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11-04-2018 | Pediatrics | Review | Article

The State of the Summer: a Review of Child Summer Weight Gain and Efforts to Prevent It

Journal: Current Obesity Reports

Authors: Lindsay A. Tanskey, Jeanne Goldberg, Kenneth Chui, Aviva Must, Jennifer Sacheck

Publisher: Springer US

Abstract

Purpose of Review

Accumulating evidence shows that children in the USA gain weight more rapidly during the summer, when school is not in session. This narrative review spanning 2007 to 2017 summarizes efforts to characterize the problem, identify key determinants, and intervene to prevent excess summer weight gain.

Recent Findings

Summer weight gain remains a concern for elementary-age youth. Few studies have examined its determinants, but unfavorable summertime shifts in diet, physical activity, sedentary time, screen media use, and sleep have been reported. Increased structure is thought to protect against summer weight gain. Interventions to support physical activity and nutrition during the summer show promise, though large-scale impact on weight outcomes remains to be seen.

Summary

Supporting health behaviors during the summer remains a priority for obesity prevention researchers, practitioners, and policymakers. Strategies to expand access to structured programs and reach beyond such programs to improve behaviors at home are of particular importance.
Literature
1.
Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity among adults and youth: United States, 2015–2016. NCHS Data Brief. 2017;(288):1–8.
2.
Yanovski JA. Pediatric obesity. An introduction. Appetite. 2015;93:3–12. https://​doi.​org/​10.​1016/​j.​appet.​2015.​03.​028.CrossRefPubMedPubMedCentral
3.
Reilly JJ, Kelly J. Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. Int J Obes. 2011;35(7):891–8. https://​doi.​org/​10.​1038/​ijo.​2010.​222.CrossRef
4.
Biro FM, Wien M. Childhood obesity and adult morbidities. Am J Clin Nutr. 2010;91(5):1499S–505S. https://​doi.​org/​10.​3945/​ajcn.​2010.​28701B.CrossRefPubMedPubMedCentral
5.
Institute of Medicine, The National Academy of Sciences. Accelerating progress in obesity prevention: solving the weight of the nation. Washington, DC, 2012.
6.
Public Law 111-296: The healthy, hunger-free kids act of 2010.
7.
Olsho LE, Klerman JA, Ritchie L, Wakimoto P, Webb KL, Bartlett S. Increasing child fruit and vegetable intake: findings from the US Department of Agriculture Fresh Fruit and Vegetable Program. J Acad Nutr Diet. 2015;115(8):1283–90. https://​doi.​org/​10.​1016/​j.​jand.​2014.​12.​026.CrossRefPubMed
8.
Feenstra G, Ohmart J. The evolution of the School Food and Farm to School Movement in the United States: connecting childhood health, farms, and communities. Child Obes. 2012;8(4):280–9. https://​doi.​org/​10.​1089/​chi.​2012.​0023.CrossRefPubMed
9.
Sobol-Goldberg S, Rabinowitz J, Gross R. School-based obesity prevention programs: a meta-analysis of randomized controlled trials. Obesity. 2013;21(12):2422–8. https://​doi.​org/​10.​1002/​oby.​20515.​ CrossRefPubMed
10.
Mahoney JL. Adolescent summer care arrangements and risk for obesity the following school year. J Adolesc. 2011;34(4):737–49. https://​doi.​org/​10.​1016/​j.​adolescence.​2010.​08.​010.CrossRefPubMed
11.
• Baranowski T, O'Connor T, Johnston C, Hughes S, Moreno J, Chen TA, et al. School year versus summer differences in child weight gain: a narrative review. Child Obes. 2014;10(1):18–24. https://​doi.​org/​10.​1089/​chi.​2013.​0116. A narrative review of summer weight gain featuring a conceptual model of influences on seasonal differences in BMI CrossRefPubMedPubMedCentral
12.
• Franckle R, Adler R, Davison K. Accelerated weight gain among children during summer versus school year and related racial/ethnic disparities: a systematic review. Prev Chronic Dis. 2014;11:E101. https://​doi.​org/​10.​5888/​pcd11.​130355. A systematic review of accelerated summer weight gain covering studies published between 2005 and 2013, with a focus on racial/ethnic disparities CrossRefPubMedPubMedCentral
13.
von Hippel PT, Powell B, Downey DB, Rowland NJ. The effect of school on overweight in childhood: gain in body mass index during the school year and during summer vacation. Am J Public Health. 2007;97(4):696–702. https://​doi.​org/​10.​2105/​AJPH.​2005.​080754.CrossRef
14.
Moreno JP, Johnston CA, Woehler D. Changes in weight over the school year and summer vacation: results of a 5-year longitudinal study. J Sch Health. 2013;83(7):473–7. https://​doi.​org/​10.​1111/​josh.​12054.CrossRefPubMed
15.
Alexander K, Entwisle D, Olson L. Lasting consequences of the summer learning gap. Am Sociol Rev. 2007;72(2):167–80. https://​doi.​org/​10.​1177/​0003122407072002​02.CrossRef
16.
• Moreno JP, Johnston CA, Chen TA, O'Connor TA, Hughes SO, Baranowski J, et al. Seasonal variability in weight change during elementary school. Obesity. 2015;23(2):422–8. https://​doi.​org/​10.​1002/​oby.​20977. A large longitudinal analysis of data from children in Southeast Texas illustrating a consistent pattern of summer weight gain that diminishes in magnitude over the elementary school years CrossRefPubMed
17.
Chen TA, Baranowski T, Moreno JP, O'Connor TM, Hughes SO, Baranowski J, et al. Obesity status transitions across the elementary years: use of Markov chain modelling. Pediatr Obes. 2016;11(2):88–94. https://​doi.​org/​10.​1111/​ijpo.​12025.CrossRefPubMed
18.
•• von Hippel PT, Workman J. From kindergarten through second grade, U.S. children’s obesity prevalence grows only during summer vacations. Obesity. 2016;24(11):2296–300. https://​doi.​org/​10.​1002/​oby.​21613. The most recent nationally representative analysis of summer weight gain, which followed over 18,000 children from kindergarten through second grade CrossRef
19.
Daratha K, Power T, Steele M, Bindler R, Ullrich-French S. Changes in BMI between summer and school months among middle school students. Wash State J Public Health Pract. 2009;2(2):13–21.
20.
Rodriguez AX, Olvera N, Leung P, O'Connor DP, Smith DW. Association between the summer season and body fatness and aerobic fitness among Hispanic children. J Sch Health. 2014;84(4):233–8. https://​doi.​org/​10.​1111/​josh.​12141.CrossRefPubMed
21.
Smith DT, Bartee RT, Dorozynski CM, Carr LJ. Prevalence of overweight and influence of out-of-school seasonal periods on body mass index among American Indian schoolchildren. Prev Chronic Dis. 2009;6(1):A20.PubMed
22.
Zhang J, Himes JH, Hannan PJ, Arcan C, Smyth M, Rock BH, et al. Summer effects on body mass index (BMI) gain and growth patterns of American Indian children from kindergarten to first grade: a prospective study. BMC Public Health. 2011;11:951. https://​doi.​org/​10.​1186/​1471-2458-11-951.CrossRefPubMedPubMedCentral
23.
Economos CD, Hyatt RR, Goldberg JP, Must A, Naumova EN, Collins JJ, et al. A community intervention reduces BMI z-score in children: Shape Up Somerville first year results. Obesity. 2007;15(5):1325–36. https://​doi.​org/​10.​1038/​oby.​2007.​155.CrossRefPubMed
24.
Economos CD, Hyatt RR, Must A, Goldberg JP, Kuder J, Naumova EN, et al. Shape Up Somerville two-year results: a community-based environmental change intervention sustains weight reduction in children. Prev Med. 2013;57(4):322–7. https://​doi.​org/​10.​1016/​j.​ypmed.​2013.​06.​001.CrossRefPubMed
25.
Carrel AL, Clark RR, Peterson S, Eickhoff J, Allen DB. School-based fitness changes are lost during the summer vacation. Arch Pediatr Adolesc Med. 2007;161(6):561–4. https://​doi.​org/​10.​1001/​archpedi.​161.​6.​561.CrossRefPubMed
26.
Gutin B, Yin Z, Johnson M, Barbeau P. Preliminary findings of the effect of a 3-year after-school physical activity intervention on fitness and body fat: the Medical College of Georgia Fitkid Project. Int J Pediatr Obes. 2008;3(Suppl 1):3–9. https://​doi.​org/​10.​1080/​1747716080189645​7.CrossRefPubMed
27.
Yin Z, Moore JB, Johnson MH, Vernon MM, Gutin B. The impact of a 3-year after-school obesity prevention program in elementary school children. Child Obes. 2012;8(1):60–70. https://​doi.​org/​10.​1089/​chi.​2011.​0085.CrossRefPubMedPubMedCentral
28.
Tovar A, Lividini K, Economos CD, Folta S, Goldberg J, Must A. School's out: what are urban children doing? The Summer Activity Study of Somerville Youth (SASSY). BMC Pediatr. 2010;10:16. https://​doi.​org/​10.​1186/​1471-2431-10-16.CrossRefPubMedPubMedCentral
29.
• Wang YC, Vine S, Hsiao A, Rundle A, Goldsmith J. Weight-related behaviors when children are in school versus on summer breaks: does income matter? J Sch Health. 2015;85(7):458–66. https://​doi.​org/​10.​1111/​josh.​12274. A cross-sectional analysis of nationally representative data to compare obesity-related behaviors in the school year and summer CrossRefPubMed
30.
United States Department of Agriculture Economic Research Service. National school lunch program. 2015 http://​www.​ers.​usda.​gov/​topics/​food-nutrition-assistance/​child-nutrition-programs/​national-school-lunch-program.​aspx. Accessed 1 May 2015.
31.
Briefel RR, Wilson A, Gleason PM. Consumption of low-nutrient, energy-dense foods and beverages at school, home, and other locations among school lunch participants and nonparticipants. J Am Diet Assoc. 2009;109(2 Suppl):S79–90. https://​doi.​org/​10.​1016/​j.​jada.​2008.​10.​064.CrossRefPubMed
32.
Au LE, Rosen NJ, Fenton K, Hecht K, Ritchie LD. Eating school lunch is associated with higher diet quality among elementary school students. J Acad Nutr Diet. 2016;116(11):1817–24. https://​doi.​org/​10.​1016/​j.​jand.​2016.​04.​010.CrossRefPubMed
33.
United States Department of Agriculture Food and Nutrition Service. National School Lunch Program and School Breakfast Program: nutrition standards for all foods sold in school as required by the Healthy, Hunger-Free Kids Act of 2010: interim final rule. Fed Regist 78(125) 2013 https://​www.​gpo.​gov/​fdsys/​pkg/​FR-2013-06-28/​pdf/​2013-15249.​pdf. Accessed 2 Febr 2018.
34.
Nord M, Romig K. Hunger in the summer. J Child Poverty. 2006;12(2):141–58. https://​doi.​org/​10.​1080/​1079612060087958​2.CrossRef
35.
United States Department of Agriculture, Economic research service. Summer Food Service Program 2017 https://​www.​ers.​usda.​gov/​topics/​food-nutrition-assistance/​child-nutrition-programs/​summer-food-service-program.​aspx. Accessed 11 Dec 2017.
36.
United States Department of Agriculture Economic research service. National School Lunch Program 2017 https://​www.​ers.​usda.​gov/​topics/​food-nutrition-assistance/​child-nutrition-programs/​national-school-lunch-program/​. Accessed 11 Dec 2017.
37.
United States Department of Agriculture. Food and nutrition service. Summer Food Service Program (SFSP). 2017. https://​www.​fns.​usda.​gov/​sfsp/​serving-summer-meals. Accessed 11 Dec 2017.
38.
Hopkins LC, Gunther C. A historical review of changes in nutrition standards of USDA child meal programs relative to research findings on the nutritional adequacy of program meals and the diet and nutritional health of participants: implications for future research and the Summer Food Service Program. Nutrients. 2015;7(12):10145–67. https://​doi.​org/​10.​3390/​nu7125523.CrossRefPubMedPubMedCentral
39.
Carson V, Spence JC. Seasonal variation in physical activity among children and adolescents: a review. Pediatr Exerc Sci. 2010;22(1):81–92.CrossRefPubMed
40.
Rich C, Griffiths LJ, Dezateux C. Seasonal variation in accelerometer-determined sedentary behaviour and physical activity in children: a review. Int J Behav Nutr Phys Act. 2012;9:49. https://​doi.​org/​10.​1186/​1479-5868-9-49.CrossRefPubMedPubMedCentral
41.
Rundle A, Goldstein IF, Mellins RB, Ashby-Thompson M, Hoepner L, Jacobson JS. Physical activity and asthma symptoms among New York City Head Start Children. J Asthma. 2009;46(8):803–9.CrossRefPubMedPubMedCentral
42.
Finn K, Johannsen N, Specker B. Factors associated with physical activity in preschool children. J Pediatr. 2002;140(1):81–5. https://​doi.​org/​10.​1067/​mpd.​2002.​120693.CrossRefPubMed
43.
Burdette HL, Whitaker RC, Daniels SR. Parental report of outdoor playtime as a measure of physical activity in preschool-aged children. Arch Pediatr Adolesc Med. 2004;158(4):353–7. https://​doi.​org/​10.​1001/​archpedi.​158.​4.​353.CrossRefPubMed
44.
McCue M, Marlatt K, Sirard J. Examination of changes in youth diet and physical activity over the summer vacation period. Internet J Allied Health Sci Pract 2013; 11(1).
45.
Staiano AE, Broyles ST, Katzmarzyk PT. School term vs. school holiday: associations with children’s physical activity, screen-time, diet and sleep. Int J Environ Res Public Health. 2015;12(8):8861–70. https://​doi.​org/​10.​3390/​ijerph120808861.CrossRefPubMedPubMedCentral
46.
Katzmarzyk PT, Denstel KD, Beals K, Bolling C, Wright C, Crouter SE, et al. Results from the United States of America’s 2016 report card on physical activity for children and youth. J Phys Act Health. 2016;13(11 Suppl 2):S307–S13. https://​doi.​org/​10.​1123/​jpah.​2016-0321.CrossRefPubMedPubMedCentral
47.
Falbe J, Rosner B, Willett WC, Sonneville KR, Hu FB, Field AE. Adiposity and different types of screen time. Pediatrics. 2013;132(6):e1497–505. https://​doi.​org/​10.​1542/​peds.​2013-0887.CrossRefPubMedPubMedCentral
48.
Robinson TN, Banda JA, Hale L, Lu AS, Fleming-Milici F, Calvert SL, et al. Screen media exposure and obesity in children and adolescents. Pediatrics. 2017;140(Suppl 2):S97–S101. https://​doi.​org/​10.​1542/​peds.​2016-1758K.CrossRefPubMedPubMedCentral
49.
Gortmaker SL, Must A, Sobol AM, Peterson K, Colditz GA, Dietz WH. Television viewing as a cause of increasing obesity among children in the United States, 1986–1990. Arch Pediatr Adolesc Med. 1996;150(4):356–62.CrossRefPubMed
50.
Council on Communications Media, Strasburger VC. Children, adolescents, obesity, and the media. Pediatrics. 2011;128(1):201–8. https://​doi.​org/​10.​1542/​peds.​2011-1066.​ CrossRef
51.
Wiecha JL, Peterson KE, Ludwig DS, Kim J, Sobol A, Gortmaker SL. When children eat what they watch: impact of television viewing on dietary intake in youth. Arch Pediatr Adolesc Med. 2006;160(4):436–42. https://​doi.​org/​10.​1001/​archpedi.​160.​4.​436.CrossRefPubMed
52.
Reid Chassiakos YL, Radesky J, Christakis D, Moreno MA, Cross C, et al. Children and adolescents and digital media. Pediatrics. 2016;138(5):e20162593. https://​doi.​org/​10.​1542/​peds.​2016-2593.CrossRefPubMed
53.
Harris JL, Bargh JA, Brownell KD. Priming effects of television food advertising on eating behavior. Health Psychol. 2009;28(4):404–13. https://​doi.​org/​10.​1037/​a0014399.CrossRefPubMedPubMedCentral
54.
Zimmerman FJ, Bell JF. Associations of television content type and obesity in children. Am J Public Health. 2010;100(2):334–40. https://​doi.​org/​10.​2105/​AJPH.​2008.​155119.CrossRefPubMedPubMedCentral
55.
Sadeghirad B, Duhaney T, Motaghipisheh S, Campbell NR, Johnston BC. Influence of unhealthy food and beverage marketing on children’s dietary intake and preference: a systematic review and meta-analysis of randomized trials. Obes Rev. 2016;17(10):945–59. https://​doi.​org/​10.​1111/​obr.​12445.CrossRefPubMed
56.
Chen X, Beydoun MA, Wang Y. Is sleep duration associated with childhood obesity? A systematic review and meta-analysis. Obesity. 2008;16(2):265–74. https://​doi.​org/​10.​1038/​oby.​2007.​63.CrossRefPubMed
57.
Nixon GM, Thompson JM, Han DY, Becroft DM, Clark PM, Robinson E, et al. Short sleep duration in middle childhood: risk factors and consequences. Sleep. 2008;31(1):71–8.CrossRefPubMedPubMedCentral
58.
Bates CR, Bohnert AM, Ward AK, Burdette KA, Kliethermes SA, Welch SB, et al. Sleep is in for summer: patterns of sleep and physical activity in urban minority girls. J Pediatr Psychol. 2016;41(6):692–700. https://​doi.​org/​10.​1093/​jpepsy/​jsw009.CrossRefPubMed
59.
• Brazendale K, Beets MW, Weaver RG, Pate RR, Turner-McGrievy GM, Kaczynski AT, et al. Understanding differences between summer vs. school obesogenic behaviors of children: the structured days hypothesis. Int J Behav Nutr Phys Act. 2017;14(1):100. https://​doi.​org/​10.​1186/​s12966-017-0555-2. A comparison of obesogenic behaviors on structured school days and unstructured weekend days to test the hypothesis that structure protects against summer weight gain CrossRefPubMedPubMedCentral
60.
Park KS, Lee MG. Effects of summer school participation and psychosocial outcomes on changes in body composition and physical fitness during summer break. J Exerc Nutr Biochem. 2015;19(2):81–90. https://​doi.​org/​10.​5717/​jenb.​2015.​15052005.CrossRef
61.
Hopkins LC, Fristad M, Goodway JD, Eneli I, Holloman C, Kennel JA, et al. Camp NERF: methods of a theory-based nutrition education recreation and fitness program aimed at preventing unhealthy weight gain in underserved elementary children during summer months. BMC Public Health. 2016;16(1):1122. https://​doi.​org/​10.​1186/​s12889-016-3765-7.CrossRefPubMedPubMedCentral
62.
Weaver RG, Brazendale K, Chandler JL, Turner-McGrievy GM, Moore JB, Huberty JL, et al. First year physical activity findings from turn up the HEAT (Healthy Eating and Activity Time) in summer day camps. PLoS One. 2017;12(3):e0173791. https://​doi.​org/​10.​1371/​journal.​pone.​0173791.CrossRefPubMedPubMedCentral
63.
George GL, Schneider C, Kaiser L. Healthy lifestyle fitness camp: a summer approach to prevent obesity in low-income youth. J Nutr Educ Behav. 2016;48(3):208–12 e1. https://​doi.​org/​10.​1016/​j.​jneb.​2015.​12.​010.CrossRefPubMed
64.
Bohnert AM, Ward AK, Burdette KA, Silton RL, Dugas LR. Active summers matter: evaluation of a community-based summertime program targeting obesogenic behaviors of low-income, ethnic minority girls. New Dir Youth Dev. 2014;2014(143):133–50. https://​doi.​org/​10.​1002/​yd.​20107.​ CrossRefPubMed
65.
Weaver RG, Beets MW, Turner-McGrievy G, Webster CA, Moore J. Effects of a competency-based professional development training on children’s physical activity and staff physical activity promotion in summer day camps. New Dir Youth Dev 2014;2014(143):57–78. doi:https://​doi.​org/​10.​1002/​yd.​20104.​
66.
Kenney EL, Lee RM, Brooks CJ, Cradock AL, Gortmaker SL. What do children eat in the summer? A direct observation of summer day camps that serve meals. J Acad Nutr Diet. 2017;117(7):1097–103. https://​doi.​org/​10.​1016/​j.​jand.​2017.​01.​026.CrossRefPubMedPubMedCentral
67.
Tilley F, Beets MW, Jones S, Turner-McGrievy G. Evaluation of compliance to national nutrition policies in summer day camps. Public Health Nutr. 2015;18(9):1620–5. https://​doi.​org/​10.​1017/​S136898001400119​0.CrossRefPubMed
68.
Alfonso ML, Thompson Z, McDermott RJ, Colquitt G, Jones JA, Bryant CA, et al. VERB summer scorecard: increasing tween girls’ vigorous physical activity. J Sch Health. 2013;83(3):164–70. https://​doi.​org/​10.​1111/​josh.​12012.CrossRefPubMed
69.
D'Haese S, Van Dyck D, De Bourdeaudhuij I, Deforche B, Cardon G. Organizing “Play Streets” during school vacations can increase physical activity and decrease sedentary time in children. Int J Behav Nutr Phys Act. 2015;12:14. https://​doi.​org/​10.​1186/​s12966-015-0171-y.CrossRefPubMedPubMedCentral
70.
Showell NN, Fawole O, Segal J, Wilson RF, Cheskin LJ, Bleich SN, et al. A systematic review of home-based childhood obesity prevention studies. Pediatrics. 2013;132(1):e193–200. https://​doi.​org/​10.​1542/​peds.​2013-0786.CrossRefPubMedPubMedCentral
71.
Bassett DR, John D, Conger SA, Fitzhugh EC, Coe DP. Trends in physical activity and sedentary behaviors of United States youth. J Phys Act Health. 2015;12(8):1102–11. https://​doi.​org/​10.​1123/​jpah.​2014-0050.CrossRefPubMed
72.
• Moreno JP, Vezina-Im LA, Vaughan EM, Baranowski T. Impact of child summertime obesity interventions on body mass index, and weight-related behaviours: a systematic review and meta-analysis protocol. BMJ Open. 2017;7(10):e017144. https://​doi.​org/​10.​1136/​bmjopen-2017-017144. A protocol describing what will be the first systematic review and meta-analysis of the impact of summertime obesity prevention and treatment interventions CrossRefPubMedPubMedCentral
73.
Johnson JA 3rd, Johnson AM. Urban-rural differences in childhood and adolescent obesity in the United States: a systematic review and meta-analysis. Child Obes. 2015;11(3):233–41. https://​doi.​org/​10.​1089/​chi.​2014.​0085.CrossRefPubMed
74.
White AH, Maroto ME. Summer meal programs provide an opportunity for nutrition education and physical activity. J Acad Nutr Diet. 2016;116(6):905–7. https://​doi.​org/​10.​1016/​j.​jand.​2016.​04.​003.CrossRefPubMed

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