Effect of the COVID-19 pandemic lockdown on the physique of school-age children in Japan.

PURPOSE: Schools in Japan were closed nationwide from March to May 2020 because of the coronavirus disease 2019 (COVID-19) pandemic. Many suspect that this school closure affected children's mental and physical health. We investigated changes in school-age children's physiques to determine the effects of the COVID-19 lockdown and restrictions on their health. METHODS: Data were extracted from a database of school physical examinations in Osaka elementary and junior high schools for 4 consecutive years from 2018 to 2021. The following characteristics were analyzed: short stature, tall stature, underweight, mild obesity, middle grade obesity, and severe obesity. The paired Student t-test was used to compare school examination data in the prepandemic period (2018-2019), pandemic lockdown (2019-2020), and post-lockdown period (2020-2021). RESULTS: Obesity rates in elementary school students aged 6-12 years, particularly in boys, were significantly higher during the lockdown than they were in 2019. After the pandemic, the tall stature rate continued to rise, while rates of short stature and underweight decreased in both sexes in 2020. In junior high school students aged 12-15 years, rates of obesity and underweight tended to decrease in 2020. However, these rates rebounded and rose in 2021 when the lockdown was lifted. CONCLUSION: During the COVID-19 pandemic lockdown, elementary school students gained weight, while junior high school students lost weight. The lockdown that was implemented during the COVID-19 pandemic had an unfavorable effect on weight gain, particularly in young school-age children.

Impact of childhood growth and obesity curves in school health examinations.

BACKGROUND: With the revision of the Japanese School Health and Safety Law in 2016, the use of growth and obesity curves has been recommended. This study aimed to determine the prevalence of growth and obesity curve creation in elementary and junior high schools using government-issued software in Japan between 2016 and 2019. METHODS: A questionnaire survey was conducted with school nursing teachers in elementary and junior high schools in Osaka, Japan. The questionnaire was distributed and collected by e-mail between 1 and 31 March 2020. RESULTS: The survey response rate was 87.1%. In total, 78.5% of the elementary schools, and 75.0% of the junior high schools had the software for creating the growth curves. The rate of adoption of growth curve creation using the software increased in elementary schools (from 16.2% in 2016 to 40.5% in 2019 and in junior high schools from 6.0% in 2016 to 33.6% in 2019. The detection rates of growth abnormalities also increased over the 4 years in elementary and junior high schools, as follows: short stature (2.48- and 3.81-fold, respectively), tall stature (2.77- and 4.77-fold, respectively), emaciation (2.62 and 4.85-fold, respectively), mild obesity (2.66 and 5.15-fold, respectively), moderate obesity (2.71- and 4.14-fold, respectively), and severe obesity (2.45- and 3.32-fold, respectively). The rates of receiving a recommendation slip and going on to consult a specialist for each growth abnormality were low. CONCLUSIONS: By utilizing these curves, the detection rate of physical development abnormalities increased, but the rate of recommending a specialist consultation and the rate of actual consultation with a specialist were still low.

Regional disparities in obesity/emaciation and income in schoolchildren in Osaka City.

BACKGROUND: We assessed the association between socioeconomic status at residential area-level in the 24 wards of Osaka City, differentiated by indices of mean income-related deprivation, and inequalities in childhood obesity and emaciation. METHODS: Data from representative samples of 26 474 schoolchildren (first and fifth grades of elementary school, and third grade of junior high school [i.e. ninth grade of elementary school]) in Osaka City taken from a somatometric check in spring 2016 were analyzed. The cross-sectional association between socioeconomic factors, that is, the census-based annual income of each ward, and the prevalence of childhood overweight/obesity and emaciation, was examined. RESULTS: The prevalence of overweight/obesity in boys and girls in the first and fifth grades of elementary school and the third grade of junior high school was 3.98% and 4.53%, 10.18% and 8.69%, and 7.02% and 5.55%, respectively. The prevalence of emaciation in boys and girls in the first and fifth grades of elementary school, and the third grade of junior high school was 0.14% and 0.10%, 0.46% and 1.06% and 3.95% and 3.05%, respectively. Mean physical value, expressed as % degree of overweight, had a negative correlation with mean annual income of each ward in girls in the first and fifth grades of elementary school, girls in the third grade of junior high school and boys in the first grade of elementary school. CONCLUSIONS: Overweight/obesity at school age is greatly affected by poverty. Efforts should be made to prevent emaciation not only in girls, but also in boys, in junior high school.