Impact of COVID-19 on children's short and long term weight status

Project: Research project

Project Details


Impact of COVID-19 on children's short and long term weight status Impact of COVID-19 on children's short and long term weight status SPECIFIC AIMS: The impact on childrens weight status of a prolonged school closure of the magnitude mandated by the COVID-19 pandemic is unknown. While students in younger grades tend to gain weight at a higher rate during summer recess, we have little basis for predicting the long-term effects on obesity prevalence of a hiatus of 6 months or more as posed by the current pandemic. Determinants of excess weight gain during school closures are yet to be fully understood, but prevailing literature points to positive energy balance resulting from poor diets, lack of structured activity, and increase in sedentary time. During the school year, low-income children comprise over 80% of students who participate in federal school-meal programs that fulfill up to half of childrens daily nutritional needs at low or no cost to parents. The nutritional quality of school meals has improved over the years, and participation in school meal programs is associated with healthier dietary patterns and weight outcomes among children. Absence of school meals during the summer has been cited as a potential reason for poor diet quality and higher rates of weight gain. While summer meals are provided to some students through the federal summer meals programs, research establishing the adequacy of these programs in addressing weight status is lacking. Pursuant to the Families First Coronavirus Response Act (P.L. 116-127), the USDA extended the summer feeding program to deliver meals to children during the pandemic-related school closures; the USDA also authorized emergency food assistance through Pandemic Electronic Benefit Transfer (P-EBT) cards for out-of-school children who qualify for school meals programs. Understanding the short- and long-term impact of COVID-19-related school closures on childrens weight status as well as the potential of child targeted food assistance programs to mitigate these negative outcomes is critical to our preparedness to respond to future disasters. This assessment is particularly critical because food insecurity rates during COVID-19 have greatly increased, further challenging low-income families ability to meet their childrens nutritional needs when schools are out. Our proposed study addresses these gaps in knowledge, relying on the unique circumstances posed by the coronavirus pandemic and our 7 years of professionally measured heights and weights of low-income students in over 100 schools in four cities in New Jersey. Our study has two specific aims: Aim 1: Examine the short- and long- term impacts of COVID-19 school closures on childrens weight status. H1: Childrens weight status (measured by BMI Z-scores and BMI percentile) in the post COVID-19 school year (2020-21) will be less healthy compared to similar measures in prior years, independent of the contributions of child- and school-level demographic characteristics and elements of the school and surrounding community food and physical activity (PA) environments. H2: Excess weight gain during COVID-19 will result in persistently higher weight status two years following the COVID-19 hiatus, compared to levels prior to the pandemic, controlling for contributions of child- and school-level demographics and elements of the school and surrounding community food and PA environments. Aim 2: Assess if access to child-targeted food assistance, implemented during the pandemic, had a protective effect on childrens post-COVID-19 weight status. H3: Children with greater access to summer meals (number of meals served in their schools catchment area during COVID closures) will have healthier post-COVID weight status compared to children who had less access, accounting for school and community level covariates including school enrollment. H4: Children who attend schools with higher eligibility for P-EBT assistance (proportion eligible for free and reduced price meals) will have lower post-COVID weight measures compared to children from schools with lower eligibility for P-EBT, controlling for school and community level factors. To address these aims, we will draw upon our existing nurse-measured heights and weights data on children attending 120 public schools, collected during four school years (SY) between 2013-14 and 2019-20 (approximately 30,000 students per year) and add two more waves of data collection, one coinciding with the re-opening of schools (SY2020-21) and the other two years later (SY2022-23); these data will facilitate interrupted time series analyses of trends in weight status. Time-sensitive funding will facilitate initiation of measurement as soon as school resumes, which is essential to address the aims. For the same SYs, we will incorporate, as covariates, our annual data on schools food and PA environments that we have found to be associated with weight status, as well as measures of the surrounding food and PA environment known to affect obesity rates. New data on child-targeted food assistance in school catchment areas over the course of school closures will be collected to establish the potential mitigating effects of these programs. Impact The proposed study will make a unique contribution to our understanding of the long-term effects of a key dimension of federal obesity policy affecting low-income children, provision of free and reduced priced school meals. As such, the findings will be critical to our readiness to respond to future disasters and to our efforts to assure the adequacy of the food safety net.
Effective start/end date9/21/208/31/22


  • HHS: National Institutes of Health (NIH): $1,947,587.00


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