ESPE Abstracts

Key Words: Childhood obesity, Prevalence, Covid-19, N. Macedonia

Abstract

Childhood obesity is a growing concern and a worldwide pandemic. North Macedonia, a small middle-income country with a population of around 2 million, is among the top 10 countries in Europe with a high prevalence of overweight and obesity. 

The aim of this study is to observe how the COVID-19 pandemic has affected children's BMI compared to an earlier study conducted just before the pandemic, between 2019 and 2020.

Between February and April 2022, we conducted a prospective cross-sectional study in 1004 children aged 6-13, from four different ethnicities. We measured their weight, and height, calculated their BMI percentile and z score, and compared them with CDC 2000 for weight by gender and age classification.

Results: The analysis of the prevalence of classified BMI for the entire sample of school children indicated that the restrictive measures of isolation and social distancing during the COVID-19 pandemic decreased the prevalence of malnutrition from 10.1% in 2019 to 5.9% in 2022. However, it increased the prevalence of overnutrition from 13.5% in 2019 to 15.9% in 2022 and obesity from 19.6% in 2019 to 21.9% in 2022. Overall, overweight and obesity increased from 33% to 37.4% during the COVID-19 pandemic. A significant association was established with an increased prevalence of overweight and obesity in 2022 (Pearson Chi-Square test: X2=13.813; df=3; p<0.003).

In addition, a general decrease in undernutrition was observed in 2022 compared to 2019 for each of the analyzed ages (6-13 years). For p<0.05, there was a significantly lower proportion of undernourished in 2022 compared to 2019 for boys aged 6+ (p=0.008), as well as a significantly lower proportion of undernourished overall for boys in 2022 compared to 2019 (p=0.017). Boys in 2022 had a significantly higher prevalence of overweight and obesity at 41.6% compared to girls at 32.9%.

In conclusion, according to the World Obesity Federation, North Macedonia has a 7 out of 11 risk score, and if we don't implement effective strategies to prevent and manage childhood obesity, we may experience a prevalence increase of 52.4% of overweight and obese children by 2030, meaning 1 out of 2 children would be affected.