Is It Possible to Detect Effects of the COVID-19 Pandemic on the Prevalence of Malnutrition-Anorexia Using Big Data Tools in a Pediatric Population?
Main Article Content
Keywords
Big data analytics, Pediatric malnutrition, Nutritional status, COVID-19 impact
Abstract
This research investigates the consequences of the COVID-19 lockdown on pediatric health, with a specific focus on nutritional deficiencies potentially linked to disordered eating. Contemporary Big Data analytical techniques provide a powerful framework for detecting such population-level shifts and exploring their underlying drivers. Primary Aim: To determine if significant changes occurred in the prevalence of malnutrition, identified by a low body mass index (BMI), among children following confinement during COVID-19. Methodology: We conducted a cross-sectional analysis of anonymized data from digital health records. Key metrics—gender, age, weight, and height—were analyzed for a cohort of young people, comparing a pre-pandemic baseline (early 2020) with a post-confinement period (early 2022). Advanced computational models were applied to process these extensive datasets. The analytical strategy utilized the Cole-Green LMS algorithm with penalized likelihood, implemented via RefCurv 0.4.2 software, chosen for its efficacy with large-scale information. Selection of hyperparameters was guided by the Bayesian Information Criterion (BIC). Our specialists in mathematics endorsed this methodological pathway as the most robust for our objectives. Nutritional status was assessed by identifying individuals whose BMI fell more than 2.0 standard deviations below the age-adjusted population mean. Findings: The study included 66,975 clinical records from individuals under 16 years, analyzing over 1.2 million distinct data points. Results and comparative visualizations across different geographical districts are presented. A notable rise of 60 instances per 100,000 residents was observed following the pandemic. This increase was not uniform, showing distinct patterns: it was more marked in boys than girls, affected females more in rural settings, and males more in urban centers. Interpretation: Leveraging Big Data allows for highly efficient public health surveillance, pinpointing demographic groups that would most benefit from targeted support, thus ensuring optimal use of limited medical resources. Based on these results, proactive screening programs in specific urban zones should concentrate on male adolescents, while in certain rural areas, the focus should shift to female adolescents, who may constitute an under-identified at-risk group.
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References
2. Mendon, P., Witsch, M., Becker, M., et al. Facilitating comprehensive child health monitoring within REDCap—an open-source code for real-time Z-score assessments. BMC Med Res Methodol. 2024;24(1):298. https://doi.org/10.11 86/s12874-024-02405-0.
3. Heude, B., Scherdel, P., Werner, A., et al. A big-data approach to producing descriptive anthropometric references: a feasibility and validation study of pediatric growth charts. Lancet Digit Health. 2019;1(8):e413–e423. https://doi.org /10.1016/S2589-7500(19)30149-9.
4. Carrascosa, L.A., Fernández García, J.M., Fernández Ramos, C., et al. Spanish cross-sectional growth study 2008. Part II: height, weight and body mass index values from birth to adult height. An Pediatr. 2008;68(6):552–569. https:// doi.org/10.1157/13123287.
5. Morales L. M. J. Anorexia nervosa in the pediatric population. Med. leg. Costa Rica. 2019;36(2):46–55. https://www .scielo.sa.cr/scielo.php?script=sci_arttext&pid=S1409-00 152019000200046.
6. van Eeden, A.E., van Hoeken, D., and Hoek, H.W. Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Curr Opinion Psychiatry. 2021;34(6):515–524. https://doi.org/10.1097/YCO.0000000000000739.
7. Silén, Y., and Keski-Rahkonen, A. Worldwide prevalence of DSM-5 eating disorders among young people. Curr Opinion Psychiatry. 2022;35(6):362–371. https://doi.org/10.1097 /YCO.0000000000000818.
8. Collantoni, E., Natali, L., Meregalli, V., et al. Decoding the impact of the Covid-19 pandemic on anorexia nervosa psychopathology: A network comparison of pre- and post-pandemic onset. Psychiatry Res. 2025;384:116493. https://doi.org/10.1016/j.psychres.2025.116493.
9. Silliman Cohen R.I., and Bosk E.A. Vulnerable youth and the COVID-19 pandemic. Pediatrics. 2020;146(1):e20201306. https://doi.org/10.1542/peds.2020-1306.
10. Child poverty report in Spain. UNICEF Report 2023. Available online: https://www.unicef.es/causas/pobreza-infantil.
11. Rasmussen, C.E. The infinite Gaussian mixture model. Proceedings of the Advances in neural information processing systems.
12. Kongens Lyngby, Denmark, 2000; Solla, S.A., Leen, T.K, eds. MIT Press: Cambridge, USA, 2000. 12. Teh, Y.W., and Jordan, M.I. Hierarchical Bayesian nonparametric models with applications. In Bayesian nonparametrics. Hjort; N.L., Holmes, C., eds. Cambridge University Press: Cambridge, UK; 2010; pp. 158–207. https://doi.org/10 .1017/CBO9780511802478.006.
13. Van der Maaten, L., and Hinton, G. Visualizing data using t-SNE. J Mach Learn Res. 2008;9(86):2579−2605. https:// www.jmlr.org/papers/v9/vandermaaten08a.html.
14. Kruskal, J.B. Non-metric multidimensional scaling: a numerical method. Psychometrika. 29(2):115–129. https:// doi.org/10.1007/BF02289694.
15. Gilholm, P., Mengersen, K., and Thompson, H. Identifying latent subgroups of children with developmental delay using Bayesian sequential updating and Dirichlet process mixture modeling. PloS one. 2020;15(6):e0233542. https:// doi.org/10.1371/journal.pone.0233542.
16. Díez-López, I., Maeso-Mendez, S., Sánchez-Merino, G. Was the COVID-19 pandemic and home confinement responsible for a childhood obesity pandemic? responses from big data. Endocrinol Metab Int J. 2024;12(3):83–90. https://doi.org /10.15406/emij.2024.12.00353.
17. Ahrens, W., Moreno. L.A., and Pigeot, I. Childhood obesity: prevalence worldwide. In: Epidemiology of Obesity in Chil-dren and Adolescents. Moreno L.A., Pigeot, I., eds. Springer Nature: London, UK; 2011. pp. 219–235. https://doi.org /10.1007/978-1-4419-6039-9_13.
18. Umekar, S., and Joshi, A. Obesity and preventive intervention among children: a narrative review.Cureus, 2024;16(2):e54520. https://doi.org/10.7759/cureus.54520.
19. Boltri, M., Brusa, F., Apicella, E., et al. Short- and long-term effects of Covid-19 pandemic on health care system for individuals with eating disorders. Front Psychiatry. 2024;15:1360529. https://doi.org/10.3389/fpsyt.2024 .1360529.
20. Dalle, G.R., Chimini, M., Cattaneo, G., et al. Intensive cognitive behavioral therapy for adolescents with anorexia nervosa outcomes before, during and after the COVID-19 crisis. Nutrients, 2024;16(10):1411. https://doi.org/10 .3390/nu16101411.
21. Winston, A.P., Taylor, M.J., Himmerich, H., et al. Medical morbidity and risk of general hospital admission associated with concurrent anorexia nervosa and COVID-19: an observational study. Int J Eat Disord. 2023;56(1):282–287. https://doi.org/10.1002/eat.23851. Epub 2022 Nov 14.
22. Schlissel, A.C., Richmond, T.K., Eliasziw, M., et al. Anorexia nervosa and the COVID-19 pandemic among young people: a scoping review. J Eat Disord. 2023;11(1):122. https://doi .org/10.1186/s40337-023-00843-7.
23. Delisle, H., Faber, M., Revault, P. Evidence-based strategies needed to combat malnutrition in Sub-Saharan countries facing different stages of nutrition transition. Public Health Nutr. 2021;24(12):3577–3580. https://doi.org/10.1017 /S1368980021001221.
24. Del Castillo, P. and Velasco, P. Child and adolescent mental health and the Covid-19 pandemic in Spain: issues and challenges. JCACAP. 2020;.37:30–44. https://doi.org/10 .3390/healthcare11050765 .
25. Deolmi, M., and Pisani, F. Psychological and psychiatric impact of COVID-19 pandemic among children and adolescents. Acta Biomedica. 2020;91(4):e2020149. https:// doi.org/10.23750/abm.v91i4.10870.
26. Duan, L., Shao, X., Wang, Y., et al. An investigation of mental health status of children and adolescents in china during the outbreak of COVID-19.J Affect Disord. 2020;275:112–118. https://doi.org/10.1016/j.jad.2020.06.029.
27. Ford, T., John, A, and Gunnell, D. Mental health of children and young people during pandemic. BMJ. 2021;372:n614. https://doi.org/10.1136/bmj.n614.
28. Galiano, M., Prado, R., and Mustelier, R. Mental health in childhood and adolescence during the COVID-19 pandemic. Rev Cubana Pediatr. 2020; 92:e1342.
29. Golberstein, E., Wen, H., and Miller, B. Coronavirus disease 2019 (COVID-19) and mental health for children and adolescents. JAMA Pediatrics. 2020. 174:819–820. https://doi .org/10.1001/jamapediatrics.2020.1456.
30. Isumi, A., Doi, S., Yamaoka, Y., et al. Do suicide rates in children and adolescents change during school closure in Japan? The acute effect of the first wave of COVID-19 pandemic on child and adolescent mental health. Child Abuse and Neglect. 2020;110: 104680. https://doi.org/10.1016 /j.chiabu.2020.104680.
31. Jones, E.A.K., Mitra, A.K., Bhuiyan, A.R. Impact of COVID-19 on mental health in adolescents: a systematic review. IJERPH. 2021;18(5):2470. https://doi.org/10.3390/ijer ph18052470.
32. Lee, J. Mental health effects of school closures during COVID-19. Lancet Child Adolesc Health. 2020;4(6):421. https://doi.org/10.1016/S2352-4642(20)30109-7.
33. Leeb, R., Bitsko, R., Radhakrishnan, L., et al. Mental health-related emergency department visits among children aged <18 years during the COVID-19 pandemic-United States, January 1–October 17, 2020. MMWR Morb Mortal Wkly Rep. 2020. 69(45):1675–1680. https://doi.org/10.15585 /mmwr.mm6945a3.
34. Loades, M.E., Chatburn, E., Higson-Sweeney, N., et al. Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19. J Am Acad Child Adolesc Psychiatry. 2020. 59(11):1218–1239. https://doi.org/10 .1016/j.jaac.2020.05.009.
35. Luijten, M.A.J., Van Muilekom, M.M., Teela, L., et al. The impact of lockdown during the COVID-19 pandemic on mental and social health of children and adolescents. Qual Life Res. 2021;30(10):2795–2804. https://doi.org/10.10 07/s11136-021-02861-x.
36. Ma, L., Mazidi, M., Li, K., et al. Prevalence of mental health problems among children and adolescents during the COVID-19 pandemic: a systematic review and meta-analysis. J Affect Disord. 2021;293:78–89. https://doi.org/10 .1016/j.jad.2021.06.021.
37. Magson, N.R., Freeman, J.Y.A., Rapee, R.M., et al. Risk and protective factors for prospective changes in adolescent mental health during the COVID-19 pandemic. J Youth Adolesc. 2021;50(1):44–57. https://doi.org/10.1007/s1 0964-020-01332-9.
38. Meade, J. Mental health effects of the COVID-19 pandemic on children and adolescents: a review of the current research. Pediatr Clin North m. 2021;68(5):945–959. https://doi.org /10.1016/j.pcl.2021.05.003.
39. Wesson, P., Hswen, Y., Valdes, G., et al. Risks and opportunities to ensure equity in the application of big data research in public health. Annu Rev Public Health. 2022;43:59–78. https://doi.org/10.1146/annurev-publhealth-051920 -110928.
