Could sport be part of pediatric obesity prevention and treatment? Expert conclusions from the 28th European Childhood Obesity Group Congress

The prevalence of pediatric obesity continues to increase worldwide,bringing with it various metabolic,functional,social,and psychological complications.1 Both the prevention and treatment of childhood obesity must be based on multidisciplinary approaches combining nutrition,physical activity(PA),and psychological support.2 As an essential element of these multicomponent strategies,regular physical activity has been acknowledged as having beneficial effects on children's and adolescents,body composition,physical fitness,and metabolic profile,as well as on their health-related quality of life,social and psychological health,and academic achievement.3,4 Given that only a relatively small proportion of children and adolescents meet the public health recommendations for PA,5 and given that weight loss exercise-based interventions suffer from a high attrition rate,there is a clear need for appropriate PAs.

Paediatric primary care in Germany during the early COVID-19 pandemic:the calm before the storm

Objectives Globally,the COVID-19 pandemic has a major impact on healthcare provision.The effects in primary care are understudied.This study aimed to explore changes in consultation numbers and patient management during the COVID-19 pandemic,and to identify challenges for patient care.Design Survey of paediatric primary care practices on consultation numbers and patient management changes,and semistructured interviews to identify challenges for patient care.Surveys and interviews were partially linked in an explanatory sequential design to identify patient groups perceived to be at higher risk for worse care during the pandemic.Setting In and around Düsseldorf,a densely populated area in Western Germany.The primary care facilities are spread over an area with approximately 2 million inhabitants.Participants Primary care in Germany is provided through practices run by self-employed specialist physicians that are contracted to offer services to patients under public health insurance which is compulsory to the majority of the population.The sample contained 44 paediatric primary care practices in the area,the response rate was 50%.Results Numbers of consultations for scheduled developmental examinations remained unchanged compared with the previous year while emergency visits were strongly reduced(mean 87.3 less/week in March-May 2020 compared with 2019,median reduction 55.0%).Children dependent on developmental therapy and with chronic health conditions were identified as patient groups receiving deteriorated care.High patient numbers,including of mildly symptomatic children presenting for health certificates,in combination with increased organisational demands and expected staff outages are priority concerns for the winter.Conclusions Primary care paediatricians offered stable service through the early pandemic but expected strained resources for the upcoming winter.Unambiguous guidance on which children should present to primary care and who should be tested would help to allocate resources appropriately,and this guidance needs to consider age group specific issues including high prevalence of respiratory symptoms,dependency on carers and high contact rates.