Ramifications of COVID-19 on Childhood Obesity: A Global Perspective

The COVID-19 pandemic has had far-reaching ramifications that extend far beyond the Clinical Diseases. Children around the world have been impacted by the socioeconomic, psychological, and physiologic effects brought about by the emergence and response to this virus. This is especially true for children already suffering from obesity. They have been placed in an almost impossible situation due to the negative effects of living in relative isolation. Using logistic regression, the hazard factors for loss of life in young overweight COVID-19 patients were investigated. According to our data, obesity is linked to many health risks for teenage COVID-19 patients. They have a significant death rate, with worsening irritant responses, greater vascular damage, and elevated rates of lung consolidation. Younger children infected with COVID-19 who were hospitalized had a high proportion of comorbidities. Infants had less severe illness. Obese child were more likely to necessitate mechanical ventilation, as well as higher indicators of Inflammation at the time of admission. While in the hospital childhood obesity was linked to serious COVID-19 disease. Europe is no exception, three weeks have passed since Italy's mandatory countrywide lock-down began; lifestyle, diet, exercise, and sleep were collected and compared to data on children gathered in 2019. The additional weight accumulated during the lock-down may not be readily reversed, and if better practices are not re-established, it may contribute to obesity in adulthood. The United States similarly has reported increasing weight gain in youth aged 2-19 during the pandemic.

Weight loss in an obese child: positive changes or not?

Weight, BMI and its changes with age are one of the key indicators in pediatrics. The values of these indicators are the main parameters for assessing nutritional status (NS) and defining nutritional disorders - obesity and protein-energy malnutrition. At the same time, body weight and its changes only conditionally reflect the mass of fat and the amount of fat-free mass (especially the compartment of skeletal muscles). In the healthy population (in which the relevant references had been obtained), the changes of BMI can significantly reflect the changes of body composition. In children with chronic diseases (and/or with metabolic disorders, and/ or in oncopediatrics) the sensitivity of BMI as an indicator of NS is significantly lower and variable. This is due to deviations from the “normal” body composition existing in these patients. As a result, a deficit of fat-free mass can be accompanied by an excess of fat mass. Sarcopenia, which has negative consequences for the child, can be masked by obesity. Therefore, this condition, sar-copenic obesity, represents a huge problem. On the one hand, due to the coexistence of two nutritional disorders in one patient. On the other hand, due to underestimation in pediatrics. The latter is the consequence of frequent understanding of the child’s body weight as an unconditional and independent indicator. This can have dramatic consequences for the development and growth of the child. Therefore, weight loss in an obese child does not yet mean positive dynamics.

Lactobacillus Mucosae Strain Promoted by a High-Fiber Diet in Genetic Obese Child Alleviates Lipid Metabolism and Modifies Gut Microbiota in ApoE-/- Mice on a Western Diet

Supplementation of probiotics is a promising gut microbiota-targeted therapeutic method for hyperlipidemia and atherosclerosis. However, the selection of probiotic candidate strains is still empirical. Here, we obtained a human-derived strain, Lactobacillus mucosae A1, which was shown by metagenomic analysis to be promoted by a high-fiber diet and associated with the amelioration of host hyperlipidemia, and validated its effect on treating hyperlipidemia and atherosclerosis as well as changing structure of gut microbiota in ApoE-/- mice on a Western diet. L. mucosae A1 attenuated the severe lipid accumulation in serum, liver and aortic sinus of ApoE-/- mice on a Western diet, while it also reduced the serum lipopolysaccharide-binding protein content of mice, reflecting the improved metabolic endotoxemia. In addition, L. mucosae A1 shifted the gut microbiota structure of ApoE-/- mice on a Western diet, including recovering a few members of gut microbiota enhanced by the Western diet. This study not only suggests the potential of L. mucosae A1 to be a probiotic in the treatment of hyperlipidemia and atherosclerosis, but also highlights the advantage of such function-based rather than taxonomy-based strategies for the selection of candidate strains for the next generation probiotics.