Effect Of The Covid-19 Pandemic On Activity And Sleep In Children And Adolescents With Obesity

Childhood obesity is a significant and expanding public health concern. Weight is influenced by physical activity (PA) and sleep, both of which were disrupted for many children during the COVID-19 pandemic. However, little is known about how these behaviors changed among children with obesity. PURPOSE: To explore the impact of the COVID-19 pandemic on objectively measured PA and sleep among children with obesity. METHODS: Data are from a randomized controlled trial evaluating the effectiveness of a clinic-community obesity treatment intervention for children and adolescents between 5-17 years of age conducted between March 2018 and June 2021 (total n = 252; mean age = 9.6; 55.5% female; 40.1% Black). The 6-month intervention phase offered six in-person PA sessions per week (participants encouraged to attend at least two), and routine clinic visits at 3-month intervals. Upon initiation of stay-at-home orders, in-person sessions were ceased and data monitoring continued virtually. PA (reported as step counts) and sleep were measured with a Garmin VivoFit 3 instructed to be worn continuously for the study duration. For PA analyses, data were used from participants with greater than 60 days of data with inclusion only of days with ≥41% wear time (n = 119). For sleep data, the daily wear time minimum was not applied, resulting in n = 203 with useable data. Differences in average daily PA from pre-pandemic (March 2018 - March 14, 2020) to during the pandemic (after March 15, 2020) were compared using a Mann Whitney U Test. RESULTS: Average daily pre-pandemic step counts were 8858 ± 1720 steps/day. After stay-at-home orders took effect, daily steps significantly dropped to 7182 ± 2025 steps/day (p < 0.01), but returned to pre-pandemic levels (8762 ± 2486 steps/day) beginning March 2021, coinciding with when many children returned to in-person learning. Overall sleep duration decreased by over 35 minutes during the pandemic, bedtimes averaged one hour later, and wake times were delayed by 35 minutes. CONCLUSION: The current findings highlight the importance of in-person school and structured activities for promoting daily PA and adequate sleep among children with obesity. Future childhood obesity treatment efforts should focus on developing more structured environments for children to improve obesogenic health behaviors.