Did adolescents gain weight during the COVID-19 lockdown? (Culture, Context, and Social Economic Position Matter)

In 2020, the COVID-19 pandemic forced many people worldwide to stay at home, those in Indonesia included. During these lockdowns, Indonesian governments implemented several restriction measures (i.e., closed all learning institutions and public facilities, such as restaurants, sport facilities, and cinemas) to prevent the spread of COVID-19. All learning institutions and public facilities, such as restaurants, sport facilities, and cinemas were closed for an extensive duration. Schools were no exception – they remained closed for almost two years (from March 2020 to January 2022). As a result, adolescents spent most of their time at home.

Previous studies have shown that, during the lockdown, adolescents generally ate more sweets and snacks^1,2, but burnt less calories through physical activity^3,4. Given that weight development is most importantly affected by changes in (the balance between) energy intake and expenditure, it is not surprising that previous studies have found weight increases among children and adolescents in Europe and Asia^1,5,6,7. We had expected to see the same pattern from 411 adolescents in Indonesia from higher socio-economic position (pre-registered, OSF; https://osf.io/kh5yb/). In contrast to the previous studies in Europe and Asia, our participants had a lower standardized body mass index (zBMI) or weight decreasing during COVID-19 (June-September 2021) compared to the pre-COVID-19 situation (October-December 2019). Moreover, our finding showed that most adolescents with higher zBMI (or higher risk to be overweight) shown stronger decreasing trends during the lockdown of COVID-19. The following might be the reasons behind these results: first, previous studies in western countries showed that higher socio-economic families present an environment where adolescents can access easily healthier food^8,9. In Indonesia, due to lockdown, the adolescents ate most of all meals at home, making them less likely to consume junk food which is usually consumed outside of home, such as at schools and their surroundings¹⁰. Adolescents´ food intake was influenced more by their parents. Second, during the lockdown adolescents might be more physically active (i.e., more walking and playing outdoor). Two previous studies^7,11 showed that Indonesian adolescents were more physically active during the lockdown, whereas studies in western countries mostly showed lower average physical activity during the lockdown compared to before^4,12. This might be related to their ways of commuting: Adolescents in Indonesia from higher SEP usually go to school by car or motorbike, in contrast to students in Europe who usually go to school by walking or by bike. So, when there was no schooling, European students, had less physical activity from commuting, but not Indonesian students. Overall, our findings suggest that Indonesian students’ zBMI decreased during COVID-19, which was opposite to what previously found among other Asian and European students. Contextual changes can affect adolescents’ calories intake and burning. Improving access to healthy food in home and encouraging parents to bring positive influence towards food intake might be promising strategies for Indonesian adolescents´ weight management.   This blog was written by Eveline Sarintohe (PhD student Behavioural Science, Radboud University) for RAD-blog, the blog about smoking, alcohol, drugs and diet.   References

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2. Androutsos, O., Perperidi, M., Georgiou, C., & Chouliaras, G. (2021). Lifestyle changes and determinants of children’s and adolescents’ body weight Increase during the first COVID-19 lockdown in Greece: The COV-EAT study. Nutrients, 13, 930-941.
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5. Anderson, L.N., Yoshida-Montezuma, Y., Dewart, N., Jalil, E., Khattar, J., De Rubeis, V., Carsley, S., Griffith, L.E., Mbuagbaw, L. (2023). Obesity and weight change during the COVID-19 pandemic in children and adults: A systematic review and meta-analysis. Obesity Review, 24, 1-16.
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12. Khan, M.A.B., Menon, P., Govender, R., Abu Samra, A.M.B., Allaham, K.K., Nauman, J., Östlundh, L., Mustafa, H., Smith, J.E.M., & Alkaabi, J.M. (2022). Systematic review of the effects of pandemic confinements on body weight and their determinants. British Journal of Nutrition, 127(2), 298–317