ESPE Abstracts

Purpose: Since the COVID-19 outbreak, the number of obese children and adolescents has increased rapidly. Obesity acts as a gateway to chronic adult diseases, so proper management during childhood and adolescence is essential. We aimed to identify the interannual changes in the prevalence of obesity, diabetes mellitus, dyslipidemia, and hypertension, and to investigate factors contributing to these changes before and during the COVID-19 pandemic.

Methods: This study was conducted using data from the 2016-2021 Korean National Health and Nutrition Examination Survey (KNHANES), which included a total of 3861 children and adolescents aged 10-18 years. The prevalence of obesity and disease was adjusted by age, sex, and income. We also analyzed the socioeconomic, nutritional, and physical activity items of the survey.

Results: During the COVID-19 pandemic, there was a significant increase in the trend of mean body mass index (BMI) (from 21.0 to 21.4 kg/m2, P=0.03) and mean glycated hemoglobin (HbA1c) (from 5.36 to 5.4%, P=0.005). The prevalence of obesity also significantly increased, ranging from 12.55% to 17.29% (P=0.002) among children and adolescents aged 10-18 years. In the obese group, there was an apparent increase in the number of metabolically unhealthy children and adolescents. The prevalence of central obesity showed a significant increasing trend (P=0.016), and the proportion of HbA1c≥5.7% increased from 9.92% to 13.99% (P=0.029). The frequency of parents' central obesity also increased. In terms of central obesity and BMI, children and their parents showed significant linear associations. The intake of food and calorie was significantly reduced in the normal-weight groups but not in the obese groups. The proportion of people who skipped breakfast has increased and eating out has been reduced regardless of obesity status. Health behavior did not show significant changes.

Conclusions: Obesity in children and adolescents is sensitive to the social environment. During COVID-19, the prevalence of metabolically unhealthy obese children has significantly increased, while the proportion of metabolically healthy normal-weight children has decreased. Attention should be paid from the beginning to improve children's health indicators. Age-specific strategies considering growth and development, genetics, and social factors are needed. Additionally, health strategies for the entire family are necessary to develop healthier habits in teenagers.