COVID-19 obesity spike in Swedish preschool children suggests socioeconomic inequality factors

03 Jan 2023 --- Obesity in preschool children increased significantly in Sweden during the COVID-19 pandemic despite the country’s relatively loose lockdown measures. This observation comes from a recent study published in the European Journal of Public Health, in which data was accumulated on 25,049 children aged three to five that underwent regular health checks at child health centers across the Dalarna, Jönköping and Sörmland counties.

Previous studies in this area have often focused on children of school age or been based in countries with tighter restrictions than Sweden during the pandemic. These studies have also generally documented increases in weight and obesity among school children during the pandemic.

The preschool study was headed by Anton Holmgren, research associate in pediatrics at Sahlgrenska Academy, University of Gothenburg, and Anna Fält, a researcher in child health and parenthood at Uppsala University.

“Although Sweden didn’t have a lockdown in the same way as many other countries, the incidence of overweight and obesity increased in three- and four-year-olds and, even at such a young age, the socioeconomic differences are evident,” notes Holmgren.

To combat rising obesity in children, Holmgren calls for greater focus on national and international guidelines aimed at reducing the consumption of sweetened products and increasing the consumption of fiber and vegetables.

“Some of the socioeconomic differences are probably due to less awareness in socially deprived areas and maybe also that sugar and less healthy foods often are quite cheap and accessible,” he tells NutritionInsight.The study suggests that socioeconomic factors are at play since Sweden experienced relatively relaxed COVID-19 restrictions.

BMI on the rise
The study documents a statistically significant rise in the Body Mass Index (BMI) of three-year-olds during COVID-19. Among the girls, the proportion of obesity rose from 2.8% before to 3.9% during the pandemic. For the boys, the corresponding proportions were 2.4% and 2.6%.

The proportion of three-year-old girls with what is usually classified as normal weight declined from 82.6% before to 80.9% during the pandemic. There was no corresponding change in normal weight status in the group of three-year-old boys.

Among the four-year-olds, there was a significant increase in BMI. Obesity rose in girls and boys alike: overweight rose from 11.1% to 12.8% in girls, while underweight in boys fell from 2.0% to 1.4%. The group of five-year-olds showed no BMI changes.

The socioeconomic link
BMI changes and socioeconomic status were found to be associated, most clearly among children in the most disadvantaged areas. There, the proportion of three- and four-year-olds with overweight rose from 9.5% to 12.4% and with obesity from 2.5% to 4.4% percent, while the proportion with normal weight decreased.

The study lead calls for more attention to be given to healthy eating recommendations.Socioeconomic variables were measured using an established method – the Care Need Index – which classifies expected care requirements based on education level, the proportion of unemployed or in labor-market programs, the proportion of single parents, and the proportion born outside the western world.

“The study highlights the need for further efforts and interventions aimed at preventing childhood obesity, especially in areas of lower socioeconomic status,” continues Holmgren.

Holmgren welcomes additional studies in Sweden and other countries which monitor whether obesity rates in children will decrease as societies recover from the COVID-19 pandemic and its economic fallout. 

Obesity in the news
In related developments, researchers from the Osaka Metropolitan University in Japan have investigated what stimulates the brain to cause overeating and discovered a genetic mechanism associated with high-calorie, food-fueled obesity.

Meanwhile, the Royal College of Paediatrics and Child Health has urged the UK government to finally implement mandatory guidelines on the amount of sugar and salt that baby food can contain amid reports of alarming amounts in everyday products.

By Joshua Poole