607 - Comparison of the pre and post COVID-19 pandemic weight gain in children over a 5 year period in a low income neighborhood in Brooklyn, NY

Poster Number: 607
Publication Number: 607.2833

Background: The COVID-19 pandemic exacerbated pediatric obesity, especially in low-income and racially diverse communities affected by shutdowns and closures. The prevalence of pediatric obesity in Brooklyn, NY increased from a pre-pandemic level of 22% in 2019 to 28% in 2021 and 24.8% in 2022, significantly higher than the national average.

Objective: We determined the prevalence of each BMI category in children aged 2-18 from the pre-pandemic to the post-pandemic period. We also compared the BMI changes of children from their pre-pandemic state to the pandemic and post-pandemic periods. We also determined which age group had the most reversal of weight gain in the post-pandemic period.

Design/Methods: A retrospective longitudinal study of changes in BMI was carried out using anthropometric data from electronic medical records of children during well visits from 2018-2022. The data was grouped by ages 2-5, 6-11, and 12-18 years, compared to BMI categories, and tracked from pre-pandemic (2018-2019), pandemic (2020) and post-pandemic (2021-2022) periods. Data was analyzed using ANOVA and Fisher Exact Tests.

Results: A total of 4293 patients qualified for the study. The BMI percentile mean of ages 2-5 remained at 68% between the pandemic and post-pandemic periods, while it decreased to 74% in ages 6-11, and to 64% for ages 12-18 in the post-pandemic period (Fig 1). Among 236 patients aged 2-5 who were overweight at baseline from the pre-pandemic period, 41.6% increased to the obese category and 31.6% normalized during the pandemic (Fig 2), compared to 35.6% who increased to obese and 32.6% who normalized in the post-pandemic (Fig 3). The difference in percentage between periods decreased as they grew older. Notably, children across all age groups with normal and obese BMI were more likely to stay in the same category in response to the pandemic.

Conclusion(s): Our study showed that children who are overweight were most sensitive to changes in the environment and either reversed or advanced BMI categories through the pandemic and post-pandemic periods, and this sensitivity decreased as they grew older. More remarkably, there was an overall decrease in the percentage of patients moving up BMI in the post-pandemic period across all age groups. This may be due to increased physical activity upon returning to school and having access to a better diet and social benefits. This is the first to study BMI changes in youth after quarantine restrictions have been lifted in the US and internationally. Aggressively targeting children, especially the younger ones, with overweight may be the key to preventing future obesity.