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Behaviour, Psychology and Sociology

Unveiling COVID-19 lockdowns shaped the growth of Chinese preschool children

Abstract

Background

Although COVID-19 is no longer classified as a pandemic, its serious impact on human health, particularly among children in China, remains profound due to the country’s lengthy and highly restrictive zero-tolerance policy. This study aims to explore the potential influence of COVID-19 on the growth of preschool children.

Methods

The participants of the study were preschool children identified in 2018, forming the baseline cohort. We systematically monitored their routine physical examination data over the following three years—2019, 2020, and 2021. Data on dependent variables such as median differences, growth levels, and nutritional status assessments were collected. Specifically, we selected 3-year-old children from the 2018 cohort and followed them for four years, analyzing paired data from 2018 to 2021 to assess the impact of COVID-19 lockdown measures on their growth. Tracking the same cohort over time with paired data reduces intergroup biases caused by variations in participants.

Results

The results of the study indicate that the major lockdown during the COVID-19 pandemic did not hinder height growth; in fact, it slightly promoted it among preschool children. However, the lockdown also accelerated weight gain, and the changes in both height and weight led to variations in BMI.

Conclusion

We conclude that the prevalence of children with overweight and obesity during the lockdown period was significantly higher compared to pre-pandemic levels, suggesting that lockdown measures exacerbated these conditions. Moreover, these negative effects are likely to persist in the long term.

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Fig. 1
Fig. 2: Demographic characteristics including age, weight, height and BMI for 1298 preschool children in 4 years, from 2018 to 2021, before and after stratification by sex.
Fig. 3: Comparison of height%, weight% and BMI% for 1298 preschool children in 4 years, from 2018 to 2021, before and after stratification by sex.
Fig. 4: Comparison of growth level assessment (GA), and post hoc testing of GA for weight, height and BMI in 4 years, from 2018 to 2021, before and after stratification by sex.
Fig. 5: Comparison of nutrition status assessment (NA), and post hoc testing of NA for weight, height and BMI in 4 years, from 2018 to 2021, before and after stratification by sex.
Fig. 6: Sensitivity analysis based on 2018 as the baseline. Comparison of rate of overweight and obesity in 2018 vs. 2021, before and after stratification by sex.

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Data availability

The data will be available upon reasonable request from the corresponding authors.

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Funding

A project supported by Center for Early Childhood Education Research, Sichuan (CECER-2022-B01); A project supported by the National Natural Science Foundation of China (82073539); A project supported by College Students’ Innovation and Entrepreneurship Training Program of Sichuan Province (S202411079090); A project supported by College Students’ Innovation and Entrepreneurship Training Program of Chengdu University (CDUCX2024173). Gansu Provincial Science and Technology Program (24RCKD001).

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Contributions

PC designed experiments, analyzed data, wrote and revised manuscript, MW analyzed and checked data, ZY collected data, YLuo verified and screened data, FZ collected data, PY verified data, YLiu verified and screened data, YLi collected data, CH verified data, BDH revised manuscript, JF designed experiments and analyzed data, XY designed experiments, SB designed experiments and revised manuscript.

Corresponding authors

Correspondence to Xiaoping Yu or Shisan Bao.

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Cai, P., Wang, M., Yang, Z. et al. Unveiling COVID-19 lockdowns shaped the growth of Chinese preschool children. Int J Obes 49, 1125–1133 (2025). https://doi.org/10.1038/s41366-025-01756-y

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