Document Type : Original Article
Authors
1
M.sc in Physiology Sport nutrition, faculty of physical education, University of Tabriz, Tabriz, Iran
2
Associate Professor of Exercise Physiology, Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tabriz, Tabriz, Iran
3
Professor of exercise physiology. Department of exercise physiology, faculty of physical education and sport science, University of Tabriz, Tabriz, Iran
Abstract
Background and Purpose
The outbreak of coronavirus disease 2019 (COVID-19), an acute respiratory illness, has imposed considerable challenges globally on healthcare systems. Following the pandemic onset, children required home-based care and education due to school and public space closures, alongside mobility restrictions limited to health or occupational necessities. Recent international reports highlight a growing obesity epidemic among school-aged children, especially over the past three decades in those aged six to nineteen. Consequent school closures and stay-at-home mandates during the pandemic caused shifts in children’s daily routines, curtailing physical activity and elevating risks of overweight and obesity. The reduction in group activities and limited physical exercise opportunities, compounded by access to a wide variety of foods, challenged children’s nutritional balance and activity level maintenance. In the context of Iranian culture and domestic facilities, predictions indicated school absence could lead to increased consumption of food—often unhealthy—or meal skipping among schoolchildren. During this period, low intake of natural or minimally processed foods alongside high consumption of highly processed foods correlated with adverse health outcomes, including excessive caloric intake combined with micronutrient deficiencies, increased body weight, metabolic impairments such as insulin resistance and dysregulated lipid profiles, lowered high-density lipoprotein (HDL) cholesterol, and elevated triglycerides (TG). Physical activity and food security remain critical factors influencing the control of children’s weight. A nutritionally balanced diet that upholds diversity and proportionality benefits not only present health but also physical, psychological, and social development, thereby positively impacting future health trajectories. Similarly, regular physical activity and exercise link to increased caloric expenditure and metabolic rate, an inverse association with body mass index (BMI), and play integral roles in appetite regulation, reduction of fat mass, augmentation of muscle mass, and diminished risks of cardiovascular diseases (CVD) and insulin resistance. Moreover, exercise attenuates the detrimental effects of unhealthy nutrition. Given the absence of studies comparing macronutrient intake and body composition between active and inactive Iranian female elementary school students to date, nutrition for this demographic emerges as an area warranting focused research. This study aims to comparatively assess the macronutrients status and body composition of active versus inactive female elementary school students in Urmia.
Methods
A total of 400 healthy female elementary school students aged 7-11 years from nine public and private schools in Urmia, Iran, participated. The research protocol consisted of anthropometric assessments using tape measures, body composition analyzers, Nutrition Four software optimized for Iranian dietary data based on US Department of Agriculture (USDA) guidelines, and administration of personal information, informed consent, and three-day food and activity logs completed by researchers and parents. Participants received full briefing regarding study purposes during coordination meetings. Anthropometric variables—including body fat percentage and BMI (evaluated via Model 770)—were measured. Notably, 77 participants were excluded due to incomplete questionnaire data. Macronutrient consumption (carbohydrates, proteins, fats, fiber) and their percentages relative to daily energy intake were analyzed via Nutrition 4 software, adapted for localized food items. Resting Energy Expenditure (REE) was calculated manually using body weight, integrating Harris-Benedict or Mifflin formulas adjusted for activity factor and duration to derive total energy expenditure calibrated against caloric food value (factor 1.1). Statistical analyses utilized descriptive statistics and inferential tests—including independent and one-sample t-tests—applying a significance threshold of α=0.05.
Results
Sedentary children exhibited poor dietary patterns, excessive caloric consumption, and prevalent overweight and obesity. To counteract these adverse trends, effective and comprehensive nutrition and lifestyle education programs must be emphasized within communities to reshape dietary and activity behaviors among children.
Analysis revealed that active children consumed significantly fewer calories and macronutrients (carbohydrates, protein, fat) than their inactive counterparts (p<0.05). Both groups' intake levels fell short of the recommended dietary allowances (RDA) except for inactive children aged 9-11, who exceeded normative values (p<0.05). The Acceptable Macronutrient Distribution Ranges (AMDRs) specify carbohydrates at 45-65%, proteins at 10-35%, and fats at 20-35% of energy intake. In this study, active and inactive groups maintained macronutrient distribution averages within these ranges—carbohydrates: 57% (active) vs. 59% (inactive); proteins: 15% vs. 12%; fats: 28% vs. 29%. Fiber intake was significantly greater among active children (p<0.05) and overall above adequate intake (AI) values in both cohorts (p<0.05). Water consumption paralleled fiber trends, with active children consuming more (p<0.05)—yet all groups' water intake remained below standard AI benchmarks (p<0.05). Anthropometrically, significant differences in weight, height, fat percentage, and waist-to-hip ratio (WHR) were observed between active and inactive groups (p<0.05). Specifically, the active group presented with lower weight, body fat, and WHR; increased height; and generally superior physical condition.
Conclusion
This investigation concludes that inactive elementary school girls consume more calories and macronutrients but still fall short of recommended nutrient standards compared to active peers. Active girls demonstrate improved body composition metrics, including lower fat mass, BMI, and WHR, alongside greater stature and muscle development. Despite higher fiber and fluid consumption in active groups, intake still lags behind guidelines. These data underpin the conclusion that the COVID-19 pandemic's disruptions to physical activity and dietary habits detrimentally impacted children’s nutrition and body composition. Accordingly, implementing educational interventions promoting regular physical activity and well-balanced nutrition remains paramount to prevent pediatric obesity and promote holistic health.
Article Message
This study highlights the pandemic’s adverse influence on children's physical activity and dietary patterns, heightening obesity risk and altering body composition. Sustained, culturally appropriate exercise and nutrition education programs are essential to reversing these trends and fostering better health outcomes in young populations.
Ethical Considerations
All ethical standards were rigorously observed throughout the research process, ensuring participant confidentiality and compliance with human research protocols.
Authors’ Contributions
· Conceptualization: Javad Vakili, Ramin Amirsasan
· Data Collection, Data Analysis, Manuscript Writing, Funding, Literature Review: Sahel Hamednia
· Project Manager: Javad Vakili
· Review and Editing: Javad Vakili, Ramin Amirsasan
Conflict of Interest
The authors declare no conflicts of interest.
Acknowledgments
This manuscript is based on the master's thesis of Miss Sahel Hamednia in Physical Education and Sport Sciences, with a specialization in Sports Nutrition at the University of Tabriz. The authors express sincere gratitude to the school staff, participating female students, and their parents for their invaluable cooperation in conducting the study.
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