Longitudinal Associations Between Child Weight Change, the Home Food Environment, and Child Feeding Practices During COVID-19

Objectives Lifestyle changes during the coronavirus 2019 (COVID-19) pandemic may result in child weight gain thus increasing obesity risk. Weight gain during COVID-19 may be, in part, be due to changes in the home food environment and child feeding practices; yet longitudinal studies have not examined these relations. This study describes patterns of child weight change, the home food environment, and child feeding practices across two timepoints during COVID-19. Methods Parents (N = 433; 95% female) in the US with a child aged 5–18 years completed two online surveys in May (T1) and September (T2) 2020. Parents reported on child feeding practices (e.g., concern for child overweight, restriction, pressure, monitoring) using the Child Feeding Questionnaire, perceived child weight status, and the home food environment before COVID-19 (i.e., baseline; retrospective report) and at twice during COVID-19 (T1 and T2). Child weight change was categorized as having gained weight vs. not. Repeated measures and chi square analyses examined differences in changes in child feeding practices and the home food environment by child weight change. Results About 30% of parents reported child weight gain from T1 to T2 (average +9.6 ± 7.1 lbs). Interactions between parents’ concern for child overweight, monitoring, and restriction, by child weight change, were observed (ps ≤ 0.02): families with child weight gain reported baseline to T1 increases in these feeding practices, that were sustained at T2; for families without child weight gain, concern, monitoring, and restriction increased at T1, but returned to baseline at T2. Overall, pressure feeding practices increased from baseline to T1, and returned to baseline at T2. No clear patterns regarding home food environment changes and child weight change were observed. Conclusions Almost one-third of parents reported child weight gain during COVID-19, which was related to sustained concern for overweight and some feeding practices, yet not home food environment changes. Further research is needed to investigate different behavioral, societal, environmental, and psychosocial factors contributing to child weight gain during COVID-19, in order to identify the most salient intervention targets to mitigate the potential long-term health consequences. Funding Sources Virginia Commonwealth University, National Cancer Institute