Temporal Changes in Energy-Balance Behaviors and Home Factors in Adolescents with Normal Weight and Those with Overweight or Obesity.

This study aimed to examine the temporal changes in energy-balance behaviors and home factors in adolescents with normal weight and those with overweight or obesity (OWOB). Adolescents or parent proxies completed survey assessments two to four years before (T0; $n=82$), ≤ six months before (T1; $n=68$), and ≤ three months after the COVID-19 pandemic outbreak (T2; $n=82$), to capture energy-balance behaviors (i.e., physical activity [PA], screen time, sleep) and home factors (i.e., food environment, food worry, parent support for PA). At T0 and T1 (before pandemic), participants visited our laboratory for anthropometric measurements. At T2, parent proxies also completed a survey to report the COVID-19 pandemic exposure and impact. The participating families experienced moderate levels of pandemic exposure and impact, although exposure was higher in the OWOB group $\left(F_{\mathrm{1,78}}=5.50,p<.05\right)$. Repeated-measure multivariate analyses of covariance (RM-MACOVAs) did not show significant time by weight status interaction effects ($p>0.05$; adjusted for race and sex). However, the models detected significant time (T0 vs. T2) by race (White vs. non-White) interaction effect $\left({\lambda }_{\mathrm{7,66}}=0.81,p<0.05\right)$, with greater increase in food worry $\left(F_{\mathrm{1,72}}=4.36,p<.05\right)$ but less increase in screen time $\left(F_{\mathrm{1,72}}=4.54,p<.05\right)$ among the non-White group. Graphical visualization depicted some favorable change patterns in adolescents with normal weight (vs. those with OWOB) for certain behaviors and home factors (e.g., number of days per week ≥ 60 mins PA, food worry). These findings suggest that the COVID-19 pandemic exerted greater adverse effects on adolescents with OWOB and specifically on screen time and food worry among non-White adolescents.