The Impact of Lockdown on Health - Louise Mercieca

The impact of lockdown on childhood activity and health

  

As we start to emerge from lockdown we will no doubt see the many health consequences of the pandemic which are likely to be felt for years to come.  One major area of concern has been the impact of the crisis on children, who have been referred to in the press* as ‘the lost generation’. This is due to the significant disruption caused in terms of their education and development at such a tender age.  Whilst children may not, in most cases, have been directly impacted by the virus itself, they have certainly been affected in many other ways.


In a quote UNICEF states: -


“UNICEF calls for averting a lost generation as COVID-19 threatens to cause irreversible harm to children’s education, nutrition and well-being - The longer the crisis persists, the deeper its impact on children’s education, health, nutrition and well-being. The future of an entire generation is at risk.”


Henrietta Fore UNICEF Executive Director 


These concerns are certainly valid however, the term ‘the lost generation’ has been criticised by some as this applies the damage is irreversible.– there is plenty that can be done to support children’s health and well-being going forward – no child should be a lost cause due to this global situation and the associated disruption. 


The impact of the past year on children’s health and well-being is multi-faceted. We have previously discussed children’s mental health as an area of particular concern with issues arising that will almost certainly require support for many years to come.   However, for the purpose of this article, I would like to look at one aspect of physical health that lockdown has had a direct impact on – children’s activity levels.


According to statistics from Sport England, lockdowns and school closures have created less-active children throughout the UK, with figures showing a decrease of 1.9% of children meeting the Chief Medical Officer’s (CMO) guidelines for physical activity each day:


31.3% of children and young people were reported to do less than 30 minutes activity each day

23.8% of children and young people were reported to do between 30 mins and an hour

44.9% of children and young people were reported to do 60 mins a day or more 


Source – Sport England


That may at first seem a small decrease, but the figures meeting the CMO’s guidelines are already quite low and once people (including children) fall out of the habit of being active, being sedentary can become habitual and, as we all know, habits are hard to break.  Childhood is therefore a key time for developing healthy activity habits.


There is a clear link between inactivity and weight gain.  Many children have gained weight during the lockdowns and, whilst the pandemic has brought to the fore some uncomfortable truths about food poverty (children going hungry and without meals), it has also raised the issue once again about childhood obesity. 

 


Childhood obesity is an extremely complicated issue and, sadly, there seems to be an overwhelming focus on weight and weight alone with the proposal by the chair of the National Obesity Forum being to:.’


weigh children when they return to school, then again in the spring to ensure they have lost their lockdown weight”


Tam Fry – Chairman of the National Obesity Forum

 

There are so many issues with this statement. Firstly, rather than focus on weighing children wouldn’t it be better to see the emphasis shift to ensuring that they are as naturally active as possible?. And by naturally active I mean to consider movement of all types - not just the traditional hour of PE.  


Why we shouldn’t focus on the weight alone


The lockdowns and the global impact of the pandemic will have affected every child, but it will have affected them differently, they may have;

 

  • Gone hungry and lost weight; the school meal may have been the only meal they got

  • Gained weight due to eating more food than usual

  • Gained weight through inactivity

  • Gained weight because they ate more processed foods

  • Turned to comfort eating as a coping mechanism to manage stress and anxiety 

  • Body weight is not always a reflection of body fat, many active children are ‘heavy’ due to having more muscle mass, this would not be reflected by the scales or a BMI which may, inapprorpriately identify them as being overweight.


Plus, there may be some children who have taken on physical challenges and come out of lockdown healthier than ever! 


There are any number of scenarios when it comes to the impact of the pandemic on children but the number on the scales isn’t necessarily the first place we should start when trying to address issues.


Activity should come naturally to children - playing, skipping, chase, movement anddance, are all ways to strengthen the body. All physical activity is exercise but exercise can be a scary word.  Some adults are put off exercise because of childhood PE experiences, and the thought of structured exercise can be a terrifying experience for some children too.


We know that encouraging activity is the best way to ensure that children are healthy (an active body is a healthier body) but allowing them to see it as something other thanstructured exercise is crucial to them embracing it.  Whereas lockdowns may have reduced activity levels, being back at school should automatically make children move a lot more in many different ways. For example: -


  • Walking/cycling/scootering to and from school

  •  Walking around a larger building all day (instead of the house)

  • Playtime and playground activities

  • Structured PE lessons

  • After school sports (where permitted)


Addressing childhood obesity through movement would be more beneficial than simply weighing children.,Weight is a factor in determining some future health outcomes but it is often not managed in a holistic way; nutrition (proper nutrition, not counting calories) and movement need to become habitual and not ‘forced’ for a child to embrace healthy habits that will have a positive impact on their future health outcomes.


In addition to issues around obesity, there are many additional (but just as important) health benefits of activity on the developing body.


Cognitive Function


Increased movement and activity causes an increase in levels of BDNF (Brain-derived neurotrophic factor). BDNF is a key molecule in our brain and is linked to learning and memory. Thus, being active sparks learning and increases creativity and problem solving capacity -  all going a long way to support a child’s education and ability to progress in a classroom environment.


Emotional balance


Activity and all forms of exercise, particularly outdoor exercise, produce feel-good hormones such as endorphins - these are natural mood elevators and make us feel happier.  Being active also increases the production of serotonin, a mood stabiliser that promotes emotional regulation enabling us to better deal with stress and anxiety. Scientists have evidenced this link, showing that exercise can indeed reduce anxiety*. With the increased awareness of the impact of the pandemic on children’s mental health and well-being, a play-based approach to exercise will not only strengthen the body and support healthy weight loss it will also be beneficial in terms of managing stress and anxiety.


Improved Sleep


The hormones produced during exercise and all forms of physical activity (including or perhaps particularly during play) will also aid a restorative night’s sleep.  The production of serotonin will support the circadian rhythm as serotonin converts to melatonin which helps us switch into the sleep cycle and feel more relaxed.  There is also the added benefit that being physically active tires you out, and the more physically tired you are the easier sleep should be (it is often the mind that keeps us awake – hence the hormones that reduce stress and anxiety are helpful to aiding restful sleep).


Bone Health


Building healthy bones during childhood helps to prevent osteoporosis and fractures in later life – this is because bone mass developed in childhood is an important factor in lifelong skeletal health.  We should invest in bone health before our skeleton has reached peak bone mass – which is obviously during childhood. After that, it’s more a case of maintenance. 


Encouraging activity in children from a young age so that an active rather than a sedentary lifestyle becomes habitual is crucial to bone health.  Just as muscles strengthen with use so do our bones.  Any movement that is considered weight bearing is the best for strengthening bones, in children this might be walking, running, dancing or playing with a ball – all of which should come naturally in the childhood desire to move for fun.  A sedentary lifestyle is very detrimental to bone health and a sedentary childhood could miss the opportunity of investing in the strength of the bone mass before it reaches its’ peak. This could potentially impact on future health outcomes. 


Other factors that support the health of our skeleton are of course the nutrients that go into building and forming bones and, when it comes to bone health and nutrition we always think of milk.  Whilst it’s true that a lot of our bone formation and strength is supported by calcium, milk isn’t the only source and calcium isn’t as effective if working in isolation. 


Calcium supporting nutrients for bone health


  • Vitamin D helps the body absorb calcium

  • Magnesium supports bone-health (stimulating calcitonin which acts as a bone preserving hormone)

  • Phosphorus works with calcium to help build bones

  • Vitamin K2 – linked to heart and bone health – helps to bind calcium to bones keeping them denser and stronger

  • Zinc – supports mineralization of bones 


There’s no doubt that children are facing a multitude of issues going forward but to label them the ‘lost generation’ just feels wrong.  How we encourage and support them now is what will influence their future health outcomes, so this is our window of opportunity to provide them with the right, holistic support that meets the needs of children in an appropriate way. Exercise can become play, and movement can become habitual. We don’t need to weigh children and label them; we need to encourage them to develop healthy habits, through regular movement and healthy eating.  Weight loss (if needed) will happen as a consequence but children should not diet and should not be made to feel that they are having to exercise because they need to lose weight; I have seen the implications of this on adult mental health -  adults who wish things had been addressed differently for them when they were young and are now experiencing dangerous eating problems. A positive and holistic approach will always create better outcomes than focusing on the negatives.