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COVID-19 school closings drive risk for weight gain, unhealthy behaviors among children

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Andrew Rundle



Throughout the United States and around the world, the COVID-19 pandemic has led to closed schools, with many districts now indicating closures could last through at least the remainder of the 2019-2020 academic year. The closings of schools — many of which provide free or discounted breakfast and lunch for some students — is likely to exacerbate the problem of pediatric obesity and lead to an unprecedented increase in food insecurity among families, and researchers are only beginning to evaluate the potential health consequences.

Healio spoke with Andrew Rundle, DrPH, an associate professor of epidemiology at Columbia University Mailman School of Public Health, about factors that increase obesity risk during a mandated school closure, heightened food insecurity during a pandemic and the need to get creative about physical activity. Rundle and colleagues’ article on mandated school closings and risk for weight gain among children was published this week in Obesity.

What led you and your colleagues to publish this piece?

Rundle: It started as a conversation over breakfast. The second author of our article, Yoosun Park, PhD, MSW, an associate professor at Smith College School for Social Work, is my spouse. We were discussing how, in the grocery stores, all the high-calorie snack foods were being wiped off the shelves. We thought produce availability would be a problem. Yet the produce section was full, and the ice cream section was empty. The Oreo cookie section was empty. It reminded us of that period between Thanksgiving and Christmas — a short, defined period of time where some people tend to indulge. Yet this situation could go on for 6 months, and not just a few weeks.

I have conducted research on obesity and behavioral changes during summer that put kids at risk for unhealthy weight gain. Essentially, every one of those risk factors have been magnified, and this period is going to last twice as long as your average summer recess.

Throughout the United States and around the world, the COVID-19 pandemic has led to closed schools, with many districts now indicating closures could last through at least the remainder of the 2019-2020 academic year. Source: Adobe Stock

You wrote that the COVID-19 pandemic exacerbates all the risk factors for weight gain associated with summer recess. Can you go over some of the challenges?

Rundle: The literature on what happens during summer break is still fairly young. That said, what we think is happening is this unstructured time is ripe for snacking and mindless — or not mindful — eating behaviors. There has been some literature on the link between screen time and sedentary behavior. Sitting in a math class is not particularly challenging in terms of physical activity; however, it seems that during the summer, we see greater amounts of screen time and greater snacking, and less mindfulness around eating vs. the fixed, regimented school day. This idea of unstructured time is an issue, and that is magnified now. Kids cannot go out and play outdoors in many cities. If you look at user statistics on online gaming, they are going through the roof.

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Our gut told us that Oreo cookie and potato chip supplies were getting wiped out, and when we started looking at publications in the trade magazines, our gut instinct was backed up by trade magazine data. People are loading up on high energy-dense foods. In a way, this makes sense: People want shelf-stable foods. Now we have this perfect storm — our pantries are stocked with these items, our children cannot get out and be active, gaming and snacking is likely to go up, and parents struggle to do their jobs remotely and are inclined to put their children in front of a video game just so they can get a Zoom meeting done. All of that magnifies the behavioral risk factors we think about as being part of the summer weight gain story.

Let’s talk specifically about food insecurity. First, can you define what that term means and how food insecurity is worsened by this pandemic?

Rundle: Food security means that families or individuals have limited or uncertain access to enough food for a healthy or active lifestyle. Food insecure people are classically people receiving Supplemental Nutrition Assistance Program (SNAP) benefits. Millions of children receive free or reduced-price school lunch and breakfast. Now that has been taken away from many children, and parents are struggling to find meals for their children. On top of that, you have all of the additional people who are financially stressed because they lost their jobs and they are going to be looking for food safety net programs. Some schools are doing really innovative things, like summer programs for lunches that they are extending, but, some schools do not have programs like that or are not ready to scale these programs 2 months early. You need staffing, you need logistics. Some schools are running school buses on the regular routes, employing their bus drivers to run their usual routes and instead drop off food to children. You’re seeing all of these innovative ideas in certain places, but without a state or national level game plan.

As part of the Families First Coronavirus Act, additional value was added to SNAP benefits, which are roughly $114 per child per month. Many families will go out and do a big shop after the SNAP benefit is released, and our stores are not necessarily geared up to be fully stocked on those release dates. Some have tried to start a movement online, asking people to not buy food on the first through the third days of the month, when social media posts state that SNAP benefits are typically released. However, the thing is states vary on what day they release SNAP benefits and how long the benefit cycle is. At the moment, we are cataloging every SNAP program in the country and building mapping tools, so you can see in each state when SNAP benefits are released.

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Food insecurity research suggests that food insecure kids are more at risk for unhealthy weight gain. Our fear is the COVID-19 pandemic has made the situation worse for people already insecure, and now additional people will become food insecure because of the economic devastation.

What are some ways to mitigate the challenges that predispose children to weight gain during this time?

Rundle: A lot of schools are sending home workbooks or conducting distance learning online; however, let’s not forget health classes and physical education classes. What is available for families across the country varies. If a family lives in a tiny apartment in the Washington Heights section of New York City, as an example, your options to be physically active are really low. Your neighbor’s ceiling is your floor. A suburban family with a backyard has many more options for physical activity.

We tend to think about weight gain as a result of energy imbalance — energy in, energy out. If the “energy out” part of that equation has shrunk, think about the energy in. Limit snacking while gaming, limit sugary beverages, which provide lots of calories but do not give you a feeling of satiety. No one can be perfect; there is no silver bullet for this. If it is impossible to be active, the focus should be on diminishing snacking or sugary beverage consumption.

What is the most important takeaway for families?

Rundle: While we’re calling attention to risk for unhealthy weight gain, the No. 1 message is that we must focus on social distancing to beat COVID-19 and stay safe. That is the immediate message: Social distancing is what we must do. Optimization of that, for children, means keeping in mind that this will likely mean a 6-month period that mirrors what we see in the summer, when risk for weight gain may be magnified. – by Regina Schaffer

Reference:

Rundle AG, et al. Obesity. 2020; doi:10.1002/OBY.22813.

Disclosures: Rundle reports no relevant financial disclosures.