Childhood Obesity and COVID-19 Lockdown: Remarks on Eating Habits of Patients Enrolled in a Food-Education Program

Childhood obesity is a worldwide health emergency. In many cases, it is directly linked to inappropriate eating habits and a sedentary lifestyle. During lockdown aimed at containing the coronavirus disease (COVID-19) spread, children have been forced to stay at home. The present study aimed at investigating the lifestyles of outpatients (aged 5–17 years) with complicated obesity enrolled in the day-hospital food education program at the Children’s Hospital Bambino Gesù in Rome. A survey was performed based on a structured questionnaire, investigating dietary habits and lifestyles. The questionnaire answers were rated as “yes/no/sometimes” or “often/never/sometimes”. Eighty-eight families correctly completed the questionnaire between March and May 2020. The results highlighted that 85.2% (N = 75) of the patients ate breakfast regularly, and 64.3% (N = 72) consumed fruit as an afternoon snack. However, 21.6% (N = 19) did just “often” home workouts, and 50.0% (N = 44) reported an increase of feeling hungry with “sometimes” frequency. There is a significant relationship of feeling hungry with gender (p < 0.0001) and age (p = 0.048) and, also, between gender with having breakfast (p = 0.020) and cooking (p = 0.006). Living a healthy lifestyle during lockdown was difficult for the outpatients, mainly due to the increase in a sedentary lifestyle and the increase in feeling hungry, but some healthy eating habits were maintained, as advised during the food education program provided before lockdown

Childhood Obesity and COVID-19 Lockdown: Remarks on Eating Habits of Patients Enrolled in a Food-Education Program

Childhood obesity is a worldwide health emergency. In many cases, it is directly linked to inappropriate eating habits and a sedentary lifestyle. During lockdown aimed at containing the coronavirus disease (COVID-19) spread, children have been forced to stay at home. The present study aimed at investigating the lifestyles of outpatients (aged 5–17 years) with complicated obesity enrolled in the day-hospital food education program at the Children’s Hospital Bambino Gesù in Rome. A survey was performed based on a structured questionnaire, investigating dietary habits and lifestyles. The questionnaire answers were rated as “yes/no/sometimes” or “often/never/sometimes”. Eighty-eight families correctly completed the questionnaire between March and May 2020. The results highlighted that 85.2% (N = 75) of the patients ate breakfast regularly, and 64.3% (N = 72) consumed fruit as an afternoon snack. However, 21.6% (N = 19) did just “often” home workouts, and 50.0% (N = 44) reported an increase of feeling hungry with “sometimes” frequency. There is a significant relationship of feeling hungry with gender (p p = 0.048) and, also, between gender with having breakfast (p = 0.020) and cooking (p = 0.006). Living a healthy lifestyle during lockdown was difficult for the outpatients, mainly due to the increase in a sedentary lifestyle and the increase in feeling hungry, but some healthy eating habits were maintained, as advised during the food education program provided before lockdown

Insulin sensitivity from preschool to school age in patients with severe obesity.

BACKGROUND: Insulin sensitivity decreases at puberty transition, but little information has been provided on its earlier time-course. Aim of the present study was to describe the time-course of insulin sensitivity in severely obese children at the transition from preschool to school age. RESEARCH DESIGN AND METHODS: Retrospective study of a cohort of 47 severely obese [Body Mass Index (BMI) ≥99° percentile] preschoolers evaluated twice, once between 2 and 6 years of age, and once before age 8. Glucose tolerance, Whole Body Insulin Sensitivity Index (WBISI), Insulinogenic Index (IGI); β-cell demand index (BCDI) and Insulin Secretion-Sensitivity Index 2 (ISSI-2) were longitudinally estimated during the oral glucose tolerance test. RESULTS: After a median follow-up of 2.23 (1-4.52) y, obese patients showed significant decrease in WBISI (p<0.0001), and increase in fasting (p = 0.005) and 2 h glucose (2HG, p = 0.001). One child in preschool age and 4 school age children presented with 2HG between 7.8-11.1 mmol/l. Best predictors of WBISI, 2HG and BCDI in the school age were changes in BMI z-score (R(2) = 0.309; p = 0.002; β = -0.556), ISSI-2 (R(2) = 0.465; p<0.0001; β = -0.682), and BMI z-score (R(2) = 0.246; p = 0.008; 0.496), respectively. CONCLUSIONS: In morbidly obese children, insulin sensitivity seems to decline even before pubertal transition, but changes in total adiposity can only partially explain this variation

Relationship between percent changes in Whole Body Insulin Sensitivity Index (WBISI) and in BMI-z score (y = −0.6622x–11.194).

<p>Relationship between percent changes in Whole Body Insulin Sensitivity Index (WBISI) and in BMI-z score (y = −0.6622x–11.194).</p

Mean values of Whole Body Insulin sensitivity (WBISI) by years of age in preschoolers and school age obese children.

<p>Mean values of Whole Body Insulin sensitivity (WBISI) by years of age in preschoolers and school age obese children.</p

Correlation analysis for age-adjusted WBISI in preschool and school age obese patients.

<p>Correlation analysis for age-adjusted WBISI in preschool and school age obese patients.</p

Relationship between percent changes over follow-up in the Insulin Secretion-Sensitivity Index 2 (ISSI-2), the oral glucose disposition index, and serum concentrations of fasting (Panel A; y = −5.8962x–497.65; p<0.0001; R² = 0.492) and 2 hour serum glucose (Panel B; y = −11.207x–979.11; p<0.0001; R² = 0.294) in school-age children. The decrease of the glucose disposition index over the follow-up period was associated with higher values of fasting and 2 h glucose in school-age children.

<p>Relationship between percent changes over follow-up in the Insulin Secretion-Sensitivity Index 2 (ISSI-2), the oral glucose disposition index, and serum concentrations of fasting (Panel A; y = −5.8962x–497.65; p<0.0001; R² = 0.492) and 2 hour serum glucose (Panel B; y = −11.207x–979.11; p<0.0001; R² = 0.294) in school-age children. The decrease of the glucose disposition index over the follow-up period was associated with higher values of fasting and 2 h glucose in school-age children.</p