Background: The Coronavirus Disease 2019 (COVID-19) pandemic has caused numerous unexpected challenges for many families, and these long-lasting demands likely contribute to higher stress for parents. The aim of this study was to describe changes in parent stress longitudinally from before (retrospective) to two timepoints during COVID-19. Stressors that influenced parenting and strategies to manage parenting difficulties at each timepoint during COVID-19 are also described.Methods: Parents (N = 433; 95% female) in the US with >1 child aged 5–18 years completed an online survey in May 2020 (T1; at the peak of stay-at-home mandates) and in September 2020 (T2; children's return to school). Surveys included the 10-item Perceived Stress Scale (PSS) and questions on parenting-specific stress, stressors that influenced parenting, and strategies to manage parenting difficulties during COVID-19. Retrospective report of pre-COVID-19 stress was assessed at T1; current stress was assessed at T1 and T2. Repeated measures analysis of variance examined changes in stress over time.Results: Parent's stress increased from before COVID-19 to T1 (PSS score: 16.3 ± 5.7 to 22.0 ± 6.4, respectively; p < 0.01), and decreased by T2 (19.2 ± 6.0), but remained elevated above pre-COVID-19 values (p < 0.01). Most parents (71.1%) reported an increase parenting-specific stress from before COVID-19 to T1, which continued to increase for 55% of parents at T2. Common stressors that impacted parenting during COVID-19 were changes in children's routines, worry about COVID-19, and online schooling demands. Common strategies parents used to manage parenting difficulties included doing family activities together, keeping in touch with family/friends virtually, and keeping children on daily routines.Conclusions: Parent stress increased substantially during COVID-19 and has not returned to pre-COVID-19 levels, suggesting the need for enhanced mental health resources and supports. Public health interventions should address parenting-specific stressors and effective strategies for managing parenting difficulties to mitigate their deleterious impact.

Objective: This study aimed to describe changes in families’ home food environment and parent feeding practices, from before to during the coronavirus disease 2019 (COVID‐19) pandemic, and examine whether changes differed by food security status.Methods: Parents (N = 584) in the US completed a single online survey, reporting on food security, home food availability, and feeding practices both retrospectively (considering before COVID‐19) and currently (during COVID‐19). χ² and univariate regressions examined associations by food security status.Results: The percent of families reporting very low food security increased by 20% from before to during COVID‐19 (P < 0.01). About one‐third of families increased the amount of high‐calorie snack foods, desserts/sweets, and fresh foods in their home; 47% increased nonperishable processed foods. Concern about child overweight increased during COVID‐19, with a greater increase for food‐insecure versus food‐secure parents (P < 0.01). Use of restriction, pressure to eat, and monitoring increased, with a greater increase in pressure to eat for parents with food insecurity compared with food‐secure parents (P < 0.05).Conclusions: During COVID‐19, increases in very low food security and changes in the home food environment and parent feeding practices were observed. Results highlight the need to address negative impacts of COVID‐19 on children’s obesity risk, particularly among those facing health disparities.

Summary: Background: COVID‐19 school closures pose a threat to children's wellbeing, but no COVID‐19‐related studies have assessed children's behaviours over multiple years .Objective: To examine children's obesogenic behaviours during spring and summer of the COVID‐19 pandemic compared to previous data collected from the same children during the same calendar period in the 2 years prior.Methods: Physical activity and sleep data were collected via Fitbit Charge‐2 in 231 children (7–12 years) over 6 weeks during spring and summer over 3 years. Parents reported their child's screen time and dietary intake via a survey on 2–3 random days/week.Results: Children's behaviours worsened at a greater rate following the pandemic onset compared to pre‐pandemic trends. During pandemic spring, sedentary behaviour increased (+79 min; 95% CI = 60.6, 97.1) and MVPA decreased (−10 min, 95% CI = −18.2, −1.1) compared to change in previous springs (2018–2019). Sleep timing shifted later (+124 min; 95% CI = 112.9, 135.5). Screen time (+97 min, 95% CI = 79.0, 115.4) and dietary intake increased (healthy: +0.3 foods, 95% CI = 0.2, 0.5; unhealthy: +1.2 foods, 95% CI = 1.0, 1.5). Similar patterns were observed during summer.Conclusions: Compared to pre‐pandemic measures, children's PA, sedentary behaviour, sleep, screen time, and diet were adversely altered during the COVID‐19 pandemic. This may ultimately exacerbate childhood obesity.

Background: The economic impacts of the coronavirus disease 2019 (COVID‐19) have drastically increased food insecurity in the United States. Initial data, collected a few months into the pandemic, showed that families, particularly those experiencing food insecurity, reported detrimental changes to their home food environment and parent feeding practices, compared to before COVID‐19.Objective: This follow‐up study obtained longitudinal data from a sample of parents in the United States to quantify changes in food security status, the home food environment, and parent feeding practices, from before to across COVID‐19 as the pandemic continued to persist.Methods: Parents (N = 433) completed online surveys May (T1) and September (T2) 2020 during COVID‐19. Food security, home food environment, and parent feeding practices were reported at each timepoint. At T1, parents also retrospectively reported on these factors pertaining to before COVID‐19. Chi square analyses and repeated measure mixed models examined associations among study variables.Results: Low or very low food security increased from before COVID‐19 (37%) to T1 (54%) and decreased by T2 (45%). About 30% of families who became food insecure, and 44% who stayed food insecure from T1 to T2, reported a decrease in total food in their home; only 3%–6% who became/stayed food secure reported this decrease. Parents' concern for child overweight and use of monitoring increased from before COVID‐19 to T1, and decreased by T2, but remained elevated above pre–COVID‐19 values.Conclusion: Rates of food insecurity remain high as this pandemic persists. Continued assessment of nutrition‐related factors and increased economic supports are critical for families to endure COVID‐19 and prevent long‐term obesity and health risks.

Temporary expansion of the Child Tax Credit (CTC) during the COVID-19 pandemic provided additional monthly income for US families, with no restrictions on use, from July through December 2021. This study examined food security and children’s dietary intake after three months of expanded CTC payments. Parents completed online surveys before and after three months of CTC payments. Among parents participating in the expansion, food and beverage purchases were the most common use of expanded CTC funds (45.9 percent), particularly in households with very low food security (63.0 percent). From before to midway through the CTC expansion, very low food security decreased from 12.7 percent to 5.6 percent, and simultaneously, food security increased from 57.4 percent to 66.4 percent. The CTC expansion was also associated with decreases in children’s consumption of added sugar, sugar-sweetened beverages, and sweetened fruit beverages. No changes were observed in children’s intake of other dietary components. Our findings suggest that the expanded CTC payments may have helped lessen food insecurity and supported reductions in children’s intake of added sugar in participating households.

The combination of hyperthermia, dehydration, and strenuous exercise can result in severe reductions in kidney function, potentially leading to acute kidney injury (AKI). We sought to determine whether six days of heat acclimation (HA) mitigates the rise in clinical biomarkers of AKI during strenuous exercise in the heat. Twenty men completed two consecutive 2 h bouts of high-intensity exercise in either hot (n = 12, 40 °C, 40% relative humidity) or mild (n = 8, 24 °C, 21% relative humidity) environments before (PreHA) and after (PostHA) 4 days of 90–120 min of exercise per day in a hot or mild environment. Increased clinical biomarkers of AKI (CLINICAL) was defined as a serum creatinine increase ≥0.3 mg·dL⁻¹ or estimated glomerular filtration rate (eGFR) reduction >25%. Creatinine similarly increased in the hot environment PreHA (0.35 ± 0.23 mg·dL⁻¹) and PostHA (0.39 ± 0.20 mg·dL⁻¹), with greater increases than the mild environment at both time points (0.11 ± 0.07 mg·dL⁻¹, 0.08 ± 0.06 mg·dL⁻¹, p ≤ 0.001), respectively. CLINICAL occurred in the hot environment PreHA (n = 9, 75%), with fewer participants with CLINICAL PostHA (n = 7, 58%, p = 0.007), and no participants in the mild environment with CLINICAL at either time point. Percent change in plasma volume was predictive of changes in serum creatinine PostHA and percent changes in eGFR both PreHA and PostHA. HA did not mitigate reductions in eGFR nor increases in serum creatinine during high-intensity exercise in the heat, although the number of participants with CLINICAL was reduced PostHA.