50个国家中，美国在儿童健身方面排名第47位。
University of Virginia School of Medicine researcher Dr. Zhen Yan has studiedexercise’s role in curbing the effects of COVID-19and agreesmore effort needs to be made to increase activity during childhood.
“If we want to protect our kids from deadly COVID-19, we must increase their physical activity and get them healthier," said Yan. "Too many kids already have pre-existing conditions such as obesity.”
Young adults who have experienced weight stigma and mistreatment are more prone to"increased vulnerability to distress" and bad eating habits during the pandemic, University of Connecticut researchers concluded in a study in the Annals of Behavioral Medicine.The likelihood of binge eating during the pandemic was almost threetimes higher for people who had experienced weight stigma beforethe pandemic than those who hadn’t. The findings were true for men and women.
Denike said the "mental health crisis" that existed before the pandemic has heightened and contributed to an increased number of eating disorder patients.
Young people at risk of eating disorders "seek areas to control during stressful times," said Denike. They have a "limited menu of options"as children, she said, so restricting or overindulging in food is convenient.
With far more people feeling distress during social isolation, there's more risk for people who"had some tendency to use food for not so good things,"said Dr. Imelda Dacones, NorthwestPermanente's CEO. "It's driving kids as well as adults to do more unhealthy things."
The National Eating Disorder Association said it's seen nearly 80%increases in monthly callsand online chats during the pandemic compared to the same months last year.
Social isolation hasn't changed much for Tierney Sadler, a work-at-home marketing writer in Alexandria, Virginia, who said she is "morbidly obese" andabout 100 pounds over the weight she should be. But she can easily identify with kids struggling today as her childhood weight problems were a constant focus of her family and source of stress, which only made her eat more, she said.
"It was never going to be good enough and I couldn’t shake that," said Sadler, 57, who was on a diet in kindergarten. "Obese kids have a lot of company today, but back in the '60s, if you were the one fat kid, it really kind of does a number on you."
Parents can help, however, she said, by shielding children from household stress.
"Food is one of the ways we comfort ourselves," said Sadler. "There are a lot of thingschildren absorb from their parents, who may be unemployed and terrified of the whole COVID thing. Their pores are so wide, they cansuck in all that negative energy."