Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Paediatrics

A scoping review of physical activity-based interventions for obesity management in children and adolescents during the COVID-19 pandemic

Abstract

Overweight and obesity have emerged as global health issues among children and adolescents. Restrictions related to the COVID-19 pandemic have aggravated the threat of paediatric obesity due to the prevalent reduction in physical activity (PA) in children and adolescents. However, this has also created an opportunity for healthcare professionals to explore new strategies to address this persistent problem. A systematically conducted scoping review was performed on 15 online databases to summarise and analyse the design, efficacy, and feasibility of PA-based weight management interventions for children and adolescents during the pandemic. Finally, we reviewed 23 eligible studies that were published between 2021 and 2023. The included interventions were presented to 1938 children and adolescents and 355 parents using a virtual or virtually blended face-to-face approach during the pandemic. The intervention design included a basic PA programme with three optional components (nutritional education, sociopsychological counselling, and medication consultations). Implementation generally resulted in favourable changes in body mass index (BMI) and/or body size or composition (primary outcomes), as well as health behaviours, physical health or fitness, and individual well-being (secondary outcomes). A longer duration of exposure to the intervention, female sex, and older age were associated with a higher efficacy of the included interventions. Moreover, the interventions showed high feasibility, with medium-high participant attendance, high acceptance/satisfaction in both children and adolescents and their parents and teachers, and strong participant engagement. This may be related to the high accessibility of health information, timely social support, and enhanced self-efficacy. In conclusion, both the virtual and blended delivery of well-planned weight management interventions during the pandemic show promise for the treatment and control of paediatric obesity. The lessons learned from the pandemic may help improve the design of future interventions and inform the proper integration of new technologies that have emerged in the post-pandemic world.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram: searching process for studies selection about the physical activity incorporated management of pediatric obesity during Covid-19 pandemic.

Similar content being viewed by others

Data availability

The data that support the findings of this study are available from the corresponding author (ETCP), upon reasonable request.

References

  1. WHO. Obesity and overweight.: World Health Organization; 2023 [Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight].

  2. Jebeile H, Kelly AS, O’Malley G, Baur LA. Obesity in children and adolescents: epidemiology, causes, assessment, and management. Lancet Diabetes Endocrinol. 2022;10:351–65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Kansra AR, Lakkunarajah S, Jay MS. Childhood and adolescent obesity: a review. Front Pediatr. 2020;8:581461.

    Article  PubMed  Google Scholar 

  4. Güngör NK. Overweight and obesity in children and adolescents. J Clin Res Pediatr Endocrinol. 2014;6:129–43.

    Article  PubMed  Google Scholar 

  5. Gromadai A, Richardsoni D, Rees G. Childcare in a global crisis: the impact of COVID-19 on work and family life. UNICEF Office of Research; 2020. Retrieved from: https://www.unicef-irc.org/publications/1109-childcare-in-a-global-crisis-the-impact-of-covid-19-on-work-and-family-life.html.

  6. Cachon-Zagalaz J, Sanchez-Zafra M, Sanabrias-Moreno D, Gonzalez-Valero G, Lara-Sanchez AJ, Zagalaz-Sanchez ML. Systematic review of the literature about the effects of the COVID-19 pandemic on the lives of school children. Front Psychol. 2020;11:569348.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Fäldt A, Nejat S, Edvinsson Sollander S, Durbeej N, Holmgren A. Increased incidence of overweight and obesity among preschool Swedish children during the COVID-19 pandemic. Eur J Public Health. 2023;33:127–31.

    Article  PubMed  Google Scholar 

  8. Jarnig G, Jaunig J, van Poppel MNM. Association of COVID-19 mitigation measures with changes in cardiorespiratory fitness and body mass index among children aged 7 to 10 years in Austria. JAMA Netw Open. 2021;4:e2121675.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kang HM, Jeong DC, Suh BK, Ahn MB. The impact of the Coronavirus disease-2019 pandemic on childhood obesity and vitamin D status. J Korean Med Sci. 2021;36:e21.

    Article  ADS  CAS  PubMed  PubMed Central  Google Scholar 

  10. Dyer O. Obesity in US children increased at an unprecedented rate during the pandemic. BMJ. 2021;374:n2332.

    Article  PubMed  Google Scholar 

  11. Lange SJ, Kompaniyets L, Freedman DS, Kraus EM, Porter R, Blanck HM, et al. Longitudinal trends in body mass index before and during the COVID-19 pandemic Among persons aged 2–19 years—United States, 2018-2020. MMWR Morb Mortal Wkly Rep. 2021;70:1278–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Calcaterra V, Verduci E, Vandoni M, Rossi V, Di Profio E, Carnevale Pellino V, et al. Telehealth: A useful tool for the management of nutrition and exercise programs in pediatric obesity in the COVID-19 era. Nutrients. 2021;13:3689.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Woo Baidal JA, Chang J, Hulse E, Turetsky R, Parkinson K, Rausch JC. Zooming toward a telehealth solution for vulnerable children with obesity during Coronavirus disease 2019. Obesity. 2020;28:1184–6.

    Article  CAS  PubMed  Google Scholar 

  14. Vandoni M, Codella R, Pippi R, Carnevale Pellino V, Lovecchio N, Marin L, et al. Combatting sedentary behaviors by delivering remote physical exercise in children and adolescents with obesity in the COVID-19 era: a narrative review. Nutrients. 2021;13:4459.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Babaei Bonab S, Parvaneh M. Effect of 12-week of aerobic exercise on hormones and lipid profile status in adolescent girls with polycystic ovary syndrome: a study during COVID-19. Sci Sports. 2023. https://doi.org/10.1016/j.scispo.2022.11.001.

  16. Yarimkaya E, Esenturk OK, Ilhan EL, Kurtipek S, Isim AT. Zoom-delivered physical activities can increase perceived physical activity level in children with autism spectrum disorder: a pilot study. J Dev Phys Disabil. 2023;35:189–207.

    Article  PubMed  Google Scholar 

  17. Vandoni M, Carnevale Pellino V, Gatti A, Lucini D, Mannarino S, Larizza C, et al. Effects of an online supervised exercise training in children with obesity during the COVID-19 pandemic. Int J Environ Res Public Health. 2022;19:9421.

    Article  PubMed  PubMed Central  Google Scholar 

  18. AltuntaŞ K, ÖZÜNlÜ PekyavaŞ N, YemİŞÇİ OÜ, Tezeren HC. The effectiveness of calisthenic exercise training in adolescents receiving online education during the COVID-19 pandemic. Int J Disabil Sports Health Sci. 2022;5:38–48.

    Google Scholar 

  19. Nambi G, Alghaider M, Elnegamy TE, Basuodan RM, Alwhaibi RM, Vellaiyan A, et al. Clinical (BMI and MRI) and biochemical (adiponectin, leptin, TNF-à, and IL-6) effects of high-intensity aerobic training with high-protein diet in children with obesity following COVID-19 infection. Int J Environ Res Public Health. 2022;19:7194.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Lee KJ, Noh B, An KO. Impact of synchronous online physical education classes using Tabata training on adolescents during covid-19: a randomized controlled study. Int J Environ Res Public Health. 2021;18:10305.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Chew CSE, Davis C, Lim JKE, Lim CMM, Tan YZH, Oh JY, et al. Use of a mobile lifestyle intervention app as an early intervention for adolescents with obesity: Single-cohort study. J Med Intern Res. 2021;23:e20520.

    Google Scholar 

  22. Eisenburger N, Friesen D, Haas F, Klaudius M, Schmidt L, Vandeven S, et al. Short report: weight management of children and adolescents with obesity during the COVID-19 pandemic in Germany. PLoS One. 2022;17:e0267601.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Pecoraro P, Gallè F, Muscariello E, Di Mauro V, Daniele O, Forte S, et al. A telehealth intervention for ensuring continuity of care of pediatric obesity during the CoVid-19 lockdown in Italy. Nutr Metab Cardiovasc Dis. 2021;31:3502–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Reschke F, Galuschka L, Landsberg S, Weiner C, Guntermann C, Sadeghian E, et al. Successful telehealth transformation of a pediatric outpatient obesity teaching program due to the COVID-19 pandemic - the ‘Video KiCK’ program. J Pediatr Endocrinol Metab. 2022;35:803–12.

    Article  CAS  PubMed  Google Scholar 

  25. Triantafyllidis A, Alexiadis A, Elmas D, Gerovasilis G, Votis K, Tzovaras D. A social robot-based platform for health behavior change toward prevention of childhood obesity. Univers Access Inf Soc. 2023;22:1405–15.

    Article  Google Scholar 

  26. Yudkin JS, Allicock MA, Atem FD, Galeener CA, Messiah SE, Barlow SE. Efficacy of a primary care eHealth obesity treatment pilot intervention developed for vulnerable pediatric patients. Child Obes. 2023. https://doi.org/10.1089/chi.2022.0185. (Ahead of print).

  27. Rawal T, Muris JWM, Mishra VK, Arora M, Tandon N, van Schayck OCP. Effect of an educational intervention on diet and physical activity among school-aged adolescents in Delhi -The i-PROMISe (PROMoting health literacy in Schools) plus study. Dialogues Health. 2023;2:100123.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Makaracı Y, Yücetaş Z, Devrilmez E, Soslu R, Devrilmez M, Akpınar S, et al. Physical activity and nutrition education programs changes body mass index and eating habits of 12th grade students: an intervention during the COVID-19 pandemic. Ann Appl Sport Sci. 2023;11:0–0.

    Article  Google Scholar 

  29. Gachupin FC, Caston E, Chavez C, Bernal J, Cager P, Harris D, et al. Primary disease prevention for Southwest American Indian families during the COVID-19 pandemic: Camp in a box. Front Sociol. 2021;6:611972.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Leonte N, Tudorancea ȘD, Vasilescu F. The impact of using modern fitness techniques vs. the traditional ones on the strength of the lower limbs in adolescent girls. Rom J Multidimens Educ. 2021;13:407–22.

    Google Scholar 

  31. Calcaterra V, Iafusco D, Carnevale Pellino V, Mameli C, Tornese G, Chianese A, et al. CoVidentary’: an online exercise training program to reduce sedentary behaviours in children with type 1 diabetes during the COVID-19 pandemic. J Clin Transl Endocrinol. 2021;25:100261.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Swierad EM, Benson LR, Williams O. Creating a scalable physical activity breaks resource through the multisensory multilevel health education model: H.Y.P.E. The breaks! Health Promot Pract. 2021;22:101S–10S.

    Article  PubMed  Google Scholar 

  33. Audor González MH, Lerma Castaño PR, Roldán González E. Effects of physical exercise on the body composition and conditional physical capacities of school children during confinement by COVID-19. Glob Pediatr Health. 2022;9:2333794X211062440.

    PubMed  PubMed Central  Google Scholar 

  34. Holmes CJ, Racette SB, Symonds L, Arbelaez AM, Cao C, Granados A. Feasibility and efficacy of telehealth-based resistance exercise training in adolescents with cystic fibrosis and glucose intolerance. Int J Environ Res Public Health. 2022;19:3297.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Nuss K, Coulter R, DeSilva B, Sheikhi R, Naylor P-J, Liu S. Evaluating the effectiveness of a Canadian family-based childhood obesity management virtual program delivered during the COVID-19 pandemic: a prospective study. JMIR Pediatr Parent. 2022;5:e40431.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Tripicchio GL, Jones GJ, Hart CN, Hyun M, DeSabato E, Giddings A, et al. A digitally enhanced home-based physical activity intervention for high-risk middle school youth during COVID-19. Transl Behav Med. 2023;13:17–24.

    Article  PubMed  Google Scholar 

  37. Nagao-Sato S, de Davila SA, Monardez Popelka J, Burk G, Soltani D, Baltaci A, et al. Feasibility of a remotely delivered program to prevent Latino adolescent obesity in the Midwestern USA. Health Promot Int. 2022;37:daac106.

    Article  PubMed  Google Scholar 

  38. Lubrecht J, Arayess L, Reijnders D, Hesselink ML, Velde GT, Janse A, et al. Weight gain in children during the COVID-19 pandemic and the protective effect of lifestyle intervention in children with obesity. Obes Facts. 2022;15:600–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Shalitin S, Phillip M, Yackobovitch-Gavan M. Changes in body mass index in children and adolescents in Israel during the COVID-19 pandemic. Int J Obes. 2022;46:1160–7.

    Article  CAS  Google Scholar 

  40. Vogel M, Geserick M, Gausche R, Beger C, Poulain T, Meigen C, et al. Age- and weight group-specific weight gain patterns in children and adolescents during the 15 years before and during the COVID-19 pandemic. Int J Obes. 2022;46:144–52.

    Article  CAS  Google Scholar 

  41. Weaver RG, Hunt ET, Armstrong B, Beets MW, Brazendale K, Turner-McGrievy G, et al. COVID-19 leads to accelerated increases in children’s BMI z-score gain: an interrupted time-series study. Am J Prev Med. 2021;61:e161–9.

    Article  PubMed  PubMed Central  Google Scholar 

  42. La Fauci G, Montalti M, Di Valerio Z, Gori D, Salomoni MG, Salussolia A, et al. Obesity and COVID-19 in children and adolescents: reciprocal detrimental influence—systematic literature review and meta-analysis. Int J Environ Res Public Health. 2022;19:7603.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Camp-Spivey LJ, Newman SD, Stevens RN, Nichols M. We’ve had to build the plane as we flew It.’: impacts of the COVID-19 pandemic on school-based weight management interventions. Child Obes. 2021;17:497–506.

    Article  PubMed  Google Scholar 

  44. Patel BP, Sathiyamoorthy T, Giruparajah M, Toulany A, Hamilton JK. Weighing in on COVID-19: the impact of the pandemic on children and adolescents with obesity participating in a weight management program. Pediatr Obes. 2022;17:12948.

    Article  Google Scholar 

  45. Richards J, Thorogood M, Hillsdon M, Foster C. Face-to-face versus remote and web 2.0 interventions for promoting physical activity. Cochrane Database Syst Rev. 2013;2013:CD010393.

    PubMed  PubMed Central  Google Scholar 

  46. Ierardi E, Bottini M, Riva Crugnola C. Effectiveness of an online versus face-to-face psychodynamic counselling intervention for university students before and during the COVID-19 period. BMC Psychol. 2022;10:35.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Charron CM, Gorey KM. Virtual versus face-to-face cognitive behavioral treatment of depression: meta-analytic test of a noninferiority hypothesis and men’s mental health inequities. Depress Res Treat. 2022;2022:2972219.

    PubMed  PubMed Central  Google Scholar 

  48. Dishman RK, Dowda M, McIver KL, Saunders RP, Pate RR. Naturally-occurring changes in social-cognitive factors modify change in physical activity during early adolescence. PLoS One. 2017;12:e0172040.

    Article  PubMed  PubMed Central  Google Scholar 

  49. O’Connor EA, Evans CV, Burda BU, Walsh ES, Eder M, Lozano P. Screening for obesity and intervention for weight management in children and adolescents: evidence report and systematic review for the US preventive services task force. JAMA. 2017;317:2427–44.

    Article  PubMed  Google Scholar 

  50. Yarımkaya E, Esentürk OK. Promoting physical activity for children with autism spectrum disorders during Coronavirus outbreak: benefits, strategies, and examples. Int J Dev Disabil. 2022;68:430–5.

    Article  PubMed  Google Scholar 

  51. Telford RM, Telford RD, Olive LS, Cochrane T, Davey R. Why are girls less physically active than boys? Findings from the LOOK longitudinal study. PLoS One. 2016;11:e0150041.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

ETCP, YF, FS, LMYC and PPLO contributed in the study design and professional consultation. YF and ETCP wrote manuscript. YF, ETCP and CKMC conducted the data collection and analysis. YF, ETCP and FS reviewed manuscript critically. All authors significantly contributed to the intellectual content of the manuscript.

Corresponding author

Correspondence to Eric Tsz Chun Poon.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethics

Since this review was conducted and analysed based on published data, Internal Review Board (IRB) approval was not required. This review was registered in PROSPERO (Ref No.: CRD42022367391).

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Poon, E.T.C., Fang, Y., Chung, L.M.Y. et al. A scoping review of physical activity-based interventions for obesity management in children and adolescents during the COVID-19 pandemic. Int J Obes 48, 302–314 (2024). https://doi.org/10.1038/s41366-023-01433-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41366-023-01433-y

Search

Quick links