The Epidemic of Childhood Obesity and the COVID-19 Pandemic: Metabolic Characteristics and Effects of Therapy

The aim of the study was to analyse whether children whose obesity occurred during the pandemic differed metabolically from children who were obese earlier and to assess the effect of one-year treatment following the end of pandemic restrictions. The prospective study of 55 children aged 10–18 years who were referred to the Outpatient’s Clinic during the pandemic due to obesity was conducted. Clinical data were analysed: time of obesity onset, BMI Z-score, body mass composition, blood pressure, abdominal ultrasound, biochemical parameters of lipid and carbohydrate metabolism, aminotransferases and Fetuin A concentration. Participants received recommendations to improve their diet and increase physical activity (PA). After 3, 6 and 12 months we assessed: BMI Z-score, compliance with recommendations, and biochemical parameters. Results: No significant differences between pandemic obesity and non-pandemic obesity were observed at the beginning and after one year. Both children who followed the dietary recommendations had significantly lower BMI Z-score after 3 months (Me 2.08 vs 1.89, p = 0.044) and children who declared increasing PA (47.3%) after 6 (Me 2.12 vs 1.86, p = 0.53) and 12 months (Me 2.12 vs 1.78, p = 0,008). The beneficial effect of PA was demonstrated in lower levels of Fetuin A in children with increased PA after 6 months (Me 480 vs 395 ug/ml, p = 0.07). Conclusions The “pandemic obesity” does not appear to be metabolically distinct from obesity that developed earlier and lasted longer.. Increase in PA and compliance with dietary recommendations seems still to be an important element in therapy and the context of metabolic complications. Fetuin A may serve as a potential new parameter for assessing compliance with PA recommendations and the rate of obesity progression.